Thoracic Endovascular Aortic Repair with Reverse Aortic Arch Debranching Technique for Ascending Aortic Pseudoaneurysm

The modern open surgical management of abdominal aortic aneurysm (AAA) has changed little since its inception in the 1950s. Endoaneurysmorrhaphy, first described by Rudolph Matas in 1888, involved ligating the branches of an aneurysm from within the aneurysm sac. Approximately 25 years later at the

Combination of a vascular plug and coiling to treat an ascending aortic pseudoaneurysm following aortic surgery

Recently published long-term outcomes of the UK Endovascular Abdominal Aortic Aneurysm Repair (EVAR) trial investigators and the Dutch Randomized Endovascular Aneurysm Repair group have continued to demonstrate the superiority of EVAR in the perioperative period, but they have failed to establish long-term sustainable durability compared to open repair because of increased graft-related complications and reinterventions.1,2 In 2005, thoracic endovascular aneurysm repair (TEVAR) was approved in the United States for the treatment of descending thoracic aortic aneurysms (DTAAs). This approval, based on the results of a phase II trial3 evaluating the GORE TAG endovascular prosthesis (W.L. Gore and Associates, Newark, Delaware), led to a nationwide explosion in the use of thoracic endovascular techniques for managing DTAAs.4 Physicians had already been performing EVAR for more than a decade. Whereas EVAR was initially used to repair abdominal aneurysms with a favorable anatomy, its use later expanded to include complex cases involving a short aneurysmal neck, a tortuous aorta, and (more recently) aneurysmal rupture. Although TEVAR has only a brief history, a similar trend is obvious: This approach is being used with reasonable success to treat dissections and even ruptured aneurysms5; in addition, various new debranching techniques are allowing TEVAR to be applied to portions of the aorta previously deemed unapproachable. Article see p 2718 Najibi and colleagues6 reported the results of the first study to compare TEVAR with open aortic repair. Their series comprised 18 patients, and the control group included a historic cohort of patients who had undergone open aortic repair during the previous 3 years. Short-term follow-up data showed that the endovascular group had significantly shorter operative times, shorter hospital and intensive-care–unit stays, and less operative blood loss. Subsequently, Bavaria and associates7 reported the results of a phase II multicenter trial that assessed GORE …

Primary aortoenteric fistula following endovascular aortic repair due to type II endoleak

Clinical Practice Guidelines for Endovascular Abdominal Aortic Aneurysm Repair: Written by the Standards of Practice Committee for the Society of Interventional Radiology and Endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Interventional Radiology Association

Commentary: The secret life of aortic dissections

Stent Graft-Induced Aortic Wall Injury—Anesthesia Pitfalls and Pearls for the Thoracic Endovascular Aortic Repair Procedure

Urgent endovascular repair for ruptured aortic aneurysm using computed tomography image fusion

Endovascular repair of extent I thoracoabdominal aneurysms with landing zone extension into the aortic arch and mesenteric portion of the abdominal aorta

<i>Circulation:</i> Clinical Summaries

Introduction: Abdominal aortic aneurysm (AAA) is associated with significant morbidity and mortality. Treatment options include open and endovascular AAA repair. We explored the utilization patterns and outcomes of open and endovascular AAA repair among hospitalized patients in the US. Hypothesis: We hypothesized that there would be no difference in the utilization patterns of open and endovascular AAA repair by race and gender. Methods: Using the ICD-10 diagnosis and procedure codes, we queried the National Inpatient Sample 2016 to 2019 for hospitalizations among patients ≥18 years old who had an open or endovascular AAA repair. Multivariable logistic regression was used to estimate the odds of death and discharge dispositions comparing open to endovascular AAA repair. Regression models were adjusted for age, sex, median income zip, history of aneurysm of carotid, iliac, and lower extremity artery, co-morbidities including diabetes, hypertension, smoking, obesity, chronic kidney disease, congestive heart failure, myocardial infarction, COPD, and atherosclerosis. Results: Our study included 132,775 and 36,010 weighted hospitalizations for endovascular and open AAA repair, respectively. The open AAA repair cohort were younger compared to those of endovascular AAA repair (mean age ± S.D: 65.0 ± 10.4 Vs.73.3 ± 9.0). A higher proportion of female underwent open AAA repair than endovascular AAA repair (33.5% vs. 20.9%). Across all racial/ethnic groups, endovascular repair for AAA was more common than open AAA repair among males, except for black males. A higher proportion of black males underwent open AAA repair than endovascular repair (5.7% vs. 3.9%). Patients who had open AAA repair had higher odds of death compared to those who had endovascular repair (Adjusted odds ratio [aOR], 5.99 [95% CI, 5.22-6.87]; p&lt;.0001 ). Conversely, a higher odd of discharge to home/short term facility was noted among patients who had endovascular compared to open AAA repair (aOR, 5.83 [95% CI, 5.38 - 6.32]; p&lt;.0001) . Conclusions: Disparities exist in the utilization of open versus endovascular AAA repair among hospitalized patients. Results could be used to support future research to examine factors driving these disparities.

What Factors Predict Wound Complications after Endovascular Aortic Aneurysm Repair?

Diagnosis of Type III Endoleak and Endovascular Treatment with Aortouniiliac Stent-Graft

Late Open Surgical Conversion After Endovascular Abdominal Aortic Aneurysm Repair: A Review of 15 Years of Experience

Nationwide database analysis of one-year readmission rates after open surgical or thoracic endovascular repair of Stanford Type B aortic dissection