Long-term outcome after Talent endograft implantation for aneurysms of the abdominal aorta: A multicenter retrospective study

Torsello, Giovanni; Osada, Nani; Florek, H.-J.; Hörsch, S.; Kortmann, H.; Luska, G; Scharrer‐Pamler, R.; Schmiedt, W.; Umscheid, Thomas; Wozniak, Gernold

doi:10.1016/j.jvs.2005.09.037

Cited by 83 publications

(66 citation statements)

References 41 publications

(47 reference statements)

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“…In the case of elective endovascular aneurysm repair (EVAR) alone, adverse anatomic features such as tortuosity at proximal neck and iliac fixation sites affect endograft placement and have been associated with the occurrence of endograft migration and endoleak 10,28,46 or iliac limb kinking resulting in graft thrombosis. 28,34,51,52 Difficulties in endograft sizing for complex and tortuous aneurysm morphologies often leads to the secondary placement of costly modular extensions in the common iliac arteries 56,60 or conversely inadvertent side branch occlusion, 28,29 factors which could adversely affect technical success of a procedure.…”

Section: Introductionmentioning

confidence: 99%

Methods for Three-Dimensional Geometric Characterization of the Arterial Vasculature

2007

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Complex vascular anatomy often affects endovascular procedural outcome. Accurate quantitative assessment of three-dimensional (3D) in-vivo arterial morphology is therefore vital for endovascular device design, and preoperative planning of percutaneous interventions. The aim of this work was to establish geometric parameters describing arterial branch origin, trajectory, and vessel curvature in 3D space that eliminate the errors implicit in planar measurements. 3D branching parameters at visceral and aortic bifurcation sites, as well as arterial tortuosity were determined from vessel centerlines derived from magnetic resonance angiography data for three subjects. Errors in coronal measurements of 3D branching angles for the right and left renal arteries were 3.1 +/- 3.4 degrees and 7.5 +/- 3.7 degrees , respectively. Distortion of the anterior visceral branching angles from sagittal measurements was less pronounced. Asymmetry in branching and planarity of the common iliac arteries was observed at aortic bifurcations. The renal arteries possessed considerably greater 3D curvature than the abdominal aorta and common iliac vessels with mean average values of 0.114 +/- 0.015 and 0.070 +/- 0.019 mm(-1) for the left and right, respectively. In conclusion, planar projections misrepresented branch trajectory, vessel length, and tortuosity proving the importance of 3D geometric characterization for possible applications in planning of endovascular interventional procedures and providing parameters for endovascular device design.

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Section: Introductionmentioning

confidence: 99%

Methods for Three-Dimensional Geometric Characterization of the Arterial Vasculature

2007

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“…Success of endovascular repair in terms of aneurysm exclusion and absence of perioperative and postoperative complications is dependent on accurate patient selection to ensure that only aneurysms with a morphology that corresponds to well-established indications are treated [5][6][7]. On the other hand, the indications for endovascular repair are continuously evolving as a result of the growing experience of surgeons and the improved versatility and applicability of the new stent-grafts [5].…”

Section: Introductionmentioning

confidence: 99%

“…One example is the new generation of endografts with suprarenal fixation that, by extending the proximal anchorage point cranially, have broadened the inclusion criteria to aneurysms with "hostile" -i.e. short, tortuous or angulated -necks, thus potentially reducing the risk of caudal migration and of type I proximal endoleaks [6,7]. However, the meshes of the uncovered metallic portion of the graft, which ensure suprarenal fixation, overlap with the ostia of the renal arteries and may cause damage to the renal arteries, the renal parenchyma and renal function.…”

Section: Introductionmentioning

confidence: 99%

Endovascular abdominal aortic aneurysm repair and renal complications: a comparison between suprarenal and infrarenal fixation of stent grafts

