Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”

D’Oria, Mario; Galeazzi, Edoardo; Veraldi, Gian Franco; Garriboli, Luca; Saccà, Salvatore; Farneti, Fabrizio; Mezzetto, Luca; Mastrorilli, Davide; Lepidi, Sandro; Gorgatti, Filippo; Taglialavoro, Jacopo; Calvagna, Cristiano; Griselli, Filippo; Ziani, Barbara; Balestrieri, Giovanni; Pinto, Luca Calia Di

doi:10.1016/j.avsg.2021.08.059

Cited by 8 publications

(4 citation statements)

References 42 publications

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“…Numerous studies have demonstrated that standard EVAR for AAA patients with an HNA can nevertheless achieve satisfactory long-term outcomes, confirming the efficiency of EVAR in cases of unfavourable morphologies [ 15 , 16 ]. However, the increased incidence of ELIa has been linked to a hostile neck anatomy due to an insufficient seal between the aortic wall and the endograft attachment sites [ 8 , 17 ]. Although fenestrated stent grafting can serve as an effective endovascular solution for some of these patients [ 18 ], it is currently not available off-the-shelf in China.…”

Section: Discussionmentioning

confidence: 99%

Selective aneurysmal sac neck-targeted embolization during endovascular repair of abdominal aortic aneurysm with hostile neck anatomy

Zhang,

Tang,

Wang

et al. 2024

J Cardiothorac Surg

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Purpose To evaluate the efficacy and safety of selective aneurysmal sac neck-targeted embolization in endovascular aneurysm repair (EVAR) in patients with a hostile neck anatomy (HNA). Materials and methods Between October 2020 and June 2022, patients with an abdominal aortic aneurysm (AAA) and HNA who underwent EVAR with a low-profile stent graft and a selective aneurysmal sac neck-targeted embolization technique were analysed. An HNA was defined by the presence of any of the following parameters: infrarenal neck angulation > 60°; neck length < 15 mm; conical neck; circumferential calcification ≥ 50%; or thrombus ≥ 50%. Before occluding the entire aneurysm during the procedure, a buddy wire was loaded prophylactically into the sac through the contralateral limb side. If a type Ia endoleak (ELIa) occurred and persisted despite adjunctive treatment such as balloon moulding or cuff extension, this preloaded wire could be utilized to enable a catheter to reach the space between the stent graft and sac neck to perform coil embolization. In the absence of ELIa, the wire was simply retracted. The primary outcome of this study was freedom from sac expansion and endoleak-related reintervention during the follow-up period; secondary outcomes included technical success and intraoperative and in-hospital postoperative complications. Results Among the 28 patients with a hostile neck morphology, 11 (39.5%) who presented with ELIa underwent intraprocedural treatment involving sac neck-targeted detachable coil embolization. Seventeen individuals (60.7%) of the total patient population did not undergo coiling. All patients in the coiling group underwent balloon moulding, and 2 patients additionally underwent cuff extension. In the noncoiling group, 14 individuals underwent balloon moulding as a treatment for ELIa, while 3 patients did not exhibit ELIa during the procedure. The coiling group showed longer operating durations (81.27 ± 11.61 vs. 70.71 ± 7.17 min, P < 0.01) and greater contrast utilization than the noncoiling group (177.45 ± 52.41 vs. 108.24 ± 17.49 ml, P < 0.01). In the entire cohort, the technical success rate was 100%, and there were no procedure-related complications. At a mean follow-up of 18.6 ± 5.2 months (range 12–31), there were no cases of sac expansion (19 cases of sac regression, 67.86%; 9 cases of stability, 32.14%) or endoleak-related reintervention. Conclusions Selective aneurysmal sac neck-targeted embolization for the treatment of ELIa in AAA patients with an HNA undergoing EVAR is safe and may prevent type Ia endoleak and related sac expansion after EVAR.

