Contemporary Results of Endovascular Repair of Isolated Abdominal Aortic Dissection with Unibody Bifurcated Stent Grafts

Zhou, Min; Cai, Hai; Li, Zhonghua; Zhang, Yepeng; Liu, Zhao; Tang, Hanfei; Qiao, Tiankui; Liu, Changjian

doi:10.1016/j.avsg.2017.10.035

Cited by 17 publications

(17 citation statements)

References 28 publications

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“…A unibody aortic bifurcated stent graft has shown excellent results in the treatment of isolated abdominal aortic dissection in a recent publication. 14 The ability of this stent graft to exclude fenestrations in an aorta with a narrow proximal landing zone and aortic bifurcation to obtain a secure and stable repair has been demonstrated. This stent graft has the fabric on the outside, similar to the Endologix device.…”

Section: Discussionmentioning

confidence: 98%

Customized endovascular repair of common iliac artery aneurysms

Hoo

Ryan

Neville

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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Open technique for elective repair of iliac artery aneurysms can be safely performed with good outcomes but not inconsequential morbidity. An endovascular approach has been shown to have both periprocedural and postoperative advantages with equivalent outcomes. Endovascular repair of common iliac arteries (CIAs) without sacrificing the hypogastric artery using an iliac branch device is a complex endovascular technique requiring a proximal seal zone that may be absent in larger CIA aneurysms. We present two cases in which CIA aneurysms were repaired with a customized endovascular technique using the benefit of the aortic bifurcation for stability in addition to providing a long proximal seal zone with the AFX device (Endologix, Irvine, Calif) paired with the iliac branch device (W. L. Gore & Associates, Flagstaff, Ariz) for internal iliac artery preservation.

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Section: Discussionmentioning

confidence: 98%

Customized endovascular repair of common iliac artery aneurysms

Hoo

Ryan

Neville

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…Recently, less invasive endovascular approaches have been proposed. This technique mainly included placement of an aortic tube graft and great effort was made to deploy the covered portion of the graft above the celiac artery [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Endovascular treatment for spontaneous supraceliac isolated abdominal aortic dissection is a fabulous option. (Case report)

Alhaizaey

Azazy

Khalil

et al. 2020

International Journal of Surgery Case Reports

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“…During follow up, other than two deaths before treatment and 35 deaths in the Kang et al 13 study with non-separated data, 21 deaths The overall 91% of IAADs were spontaneous, which is comparable to previous studies reporting dissection types (66.7e100%). 3,7,9,11,14,18,19,21,25,26 Hypertension, smoking, and hyperlipidaemia were the most common concomitant risk factors of IAAD, which could induce endothelial damage and a persistent inflammatory response to stimulate formation of atherosclerosis and spontaneous aortic dissection. 27,28 Therefore, all patients with IAAD should be advised on basic lifestyle interventions, including hypertension control, smoking cessation, and a decrease of salt and fat in diet.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…3,7e 9,11,13e16,18e21,25 In the pooled result, 28% of patients suffered concomitant AAAs at the time of first admission, similar to other experiences. 3,7 Although the optimal size of dissection aneurysm for intervention remains poorly defined, some studies state that an abdominal aorta >5 cm diameter was the indication for intervention, 13,15,21,25 while other studies recommended that the threshold for intervention should probably be decreased to 3 cm because a dissecting aneurysm is more likely to rupture and need earlier intervention. 9,14,18e20 Therefore, more comparative studies investigating the optimal threshold for invasive intervention in patients with IAAD are needed in the future.…”

Section: Clinical Outcomesmentioning

confidence: 99%

Systematic Review and Meta-analysis of Current Literature on Isolated Abdominal Aortic Dissection

Yang

Han

Zhao

et al. 2020

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDSThis meta-analysis presents the pooled quantitative evidence of basic profiles, initial treatment strategies, and clinical outcomes in patients with isolated abdominal aortic dissection. Major findings suggest that appropriate initial treatment strategies can obtain acceptable clinical outcomes, with a 30 day mortality of 3%, a long term mortality of 8%, and a re-intervention rate of 8%. Endovascular repair or open surgery is necessary if patients match certain indications for intervention. Regular imaging surveillance should be provided for all patients, especially those treated conservatively, who appear to be most at risk of second intervention.Objective: To present the pooled quantitative evidence of basic profiles, initial treatment strategies, and clinical outcomes in patients with isolated abdominal aortic dissection (IAAD). Methods: A comprehensive systematic review and meta-analysis was performed of all available studies reporting IAAD, retrieved from the MEDLINE, Embase, and Cochrane Databases. The logistic normal random effect model was fitted using the generalised linear mixed model with random intercepts to calculate the pooled proportion estimates.Results: Seventeen studies with 482 patients were included in this meta-analysis. Male smokers with hyperlipidaemia and hypertension were the most prominent basic profile. IAADs were predominantly spontaneous and infrarenal, and roughly half were acute and symptomatic. Approximately 67% [95% confidence interval (CI) 42e86%] of patients were managed initially conservatively. In the overall population, the 30 day all cause mortality was 3% (95% CI 1e5%) and the long term mortality during follow up was 8% (95% CI 5e14%). Re-intervention during follow up occurred in 8% (95% CI 5e15%) of patients. In the subgroup analysis, patients with conservative treatment had a 30 day mortality of 1% (95% CI 0e8%), a long term mortality of 5% (95% CI 1e29%), and a re-intervention rate of 18% (95% CI 10e29%). Patients with open surgery had a 30 day mortality of 9% (95% CI 0e82%), a long term mortality of 12% (95% CI 4e31%), and a re-intervention rate of 9% (95% CI 1e44%). Patients with endovascular repair had a 30 day mortality of 2% (95% CI 0e10%), a long term mortality of 5% (95% CI 2e13%), a re-intervention rate of 6% (95% CI 3e 13%), and a persistent endoleak rate of 4% (95% CI 2e10%). Conclusion: Appropriate initial treatment strategies can be used to obtain acceptable clinical outcomes in patients with IAAD. Invasive intervention is necessary if patients match certain indications for intervention. Regular imaging surveillance should be provided for all patients, especially those treated conservatively.

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Contemporary Results of Endovascular Repair of Isolated Abdominal Aortic Dissection with Unibody Bifurcated Stent Grafts

Cited by 17 publications

References 28 publications

Customized endovascular repair of common iliac artery aneurysms

Customized endovascular repair of common iliac artery aneurysms

Endovascular treatment for spontaneous supraceliac isolated abdominal aortic dissection is a fabulous option. (Case report)

Systematic Review and Meta-analysis of Current Literature on Isolated Abdominal Aortic Dissection

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