Fenestrated endovascular grafting: The renal side of the story

Haddad, Fady; Greenberg, Roy K.; Walker, Esteban; Nally, Joseph V.; O’Neill, Sean M.; Kolin, Gail; Lyden, Sean P.; Clair, Daniel G.; Sarac, Timur P.; Ouriel, Kenneth

doi:10.1016/j.jvs.2004.11.025

Cited by 162 publications

(118 citation statements)

References 19 publications

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“…39 Moreover, the risk for adverse renal events was 16% in patients without preoperative renal dysfunction and 39% in patients with preoperative renal dysfunction. 96 In other studies, transient as well as permanent post-procedural renal impairment was not influenced by preoperative renal status. 34 If the high prevalence of renal insufficiency of the patient population prior to treatment of aneurysms that involve or abut the renal arteries is a stronger contributing factor, remains to be determined.…”

Section: Renal Issuesmentioning

confidence: 77%

“…Long-term survival after open repair of infrarenal AAAs decreases from 51% to only 12% at 10 years in the setting of the presence or absence of post-procedural renal dysfunction. 96 Short-term mean endovascular postoperative eGFR and serum creatinine values were presented significantly lower compared to those obtained after open surgical repair. 40 The avoidance of suprarenal clamping and ischemia possibly explains the excellent results of the endovascular arm (FEVAR and chimney EVAR) in comparable studies with open surgical repair (0 vs 6.5% requirement of persistent dialysis).…”

Section: Renal Issuesmentioning

confidence: 79%

“…39 Mortality has also been correlated with adverse renal events, as shown in several studies. 34,96 Patients experiencing spinal cord ischemia, for example, have a 10 times greater risk of death and notably the majority of those not fully recovered die rapidly. 39 There is also evidence that outcomes are strongly correlated to the level and to the proximal extension of aneurysm disease.…”

Section: Perioperative and Late Mortalitymentioning

confidence: 99%

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Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

et al. 2016

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The introduction of fenestrated stent grafts (SGs) to treat abdominal aortic aneurysms (AAAs) with short proximal necks began in 1999. Nowadays, the whole visceral aorta can be treated totally by endovascular means. The established use of fenestrated devices to treat complex AAAs as a first-line management option has been previously reported. An up-to-date evaluation of the literature was performed including all types of publications regarding the use of fenestrated technology to repair complex AAAs. Fenestrated repair is now an established alternative to hybrid/chimney/snorkel repairs. However, specific criteria and prerequisites are required for the use and improvement of this method. Multiple device morphologies have been used incorporating the visceral arteries in various combinations. This modular strategy connects different devices (bridging covered stents and bifurcated SGs) with the aortic main body, thus excluding the aneurysm from the circulation. Precise deployment of the fenestrated SG is mandatory for successful visceral vessel revascularization. Accurate SG sizing and customization, a high level of technical skill, and facilities with modern imaging techniques including 3D road mapping and dedicated hybrid rooms are required. Most experience has been with the custom-made Zenith Cook platform, although off-the-shelf devices have been recently implanted. More complex repairs have been performed over the last few years, but device complexity has also increased. Perioperative, mid-term, and a few recently reported long-term results are encouraging. Secondary interventions remain the main problem, similar to that observed after traditional endovascular abdominal aortic aneurysm repair (EVAR).

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Section: Renal Issuesmentioning

confidence: 77%

Section: Renal Issuesmentioning

confidence: 79%

Section: Perioperative and Late Mortalitymentioning

confidence: 99%

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Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

et al. 2016

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“…Ten studies did not adequately report attrition. 25,27,31,35,41,45,46,54,58,59 Otherwise most studies satisfied the qualitative assessments in the other domains of potential bias. Publication bias was detected in analysis of all cause mortality, demonstrated in the final sentence of paragraph 3 on this page, and also acute kidney injury, which is discussed in the second paragraph on page 14.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 91%

Preoperative Estimates of Glomerular Filtration Rate as Predictors of Outcome after Surgery

et al. 2013

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Background: Kidney dysfunction is a strong determinant of prognosis in many settings. Methods: A systematic review and meta-analysis was undertaken to explore the relationship between estimated glomerular filtration rate (eGFR) and adverse outcomes after surgery. Cohort studies reporting the relationship between eGFR and major outcomes, including all-cause mortality, major adverse cardiovascular events, and acute kidney injury after cardiac or noncardiac surgery, were included. Results: Forty-six studies were included, of which 44 focused exclusively on cardiac and vascular surgery. Within 30 days of surgery, eGFR less than 60 ml·min·1.73 m −2 was This article has been selected for the ANESTHESIOLOGY CME Program. Learning objectives and disclosure and ordering information can be found in the CME section at the front of this issue. ABSTRACTThe use of ultrasound guidance has provided an opportunity to perform many peripheral nerve blocks that would have been difficult to perform in children based on pure landmark techniques due to the potential for injection into contiguous sensitive vascular areas. This review article provides the readers with techniques on ultrasoundguided peripheral nerve blocks of the extremities and trunk with currently available literature to substantiate the available evidence for the use of these techniques. Ultrasound images of the blocks with corresponding line diagrams to demonstrate the placement of the ultrasound probe have been provided for all the relevant nerve blocks in children. The authors hope that this review will stimulate further research into ultrasound-guided regional anesthesia in infants, children, and adolescents and stimulate more randomized controlled trials to provide a greater understanding of the anatomy and physiology of regional anesthesia in pediatrics.

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“…blood flow reduction and following intrastent thrombosis [1,2,5,6]. Branched aortic endografts are modular devices that could be affected by distracting forces and intercomponent movement causing collapse or kinking of the branched stent graft with subsequent occlusion.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Revascularization of a Renal Branch Occlusion in a Monorenal Patient after a 3-Branched Stent Graft Procedure of the Abdominal Aorta

Zander¹,

Gonzalez²,

Valdéz³

et al. 2015

J Vasc Med Surg

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Fenestrated endovascular grafting: The renal side of the story

Cited by 162 publications

References 19 publications

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

Fenestrated stent grafts for the treatment of complex aortic aneurysm disease: A mature treatment paradigm

Preoperative Estimates of Glomerular Filtration Rate as Predictors of Outcome after Surgery

Endovascular Revascularization of a Renal Branch Occlusion in a Monorenal Patient after a 3-Branched Stent Graft Procedure of the Abdominal Aorta

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