Incidence of Post-Implantation Syndrome with Different Endovascular Aortic Aneurysm Repair Modalities and Devices and Related Etiopathogenetic Implications

Martinelli, Ombretta; Girolamo, Alessia Di; Belli, Cristina; Gattuso, Roberto; Baratta, Francesco; Gossetti, Bruno; Alunno, Alessia; Irace, L

doi:10.1016/j.avsg.2019.08.095

Cited by 11 publications

(9 citation statements)

References 21 publications

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“…The published literature on the performance of the AFX2 endograft is limited [5][6][7][8][9], but a recent publication by Chang et al (2021) [10] which reported a single integrated healthcare system experience of AFX and AFX2, suggested that the AFX2 endograft was associated with a high rate of adverse clinical events during follow up. The present study was designed to evaluate the outcomes derived by the AFX2 endograft in a series of patients from multiple centers in the USA.…”

Section: Introductionmentioning

confidence: 99%

Midterm outcomes of 455 patients receiving the AFX2 endovascular graft for the treatment of abdominal aortic aneurysm: A retrospective multi-center analysis

et al. 2021

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Since being introduced into clinical practice the AFX family of endografts has undergone labelling updates, design and manufacturing changes to address a Type III failure mode. The published literature on the performance of the current endograft–AFX2 –is limited to small series with limited follow up. The present study reports the largest series of patients implanted with AFX2 for the treatment of abdominal aortic aneurysms. The study was a retrospective, 5 center study of patients receiving an AFX2 endograft from January 2016 until Dec 2020. Electronic case report forms were provided to four of the centers, with one additional site providing relevant outcomes in an independent dataset. Relevant outcomes were reported via Kaplan-Meier analysis and included all-cause mortality, aneurysm-related mortality, post EVAR aortic rupture, open conversion, device related reinterventions and endoleaks. Among a cohort of 460 patients, 405 underwent elective repair of an AAA, 50 were treated for a ruptured AAA, and 5 were aorto-iliac occlusive disease cases. For the elective cohort (mean age 73.7y, 77% male, mean AAA diameter 5.4cm), the peri-operative mortality was 1.7%. Freedom from aneurysm-related mortality was 98.2% at 1,2,3 and 4 years post-operatively, there were no post-operative aortic ruptures, and 2 patients required open conversion. Freedom from Type Ia endoleaks was 99.4% at 1, 2, 3 and 4 years. Freedom from Type IIIa and Type IIIb endoleaks were 100% and 100% (year 1), 100% and 99.6% (year 2), 99.4% and 99.6% (year 3), 99.4% and 99.6% (year 4) respectively. Freedom from all device-related reintervention (including Type II endoleaks) at 4 y was 86.8%. The AFX2 endograft appears to perform to a satisfactory standard in terms of patient centric outcomes in mid-term follow up. The Type Ia and Type III endoleaks rates at 4y appear to be within acceptable limits. Further follow up studies are warranted.

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Section: Introductionmentioning

confidence: 99%

Midterm outcomes of 455 patients receiving the AFX2 endovascular graft for the treatment of abdominal aortic aneurysm: A retrospective multi-center analysis

et al. 2021

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“…Los pacientes con diagnóstico de SPI presentan una probabilidad 4 veces mayor de sufrir un evento cardiovascular o evento adverso 26 , por cada día El SPI conduce a una recuperación posoperatoria más exigente, aumentando la morbilidad cardiovascular, readmisión y estancia hospitalaria, con los correspondientes riesgos y costos asociados, en consecuencia podría considerarse una complicación de la reparación aórtica endovascular.…”

Section: Discussionunclassified

Síndrome postimplantación en la reparación aórtica endovascular.

2021

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Introducción: El síndrome postimplantación es un trastorno frecuente, producido en el postoperatorio inmediato posterior al tratamiento endovascular de la enfermedad aórtica, caracterizado por la presencia de anorexia, dolor lumbar, leucocitosis, fiebre y elevación de la proteína C reactiva, asociado ocasionalmente a disminución del recuento de plaquetas o alteración de la coagulación.Objetivo: Determinar la incidencia y morbilidad asociada al síndrome postimplantación, posterior a la reparación endovascular de la patología aórtica.Materiales y Método: Estudio observacional y descriptivo, donde se analiza la presencia del síndrome post implantación en pacientes sometidos a Reparación endovascular torácica aórtica (TEVAR) y Reparación endovascular de aneurisma (EVAR), durante un período de 10 años (2009 al 2019), en el Hospital Dr. Eduardo Pereira de Valparaíso, Chile.Resultados: Se incluyeron 112 reparaciones endovasculares, 72,32% correspondientes a EVAR y 27,68% a TEVAR, incidencia del síndrome post implantación (17,85%), factores de riesgo asociados: edad ≤ 75 años, uso de endoprótesis compuesta por poliester, recubrimiento aórtico ≥ 20cm y tiempo quirúrgico >180 min; (p<0,05), evidenciando en este grupo de pacientes mayor readmisión, estancia hospitalaria y morbilidad cardiovascular (p<0,05).Discusión: El síndrome post implantación conduce a una recuperación postoperatoria más exigente, aumentando la morbilidad cardiovascular, readmisión y estancia hospitalaria, con los correspondientes riesgos y costos asociados, en consecuencia podría considerarse una complicación de la reparación aórtica endovascular.Conclusión: La respuesta inflamatoria puede ser intensa posterior a la reparación endovascular de la aorta, el grupo de pacientes que desarrolla este síndrome, amerita una estrecha vigilancia, con énfasis durante el primer mes de post operatorio.

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“…PIS is a known entity after aortic endovascular aneurysm repair (EVAR); however, to our knowledge, there is no literature regarding its occurrence in patients undergoing endovascular stent placement for TICAP. 5,6 This case report describes the development of PIS in a young female patient after endovascular treatment of a TICAP.…”

Section: Introductionmentioning

confidence: 94%

Postimplantation Syndrome after Traumatic Internal Carotid Artery Pseudoaneurysm Repair with Stent

Romanelli,

Langone,

Vicinanza

et al. 2024

J Neuroanaesth Crit Care

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Endovascular repair of traumatic internal carotid artery pseudoaneurysm (TICAP) with covered stents represents a safe treatment with few complications. However, the presence of foreign material used to treat TICAP and blood clots in the excluded pseudoaneurysms can trigger an acute systemic inflammatory response syndrome called postimplantation syndrome (PIS). To the best of our knowledge, PIS is described only after abdominal aortic endovascular aneurysm repair. Here, we report the case of PIS in a young, healthy, polytraumatized female patient with TICAP treated with endovascular covered stent.

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Incidence of Post-Implantation Syndrome with Different Endovascular Aortic Aneurysm Repair Modalities and Devices and Related Etiopathogenetic Implications

Cited by 11 publications

References 21 publications

Midterm outcomes of 455 patients receiving the AFX2 endovascular graft for the treatment of abdominal aortic aneurysm: A retrospective multi-center analysis

Midterm outcomes of 455 patients receiving the AFX2 endovascular graft for the treatment of abdominal aortic aneurysm: A retrospective multi-center analysis

Síndrome postimplantación en la reparación aórtica endovascular.

Postimplantation Syndrome after Traumatic Internal Carotid Artery Pseudoaneurysm Repair with Stent

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