Rupture of Infra-renal Aortic Aneurysm after Endovascular Repair: A Series from EUROSTAR Registry

Fransen, Gerdine A. J.; Vallabhaneni, S. Rao; Marrewijk, C.J. van; Laheij, R.J.F.; Harris, Peter L.; Buth, Jacob

doi:10.1016/s1078-5884(03)00350-2

Cited by 178 publications

(160 citation statements)

References 9 publications

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“…Thus, the association of type I endoleaks with an increased aneurysm rupture risk is a strong recommendation for treatment. 17,18 In such cases, an open aortic repair is generally performed in EVAR failure, despite a high mortality of up to 22%. 19 However, advanced age, suprarenal or supraceliac aortic clamping, and the technical challenge of endograft removal (stent incorporation into the aortic wall, presence of external stents or barbs, and periaortic inflammation) expose the patients to a high surgical risk, especially in the nonelective setting.…”

Section: Discussionmentioning

confidence: 99%

A 12-Year Experience With Chimney and Periscope Grafts for Treatment of Type I Endoleaks

et al. 2015

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PURPOSE: To evaluate the midterm outcomes of chimney and/or periscope grafts (CPGs) in patients presenting type I endoleak after a previous endovascular aneurysm repair (EVAR). METHODS: Between June 2002 and April 2014, 24 consecutive patients (mean age 73.9±9.2 years; 23 men) presenting a type I endoleak were addressed with CPGs to extend the proximal and/or distal landing zone and to maintain side branch perfusion. Indication for treatment was a type Ia endoleak in 23 (96%) patients and a type Ib endoleak in one. Median interval from the previous EVAR to endoleak treatment with CPGs was 52.2±48.9 months (range 0.2-179). All patients had proximal/distal landing zones precluding any standard endovascular reintervention. Measured outcomes included technical success and perioperative mortality and morbidity. Technical success was defined as a procedure completed as intended, with no secondary procedures within 30 days. Midterm outcomes included survival, CPG patency, endoleaks, and freedom from reintervention. RESULTS: Technical success was 96%; a single patient required an additional procedure to seal a recurrent type Ia endoleak. Intraoperative revascularization of all 55 target vessels (2.3/patient) with CPGs was successful. One (4%) patient died within 30 days. Estimated survival at 12, 24, and 36 months was 83%; estimated CPG patency at the same intervals was 94%. Over a mean follow-up of 23.4±29 months, 6 (25%) reinterventions were performed; of these, 4 were secondary to type I endoleak. Aneurysm diameters reduced from 88.3±26 to 85.5±33 mm (p=0.49) over the mean follow-up. CONCLUSION: The CPG technique is a safe and effective tool for treatment of type I endoleak after previous EVAR. The CPG technique is feasible even in nonelective patients, with excellent outcomes in terms of patency. Close imaging follow-up is warranted to rule out recurrent or de novo endoleaks.

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Section: Discussionmentioning

confidence: 99%

A 12-Year Experience With Chimney and Periscope Grafts for Treatment of Type I Endoleaks

et al. 2015

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“…An endovascular device or Dacron bypass are fitted exactly to the aortic size, but if aortic size changes with time, particularly at the anastomosis sites, then late leaks and rupture can occur. 5,22 It is important to apply the findings of this study not only to the surveillance of small aneurysms, but also postoperative follow-up, particularly after endovascular repair. Patients need to appreciate that the durability of AAA repair could be threatened if they continue to smoke and the dilatation process continues.…”

Section: Brady Et Al Abdominal Aortic Aneurysm Expansionmentioning

confidence: 99%

Abdominal aortic aneurysm expansion: Risk factors and time intervals for surveillance

Brady¹,

Thompson²,

Fowkes³

et al. 2004

ACC Current Journal Review

210

360

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on behalf of the UK Small Aneurysm Trial Participants Background-Intervention to reduce abdominal aortic aneurysm (AAA) expansion and optimization of screening intervals would improve current surveillance programs. The aim of this study was to characterize AAA growth in a national cohort of patients with AAA both overall and by cardiovascular risk factors. Methods and Results-In this study, 1743 patients were monitored for changes in AAA diameter by ultrasonography over a mean follow-up of 1.9 years. Mean initial AAA diameter and growth rate were 43 mm (range 28 to 85 mm) and 2.6 mm/year (95% range, Ϫ1.0 to 6.1 mm/year), respectively. Baseline diameter was strongly associated with growth, suggesting that AAA growth accelerates as the aneurysm enlarges. AAA growth rate was lower in those with low ankle/brachial pressure index and diabetes but higher for current smokers (all PϽ0.001). No other factor (including lipids and blood pressure) was associated with AAA growth. Intervals of 36, 24, 12, and 3 months for aneurysms of 35, 40, 45, and 50 mm, respectively, would restrict the probability of breaching the 55-mm limit at rescreening to below 1%. Conclusions

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“…6 Although the development of renal and mesenteric fenestration or branched stent graft technology to extend the landing zone more proximally may overcome type 1a endoleaks, these devices may not be ideal because of regulations, complexity, and manufacturing delays. 7 In addition, contemporary published literature does not provide sufficiently strong evidence to warrant a change in treatment guidelines for juxtarenal or short-neck aneurysm.…”

Section: 血管腔內主動脈瘤修復過程中使用近端修復 Palmaz支架置入來阻止血管滲漏的成效mentioning

confidence: 99%

Effectiveness of proximal intra-operative salvage Palmaz stent placement for endoleak during endovascular aneurysm repair

2016

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Rupture of Infra-renal Aortic Aneurysm after Endovascular Repair: A Series from EUROSTAR Registry

Cited by 178 publications

References 9 publications

A 12-Year Experience With Chimney and Periscope Grafts for Treatment of Type I Endoleaks

A 12-Year Experience With Chimney and Periscope Grafts for Treatment of Type I Endoleaks

Abdominal aortic aneurysm expansion: Risk factors and time intervals for surveillance

Effectiveness of proximal intra-operative salvage Palmaz stent placement for endoleak during endovascular aneurysm repair

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