Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms: A Valuable Alternative?—Case Report and Review of Literature

Ruppert, Volker; Verrel, F.; Kellner, Wolfgang; Brandl, Thomas; Reininger, Cornelia; Steckmeier, B.

doi:10.1007/s10016-004-0031-8

Cited by 21 publications

(12 citation statements)

References 26 publications

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“…The potential technical difficulties of OSR are avoided, and multiple reports of successful endovascular repair leading to subsequent improvement in the extent and severity of the perianeurysmal and retroperitoneal fibrotic process, similar to that seen following conventional OSR, have been published. 234,235 Horseshoe kidney. Advanced knowledge of a horseshoe, ectopic, or pelvic kidney associated with an AAA is particularly important in view of the frequently complex renal artery anatomy, possibility of anomalous ureteral drainage, and other technical challenges for OSR.…”

Section: Unusual Aneurysmsmentioning

confidence: 99%

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Chaikof

Brewster

Dalman

et al. 2009

Journal of Vascular Surgery

636

520

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DEFINITION OF THE PROBLEM Purpose of these guidelinesThe Clinical Practice Council of the Society for Vascular Surgery charged a writing committee with the task of updating practice guidelines, initally published in 2003, for surgeons and physicians who are involved in the preoperative, operative, and postoperative care of patients with abdominal aortic aneurysms (AAA). 1 This document provides recommendations for evaluating the patient, including risk of aneurysm rupture and associated medical co-morbidities, guidelines for selecting surgical or endovascular intervention, intraoperative strategies, perioperative care, long-term follow-up, and treatment of late complications.Decision making related to the care of patients with AAA is complex. Aneurysms present with varying risks of rupture and patient specific factors influence anticipated life expectancy, operative risk, and the need to intervene. Careful attention to the choice of operative strategy, as influenced by anatomic features of the AAA, along with optimal treatment of medical co-morbidities is critical to achieving excellent outcomes. Moreover, appropriate postoperative patient surveillance and timely intervention in the case of a late complication is necessary to minimize subsequent aneurysm-related death or morbidity. All of these clinical decisions are determined in an environment where cost-effectiveness will ultimately dictate the ability to provide optimal care to the largest possible segment of the population. Currently available clinical data sets have been reviewed in formulating these recommendations. However, an important goal of this document is to clearly identify those areas where further clinical research is necessary. Methodology and evidenceA comprehensive review of the available clinical evidence in the literature was conducted in order to generate a concise set of recommendations. The strength of any given recommendation and the quality of evidence was scored based on the GRADE system (Table I). 2 When the benefits of an intervention outweighed its risks, or, alternatively, risks outweighed benefits, a strong recommendation was noted. However, if benefits and risks were less certain, either because of low quality evidence or because high quality evidence suggests benefits and risks are closely balanced, a weak recommendation was recorded. The quality of evidence that formed the basis of these recommendations was scored as high, moderate, or low. Not all randomized controlled trials are alike and limitations may compromise the quality of their evidence. In addition, if there is a large magnitude of effect, the quality of evidence derived from observational studies may be high. Thus, quality of evidence was scored as high when additional research is considered very unlikely to change confidence in the estimate of effect; moderate when further research is likely to have an important impact in the estimate of effect; or low when further research is very likely to change the estimate of the effect.

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Section: Unusual Aneurysmsmentioning

confidence: 99%

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Chaikof

Brewster

Dalman

et al. 2009

Journal of Vascular Surgery

636

520

View full text Add to dashboard Cite

show abstract

“…Several other individual series and some meta-analyses have also reported PAF regression. [9][10][11][19][20][21][22][23][24][25][26] A meta-analysis published in 2005 reported complete PAF regression in 51% of patients, unchanged in 42%, and progression in 7%, concluding that EVAR for IAAA is feasible and reduces PAF. 12 No PAF progression was noted in this series.…”

Section: Discussionmentioning

confidence: 95%

Inflammatory Abdominal Aortic Aneurysm Endovascular Repair into the Long-Term Follow-Up

Coppi¹,

Rametta²,

Aiello³

et al. 2010

Annals of Vascular Surgery

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“…It is estimated that since then, more than 25,000 patients worldwide have received an aortic stent graft (5). Many studies have suggested that endovascular aneurysm repair (EVAR) offers an important new alternative to open repair (OR) of aortic abdominal aneurysm (AAA), especially in older patients with significant comorbidity (6–8).…”

Section: Introductionmentioning

confidence: 99%

Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair - single centre experience

Chan¹,

Morales²,

Gulamhuseinwala³

et al. 2007

International Journal of Clinical Practice

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Summary Endovascular aneurysm repair (EVAR) has become an established alternative to open repair (OR). We present a consecutive series of 486 elective patients with large infra‐renal aortic abdominal aneurysm, comparing OR with EVAR. Prospective data collected during an 8‐year period from January 1997 to October 2005 was reviewed. Statistical analysis performed using SPSS data editor with χ2 tests and Mann–Whitney U‐tests. There were 486 patients with 329 OR (293 males, 36 females) with median age of 72 years with median diameter 6.3 cm and 157 EVAR (148 males, 9 females) with median age 75 years with median diameter 6.1 cm. Mortality was 13 (4%) for OR and 5 (3.2%) for EVAR (three of whom were in the UK EVAR 2 trial). Blood loss was significantly less for EVAR 500 ml vs. 1500 ml for OR. Sixty‐five (19.8%) patients with OR had significantly more peri‐operative complications compared with 14 (8.9%) with EVAR. The length of stay in hospital was significantly less for EVAR. This non‐randomised study shows that although EVAR does not have a statistically significantly lower mortality, it does have statistically significantly lower complication rates compared with OR. EVAR can be achieved with good primary success, but long‐term follow‐up is essential to assess durability.

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Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms: A Valuable Alternative?—Case Report and Review of Literature

Cited by 21 publications

References 26 publications

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

The care of patients with an abdominal aortic aneurysm: The Society for Vascular Surgery practice guidelines

Inflammatory Abdominal Aortic Aneurysm Endovascular Repair into the Long-Term Follow-Up

Large infra-renal abdominal aortic aneurysms: endovascular vs. open repair - single centre experience

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