Iezzi

Giancristofaro

et al. 2007

Radiol med

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Purpose. This study was performed to compare the rate of morphological (renal infarction and/or ischaemic lesions) and functional renal complications after the suprarenal and infrarenal fixation of aortic stent-grafts for endovascular abdominal aortic aneurysm repair (EVAR). Materials and methods. We retrospectively reviewed all followup computed tomography (CT) angiograms (obtained at 1, 6 and 12 months and yearly thereafter) and laboratory data pertaining to 102 patients who underwent suprarenal (60 patients, group A) or infrarenal (42 patients, group B) placement of aortic stent-grafts. The groups were compared in terms of complications affecting kidney function (creatinine clearance) and morphology (renal artery steno-occlusions, morphological and structural parenchymal changes), and pre-and postprocedural arterial pressure (AP). Results. Analysis of patient demographics revealed no statistically significant difference between the two groups. The proximal neck was shorter in group A (2.14 cm±0.84 cm) than in group B (3.41 cm±1.21 cm). Creatinine clearance (CrCl) decreased in both groups (group A: from 64.24 ml/min to 60.66 ml/min; group B: from 72.41 ml/min to 68.73 ml/min) without any significant difference in terms of changes in renal function (CrCl variation: -8.75% vs. -6.4%) or morphology (post-EVAR stenosis: 2.6% vs. 0%; progression of existing steno-occlusive lesions: 1% vs. 0%; ischaemic lesions: 3.2% vs. 0%), or in AP. Conclusions. In our experience, the use of abdominal endografts with suprarenal fixation did not lead to any significant increase in morphological and/or functional renal complications compared with those with infrarenal fixation. RiassuntoObiettivo. Confrontare il tasso di complicanze renali morfologiche (infarto e/o lesioni ischemiche renali) e funzionali dopo posizionamento di endoprotesi aortiche ad aggancio sopra e sottorenale per il trattamento endovascolare dell'aneurisma dell'aorta addominale (EVAR). Materiali e metodi. Sono stati analizzati retrospettivamente tutti gli esami angio-TC di controllo (follow-up a 1, 6, 12 mesi e quindi 1/anno) e i test di laboratorio eseguiti su 102 pazienti sottoposti a posizionamento di endoprotesi ad aggancio soprarenale (60 pazienti, gruppo A) o sottorenale (42 pazienti, gruppo B). I due gruppi di pazienti sono stati confrontati in termini di complicanze renali funzionali (valutazione della funzionalità renale mediante clearance della creatinina) e morfologiche (steno-ostruzioni delle arterie renali; alterazioni morfo-strutturali del parenchima renale) e di pressione arteriosa pre-e post-procedurale. Risultati. I due gruppi di pazienti sono risultati omogenei da un punto di vista epidemiologico. La lunghezza del colletto prossimale è risultata inferiore nel gruppo A (2,14 cm±0,84 cm) rispetto al gruppo B (3,41 cm±1,21 cm). In entrambi i gruppi di pazienti si è registrato un decremento della ClCr (gruppo A: da 64,24 ml/min a 60,66 ml/min; gruppo B: da 72,41 ml/min a 68,73 ml/min), in assenza di differenze statisticamente significative in termin...

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“…10 Third, the chronic evaluation of the system in vivo is critical. 29 Finally, the present study used ferromagnetic materials at the two ends of the stent. The angle h between " n and " B ( Fig.…”

Section: Discussionmentioning

confidence: 99%

A Magnetic Device to Eliminate Endograft Migration: Theory and Experiment

et al. 2007

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Endograft migration is a recognized problem in endovascular aneurysm repair, which may lead to aneurysm rupture, acute vessel thrombosis, or occlusion. This study presents a novel device to eliminate endograft migration that involves the use of a ferromagnetic stent graft (internal of vessel) and two magnetic rings (external to vessel, at the two necks of the stent). The magnetic rings (proximal and distal on the graft) with sufficient adhesion force were proposed to eliminate migration without overcompression of the aorta. Specifically, the objectives of the study are (1) to design the geometry and magnetic properties of the magnetic ring based on a mathematical model to produce the necessary tangential force to prevent endograft migration and (2) to validate the theoretical model with in vitro experiments. Our experimental results were in agreement with the numerical model, which showed feasibility of the approach to eliminate migration. This magnetic approach to eliminate endograft migration may lay the foundation for improvement of endograft repair of aortic aneurysm.

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Long-term outcome after Talent endograft implantation for aneurysms of the abdominal aorta: A multicenter retrospective study

Cited by 83 publications

References 41 publications

Methods for Three-Dimensional Geometric Characterization of the Arterial Vasculature

Methods for Three-Dimensional Geometric Characterization of the Arterial Vasculature

Endovascular abdominal aortic aneurysm repair and renal complications: a comparison between suprarenal and infrarenal fixation of stent grafts

A Magnetic Device to Eliminate Endograft Migration: Theory and Experiment

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