Outcomes for concomitant common iliac artery aneurysms after endovascular abdominal aortic aneurysm repair

Bannazadeh, Mohsen; Jenkins, Christina; Forsyth, Andrew; Kramer, Jason; Aggarwal, Ankur; Somerset, Amy; Bove, P; Long, Graham W.

doi:10.1016/j.jvs.2017.02.058

Cited by 24 publications

(23 citation statements)

References 21 publications

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“…It is of interest to note that the study detected a greater tendency in men to dilation of arteries as age advances, such as the abdominal aorta and RCIA, as has been suggested before in other studies. [17][18][19][20][21][22] The SMA also exhibited greater changes in angle and diameter in men. The lesser predisposition towards changes in arterial anatomy among women may be related to the role played by estrogen, 6,9,22 which increases the bioavailability of nitric oxide (NO) without increasing expression and/or activity of endothelial nitric oxide-synthase (eNOS), which has antioxidant properties that may induce or accelerate vascular aging.…”

Section: Discussionmentioning

confidence: 92%

“…5,12,15,22,25 Arterial changes over the course of life are also influenced by modifiable cardiovascular risk factors, such as hypertension, obesity, smoking, and lifestyle, and also by unmodifiable factors, such as genetics, age, and family history. 15,16,21 It is known that aortic rigidity increases after 50 years of age even in healthy patients 7,26 and postmortem studies show that thickening of the aorta wall during aging occurs through increased tunica intima thickness, even in populations with low incidence of atherosclerosis. 7,8,10,15,17 Anatomically, these changes do not only manifest as increased diameter, but also as aortic elongation, and, from a physiological point of view, arterial thickening, which is related to pulse wave velocity, and has been shown to be an independent risk factor for cardiovascular events.…”

Section: Discussionmentioning

confidence: 99%

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Sexo e idade e sua influência sobre a anatomia da aorta abdominal e seus ramos

et al. 2020

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Resumo Contexto Não se sabe ao certo como a idade e o sexo do paciente influenciam na anatomia da aorta abdominal e de seus ramos. Objetivos Determinar os padrões anatômicos (diâmetro e angulações) mais frequentes da aorta abdominal e de seus ramos e a influência do sexo e da idade dos pacientes sobre esses padrões. Métodos Foram avaliadas tomografias computadorizadas de abdome com contraste endovenoso de 157 pacientes. Foram aferidos calibre e angulação de artérias abdominais em indivíduos de ambos os sexos, agrupados em cinco faixas etárias: 20 a 30 anos, 31 a 40 anos, 41 a 50 anos, 51 a 60 anos e 61 a 70 anos. Foram analisadas 18 variáveis: seis ângulos de emergências arteriais, nove diâmetros arteriais, taxas de dilatação, sexo e faixa etária. Para a obtenção das medidas, utilizou-se o programa de computador RadiAnt 4.2.1 DICOM viewer (Medixant, Poznan, Polônia). Resultados Entre as 157 tomografias, 69 eram de homens e 88, de mulheres. Apresentaram diferença estatística (p < 0,05): ângulo de origem e diâmetro da artéria mesentérica superior; ângulo e diâmetro das artérias renais; diâmetro das artérias ilíacas comuns; diâmetro e taxa de dilatação em diversos segmentos da aorta, exceto na porção proximal ao tronco celíaco. Conclusões Os diâmetros da aorta (em diversos segmentos) e de seus ramos (exceto da artéria renal esquerda) aumentam progressivamente com o passar da idade em ambos os sexos e são maiores e possuem taxa de dilatação mais elevada em homens do que em mulheres da mesma faixa etária. Entre os sexos, o ângulo de emergência da artéria mesentérica superior foi maior em homens, exceto entre 20 e 30 anos; o ângulo de origem da artéria renal esquerda foi maior em mulheres entre 51 e 60 anos.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Sexo e idade e sua influência sobre a anatomia da aorta abdominal e seus ramos

et al. 2020

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“…Furthermore, the presentation and treatment of aortic aneurysms have been changing . Endovascular techniques have become accepted practice for the management of aneurysmal disease . This change may confound comparisons of LTS estimates as treatments may be offered to those persons who are less fit .…”

Section: Introductionmentioning

confidence: 99%

“…12 Endovascular techniques have become accepted practice for the management of aneurysmal disease. 12,13 This change may confound comparisons of LTS estimates as treatments may be offered to those persons who are less fit. 14 In addition, population surveillance for AAA may identify persons earlier in the natural history of the disease and may likely influence LTS following intervention.…”

Section: Introductionmentioning

confidence: 99%

Long‐term survival following successful abdominal aortic aneurysm repair evaluated using Australian administrative data

Purkiss

Keegel

Vally

et al. 2019

ANZ Journal of Surgery

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Background Long‐term survival (LTS) following abdominal aortic aneurysm (AAA) surgery is an outcome that can compare open surgical repair (OSR) and endovascular AAA repair (EVAR) methods. We examined the LTS of persons following successful AAA repair using administrative health data covering the Australian Pharmaceutical Benefits and Medicare Benefits Schemes from 1993 to 2014. Methods Participants undergoing AAA surgery were identified using procedure codes and the last service provision date used as a proxy mortality marker. LTS and relative survival with control populations in those who survived the initial post‐operative period were used to compare OSR and EVAR and estimates between the first and second halves of the study. Results A total of 2060 persons who had undergone AAA repair were identified. Overall median LTS (95% CI) following elective, ruptured OSR and EVAR were 10.4 (9.1–11.0), 8.5 (6.7–10.3) and 9.7 (8.1–11.3) years, respectively. Relative survival rates at 5 and 10 years were 0.89 and 0.7 for OSR and 0.87 and 0.66 for EVAR. LTS rates were similar for OSR and EVAR in age groups 65–84 years (EVAR/OSR range 0.96–1.16); however, EVAR was superior to OSR in persons aged >85 years at 5 years (EVAR/OSR 1.32, log‐rank P < 0.05). Relative survival following all techniques of AAA repair showed no significant change over the duration of the study. Conclusion LTS following AAA repair was heterogeneous in comparison with control populations and varied with age and procedure. The 5‐year LTS following EVAR in persons aged >85 years is superior to OSR. Administrative data can define long‐term outcomes following aortic aneurysm surgery and may complement data already collected by surgeons.

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“… 1 , 2 Concomitant abdominal aortic aneurysm and common iliac artery (CIA) aneurysm is common; the incidence has been reported to be between 16% and 40%. 3 , 4 , 5 The use of an IBD has been shown to be an effective treatment option for iliac aneurysms, including for patients with challenging anatomies. 6 Complex aortic and iliac anatomy as graded by the anatomic severity grade has been shown to be associated with increased complications, resource utilization, and mortality.…”

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confidence: 99%

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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Outcomes for concomitant common iliac artery aneurysms after endovascular abdominal aortic aneurysm repair

Cited by 24 publications

References 21 publications

Sexo e idade e sua influência sobre a anatomia da aorta abdominal e seus ramos

Sexo e idade e sua influência sobre a anatomia da aorta abdominal e seus ramos

Long‐term survival following successful abdominal aortic aneurysm repair evaluated using Australian administrative data

Customized endovascular repair of common iliac artery aneurysms

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