Endovascular treatment of abdominal aortic aneurysms: a review

Uflacker, Renan; Robison, Jacob G.

doi:10.1007/s003300000747

Cited by 57 publications

(34 citation statements)

References 33 publications

(45 reference statements)

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“…This makes our statistical analysis less consistent, in particular for the detection of risk factors. For example, the use of stent grafts with suprarenal fixation, with or without side branches, could determine a significant reduction in the incidence of proximal neck enlargement and stent migration [26].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

et al. 2003

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The aim of this study was to evaluate incidence, potential risk factors and effects on stent-graft migration of proximal neck dilatation after endoluminal repair of abdominal aortic aneurysm (EVAR), and the role of ultrasound (US) in detecting neck enlargement. From November 1998 to October 2001, 90 patients underwent EVAR. On follow-up, US and CT angiography (CTA) were performed, and diameters of the suprarenal and infrarenal aortic necks were monitored. Incidence of significant neck enlargement (> or =2.5 mm) and distal stent-graft migration (>10 mm) was calculated. Several factors were evaluated as predictive of neck enlargement. Ultrasound and CTA measurements were compared. The US and CTA examinations were available in 68, 39, and 11 patients at 1, 2, and 3 years follow-up (mean follow-up 15 months). Incidence of significant neck dilatation was 21.8% at the infrarenal level (13, 33, and 36% at 1, 2, and 3 years follow-up) and 13.8% at the suprarenal level (9, 18, and 27% at 1, 2, and 3 years follow-up). Significant stent-graft migration occurred in 14 of 87 patients (16%) and was associated with neck dilatation in 8 (2 suprarenal and 6 infrarenal). No risk factors were identified. Ultrasound was less accurate than CT in measuring neck diameter, in particular at the suprarenal level. Proximal aortic neck enlargement occurs in up to 30% of patients after EVAR and represents the main risk factor for stent-graft migration. The risk of infrarenal neck dilatation is higher at 2 years follow-up, whereas the suprarenal neck enlarges later. Ultrasound is not useful in monitoring neck diameter.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

et al. 2003

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“…The diameter of aortic aneurysm is an established objective criterion for assessment of the results of endovascular or open repair surgery in patients with abdominal aortic aneurysm (AAA) [1,2,3,4]. Cross-sectional imaging is routinely performed to assess aortic diameter.…”

Section: Introductionmentioning

confidence: 99%

Aneurysmal sizing after endovascular repair in patients with abdominal aortic aneurysm: interobserver variability of various measurement protocols and its clinical relevance

et al. 2003

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The aim of this study was to determine the variability of various measurement protocols for measurement of abdominal aortic aneurysm (AAA) and the clinical relevance of variability. Three radiologists performed computed tomographic angiography measurements of both the aorta and the largest portion of the aneurysm on selected axial slices. Then measurements of the largest portion of the aneurysm were performed on unselected axial slices, sagittal and coronal reformatted. Finally, aortic volume was calculated. Measurements and volume calculation were performed before and after endovascular repair and assessed: Part 1: interobserver variability for maximum anteroposterior (MAP) and maximum transverse (MTR) diameters on selected slices; part 2: interobserver variability for unselected slices considering MAP and MTR; part 3: interobserver variability considering maximum diameter in any direction (MAD); part 4: interobserver variability for sagittal (SAG) and coronal (COR) free curved multiplanar reformation (MPR); and part 5: volume calculations. We then determined which technique of measurement was the most clinically relevant for detecting changes in aneurysm size or aortic volume. Parts 1 and 2: interobserver variability was 4.1 mm for both MAP and MTR; part 3: interobserver variability was 7 mm for MAD; part 4: interobserver variability was 5.5 mm (COR) and 4.9 mm (SAG); part 5: interobserver variability for volume was 5.5 ml. A combination of MAP and MTR was the most useful for detecting aortic modification. Volume calculation was needed in only a few cases. We recommend avoiding MAD and MPR measurements and suggest instead measuring both maximum anteroposterior and maximum transverse diameters. If aneurysm size remains stable after endovascular repair, aneurysm volume should be measured.

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“…Practical applications of SMA in medicine are seen particularly in vascular medicine [107][108][109][110][111], dentistry [112,113], orthopedics [114][115][116], and other related areas [117][118][119][120]. In this section, the application of SMA actuators in the biomedical field is presented.…”

Section: Micromechanism Device For Biomedical Applicationsmentioning

confidence: 99%

Micromachined Shape-Memory-Alloy Microactuators and Their Application in Biomedical Devices

2015

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Shape memory alloys (SMAs) are a class of smart materials characterized by shape memory effect and pseudo-elastic behavior. They have the capability to retain their original form when subjected to certain stimuli, such as heat or a magnetic field. These unique properties have attracted many researchers to seek their application in various fields including transportation, aerospace, and biomedical. The ease process adaption from semiconductor manufacturing technology provides many opportunities for designing micro-scale devices using this material. This paper gives an overview of the fabrication and manufacturing technique of thin-film and bulk micromachined SMAs. Key features such as material properties, transformation temperature, material composition, and actuation method are also presented. The application and micromechanism for both thin-film and bulk SMA are described. Finally, the microactuator devices emphasized for biomedical applications such as microgrippers and micropumps are highlighted. The presented review will provide information for researchers who are actively working on the development of SMA-based microscale biomedical devices.

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Endovascular treatment of abdominal aortic aneurysms: a review

Cited by 57 publications

References 33 publications

Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

Evaluation of the proximal aortic neck enlargement following endovascular repair of abdominal aortic aneurysm: 3-years experience

Aneurysmal sizing after endovascular repair in patients with abdominal aortic aneurysm: interobserver variability of various measurement protocols and its clinical relevance

Micromachined Shape-Memory-Alloy Microactuators and Their Application in Biomedical Devices

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