AIM: Most endovascular stent-grafts in endovascular aortic aneurysm repair (EVAR) are designed to deploy from the renal artery level down to the iliac level. The Powerlink device (Endologix Inc, Irvine, Calif) can be deployed from the iliac level up to the renal artery level. The aim of this study was ...

The introduction of ultrasound screening combined with the increasingly elderly population means that the number of small abdominal aortic aneurysms (AAAs) detected is expected to increase over the next decade. At present open or endovascular surgery are the only treatment options for AAA. In this mini-review we discuss the rationale ...

PURPOSE: To evaluate the morbidity associated with thoracic and abdominal aortic repair using endovascular exclusion alone or combined endovascular and open repair. METHODS: Between January 1998 and February 2007, 49 patients (36 men; mean age 70 years) underwent treatment for thoracic and abdominal aorta disease with descending thoracic aortic (DTA) ...

The evolution of stent-grafts and endovascular delivery systems has substantially improved the application rate for and patient outcomes with endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA), but further development is needed in order to reduce the continuing incidence of complications and secondary re-interventions. Severe angulations at the proximal ...

Disseminated intravascular coagulation (DIC) has been shown to affect 2% to 4% of patients with abdominal aortic aneurysms. In rare cases of DIC caused by aneurysms, operative repair has been curative. Endovascular aneurysm repair (EVAR) has been established as an effective treatment. We report a 73-year-old man in whom severe ...

OBJECTIVE: This study investigated the importance of iliac fixation to secure endograft fixation. MATERIALS AND METHODS: Computed tomography (CT) scans of patients who underwent endovascular aneurysm repair with an endoprosthesis of great columnar strength (Talent stent graft) were analysed retrospectively. Patients were enrolled consecutively between June 2000 and January 2007 ...

OBJECTIVES: Aorto-iliac angulations may be challenging for modular stent-graft systems (SGSs) from a single manufacturer. This study aims to define the pullout forces (POFs) of SGSs derived from the same (non-hybrid) or different manufacturers (hybrid). METHODS: The POFs were tested in a vertical position in air and 5% albumin. We ...

The purpose of this study was to examine the immediate and midterm outcomes of percutaneous endovascular repair of thoracic and abdominal aortic pathology. Between December 2003 and June 2005, 21 patients (mean age: 60.4 +/- 17.1 years; 15 males, 6 females) underwent endovascular stent-graft insertion for thoracic (n = 13) ...

Ruptured abdominal aortic aneurysm (RAAA) is the most common and devastating complication affecting a patient with abdominal aortic aneurysm (AAA). Despite advances in surgery and critical care, the mortality rate associated with RAAA remains largely unchanged. Emergency open repair is the gold standard conventional treatment of RAAA but is associated ...

The purpose of this study was to evaluate the accuracy of centerline of flow (CLF) measurement for precise sizing of the Zenith AAA endovascular graft (Zenith) and to identify predictive factors of risk of inadequate endograft sizing. We analyzed 42 consecutive patients treated using the Zenith with pre- and postoperative ...

We report the case of a patient who underwent endovascular repair and then reintervention as a result of the presence of a persistent endoleak complicated by an aortocaval fistula. A 76-year-old patient with a history of endovascular treatment for abdominal aortic aneurysm 2 years earlier had a palpable abdominal mass, ...

Thromboembolic events with partially or completely persisting neurologic deficits are reported in a substantial number of patients after endovascular aneurysm therapy. The authors discuss the current status of periinterventional coagulation management in endovascular aneurysm therapy. First, some basic aspects of coagulation physiology relevant to neurointerventions are introduced. Second, the most ...

Randomized clinical trials have documented clinical equipoise when comparing endovascular abdominal aortic aneurysm repair (EVAR) with open aneurysm repair (OAR). Studies using large administrative databases in the United States have documented a trend whereby the majority of patients undergoing elective abdominal aortic aneurysm (AAA) repair in the United States are ...

