Branched Grafting for Aortoiliac Aneurysms

Haulon, Stéphan; Greenberg, Roy K.; Pfaff, Kathryn; Francis, Catherine; Koussa, Mohamad; West, Karl

doi:10.1016/j.ejvs.2006.12.008

Cited by 116 publications

(88 citation statements)

References 12 publications

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“…These observations have caused us to carefully consider the use of ER in patients with prior distal repairs, particularly in the presence of compromised internal iliac circulation. In a number of cases in the ER group (after 2004), internal iliac branched grafts 46 were used in concert with visceral branch devices to maintain antegrade pelvic blood flow. The absence of SCI after the ER of aneurysms with aortic dissections was also noted; however, most patients with aneurysmal dilation and chronic aortic dissections had limited distal aortic involvement.…”

Section: Greenberg Et Al Thoracic and Thoracoabdominal Aneurysm Repairmentioning

confidence: 99%

Contemporary Analysis of Descending Thoracic and Thoracoabdominal Aneurysm Repair

et al. 2008

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Section: Greenberg Et Al Thoracic and Thoracoabdominal Aneurysm Repairmentioning

confidence: 99%

Contemporary Analysis of Descending Thoracic and Thoracoabdominal Aneurysm Repair

et al. 2008

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“…More recently, fenestrated and branched graft designs have become available for aortas with more challenging anatomy but these are expensive and do not reflect current standard EVAR practice. [125][126][127] Over the last 15 years, various manufacturers have developed a number of grafts, but all of these have required some form of technical revision and some have been withdrawn from the market due to high complication rates. 128 Given that EVAR is still a relatively young treatment modality, the long-term efficacy remains unknown and this has meant that most clinicians still monitor their patients following EVAR.…”

Section: Endovascular Aneurysm Repairmentioning

confidence: 99%

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Brown

Powell²,

Thompson³

et al. 2012

Health Technol Assess

207

170

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“…All of the devices, regardless of the branch design, may be coupled with distal aortic bifurcated components and may also be combined with branched grafts used to treat common and internal iliac aneurysms. 40 It must be understood that a great deal of the decision making pertaining to device design relates to patientspecific anatomy. For example, severe aortic tortuosity may limit the ability to predict how reinforced fenestrations will align with branches or may actually cause compression of long branches.…”

Section: Greenberg and Lytle Endovascular Repair Of Thoracoabdominal mentioning

confidence: 99%

Endovascular Repair of Thoracoabdominal Aneurysms

2008

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Background-Morbidity and mortality after conventional repair of thoracoabdominal aneurysms remain high. Alternative techniques have been proposed and are the subject of this report. Methods and Results-Endovascular grafts that have a means of incorporating the visceral vessels into the aortic repair were divided into devices with fenestrations and those with formal branches. Hybrid procedures whereby an extra-anatomic bypass procedure is used to provide inflow to the renal and mesenteric arteries followed by aortic relining with stent grafts were reviewed and tabulated. A description of the techniques and review of the current results are provided. Only 4 series with Ͼ10 cases of hybrid procedures have been published. The experience with such a procedure suggests feasibility, but most reports describe a persistently high risk of mortality (up to 25%). Larger series of fenestrated stent grafts to treat juxtarenal aneurysms have been published, and intermediate-term results confirm the safety and efficacy of the procedure. A larger multicenter trial is under way. Other pure endovascular methods have been used to treat thoracoabdominal aneurysms with both reinforced fenestrations and directional branches. Without counting small series (Ͻ10 cases), 2 series exist with Ϸ100 cases that noted perioperative mortality rates between 3% and 6%, without evidence of late ruptures. Conclusions-Endovascular repair of thoracoabdominal aneurysms is feasible and is associated with relatively low perioperative mortality. Several methods of visceral vessel incorporation have been described. Because of persistently high mortality, hybrid procedures will likely be relegated to nonsurgical and nonendovascular patients with sizable aneurysms. Endografts with branches continue to evolve and will be assessed in the context of clinical trials.

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Branched Grafting for Aortoiliac Aneurysms

Abstract: The placement of endovascular prostheses that maintain antegrade perfusion of one or both internal iliac arteries is feasible, and early results provide evidence for optimism with regard to safety and efficacy.

Cited by 116 publications

References 12 publications

Contemporary Analysis of Descending Thoracic and Thoracoabdominal Aneurysm Repair

Contemporary Analysis of Descending Thoracic and Thoracoabdominal Aneurysm Repair

The UK EndoVascular Aneurysm Repair (EVAR) trials: randomised trials of EVAR versus standard therapy.

Endovascular Repair of Thoracoabdominal Aneurysms

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