Ultrasound-guided erector spinae plane block to avoid postoperative opioids in open abdominal aortic aneurysm repair.
Ultrasound-guided erector spinae plane block to avoid postoperative opioids in open abdominal aortic aneurysm repair. Minerva Anestesiol. 2020 Apr 06;: Authors: Zani G, Righetti R, Piraccini E, Santonastaso DP, Terenzoni M, Gecele C, Baccarini FD, Fusari M PMID: 32251576 [PubMed - as supplied by publisher]
The study by Baderkhan et al.1 is a retrospective analysis of prospectively recorded data of patients having had endovascular abdominal aortic aneurysm repair (EVAR) between 1998 and 2012 at two Swedish centres. The authors reached two conclusions after analysing the cohorts compliant and not compliant with a post-EVAR su rveillance protocol. The compliant protocol required early post-EVAR computed tomographic angiography (CTA) imaging and annual follow up imaging with CTA and/or duplex ultrasound (DUS).
ConclusionsCharacteristics suggestive of AAA rupture may be seen on ultrasound. As ED physicians become more familiar with the use of point-of-care ultrasound in the evaluation of abdominal pain, identification of these characteristics may aid in the rapid diagnosis of AAA rupture.
on Ristow A Abstract OBJECTIVE: The bell-bottom technique is a widely used technique to treat aortoiliac aneurysms with preservation of the hypogastric arteries. The published data are scarce with conflicting results regarding the evolution. The aim of this study was to compare the outcomes of patients submitted to endovascular abdominal aortic aneurysm repair with standard technique (S-EVAR) versus bell-bottom technique. METHODS: This retrospective cohort study compared the outcomes of standard endovascular aneurysm repair (
Introduction: The treatment of abdominal aortic aneurysm (AAA) is increasingly performed via endovascular aneurysm repair (EVAR). Different types of fixation are possible with EVAR, i.e., below (infrarenal fixation) or above (suprarenal fixation) the renal arteries. Hemodynamic alterations in renal arterial flow with suprarenal (SR) fixation remain to be demonstrated. The IFIXEAR (Impact of Supra-renal Fixation of EVAR on Hemodynamics of Renal Arteries) study is designed to assess the hemodynamic effects at the ostia of at least 1 renal artery, generated immediately post-surgery by the implantation of an aortic stent wit...
ConclusionSWS has the potential to detect endoleaks in AAA after EVAR with comparable sensitivity to CTA and superior sensitivity to CDUS.Key Points• Dynamic elastography with shear wave sonoelastography (SWS) detected 100% of endoleaks in abdominal aortic aneurysm (AAA) follow-up that were identified by a combination of CT angiography (CTA) and color Doppler ultrasound (CDUS).• Based on elasticity maps, SWS differentiated endoleaks from thrombi within the aneurysm sac (p
Authors: Baldino G, Rossi UG, Di Gregorio S, Gori A Abstract Percutaneous endovascular abdominal aortic aneurysm repair is nowadays considered a safe and effective procedure and has gained widespread globally acceptance. However, intraoperative persistent bleeding due to percutaneous access closure device failure can occur. Open conversion is first-line treatment to manage this complication. The fascia suture technique was introduced as an alternative to access closure device or as a solution to manage unsatisfactory hemostasis during percutaneous endovascular abdominal aortic aneurysm repair. In this article, we r...
Abstract Current guidelines for abdominal aortic aneurysm (AAA) repair are primarily based on the maximum diameter. Since these methods lack robustness in decision making, new image-based methods for mechanical characterization have been proposed. Recently, time-resolved 3D ultrasound (4D US) in combination with finite element analysis was shown to provide additional risk estimators such as patient-specific peak wall stresses and wall stiffness in a non-invasive way. The aim of this study is to: 1) assess the reproducibility of this US-based stiffness measurement in vitro and in vivo, and 2) verify this 4D US stif...
Introduction: This is a study designed to assess the effectiveness of the new Angio PLanewave UltraSensitive imaging (Angio PL.U.S.) method as a non-invasive alternative to Contrast-Enhanced Ultrasound (CEUS) and Computed Tomography Angiography (CTA) for endoleak detection and classification in patients followed up after endovascular abdominal aortic aneurysm repair (EVAR). The authors emphasize the potential role of Angio PL.U.S. in patients undergoing post-EVAR follow-up.
Introduction: Yearly imaging surveillance is recommended to all patients following endovascular aortic repair (EVAR) to detect complications requiring re-intervention. EVAR is currently the predominant technique for elective infrarenal abdominal aortic aneurysm (AAA) repair in the Netherlands. Consequently, a cumulative amount of hospital visits for imaging surveillance will arise. This causes a burden on both patients and the healthcare system. We therefore aimed to study the re-intervention free survival and survival stratified for patients with and without yearly imaging surveillance.
CONCLUSION: The present data underline that ELIB is a non-negligible occurrence during long term EVAR follow up and requires further interventions, most often by endovascular solutions. According to the ELIB risk factors identified in this study, an iliac leg diameter oversize>10% and extensive common iliac artery coverage (