Endovascular Aortic Aneurysm Repair Research Articles

Increased Mortality After Endovascular Aortic Aneurysm Repair in Patients With Enlarged Aortic Necks

Increased Mortality After Endovascular Aortic Aneurysm Repair in Patients With Enlarged Aortic Necks

Leveraging The Vascular Quality Initiative To Reduce Length Of Stay Following Elective Carotid Endarterectomy And Endovascular Aortic Aneurysm Repair

Leveraging The Vascular Quality Initiative To Reduce Length Of Stay Following Elective Carotid Endarterectomy And Endovascular Aortic Aneurysm Repair

Widespread Surveillance Failure Following Endovascular Aortic Aneurysm Repair in Current U.S. Practice

Widespread Surveillance Failure Following Endovascular Aortic Aneurysm Repair in Current U.S. Practice

Thirty-day Outcomes After Endovascular Repair of Abdominal Aortic Aneurysms in Patients With Dependent Functional Status

Thirty-day Outcomes After Endovascular Repair of Abdominal Aortic Aneurysms in Patients With Dependent Functional Status

Laser Fenestrated Endovascular Aortic Repair for Symptomatic Infected Juxtarenal Aortic Aneurysm

Laser Fenestrated Endovascular Aortic Repair for Symptomatic Infected Juxtarenal Aortic Aneurysm

Percutaneous Endovascular Aortic Repair of Abdominal Aortic Aneurysm can be Safely Performed in Over Ninety Percent of Elective Cases Despite Instruction for Use Recommendations

Percutaneous Endovascular Aortic Repair of Abdominal Aortic Aneurysm can be Safely Performed in Over Ninety Percent of Elective Cases Despite Instruction for Use Recommendations

Contemporary Age-stratified Outcomes After Endovascular Aortic Repair for Intact Abdominal Aortic Aneurysm in Medicare Beneficiaries

Contemporary Age-stratified Outcomes After Endovascular Aortic Repair for Intact Abdominal Aortic Aneurysm in Medicare Beneficiaries

Impact of Neck Morphology on Outcomes of Emergent Endovascular Abdominal Aortic Aneurysm Repair

Impact of Neck Morphology on Outcomes of Emergent Endovascular Abdominal Aortic Aneurysm Repair

A Prospective Randomized Trial of Renal Ischemic Preconditioning for Reducing Nephropathy Risk Following Fenestrated Endovascular Aortic Aneurysm Repair

A Prospective Randomized Trial of Renal Ischemic Preconditioning for Reducing Nephropathy Risk Following Fenestrated Endovascular Aortic Aneurysm Repair

A Multivariate Analysis of a Modified Frailty Index on Perioperative Morbidity and Mortality Following Nonemergent Endovascular Aortic Aneurysm Repair

A Multivariate Analysis of a Modified Frailty Index on Perioperative Morbidity and Mortality Following Nonemergent Endovascular Aortic Aneurysm Repair

Durability of a Second-generation Balloon-expandable Covered Stentgraft in Patients Treated With Fenestrated, Branched, and the Chimney Endovascular Aortic Aneurysm Repair Techniques

Durability of a Second-generation Balloon-expandable Covered Stentgraft in Patients Treated With Fenestrated, Branched, and the Chimney Endovascular Aortic Aneurysm Repair Techniques

Gastrointestinal Complications and Visceral Circulation Changes After Intentional Celiac Artery Embolization During Complex Endovascular Aortic Aneurysm Repair

Gastrointestinal Complications and Visceral Circulation Changes After Intentional Celiac Artery Embolization During Complex Endovascular Aortic Aneurysm Repair

Using Machine Learning to Predict Outcomes Following Thoracic and Complex Endovascular Aortic Aneurysm Repair

Using Machine Learning to Predict Outcomes Following Thoracic and Complex Endovascular Aortic Aneurysm Repair

Single-center Experience on the Elective Hybrid Combination of Single Perclose + Angio- Seal VIP 8F Compared to Standard Dual Perclose During Percutaneous Endovascular Aortic Aneurysm Repair

Single-center Experience on the Elective Hybrid Combination of Single Perclose + Angio- Seal VIP 8F Compared to Standard Dual Perclose During Percutaneous Endovascular Aortic Aneurysm Repair

Trends in hospitalization of patients undergoing endovascular treatment of thoracoabdominal aortic aneurysms based on cerebrospinal fluid drainage strategy

