Endovascular Aneurysm Repair of Abdominal Aortic Aneurysms: Standards, Technical Options and Advanced Indications

Ketelsen, Dominik; Thomas, Christoph; Schmehl, Jörg; König, C.; Syha, Roland; Rittig, Kilian; Balletshofer, Bernd; Claussen, Claus D.; Brechtel, Klaus

doi:10.1055/s-0034-1366185

Cited by 9 publications

(6 citation statements)

References 57 publications

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“…Ruptured juxtarenal AAA are morphologically unsuitable for immediate endovascular treatment, but not impossible. Chimney technique can be used with higher risk for proximal perigraft type Ia endoleak 52,53 . With increasing surgical specialisation and centralisation, some surgical emergencies are treated only in specialised centres.…”

Section: Treatment Of Ruptured Aneurysmsmentioning

confidence: 99%

Acute aorta, overview of acute CT findings and endovascular treatment options

Černá¹,

Köcher²,

Thomas³

2017

BIOMED PAP

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Acute aortic pathologies include acute aortic syndrome (aortic dissection, intramural hematoma, penetrating aortic ulcer), impending rupture, aortic aneurysm rupture and aortic trauma. Acute aortic syndrome, aortic aneurysm rupture and aortic trauma are life-threatening conditions requiring prompt diagnosis and treatment. The basic imaging modality for "acute aorta" is CT angiography with typical findings for these aortic pathologies. Based on the CT, it is possible to classify aortic diseases and anatomical classifications are essential for the planning of treatment. Currently, endovascular treatment is the method of choice for acute diseases of the descending thoracic aorta and is increasingly indicated for patients with ruptured abdominal aortic aneurysms.

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Section: Treatment Of Ruptured Aneurysmsmentioning

confidence: 99%

Acute aorta, overview of acute CT findings and endovascular treatment options

Černá¹,

Köcher²,

Thomas³

2017

BIOMED PAP

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“…The treatment of choice for abdominal aortic aneurysm (AAA) repair has shifted from open repair toward endovascular aneurysm repair (EVAR), mainly because of favorable early results. 1 – 4 The introduction of fenestrated endografts enabled endovascular treatment of short-necked, juxtarenal, and suprarenal AAAs. The fenestrations maintain flow through the visceral arteries, while the endograft is landed in a healthy neck above the aneurysm.…”

Section: Introductionmentioning

confidence: 99%

Endograft Conformability in Fenestrated Endovascular Aneurysm Repair for Complex Abdominal Aortic Aneurysms

et al. 2020

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Purpose: To compare the impact of 2 commercially available custom-made fenestrated endografts on patient anatomy. Materials and Methods: The records of 234 patients who underwent fenestrated endovascular aneurysm repair for abdominal aortic aneurysm from March 2002 to July 2016 in 2 hospitals were screened to identify those who had pre- and postoperative computed tomography angiography assessments with a slice thickness of ≤2 mm. The search identified 145 patients for further analysis: 110 patients (mean age 72.4±7.1 years; 94 men) who had been treated with the Zenith Fenestrated (ZF) endograft and 35 patients (mean age 72.3±7.3 years; 30 men) treated with the Fenestrated Anaconda (FA) endograft. Measurements included aortic diameters at the level of the superior mesenteric artery (SMA) and renal arteries, target vessel angles, target vessel clock positions, and the target vessel tortuosity index. Variables were tested for inter- and intraobserver agreement. Results: There was a good agreement between observers in all tested variables. The native anatomy changed in both groups after endograft implantation. In the ZF group, changes were seen in the angles of the celiac artery (p=0.012), SMA (p=0.022), left renal artery (LRA) (p<0.001), and the right renal artery (RRA) (p<0.001); the aortic diameter at the SMA level (p<0.001); and the LRA (p<0.001) and RRA (p<0.001) clock positions. In the FA group, changes were seen in the angles of the LRA (p=0.001) and RRA (p<0.001) and in the SMA tortuosity index (p=0.044). Between group differences in changes were seen for the aortic diameters at the SMA and renal artery levels (p<0.001 for both) and the LRA clock position (p=0.019). Conclusion: Both custom-made fenestrated endografts altered vascular anatomy. The data suggest a higher conformability of the Fenestrated Anaconda endograft compared with the Zenith Fenestrated.

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“…9 Endovascular aneurysm repair (EVAR) has gradually become a standard treatment of AAA and been widely used in medicine with the occurrence of advanced technology, newest stent grafts, and custom-made prosthesis systems that can allow the treatment of complex pararenal and suprarenal aneurysms with a feasibility of endovascular recanalization of splanchnic vascular. 10 Evidence has shown that although EVAR has lower perioperative morbidity and mortality compared with traditional open surgical repair (OSR), the procedure is associated with different types of postoperative complications such as endoleaks. 11,12 EVAR is characterized by slight trauma, which avoids great pain and anguish brought by traditional surgery, reduces the incidence of complications and mortality of patient heart, lungs, and other vital organs, especially provides treatment opportunities for patients who are with serious complications and cannot be expected to tolerate traditional OSR.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy of Endovascular Aneurysm Repair Versus Open Surgical Repair in Middle/High-Risk Patients With Abdominal Aortic Aneurysm

Zhang

Song²,

Wang³

2016

American Journal of Therapeutics

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To explore the efficacy of endovascular aneurysm repair (EVAR) compared with traditional open surgical repair (OSR) in the treatment of middle/high-risk patients with abdominal aortic aneurysm (AAA). With a retrospective method, we analyzed the clinical data of 57 patients with middle/high-risk AAA admitted to Linyi People's Hospital Affiliated to Shandong University from January 2010 to January 2014. Twenty-eight of the 57 patients received EVAR and 29 others received OSR. Statistical analysis was conducted by the design of spreadsheet according to preoperative, intraoperative, perioperative, and postoperative follow-up relevant information. Our study showed that the difference in baseline characteristics of different therapies in middle/high-risk AAA patients was not statistically significant in preoperative period (P > 0.05). In intraoperative period, the efficacy of middle/high-risk AAA patients in EVAR group was significantly superior to OSR group in terms of blood loss, blood transfusion, and general anesthesia rate (all P < 0.01). In perioperative period, the ICU observation time and the average fasting time of middle/high-risk AAA patients in EVAR group were remarkably lower than OSR group (all P < 0.01), but the average hospital stay and the operation cost of middle/high-risk AAA patients in EVAR group were notably higher than OSR group. In postoperative follow-up period, OSR group was identified with a lower incidence of surgery-related complications than EVAR group (P < 0.05), but EVAR group was demonstrated with a higher survival rate than OSR group (P < 0.05); after 12 months of follow-up, SF-36 scale scores in OSR group were higher than EVAR group (P < 0.05). In conclusion, EVAR may have a better short-term effect, whereas OSR may have a better long-term effect in the treatment of middle/high-risk AAA patients.

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Endovascular Aneurysm Repair of Abdominal Aortic Aneurysms: Standards, Technical Options and Advanced Indications

Cited by 9 publications

References 57 publications

Acute aorta, overview of acute CT findings and endovascular treatment options

Acute aorta, overview of acute CT findings and endovascular treatment options

Endograft Conformability in Fenestrated Endovascular Aneurysm Repair for Complex Abdominal Aortic Aneurysms

Comparison of Efficacy of Endovascular Aneurysm Repair Versus Open Surgical Repair in Middle/High-Risk Patients With Abdominal Aortic Aneurysm

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