Endovascular repair of abdominal and thoracic aortic aneurysms (AAAs and TAAs, respectively) has become the standard of care for anatomically appropriate patients. All the devices developed to date for endograft repair of AAAs and TAAs are deployed through relatively large (12F to 24F) sheaths. Traditionally, this access has required arterial ...

OBJECTIVE: The etiology of abdominal aortic aneurysm (AAA) includes atherosclerotic, inflammatory, immunological and coagulatory mechanisms. The aim of this study was to evaluate associations between markers for some of these mechanisms and AAA-size, in order to identify markers which might later be evaluated in relation to aneurysm growth. MATERIAL AND ...

OBJECTIVE: To examine contemporary operative techniques and outcomes for repair of isolated iliac artery aneurysms. METHODS: We retrospectively reviewed the charts of all patients who underwent repair of an isolated iliac artery aneurysm from February 1995 to June 2007. Mycotic aneurysms and patients with concurrent infrarenal abdominal aortic aneurysms greater ...

OBJECTIVE: Patients with an abdominal aortic aneurysm (AAA) often develop common iliac artery (CIA) aneurysms. We wished to assess the natural history of the CIA in the presence of an AAA and develop a model to predict CIA growth. METHODS: Data were gathered at a single center from 1996 to ...

OBJECTIVES: There is lack of consensus regarding concurrent vs. staged approaches, and the prioritisation of staged procedures in cases presenting with colorectal carcinoma (CRC) and abdominal aortic aneurysm (AAA) synchronously. We aim to present our experience, review the literature on this therapeutic dilemma and examine the role of endovascular aortic ...

BACKGROUND: Endoleaks after stent-graft repair of aortic dissections are poorly understood but seem substantially different from those seen after aneurysm repair. We studied anatomic and clinical factors associated with endoleaks in patients who underwent stent-graft repair of complicated type B aortic dissections. METHODS AND RESULTS: From 2000 to 2007, 37 ...

INTRODUCTION: The association of aortic aneurysm with congenital pelvic kidney is an uncommon condition and has been described in association with abdominal aortic aneurysm (AAA) open repairs. REPORT: We present a case of a patient with a type IV thoraco-abdominal aortic aneurysm (TAAA) extending into the left common and internal ...

Major aortic surgery results in significant haemodynamic and oxidative stress to the myocardium. Cytokine release is a major factor in causing cardiac injury during aortic surgery. Endovascular aortic aneurysm repair (EVAR) has the potential to reduce the severity of the ischaemia reperfusion syndrome and its systemic consequences. The aim of ...

OBJECTIVES: Abdominal aortic aneurysms (AAAs) are associated with an inflammatory cell infiltrate and enzymatic degradation of the vessel wall. The aim of this study was to detect increased metabolic activity in the wall of the AAA with 18F-fluorodeoxyglucose ((18)F-FDG), mediated by glucose transporter protein (GLUTs), using a dedicated hybrid PET/64-detector ...

We report our initial experience using the Amplatzer Vascular Plug II (AVP2) in the treatment of a left common iliac aneurysm. Following investigation by computerized tomographic angiography and catheter angiography, a 79-year-old man was found to have a markedly tortuous iliac system, with a left common iliac artery aneurysm that ...

OBJECTIVE: To evaluate the early and intermediate outcome of a consecutive series of emergency endovascular aneurysm repairs (eEVAR) of computed tomography (CT)-verified infrarenal ruptured abdominal aortic aneurysm (rAAA) at a single tertiary referral centre. METHODS: Prospectively collected data of patients operated between April 2000 and October 2007 were retrospectively reviewed ...

OBJECTIVE: To report a case and to review previous publications regarding the rare complication of aorto-enteric fistula following endovascular aortic aneurysm repair. METHODS: We report the case of a stent-graft infection secondary to an aorto-enteric fistula 14 months after uncomplicated endovascular treatment of an infra-renal aortic aneurysm. RESULTS: The surgical ...

