Risk factors for target vessel endoleaks after physician-modified fenestrated or branched endovascular aortic repair for postdissection thoracoabdominal aortic aneurysms

Chen, Zhipeng; Liu, Zhao; Cai, Jun; Liu, Cheng; Li, Zhigao; Liu, Heqian; Mamateli, Subinur; Lv, Xiaochen; Liu, Chen; Feng, Ru; Wang, Wei; Zhang, Ming; Li, Xiaoqiang; Qiao, Tiankui

doi:10.1016/j.jvs.2022.10.012

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…During follow-up, when compared with patients with degenerative TAAAs, endoleaks were more frequent in post-dissection patients, but overall survival and freedom from aorta-related deaths were similar. This is consistent with the findings of a recent retrospective study showing higher rates of target artery-related endoleaks in chronic dissections compared with degenerative TAAAs [98].…”

Section: Chronic Dissectionssupporting

confidence: 92%

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Cochennec,

Couture,

Chiche

2023

JCM

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The optimal surgical treatment for extended thoracoabdominal aortic aneurysms (TAAAs) is still a matter of debate. The historical treatment is open repair (OR), but over the past fifteen years, endovascular strategies have gained widespread acceptance. Although several endovascular techniques have been described for the treatment of TAAAs, fenestrated and branched stent grafts (F/BEVARs) are the most frequently used and best documented. They have become the first-line treatment for both high- and moderate-risk surgical patients in most vascular centers. However, no randomized study comparing OR and F/BEVAR has been published, and decision-making is mainly based on the physician’s preference and/or hospital expertise. The objective of this manuscript is to provide an overview of current comparative data for OR and F/BEVAR.

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Section: Chronic Dissectionssupporting

confidence: 92%

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Cochennec,

Couture,

Chiche

2023

JCM

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“…Expression (Chen et al, 2023) and Expression (Teng et al, 2022) are the indirect and direct solutions of total EL in the aorta, respectively. The two parts should have the same value.…”

Section: Component Quantification Of Energy Lossmentioning

confidence: 99%

“…The most serious result of AAA is aneurysm rupture, with an overall mortality rate of 70%-90% (Assar and Zarins, 2009;Sakalihasan et al, 2018). Moreover, intraluminal thrombus (ILT) within AAA is another high-risk complication which has the risk of detachment, resulting in serious consequences such as acute lower extremity arterial embolization (Patel et al, 1994;Sakalihasan et al, 2018;Chen et al, 2023). Thus, it is necessary to evaluate the risk of thrombosis and rupture, and to intervene in advance.…”

Section: Introductionmentioning

confidence: 99%

A hemodynamic analysis of energy loss in abdominal aortic aneurysm using three-dimension idealized model

Wang,

Jiang,

Zhang

et al. 2024

Front. Physiol.

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Objective: The aim of this study is to perform specific hemodynamic simulations of idealized abdominal aortic aneurysm (AAA) models with different diameters, curvatures and eccentricities and evaluate the risk of thrombosis and aneurysm rupture.Methods: Nine idealized AAA models with different diameters (3 cm or 5 cm), curvatures (0° or 30°) and eccentricities (centered on or tangent to the aorta), as well as a normal model, were constructed using commercial software (Solidworks; Dassault Systemes S.A, Suresnes, France). Hemodynamic simulations were conducted with the same time-varying volumetric flow rate extracted from the literature and 3-element Windkessel model (3 EWM) boundary conditions were applied at the aortic outlet. Several hemodynamic parameters such as time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), endothelial cell activation potential (ECAP) and energy loss (EL) were obtained to evaluate the risk of thrombosis and aneurysm rupture under different conditions.Results: Simulation results showed that the proportion of low TAWSS region and high OSI region increases with the rising of aneurysm diameter, whereas decreases in the curvature and eccentric models of the corresponding diameters, with the 5 cm normal model having the largest low TAWSS region (68.5%) and high OSI region (40%). Similar to the results of TAWSS and OSI, the high ECAP and high RRT areas were largest in the 5 cm normal model, with the highest wall-averaged value (RRT: 5.18 s, ECAP: 4.36 Pa−1). Differently, the increase of aneurysm diameter, curvature, and eccentricity all lead to the increase of mean flow EL and turbulent EL, such that the highest mean flow EL (0.82 W · 10−3) and turbulent EL (1.72 W · 10−3) were observed in the eccentric 5 cm model with the bending angle of 30°.Conclusion: Collectively, increases in aneurysm diameter, curvature, and eccentricity all raise mean flow EL and turbulent flow EL, which may aggravate the damage and disturbance of flow in aneurysm. In addition, it can be inferred by conventional parameters (TAWSS, OSI, RRT and ECAP) that the increase of aneurysm diameter may raise the risk of thrombosis, whereas the curvature and eccentricity appeared to have a protective effect against thrombosis.

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The Current State of Physician-Modified Endovascular Grafts in Complex Abdominal Aortic Aneurysms

Neves,

Kanitra,

Malgor

et al. 2024

The American Journal of Cardiology

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Risk factors for target vessel endoleaks after physician-modified fenestrated or branched endovascular aortic repair for postdissection thoracoabdominal aortic aneurysms

Cited by 4 publications

References 19 publications

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

Comparison of Immediate, Medium, and Long-Term Postoperative Results of Open Surgery and Fenestrated/Branched Stent Grafts for Extended Thoracoabdominal Aortic Aneurysms

A hemodynamic analysis of energy loss in abdominal aortic aneurysm using three-dimension idealized model

The Current State of Physician-Modified Endovascular Grafts in Complex Abdominal Aortic Aneurysms

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