FJVIS 34. First-in-Man Clinical Application of the TrackCath System in Endovascular Repair of Aortic Aneurysms —A Prospective Multicenter Clinical Trial
The cannulation of aortic side branches in endovascular aneurysm repair (EVAR) can be a challenging task. Normally, the branch identification can be performed only by using radiography and contrast dye, with documented safety risks to the patient. The TrackCath system (Medyria AG, Winterthur, Switzerland) aims to support the identification and cannulation of aortic side branches with a guiding catheter or a guidewire. It uses the low-energy hot-wire anemometry principle to detect changes in blood flow velocity and direction.
This study investigates sarcopenia as a method to predict 1-year survival in patients undergoing EVAR.
Endovascular aneurysm repair (EVAR) offered outstanding survival benefit but at the expense of cost, periodic radiographic monitoring, and higher reinterventions rates. Perioperative complications, although rare, can occur after EVAR, contributing to longer hospitalization, higher cost, and significant comorbidity and mortality. Therefore, the aim of this study was to identify the predictors of in-hospital events (IHEs) after elective EVAR.
This study aims to identify prognostic factors that could be incorporated in follow-up protocols, which might lead to better personalized, lower cost and safe EVAR follow-up. METHODS: A retrospective study was performed including all patients who underwent elective EVAR from January 2000 to December 2015. Follow-up data were gathered by reviewing medical files for radiographic imaging. Linear and logistic regressions were used to assess predictive factors for aneurysm shrinkage. RESULTS: In 361 patients, aneurysm sac shrinkage of 10 millimeter or more was measured in 152 (42.1%) patients. Patients with ≥10mm a...
Abstract Despite technological advances, the long-term outcomes of endovascular aortic aneurysm repair (EVAR) are still debatable. Although most endograft failures after EVAR can be corrected with endovascular techniques, open conversion may still be required. A 70-year-old male patient presented at the emergency unit with abdominal pain. Twice, in the third and fourth years after the first repair, a stent graft had been placed over a non-adhesive portion of the stent graft due to type Ia endoleaks. In the most recent admission, a CT scan showed type III endoleak and ruptured aneurysm sac. On this occasion the patient unde...
This study investigated sarcopenia as a method of predicting a primary outcome of survival for patients undergoing EVAR.
An 84-year-old man with a history of endovascular aneurysm repair for abdominal aortic aneurysm (AAA) with multiple interventions for recurrent type II endoleaks including coil and ethylene vinyl alcohol copolymer (EVOH) (Onyx; Medtronic, Minneapolis) embolization presented to the emergency department with a 4-day history of left hip pain but no hemodynamic compromise. Plain radiography (Fig 1) and computed tomography (CT) (Fig 2) demonstrated ruptured AAA with extravasation of blood and EVOH into the retroperitoneum tracking inferiorly to the left acetabulum.
AbstractOpen repair for infra-renal abdominal aortic and iliac artery aneurysms (AAAs) is a robust treatment. On the other hand, endovascular aneurysm repair (EVAR) has been widespread because of its less invasiveness. However, patients after EVAR frequently require postoperative radiographic examinations and may feel anxiety for their endoleaks. We prospectively evaluated Health-related Quality of Life of the patients with these two fashions using the 8-item Short Form (SF-8). From 2011 to 2013, 89 consecutive elective cases of AAAs were treated. They were prospectively divided into EVAR and open repair groups but not ran...
Conclusion: After publication of a few such cases with the older Zenith device, the union between the suprarenal stent and main body was reinforced in 2002 to prevent this complication. Since modification of the device, this sequela had not been described. The reappearance of this complication underscores the need for continued surveillance, considering that these late events may require a reintervention to maintain the clinical success of the procedure.
Conclusions: This global experience represents the largest series in the ch-EVAR literature and demonstrates comparable outcomes to those in published reports of branched/fenestrated devices, suggesting the appropriateness of broader applicability and the need for continued careful surveillance. These results support ch-EVAR as a valid off-the-shelf and immediately available alternative in the treatment of complex abdominal EVAR and provide impetus for the standardization of these techniques in the future.
Conclusion: Patients presenting with abdominal aortic aneurysms with DCIA can be successfully treated with EVAR with no increase in complications without extension into the EIA.