OBJECTIVE: Endovascular repair for degenerative aortic aneurysms is well established, but its role in those with infective pathology remains controversial. This study aims to assess the durability of endovascular repair with a review of our midterm results. METHOD: A retrospective analysis of a prospectively maintained endovascular database (1998-2008) was conducted, ...

OBJECTIVE: The objective of our study was to review expected findings and complications after thoracic endovascular aortic repair on CT angiography (CTA). CONCLUSION: Luminal and extraluminal changes to the thoracic aorta occur after endovascular stent-grafting. The radiologist can facilitate appropriate management by detecting and differentiating expected CTA findings from complications.

Recent numerical studies of abdominal aortic aneurysm (AAA) suggest that intraluminal thrombus (ILT) may reduce the stress loading on the aneurysmal wall. Detailed fluid structure interaction (FSI) in the presence and absence of ILT may help predict AAA rupture risk better. Two patients, with varied AAA geometries and ILT structures, ...

AIM: The aim of this single center retrospective study was to determine gender-related differences in patients undergoing repair of aortic aneurysm. METHODS: A total of 296 consecutive patients with an abdominal aneurysm undergoing elective endovascular or surgical repair was included in the study. Among these, 24 (8.1%) were females and ...

PURPOSE: The purpose of this study was to describe an alternative endovascular procedure to exclude iliac artery aneurysms, preserving perfusion to the internal iliac artery. CASES: Two patients, considered unfit for open repair, underwent endovascular repair of iliac artery aneurysms. One of these occurred after previous placement of a bifurcated ...

Endovascular aneurysm repair (EVAR) affords patients the opportunity to undergo a less invasive method of repairing abdominal aortic aneurysms. The EVAR procedure results in a shorter hospital stay, less pain, and less chance of morbidity. This procedure can be performed in a variety of settings (eg, OR, interventional radiology suite, ...

Endovascular treatment of thoracic and thoraco-abdominal aortic aneurysm with celiac artery ostium coverage, seems to be safe according to the literature. We present a case in which the endograft deployement was achieved through a right common carotid artery access because four years before the patient was submitted to an axillo-bifemoral ...

Endovascular therapy is a safe alternative to treat the late complications of open aortic surgery. Here we report the endoluminal treatment of a recurrent common iliac aneurysm. A 68-year-old man, who submitted five years previously to an aorto bifemoral in order to exclude a juxta renal aortic aneurysm, developed a ...

Endovascular treatment of abdominal aortic aneurysm is commonplace at present. It has got lower mortality and morbidity compared to open surgical repair. However, it requires long-term follow-up. The main complications are endoleaks, stent migrations, kinks, and rupture. Ureteric obstruction is uncommon but an important complication following endovascular treatment of abdominal ...

With the expansion of elective abdominal aortic aneurysm (AAA) repair after the introduction of endovascular aneurysm repair (EVAR), there is a concern that even with a lower operative mortality there could be an increasing number of aneurysm-related deaths. To evaluate this, we looked at national trends in AAA repair volume ...

Over the past 15 years, endovascular aneurysm repair of abdominal aortic aneurysms has become widely accepted as a means of treating aneurysms located in the infrarenal portion of the aorta. It has been estimated that 30% to 40% of patients with abdominal aortic aneurysms are not candidates for endovascular repair ...

Thoracoabdominal aortic aneurysms (TAAA) remain a formidable surgical challenge, with conventional open repair associated with significant rates of mortality and morbidity. Furthermore, many of these patients are elderly with significant comorbidities and may not be candidates for repair. Consequently, the availability of a "hybrid" option, including open visceral debranching with ...