ObjectiveThe aim of this study was to identify trends in hospital length of stay (HLOS) and intensive care unit length of stay (ICULOS), and the relationship with cerebrospinal fluid drainage (CSFD) protocols in patients undergoing fenestrated-branched endovascular aortic repair (FB-EVAR) of thoracoabdominal aortic aneurysms (TAAAs). MethodsA retrospective review of patients who underwent elective FB-EVAR for extent I to IV TAAAs between 2008 and 2023 at a single aortic center of excellence was conducted. Patient demographics, cardiovascular comorbidities, surgical risk, technical details, CSFD strategy (prophylactic or therapeutic), procedural success, and perioperative outcomes were collected. Patients were divided into two groups based on CSFD protocol. Group 1 included patients treated before 2020 when prophylactic CSFD was performed widely, and Group 2 consisted of patients treated since 2020 with therapeutic CSFD. Primary end points were HLOS, ICULOS, major adverse events, and perioperative mortality. ResultsFB-EVAR was performed in 702 patients; 412 underwent elective TAAA repair and were included in the analysis. Mean age was 73 ± 8 years and 68% were male. Patient-specific manufactured devices were used in 252 patients (61%), physician-modified endografts in 110 (27%), and 50 patients (12%) were treated with off-the-shelf devices. Demographics, aneurysm extent, major adverse events (including spinal cord ischemia [SCI]), and mortality were similar in both groups. A significant reduction in mean HLOS between the groups (9 ± 9 vs 6 ± 5 days; P = .02) coincided with decreased use of prophylactic CSFD (70% vs 1.2%; P < .001), with similar rates of SCI (7.6% vs 4.9%; P = .627) and ICULOS (3 ± 3 vs 2.5 ± 3; P = .19). Patients in the therapeutic drainage cohort (group 2) had a higher incidence of congestive heart failure (24% vs 11%; P = .003), hypercholesterolemia (91% vs 80%; P = .015), chronic obstructive pulmonary disease (55% vs 37%; P = .004), and peripheral artery disease (39% vs 19%; P < .001) compared with group 1, suggesting treatment of a more complex patient cohort. On adjusted multivariable analysis accounting for American Society of Anesthesiologists score, comorbidities, and device type, the difference in HLOS remained statistically significant (P = .01). ConclusionsHLOS decreased over time in patients undergoing FB-EVAR for TAAA after transition from a prophylactic to a therapeutic CSFD protocol. This transition was the only modifiable, independent risk factor for a shorter HLOS, without an increase in SCI, albeit with similar ICULOS.

Simultaneous Transcatheter Aortic Valve Implantation and Endovascular Aneurysm Repair for Severe Aortic Stenosis and Symptomatic Abdominal Aortic Aneurysm: Mini Review.

Background: The treatment of patients with severe aortic stenosis (SAS) who concomitantly present with abdominal aortic aneurysm (AAA) is not defined. Aortic valve replacement surgery, performed alone, increases the risk of AAA rupture. Transcatheter aortic valve replacement (TAVR) and endovascular abdominal aortic aneurysm repair (EVAR) in the same intervention, especially in high-risk patients, is a safe alternative. Purpose: We report a case of simultaneous endovascular treatment of SAS and AAA and a mini literature review of nineteen cases with similar characteristics. Research design: Case report and literature review. Data Collection: An electronic search of PubMed and Scopus was performed from inception to December 2023. Results: Nineteen case reports of simultaneous transcatheter aortic valve repair and endovascular aneurysm repair for SAS and symptomatic AAA were identified published in the literature. Conclusions: We regard the simultaneous endovascular approach to both pathologies as a promising treatment alternative for selected patients with severe aortic stenosis and abdominal aortic aneurysm. We highlight the need to conduct randomized clinical trials in this patient population.

Endovascular interventions for endoleaks

Endoleak represents the most common complication after endovascular aortic aneurysm repair (EVAR) and is de&amp;#64257; ned as persistent perfusion of the aneurysmal sac, which subsequently could lead to its expansion and possibly rupture. There are different types of endoleaks, depending on their in&amp;#64258; ow source, regardless of the number and type of other vessels involved in the out&amp;#64258; ow (endoleak type I A/B/&amp;#1057;, type II, type III, type IV and type V). The current gold standard for the diagnosis of endoleak is the contrast-enhanced helical computed tomography (CT). Since, there is no generally accepted consensus for the best surveillance and treatment methods for this pathology, in this article we will present the most effective endovascular interventions for the successful management of the different types of endoleaks.&amp;nbsp;

Dynamic Radial MR Imaging for Endoleak Surveillance after Endovascular Repair of Abdominal Aortic Aneurysms with Inconclusive CT Angiography: A Prospective Study.

