Trends and outcomes in endovascular and open surgical treatment of visceral aneurysms

Chin, Jason A.; Heib, Adele; Chaar, Cassius Iyad Ochoa; Cardella, Jonathan; Orion, Kristine C.; Sarac, Timur P.

doi:10.1016/j.jvs.2017.02.036

Cited by 11 publications

(4 citation statements)

References 9 publications

(16 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After reviewing the titles and abstracts, 3873 studies were excluded, with 616 studies retained for further detailed evaluation. Based on the inclusion and exclusion criteria, 595 studies were excluded, leaving 21 ( n = 21) cohort studies 11–15,17–32 reporting clinical data of interest and meeting the inclusion criteria (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

Improved outcomes from endovascular aortic repair in younger patients: Towards improved risk stratification

et al. 2019

View full text Add to dashboard Cite

Objectives Abdominal aortic aneurysms are conventionally treated by open repair surgery. While endovascular aortic repair improves survival in high-risk patients, younger patients (40–65 years) potentially at lower risk with asymptomatic abdominal aortic aneurysms undergoing endovascular aortic repair usually have poorer post-operative outcomes and require longer term follow-up. In this study, clinical data on younger patients were analyzed to investigate whether endovascular aortic repair leads to poorer short- and long-term outcomes. Methods This was a systematic review and meta-analysis of articles comparing clinical outcomes in patients aged 40–65 years undergoing open repair or endovascular aortic repair and published between 2000 and 2017. In-hospital mortality, long-term mortality, and post-operative complication data were retrieved from eligible studies and clinical outcomes were compared. Twenty-one retrospective cohort analyses were included, accounting for 250,837 patients (149,051 endovascular aortic repair; 101,786 open repair). Risk ratios were pooled using the DerSimonian and Laird random effects model. All statistical analyses were performed in Review Manager 5.3. Results Younger patients with asymptomatic abdominal aortic aneurysms undergoing endovascular aortic repair had a significantly reduced 30-day mortality (odds ratio (OR) = 0.40, 95% confidence intervals (CI) 0.28–0.57; p < 0.00001), long-term mortality (OR = 0.37, 95% CI 0.17–0.82; p = 0.01), incidence of reintervention (OR = 0.47, 95% CI 0.34–0.66; p < 0.0001), and incidence of renal failure (OR = 1.58, 95% CI 1.37–1.82; p < 0.00001). Conclusions Endovascular aortic repair may improve short- and long-term survival and reduce post-operative complications in younger patients with asymptomatic abdominal aortic aneurysms.

show abstract

Section: Resultsmentioning

confidence: 99%

Improved outcomes from endovascular aortic repair in younger patients: Towards improved risk stratification

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Advantages of endovascular techniques are their minimally invasive nature, shorter recovery time, and lower risk of morbidity and death 8 . However, TAE may not always be technically feasible because of difficulties in selective cannulation of feeding vessels of the aneurysm and may lack durability due to refilling of the aneurysm from collateral 32,33 …”

Section: Discussionmentioning

confidence: 99%

Aneurysms of pancreaticoduodenal arcade: Clinical profile and endovascular strategies

et al. 2020

View full text Add to dashboard Cite

Background and Aim: Pancreaticoduodenal arcade aneurysms (PDAAs) are uncommon lesions associated with a significant risk of rupture and mortality. This study describes the etiology, clinical presentation, and endovascular management strategies of PDAAs across a spectrum of indications. Methods: The clinical records of patients with PDAAs referred for endovascular management from January 2018 till November 2019 were retrospectively reviewed. Data on presenting symptoms, associated etiologies, and outcomes after endovascular treatment were collected and studied. Results: We found 15 patients with false and 1 patient with true aneurysm of pancreatoduodenal arcade (PDA). The associated conditions were coeliac artery stenosis, severe necrotizing pancreatitis, and chronic pancreatitis or iatrogenic (postendoscopic papillotomy and percutaneous metallic biliary stenting). The main presenting feature was gastrointestinal bleed, while 2 patients had abdominal pain and 1 had gastric outlet obstruction. A multiphase computed tomography scan demonstrated the ruptured aneurysm in all patients. Site of origin of PDAA influenced the choice of transarterial endovascular strategy (coiling for aneurysms of main trunk of arteries and glue injection for those arising from small arterial branches). This was carried out in an emergency setting for 12 patients and as an elective procedure in 4 patients. Technical success was demonstrated in all patients and clinical success in 14. The two patients who had rebleed were salvaged by repeat endovascular procedure. Postembolization syndrome was seen in three patients. Conclusions: With advancing technology, endovascular strategies continue to evolve. Careful attention to ensure hemodynamic resuscitation and stability, correction of preexisting coagulopathy and attention to technique can lead to the possibility of endovascular approaches as a dependable option in the management of ruptured PDAAs.

show abstract

“…The option of intervention method relied on aneurysm anatomy, patient's general condition, and surgeon preferences. Recently, the advantage of endovascular management on low perioperative morbidity and mortality is widely accepted [5,7,10] . In general, endovascular interventions have…”

Section: Interventionmentioning

confidence: 99%

“…Endovascular repair becomes increasingly popular in the field of vascular surgery because it is safe, effective, and less invasive. Chin et al's population-based evaluation in the management of visceral aneurysm demonstrated that endovascular management compared with open repair is associated with decreased mortality and complications and shorter hospital days [10] . They further recommended this method as the first alternative option.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Endovascular and Surgical Management of Intact Splenic Artery Aneurysm

Zhu

Zhao

Yuan

et al. 2019

Annals of Vascular Surgery

View full text Add to dashboard Cite

This study aims to reveal the experience with endovascular and surgical management of intact splenic artery aneurysms in our single center. MethodBetween January 2011 and June 2017, 42 patients with intact splenic artery aneurysm were enrolled in this study. Twenty patients undergoing surgical intervention were classified as the surgical group, and twenty-two patients who received endovascular repair were categorized as the endovascular group. Demographic data, preoperative comorbidities, and aneurysm anatomical characteristics were collected and analyzed. Details of interventions, perioperative outcomes, and follow-up resultswere evaluated and compared between the two groups. ResultsForty-two patients with a mean age of 53.4±11.6 years were enrolled in this study, and 44 aneurysms were repaired. Thirty-nine (92.9%) patients were asymptomatic, and three (7.1%) patients were symptomatic. The diameter of splenic artery aneurysms was 3.3±1.6 cm, and the shape was mostly saccular. In the surgical group, the common methods used were splenic artery aneurysm resection (nine patients), followed by splenic artery aneurysms resection and splenectomy (six patients), splenic artery aneurysm resection and arterial reconstruction with end-to-end ACCEPTED MANUSCRIPT invasive accompanied with an obvious decrease in surgery time and rapid recovery with a short hospital time.

show abstract

Trends and outcomes in endovascular and open surgical treatment of visceral aneurysms

Abstract: Endovascular VAA repairs are increasing. Despite patients' having worse comorbidities and more nonelective admissions, endovascular therapy appears to be associated with decreased mortality and complications and shorter hospital stays.

Cited by 11 publications

References 9 publications

Improved outcomes from endovascular aortic repair in younger patients: Towards improved risk stratification

Improved outcomes from endovascular aortic repair in younger patients: Towards improved risk stratification

Aneurysms of pancreaticoduodenal arcade: Clinical profile and endovascular strategies

Endovascular and Surgical Management of Intact Splenic Artery Aneurysm

Contact Info

Product

Resources

About