Patients with symptomatic abdominal aortic aneurysms (AAAs) should undergo repair, regardless of AAA diameter, whereas guidelines for asymptomatic patients suggest repair for AAAs > or = 5.5 cm in diameter. For most patients with medium-sized AAAs, regular surveillance and intensive medical therapy are appropriate. Patients with an AAA should undergo ...

PURPOSE: Aneurysms involving the supra-aortic vessels are rare but carry serious risk of embolization, thrombosis, and rupture. We describe our experience with the diagnosis, treatment strategies, and outcomes in patients with extended follow-up. METHODS: Data during a 17-year period (January 1990 to December 2007) was analyzed. We assessed age, gender, ...

Herein, we report a single institution's experience with endovascular abdominal aortic aneurysm repair in nonagenarians, over a 4-year period of time. We performed a retrospective study of cases, in which we documented patient demographics, symptoms, physical findings, surgical interventions, complications, and deaths. The survivors answered a questionnaire. Endovascular abdominal aneurysm ...

Non-traumatic middle meningeal artery aneurysm and rupture resulting in intracranial haemorrhage is rare. In the present case, a 73-year-old man was admitted to hospital with a history of a minor head trauma. A CT scan of the head revealed a 2×2 cm intraparenchymal haematoma without significant mass effect in the ...

The objective of our research is to develop an ultrasound, time-of-flight triangulation based system for real-time, intraoperative 3-dimensional tracking of minimally invasive surgical instruments. We have chosen to first apply this technology towards tracking catheters used in endovascular aortic stent-grafting. To demonstrate the feasibility of this concept, we have developed ...

Transient intraluminal infusion of porcine pancreatic elastase into the infrarenal segment of the abdominal aorta is the most widely used animal model of abdominal aortic aneurysm (AAA) ever since it was first described in rats by Anidjar and colleagues.(1) The rationale for its development was based on the disrupted nature ...

A celiomesenteric trunk (CMT) accounts for fewer than 1% of all visceral artery anomalies. Aneurysms involving a CMT are exceptionally rare: our search of the literature found only eight cases reported. We treated a 73-year-old man with both a fusiform CMT aneurysm and an abdominal aortic aneurysm (AAA). The celiac ...

The diameter of an abdominal aortic aneurysm (AAA) is the single most important factor in deciding whether to repair an aneurysm or to monitor it conservatively. Open surgical repair does not appear to be beneficial until the diameter of the aneurysm is >5.5 cm. Prospective clinical trials, however, confirmed a ...

Endoleaks and endotension remain the primary limitation of endovascular aortic repair with stent-grafts. Consequently, all endovascular surgeons performing thoracic or abdominal endovascular aortic repairs require a comprehensive knowledge and understanding of how to survey and manage endoleaks. The derivation of the current endoleak classification scheme, the clinical impact of endoleaks, ...

Interventional medical practitioners are specialists who do minimally invasive procedures instead of surgery or other treatment. Most often, these procedures utilize various imaging and catheterization techniques in order to diagnose and treat vascular issues in the body. Interventionalist techniques, including injecting arteries with dye, visualizing these via x-ray, and opening ...

Descending thoracic aortic aneurysmal disease is associated with poor 5-year survival rates as low as 10%-15% if untreated. This is probable because of a combination of the aneurysmal disease, comorbidities, and in many patients advanced age. In the search for better outcomes and newer techniques, the endovascular approach for the ...

An adequate landing zone for fixation and sealing is necessary for endovascular aneurysm repair (EVAR). This report presents two cases of a successful EVAR for thoracic aortic aneurysms (TAA) with a stent-graft covering the celiac artery (CA) to secure a distal landing zone. Case 1 was a 61-year-old man with ...

The purpose of this article is to report the feasibility and preliminary results of the treatment of isolated iliac artery aneurysms (IAAs) with Anaconda limbs (Vascutek Ltd., Inchinnan, Renfrewshire, Scotland). A prospective cohort is reported of consecutive IAAs treated by two senior surgeons from May to December 2006. One or ...