Routine Use of Intravascular Ultrasound for Endovascular Aneurysm Repair: Angiography is not Necessary

Segesser, Ludwig Karl von; Marty, Bettina; Ruchat, Patrick; Bogen, M.; Gallino, Augusto

doi:10.1053/ejvs.2002.1657

Cited by 89 publications

(44 citation statements)

References 3 publications

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“…7) Furthermore, to minimize the cumulative nephrotoxic effects of intravascular contrast agents, intraoperative imaging, including arteriography and intravascular ultrasounds (Volcano s5 Imaging System), were used for target site identification, landing zone measurement, neck quality analysis, preprocedural quality assessment, and trouble-shooting during EVAR. 12) A retrospective review was performed from the charts, surgical reports, and laboratory data of these patients. In the initial post-operative period, the serum Cr was measured on post-operative days 1, 2 and 7.…”

Section: Methodsmentioning

confidence: 99%

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Guntani

Okadome

Kawakubo

et al. 2012

Annals of Vascular Diseases

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Objective: Chronic renal insufficiency may be a relative contraindication to endovascular aneurysm repair (EVAR) for the use of contrast enhanced mediums. It is thought that more contrast enhanced media are needed in patients who are not anatomically suitable for EVAR, because of procedural difficulties. We reviewed a 2 year EVAR experience at our institution to determine whether the procedure and use of contrast enhanced mediums has any deleterious effect on renal function in patients with pre-existing chronic renal insufficiency. Materials and Methods: EVAR was performed in 46 patients with pre-existing chronic renal insufficiency without hemodialysis. Patients were retrospectively assigned to two groups on the basis of their preoperative creatinine clearance levels. Furthermore, patients were assigned to two other groups on the basis of anatomical suitability for EVAR. The absolute change in the serum creatinine (Cr) level was reviewed in the each renal insufficiency group between the preoperative and post-operative time periods. Results: No increase in the serum Cr level was noted, and no patient required temporary or permanent hemodialysis, in any of the groups. Conclusions: EVAR with contrast agents can be accomplished in patients with chronic renal insufficiency without hemodialysis; therefore,elevated Cr levels maynot be a contraindication in EVAR.

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Section: Methodsmentioning

confidence: 99%

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Guntani

Okadome

Kawakubo

et al. 2012

Annals of Vascular Diseases

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“…Reported entities that have been utilized to avoid iodinated contrast during EVAR are (IVUS) and the use of carbon dioxide as radio-opaque agent at angiography. 2,4,5) However, these techniques are not widely used and available. Moreover, both techniques lack the diagnostic sensitivity to detect endoleaks.…”

Section: Case Reportmentioning

confidence: 99%

“…For example Intravascular ultrasound (IVUS) as well as contrast-enhanced ultrasound (CEUS), with micro bubbles, have been shown feasible for endovascular repair of Abdominal Aortic Aneurysm (AAA) in patients with contra-indication for contrast agents. [4][5][6][7] Using intra-operative doppler-ultrasound contrast agents can be completely abolished during EVAR-procedures. This report describes three cases in which duplex-assisted EVAR (D-EVAR) was employed.…”

Section: Introductionmentioning

confidence: 99%

Contrast Free Duplex-Assisted EVAR in Patients with Chronic Renal Insufficiency

Krasznai

Sigterman

Bouwman

2014

Annals of Vascular Diseases

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Renal insufficiency and allergy for iodinated contrast are the main contra-indications for Endovascular Aortic Repair (EVAR). Various techniques have been used to minimize utilization of contrast in order to prevent contrast induced nephropathy. EVAR can be performed without nephrotoxic contrast, using additional duplex-guidance. This report describes three cases of duplex-assisted EVAR in patients with chronic renal insufficiency.

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“…Unfortunately, following extensive use of contrast medium, patients selected for trans-catheter AVR and suffering from chronic renal insufficiency are exposed to a higher risk of acute postoperative renal failure [2]. Consequently, we believe that the quantity of contrast medium administered intraoperatively should be decreased or completely avoided: following our experience on endovascular aorta repair without contrast medium [3,4], we identified a valid alternative in the fully echo-guided trans-catheter valve replacement.…”

Section: Introductionmentioning

confidence: 97%

A fully echo-guided trans-apical aortic valve implantation

Ferrari

Sulzer

Rizzo

et al. 2009

European Journal of Cardio-Thoracic Surgery

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The trans-apical aortic valve implantation (TA-AVI) is an established technique for high-risk patients requiring aortic valve replacement. Traditionally, preoperative (computed tomography (CT) scan, coronary angiogram) and intra-operative imaging (fluoroscopy) for stent-valve positioning and implantation require contrast medium injections. To preserve the renal function in elderly patients suffering from chronic renal insufficiency, a fully echo-guided trans-catheter valve implantation seems to be a reasonable alternative. We report the first successful TA-AVI procedure performed solely under trans-oesophageal echocardiogram control, in the absence of contrast medium injections.

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Routine Use of Intravascular Ultrasound for Endovascular Aneurysm Repair: Angiography is not Necessary

Abstract: IVUS is a reliable tool for EVAR. In most cases, perprocedural angiography is not necessary.

Cited by 89 publications

References 3 publications

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Clinical Results of Endovascular Abdominal Aortic Aneurysm Repair in Patients with Renal Insufficiency without Hemodialysis

Contrast Free Duplex-Assisted EVAR in Patients with Chronic Renal Insufficiency

A fully echo-guided trans-apical aortic valve implantation

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