Late Rupture of Abdominal Aortic Aneurysm After Previous Endovascular Repair

Antoniou, George Α.; Georgiadis, George S.; Antoniou, Stavros A.; Neequaye, Simon; Brennan, John A.; Torella, Francesco; Vallabhaneni, S. Rao

doi:10.1177/1526602815601405

Cited by 135 publications

(127 citation statements)

References 51 publications

Supporting

Mentioning

116

Contrasting

Unclassified

Order By: Relevance

“…Recent studies have shown that the incidence of delayed rupture is 0.9% and that it occurs mainly because of type I endoleak [1]. For EVAR-suitable patients with rupture due to type I or III endoleaks, endovascular procedures are considered a superior treatment option compared with surgical conversion [5].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Trans-stent Graft Embolization Using a Brockenbrough Needle for Delayed Rupture Due to Isolated Type II Endoleak after Endovascular Aortic Aneurysm Repair

Koike

Date

Kiss

et al. 2017

Interventional Radiology

View full text Add to dashboard Cite

Delayed rupture after endovascular aortic aneurysm repair (EVAR) secondary to an isolated type II endoleak is rare. A woman in her 90s developed an abdominal aortic aneurysm rupture 20 months following EVAR. A type II endoleak was revealed via digital subtraction angiography. The trans-stent graft approach using a Brockenbrough needle was immediately performed, and the endoleak cavity was occluded with nbutyl-2-cyanoacrylate. Trans-stent graft embolization can be adopted promptly following angiography without changing the body position or access site, even in cases of delayed rupture due to isolated type II endoleak.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Delayed rupture after endovascular aortic aneurysm repair (EVAR) is a potentially fatal complication that mainly occurs because of type I endoleak [1]. Delayed rupture caused by an isolated type II endoleak is rare [2], and its management has not yet been established.…”

Section: Introductionmentioning

confidence: 99%

Trans-stent Graft Embolization Using a Brockenbrough Needle for Delayed Rupture Due to Isolated Type II Endoleak after Endovascular Aortic Aneurysm Repair

Koike

Date

Kiss

et al. 2017

Interventional Radiology

View full text Add to dashboard Cite

show abstract

“…26 Furthermore, type III endoleak is the second commonest cause of post-EVAR aneurysm rupture. 27 These studies do not necessarily differentiate between type IIIa and IIIb endoleaks; however, fabric degradation with type IIIb endoleak is becoming more recognized as a late failure modality. 28 Treatment of type IIIb endoleak can be endovascular or open.…”

Section: Discussionmentioning

confidence: 99%

Type IIIb Endoleak and Relining

et al. 2016

Self Cite

View full text Add to dashboard Cite

Purpose: To examine the changes in distraction force following relining of a conventional abdominal aortic stent-graft with a type IIIb endoleak using the Nellix endovascular sealing device compared to a unilateral stent-graft. Methods:Relining is often used to repair type IIIb endoleaks, but the consequences to graft stability are unknown. A mathematical model was constructed based on pressure and volume flow through the stent-grafts, incorporating recognized distraction force equations. Steady flow was presumed at peak systolic pressures to calculate the maximum distraction force, with gravity ignored. Distraction forces for 28-to 36-mmdiameter stent-graft bodies with 16-mm limbs were calculated and compared to forces following relining with single and double Nellix devices or the Renu unilateral device.Results: Distraction forces for the 28-, 32-, and 36-mm stent-grafts prior to relining were 5.99, 10.21, and 14.99 N, respectively. Similar forces were reported after relining with bilateral Nellix devices (5.86, 10.08, and 14.86 N, respectively). However, use of a unilateral Nellix increased the distraction forces to 9.92, 14.14, and 18.92 N, respectively. These were comparable to the increase observed after relining with a Renu unilateral stent-graft (9.87, 14.09, and 18.86 N, respectively). The proportional increase in distraction force for a unilateral relining ranged from 26% to 66%, with the greatest increase noted in the smaller diameter main bodies. Conclusion:Relining a stent-graft with a type IIIb endoleak using bilateral Nellix devices does not increase the distraction force. However, a unilateral Nellix device or the Renu system could theoretically increase the distraction force by up to 66%, potentially risking migration and type Ia endoleak. In clinical practice, these results suggest that a relining with bilateral Nellix may have benefits over the Renu unilateral stent-graft.

show abstract

“…Mortality data favored an endovascular approach for repair of rupture after EVAR. Also, the importance of post-EVAR follow-up must be stressed, as 37 % of ruptures occurred in patients who were non-compliant with surveillance [70]. Follow-up is typically performed with CTA, which has inherent risks due to contrast and radiation exposure.…”

Section: Follow-up Imagingmentioning

confidence: 99%

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

O’Mara

Bersin

2016

Curr Treat Options Cardio Med

View full text Add to dashboard Cite

Endovascular aneurysm repair (EVAR) has become the predominant method of treatment for abdominal aortic aneurysms (AAA). The use of conscious sedation with local anesthesia and percutaneous femoral access has further decreased the morbidity of the procedure. Current devices can more effectively manage increasingly "hostile" aneurysm necks, while chimney grafts or dedicated fenestrated stent-grafts can be used for juxta-renal disease with favorable results. However, endovascular repair does present a new set of challenges, and endoleaks remain an area of concern. While there is general consensus that type I and type III endoleaks require treatment, type II endoleaks are the topic of ongoing research and debate. Development of devices and techniques to prevent and treat endoleak continues to progress. Advances in contrast-enhanced ultrasound are reducing reliance on computed tomography for post-operative monitoring. This is an important step in this population at high risk for the development of kidney failure. Despite these many innovations, further research is needed to optimize the care of patients with AAA.

show abstract

Late Rupture of Abdominal Aortic Aneurysm After Previous Endovascular Repair

Abstract: Graft-related endoleaks appear to be the predominant causes of late aneurysm rupture. Quality of and compliance with post-EVAR surveillance are important factors in late rupture; a large proportion of late ruptures are amenable to endovascular treatment.

Cited by 135 publications

References 51 publications

Trans-stent Graft Embolization Using a Brockenbrough Needle for Delayed Rupture Due to Isolated Type II Endoleak after Endovascular Aortic Aneurysm Repair

Trans-stent Graft Embolization Using a Brockenbrough Needle for Delayed Rupture Due to Isolated Type II Endoleak after Endovascular Aortic Aneurysm Repair

Type IIIb Endoleak and Relining

Endovascular Management of Abdominal Aortic Aneurysms: the Year in Review

Contact Info

Product

Resources

About