Background/Objectives: To assess free-breathing, dynamic radial magnetic resonance angiography (MRA) for detecting endoleaks post-endovascular aortic repair (EVAR) in cases with inconclusive computed tomography angiography (CTA). Methods: This prospective single-center study included 17 participants (mean age, 70 ± 9 years; 13 males) who underwent dynamic radial MRI (Golden-angle RAdial Sparse Parallel-Volumetric Interpolated BrEath-hold, GRASP-VIBE) after inconclusive multiphasic CT for the presence of endoleaks during the follow-up of EVAR-treated abdominal aortic aneurysms. CT and MRI datasets were independently assessed by two radiologists for image quality, diagnostic confidence, and the presence/type of endoleak. Statistical analyses included interrater and intermethod agreement, and diagnostic performance (sensitivity, specificity, area under the curve (AUC)). Results: Subjective image analysis demonstrated good image quality and interrater agreement (k ≥ 0.6) for both modalities, while diagnostic confidence was significantly higher in MRA (p = 0.03). There was significantly improved accuracy for detecting type II endoleaks on MRA (AUC 0.97 [95% CI: 0.87, 1.0]) compared to CTA (AUC 0.66 [95% CI: 0.41, 0.91]; p = 0.03). Although MRA demonstrated higher values for sensitivity, specificity, AUC, and interrater agreement, none of the other types nor the overall detection rate for endoleaks showed differences in the diagnostic performance over CT (p ≥ 0.12). CTA and MRA revealed slight to moderate intermethod concordance in endoleak detection (k = 0.3-0.64). Conclusions: The GRASP-VIBE MRA characterized by high spatial and temporal resolution demonstrates clinical feasibility with good image quality and superior diagnostic confidence. It notably enhances diagnostic performance in detecting and classifying endoleaks, particularly type II, compared to traditional multiphase CTA with inconclusive findings.

The Use of Advanced Three-Dimensional Computed Tomography During Simple and Complex Endovascular Aortic Aneurysm Repairs

ObjectivesEndovascular aneurysm repair (EVAR) success depends on imaging technology both in the planning and operative phases. Endovascular repair requires intravenous contrast and radiation exposure to the patient as well as radiation exposure to the operator. Recent developments in imaging technology attempt to merge preoperative imaging with intraoperative imaging to improve the efficiency and accuracy of EVAR. The Cydar 3D imaging system combines the preoperative and intraoperative imaging during the operation. We aim to investigate the use of the Cydar 3D imaging system during EVAR compared to conventional methods. MethodRetrospective review of all patients undergoing an EVAR at a single quaternary vascular center from 2019-2023 was collected. This cohort was divided into two groups: (1) Repair using Cydar 3D imaging or (2) Repair without Cydar 3D imaging. Overall, 138 unique patients were identified with 27 operations using Cydar 3D imaging and 111 operations without Cydar 3D imaging. We performed a 1-to-1 propensity score – matched analysis using nearest-neighbor matching for variables including age, case urgency, and if the case was performed in the operative room or interventional radiology room. A match occurred when a patient in the Cydar 3D imaging group had an estimated score within 0.01 standard deviations of a patient in the control group. From this we paired 27 from each cohort for a total of 54 patients. Demographic data included length of stay (LOS) in days, contrast volume (ml), Fluoroscopy time (min), procedure length (mins), mortality, blood loss (ml). Univariate analyses were performed and a p-value less than 0.05 was considered statistically significant. ResultsA total of 54 vascular patients were analyzed: 27 without the Cydar 3D imaging and 27 with the Cydar 3D imaging. In the univariate analysis there was no statistical difference in the average length of stay (6.4 days ± 11.76 vs. 4.1 ± 6.03, p = 0.372), aneurysm size (5.9 ± 1.4 vs. 5.9 ± 1.2, p=0.88), contrast volume in mL (91.3 ± 47.0 vs. 91.1-33.49, p=9.88), fluoroscopy time in mins (20.2±17.2 vs. 19.5±19.4, p=0.89) , procedure length (299.3±177.9 vs. 353±191.98, p=0.279), blood loss in mL (513.8±791 vs. 353±191.98, p=0.594). There was an increase in reintervention for endoleaks in the group with use of Cydar 3D imaging (0 vs 6, p=0.043). A sub-analysis of patients undergoing physician modified EVARs did show a 15% reduction in the contrast volume used. ConclusionThe use of 3D imaging technology has the potential to increase the safety of EVAR to both patients and operators. In our study we did not find any difference in standard EVARs however there was a contrast use decrease in physician modified EVARs. Further studies will need to be performed to determine the realized benefit from performing EVARs using this new technology.

Endovascular Aneurysm Repair (EVAR) in Rupture of the Infrarenal Abdominal Aortic Aneurysm (AAA) with Severe Neck Angulation in Conscience of National Health Coverage in Tertiary Referral Hospital in Indonesian: Case Report

AbstractAn aortic aneurysm is a condition with focal dilation of 50% or more over the normal aortic diameter. The most frequent form of aortic aneurysms is infrarenal. Endovascular aortic aneurysm repair is a valid treatment for treating patients with abdominal aortic aneurysm. Abdominal aortic aneurysms (AAAs) are electively repaired to prevent rupture. We present a case of an elderly man with an impending rupture of intraluminal infrarenal AAA with bilateral common iliac arteries aneurysms. Overall, the patient had completed the procedure and made a good postoperative recovery with fully coverage of Indonesian national health insurance.