Multibranched endovascular aortic aneurysm repair in patients with and without chronic aortic dissections
The objective of this study was to compare multibranched endovascular aneurysm repair (MBEVAR) of postdissection thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAAs) with MBEVAR of degenerative TAAAs and PRAAs and to assess the role played by the preoperative correction of potential complicating factors, such as true lumen compression and false lumen origin of vital branches, using adjunctive maneuvers.
ConclusionThe mesh plug repair is safe and useful for the treatment of inguinal hernia after FFB, for which preoperative CT is helpful for understanding precise anatomy which facilitates surgical planning.
We read with great interest the study by O'Donnell et al,1 which investigated the risk factors of postoperative renal dysfunction after open repair of abdominal aortic aneurysm (AAA) in a large retrospective cohort.
The three randomized trials comparing endovascular aneurysm repair (rEVAR) with open surgical repair (rOSR) of ruptured abdominal aortic aneurysm (rAAA) were poorly designed and heavily criticized. The short- and long-term survival advantages of rEVAR remain unclear. We sought to compare the two treatment modalities using a propensity-matched analysis in a real-world setting.
The objective of this study was to report the 5-year outcomes of the Food and Drug Administration investigational device exemption clinical trial of endovascular aneurysm repair (EVAR) with the Ovation (Endologix, Irvine, Calif) stent graft for elective treatment of abdominal aortic aneurysm (AAA).
The use of endovascular aneurysm repair (EVAR) has changed the treatment algorithm for patients with ruptured abdominal aortic aneurysms (RAAAs). Whereas the overall incidence of RAAA is declining, the proportion of patients treated with EVAR in contemporary practice in the United States is unknown. Therefore, we described the change in incidence, treatment pattern, and outcomes of RAAA using the National Inpatient Sample database from 2004 to 2015.
Growing calls for guidelines advocating minimum annual case volumes for surgeon credentialing remain controversial. Specifically, the impact of surgeon experience on procedure outcomes, such as open aortic repair (OAR), remains poorly understood. Therefore, the purpose of this study was to explore the influence of surgeon experience on case selection and real-world outcomes after OAR.
Surgical volume has been used as a surrogate for quality. Previous studies (with patient data before 2008) have suggested minimum volume requirements for surgeons (9-13 open abdominal aortic aneurysm repairs [OAAARs] per year) to achieve acceptable results. Given concerns about the decreasing volume of OAAAR, we examined the impact of surgeon volume on mortality in the Vascular Quality Initiative (VQI) registry.
A 73-year-old woman with a history of a 6-cm juxtarenal abdominal aortic aneurysm who underwent a fenestrated endovascular aortic repair using the Zenith fenestrated endovascular (ZFEN) device (Cook Medical, Bloomington, Ind) presented with a type IA endoleak found on routine surveillance computed tomography angiography (CTA). The previously placed ZFEN device included a scallop for the superior mesenteric artery (SMA) and bilateral stented fenestrations to the renal arteries.
Reintervention after endovascular aneurysm repair (EVAR) is common. However, the financial impact of reintervention after EVAR on the national scale is poorly understood. Our objective was to describe the overall reimbursement for aneurysm treatment (EVAR plus reinterventions) among a cohort of patients with known follow-up for 5 years after repair.
Lumbar drain placement, with cerebrospinal fluid (CSF) drainage, has been demonstrated to be an effective adjunct for reducing the risk of spinal cord ischemia in patients undergoing complex aortic aneurysm repair. However, lumbar drain placement is a challenging procedure and can be associated with significant complications. We sought to characterize complications occurring as a result of lumbar drain placement in a large, single-center experience of patients who underwent fenestrated/branched endovascular aneurysm repair (F/BEVAR).