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Section: Discussionmentioning

confidence: 99%

Selective aneurysmal sac neck-targeted embolization during endovascular repair of abdominal aortic aneurysm with hostile neck anatomy

Zhang,

Tang,

Wang

et al. 2024

J Cardiothorac Surg

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“…Известно, что универсальность методик ЭВП брюшной аорты ограничена некоторыми анатомическими параметрами, в том числе характеристиками ее проксимальной шейки [6].…”

Section: Discussionunclassified

“…Неблагоприятная анатомия проксимальной шейки аорты или ее отсутствие являются наиболее распространенными причинами отказа от метода ЭВП аорты. В свою очередь, пренебрежение анатомическими критериями с использованием ЭВПр вне рекомендованной производителем инструкции может ухудшать прогноз после ЭВП [6,7].…”

Section: Discussionunclassified

Endovascular aneurysm repair using fenestrated endoprostheses made to order from the manufacturer: Case report

Abugov,

Vlasko,

Polyakov

et al. 2023

Consilium Medicum

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This article presents two clinical cases of endovascular aneurysm repair using fenestrated endografts manufactured by the manufacturer in patients with juxta and pararenal aortic aneurysm. The variants of endovascular approaches to the treatment of pathology were analyzed. Clinical examples show the specifics of the choice and justification for the use of endovascular treatment. The conclusion is made about the effectiveness of the method.

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“…Nowadays, the endovascular treatment of abdominal aortic [ 1 , 2 , 3 , 4 , 5 ] and visceral aneurysms [ 6 , 7 , 8 ] with endoprosthesis represents the first therapeutic choice in many hospitals, less burdened by morbidity and mortality than surgery. Endovascular abdominal aortic aneurysm repair (EVAR) is complicated by an endoleak—defined as the persistence of a vascular communication between the systemic circulation and the aneurysmal sac—in approximately 45% of cases [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

EVAR Follow-Up with Ultrasound Superb Microvascular Imaging (SMI) Compared to CEUS and CT Angiography for Detection of Type II Endoleak

et al. 2022

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The aim of this study was to evaluate the usefulness of superb microvascular imaging (SMI) versus contrast-enhanced ultrasound (CEUS) and compared to computed tomography angiography (CTA) as a reference standard, for detection of type II endoleak during follow-up of endovascular abdominal aortic aneurysm repair (EVAR). Between April 2017 and September 2020, 122 patients underwent post-EVAR follow-up with CTA at 3 months and with ultrasound SMI and CEUS at 4 months from the EVAR procedure. Aneurysmal sac diameter and graft patency were evaluated; endoleaks were assessed and classified. Sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy were calculated both for SMI and CEUS and compared to CTA. Furthermore, the percentage of agreement and Cohen’s Kappa coefficient were calculated. CTA revealed 54 type II endoleaks. Ultrasound SMI and CEUS presented the same sensitivity (91.5%), specificity (100%), positive (100%), and negative (92.8%) predictive and accuracy (95.9%) value for detecting type II endoleak. The same percentage of agreement of 94.9% was found between SMI/CEUS, and CTA with a Cohen’s Kappa coefficient of 0.89. The diagnostic accuracy of SMI is comparable with CEUS in the identification of type II endoleaks after EVAR. Since SMI is less invasive, less expensive, and less time-consuming, this method may be considered to be a potential tool for monitoring patients after EVAR implantation.

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Impact of Proximal Neck Anatomy on Short-Term and Mid-Term Outcomes After Treatment of Abdominal Aortic Aneurysms With New-Generation Low-Profile Endografts. Results From the Multicentric “ITAlian North-East Registry of ENDOvascular Aortic Repair With the BOltOn Treo Endograft (ITA-ENDOBOOT)”

Cited by 8 publications

References 42 publications

Selective aneurysmal sac neck-targeted embolization during endovascular repair of abdominal aortic aneurysm with hostile neck anatomy

Selective aneurysmal sac neck-targeted embolization during endovascular repair of abdominal aortic aneurysm with hostile neck anatomy

Endovascular aneurysm repair using fenestrated endoprostheses made to order from the manufacturer: Case report

EVAR Follow-Up with Ultrasound Superb Microvascular Imaging (SMI) Compared to CEUS and CT Angiography for Detection of Type II Endoleak

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