Transrenal versus Infrarenal Endograft Fixation: Influence on Type I Endoleaks

Shames, Murray L.; Betros, Fred; Dennien, B; Gray-Weale, Anthony C.; Lippey, Eric; Thursby, Peter; Lusby, Robert J.

doi:10.1007/s10016-001-0276-4

Cited by 9 publications

(7 citation statements)

References 18 publications

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“…19,48 This left 16 series that were cohort studies of both infrarenal and suprarenal fixation. † One of these provided no data on postprocedural renal function, 35 and three series contained both suprarenal and infrarenal fixation patients but did not assess the impact of fixation on renal function. 46,47,49 One series used the number of kidneys rather than patients as the study denominator.…”

Section: Resultsmentioning

confidence: 98%

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Suprarenal endograft fixation and medium-term renal function: Systematic review and meta-analysis

Walsh

Boyle

Lynch

et al. 2008

Journal of Vascular Surgery

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Currently available data are insufficient to determine the precise effect of suprarenal fixation on medium-term renal function. Conventional Kaplan-Meier analysis of the pooled data set suggested that suprarenal fixation increased the risk of renal dysfunction; however, the effect disappeared when sophisticated statistical modelling was performed to account for study heterogeneity. A randomised controlled trial of suprarenal fixation may resolve this issue.

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Section: Resultsmentioning

confidence: 98%

“…5 Fourteen articles only presented data regarding suprarenal fixation without any infrarenal comparison group,* and three series contained no renal outcome data. [33][34][35] Two reports from the same group compared suprarenal fixation to open repair. 19,48 This left 16 series that were cohort studies of both infrarenal and suprarenal fixation.…”

Section: Resultsmentioning

confidence: 99%

Suprarenal endograft fixation and medium-term renal function: Systematic review and meta-analysis

Walsh

Boyle

Lynch

et al. 2008

Journal of Vascular Surgery

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“…Likewise, dilated, irregular and tortuous iliac arteries that may pose problematic distal attachments could result in the late presentation of endoleaks (type 1b) [13] . Despite various recommendations for proximal fixation of the stents, the type of fixation (Transrenal Vs Infrarenal) showed no difference in late formation of the endoleaks [14] .…”

Section: Discussionmentioning

confidence: 87%

Aneurysmal degeneration and type Ib endoleak with proximal aneurysm rupture: A case report, review of literature and technical suggestions

Kordzadeh

Scott

Railton

et al. 2014

Annals of Medicine &Amp; Surgery

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IntroductionDespite the reduction in mortality incidences of AAA in proportion to increased use of EVAR, the natural history of aneurysms with the presence of an endoleak post EVAR remains unclear. With a cumulative AAA rupture incidence of 2% at six years post EVAR, the lack of an immediate endoleak is not an indicator of success.Case reportWe present a case of an 80-year-old man who presented to the emergency department with generalised abdominal pain and hypotension. Four years earlier he had underwent an EVAR for a 6 cm infra-renal AAA. The computed tomography angiogram (CTA) illustrated aneurysmal dilatation of the left common iliac artery with extensive retroperitoneal haemorrhage. The patient was transferred to the operating room for an endovascular repair but due to significant episodes of haemodynamic instability, an emergency exploratory laparotomy was performed. To our surprise, there was a left-sided infra-renal anterolateral rupture of the aneurysm sac. The stent was explanted with difficulty from its fixed proximal aortic section down to left-sided common iliac artery. The fixed bare portion of the stent in the proximal aorta and in the right common iliac artery was left in-situ and the rest was integrated to a trouser graft with an end-to-end technique.DiscussionOn detection of an endoleak, the aim should focus on their endovascular management, as open conversions are associated with high mortality and morbidity. Conclusion: If open conversion is indicated, all technical aspects of the repair including partial stent extraction should be considered for best outcome.

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“…There was no difference in frequency of the type I endoleak seen on intraoperative angiograpgy or postprocedure CT scans. Shames et al compared the endoleak rate between transrenal and infrarenal endograft fixation [42]. They found no difference in the endoleak rate between these two, and concluded that patient selection is more important than the type of proximal fixation in preventing endoleaks.…”

Section: Risk Factors and Preventionmentioning

confidence: 99%