Parallel Covered Stents Technique in the Treatment of Abdominal Aortic Diseases

Yao, Chen; Ning, Junjie; Li, Zilun; Wang, Mian; Wu, Ridong; Wang, Shenming; Chang, Guangqi

doi:10.1016/j.jvir.2019.09.022

Cited by 4 publications

(1 citation statement)

References 16 publications

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“…For patients appropriate for endovascular repair, aortography was performed to determine the primary entry tear site, and the location and extent of the dissection. Endovascular repair including standard EVAR, EVAR with chimney technique to reconstruct visceral arteries, straight stent graft to cover the tears, kissing stent graft technique (16), and hybrid strategy was applied to individual patients depending on the anatomical features. Patients without surgical indications were treated with conservative therapy including strict control of blood pressure and heart rate.…”

Section: Treatment Strategymentioning

confidence: 99%

Clinical characteristics and therapeutic strategy for patients with spontaneous isolated abdominal aortic dissection

Zhao,

Liu,

Liu

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveSpontaneous isolated abdominal aortic dissection (SIAAD) is a rare aortic emergency and not yet fully understood. This study aims to report the characteristics and treatments of 31 patients with SIAAD in the past 12 years.MethodsA total of 31 consecutive patients with SIAAD between 2010 and 2022 were included. The clinical manifestations, treatment strategies, and outcomes were reviewed. Following the SVS/STS reporting standard, we compared the clinical characteristics with different locations of primary entry, or different numbers of dissected zones. Furthermore, we compared the effects of surgical and conservative therapies on the outcome during the follow-up.ResultsAmong the 31 patients with SIAAD, 16 (51.6%) were in the acute phase on admission. The primary entry of SIAAD was mainly located in Zone 9 (67.7%). Most patient presented with dissection involving 1 or 2 aortic zones (61.3%). In addition, 35.5% and 64.5% of SIAADs involved the visceral and iliac arteries, respectively. Compared with asymptomatic SIAADs, the symptomatic ones had longer dissection lengths (P = 0.008) and tended to involve iliac artery more frequently (P = 0.098). There were differences in the number of dissected aortic zones (P = 0.005) among patients with primary entry located in Zone 5 (Supraceliac aorta), Zone 6–8 (Paravisceral aorta) and Zone 9 (Infrarenal aorta). The involvement of visceral artery (P = 0.039) and iliac artery (P = 0.006) was significantly different between the subgroups of SIAAD involving one, two, and three or more aortic zones. The cumulative incidence of adverse false lumen progression events was significantly lower (P = 0.000) and the rate of false lumen thrombogenesis or disappearance was higher in patients receiving surgery (P = 0.001). The cumulative all-cause mortality was 9.7% at 1-year, and 19.7% at 5-year, with no significant difference between surgical and conservative therapies.ConclusionsClinical features of SIAAD vary depending on the location of the primary entry and the number of dissected aortic zones. Although surgery was not associated with a lower all-cause mortality compared with conservative therapy, it was associated with a lower incidence of adverse false lumen progression and a higher rate of aortic remodeling.

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Section: Treatment Strategymentioning

confidence: 99%

Clinical characteristics and therapeutic strategy for patients with spontaneous isolated abdominal aortic dissection

Zhao,

Liu,

Liu

et al. 2023

Front. Cardiovasc. Med.

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Outcomes of endovascular repair of infrarenal penetrating aortic ulcers

Hatzl

Behrendt

Schmitz‐Rixen

et al. 2023

Vasa

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Summary: Background: To report technical success as well as perioperative outcomes of patients who underwent endovascular aortic repair (EVAR) of penetrating abdominal aortic ulcers ≤35 mm in diameter (PAU). Patients and methods: The abdominal aortic aneurysm (AAA) quality registry of the German institute for vascular research (DIGG) was used to identify patients with standard EVAR for infrarenal PAU ≤35 mm between 1/1/2019 and 12/31/2021. Infectious, traumatic, inflammatory PAUs, PAUs associated with connective tissue disease, PAUs following aortic dissection as well as true aneurysms were excluded. Demographics, cardiovascular comorbidity, technical success as well as perioperative morbidity and mortality were determined. Results: Amongst 11 537 patients who underwent EVAR during the study period, 405 with PAU ≤35 mm were eligible from 95 participating hospitals across Germany (22% women, 20.5% octogenarians). The median aortic diameter was 30 mm (Interquartile range 27–33). Cardiovascular comorbidities were frequent with coronary artery disease (34.8%), chronic heart failure (30.9%), history of myocardial infarction (19.8%), hypertension (76.8%), diabetes (21.7%), smoking (20.8%), history of stroke (9.4%), symptomatic lower extremity peripheral arterial disease (20%), chronic kidney disease (10.4%) and chronic obstructive pulmonary disease (9.6%). Most patients were asymptomatic (89.9%). Among the symptomatic patients, 13 presented with distal embolization (3.2%) and 3 with contained ruptures (0.7%). Technical success of endovascular repair was 98.3%. Both, percutaneous (37.1%) or femoral cut-down access approaches (58.5%) were registered. Endoleaks of any type were present with type 1 (0.5%), type 2 (6.4%) and type 3 (0.3%) endoleaks. Overall mortality was 0.5%. Perioperative complications occurred in 12 patients (3.0%). Conclusions: According to this registry data, endovascular repair of PAU is technically feasible with acceptable perioperative outcomes, but further studies investigating mid- and long-term data are needed before invasive treatment of PAU disease in an elderly and comorbid patient population should be recommended.

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Upside-down and kissing stent graft techniques for late extravasation of a prosthetic graft implanted in the abdominal aorta

Masuyama¹,

Azuma

Inoue³

et al. 2020

Interactive CardioVascular and Thoracic Surgery

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Extravasation of prosthetic grafts is rare. Various anatomical problems after graft replacement might make standard endovascular treatment difficult. Use of a commercially available main body requires an adequate distance of the flow divider. An 86-year-old man developed extravasation of a graft that had been implanted in the infrarenal abdominal aorta 24 years previously. Endovascular repair with upside-down and kissing stent graft techniques using the contralateral leg was successfully performed.

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Parallel Covered Stents Technique in the Treatment of Abdominal Aortic Diseases

Cited by 4 publications

References 16 publications

Clinical characteristics and therapeutic strategy for patients with spontaneous isolated abdominal aortic dissection

Clinical characteristics and therapeutic strategy for patients with spontaneous isolated abdominal aortic dissection

Outcomes of endovascular repair of infrarenal penetrating aortic ulcers

Upside-down and kissing stent graft techniques for late extravasation of a prosthetic graft implanted in the abdominal aorta

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