Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

Jaldin, Rodrigo Gibin; Sobreira, Marcone Lima; Moura, Regina; Bertanha, Matheus; Mariaúba, Jamil Víctor de Oliveira; Pimenta, Rafael Elias Farres; Yoshida, Ricardo de Alvarenga; Yoshida, Winston Bonetti

doi:10.1590/1677-5449.0021

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Access artery tortuosity can result in a more complicated TEVAR if additional intraoperative procedures such as iliac stenting, or endo-or open iliac conduits become necessary. 24,25 Despite the challenging cohort that was treated in this trial, there were no access artery failures. Four patients required the use of iliac stenting, but there was no placement of access artery conduits for tortuosity.…”

Section: Discussionmentioning

confidence: 97%

Pivotal results for the Valiant Navion stent graft system in the Valiant EVO global clinical trial

Azizzadeh

Desai

Arko

et al. 2019

Journal of Vascular Surgery

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Objective: The Valiant Navion stent graft system (Medtronic, Santa Rosa, Calif) is a new iteration of a thoracic endograft for the treatment of descending thoracic aortic aneurysms. Herein, the 30-day primary safety and efficacy outcomes and secondary end points are presented. Methods:The Valiant EVO global clinical trial is a prospective, nonrandomized, single-arm trial. Patient enrollment occurred from April 2016 to October 2017. The primary end point was defined as access and/or deployment failure and/or a major device effect (MDE), including device-related secondary procedures, device-related mortality, conversion to open surgery, or thoracic aortic aneurysm rupture within 30 days of the index procedure. Other measures of stent graft performance including procedural data, rates of secondary procedures, and frequency of endoleaks are also reported.Results: Of the 87 consecutive patients undergoing thoracic endovascular aneurysm repair who were enrolled, 33 (37.9%) were female with 61 (70.9%) presenting with severe access artery tortuosity and 66 (85.7%) with high thoracic aortic tortuosity per core laboratory evaluation. The mean procedure duration was 88.7 6 53.4 minutes and geographical differences existed such as percutaneous access (37/52 [71.2%]) in the United States and surgical cut down in the outside of the U.S. sites (28/35 [80.0%]). There were no access or deployment failures and only 2.3% of the patients (2/87; P < .0001; performance goal of 16%) experienced a MDE within 30 days of the index procedure. Two secondary procedures (n ¼ 1 retrograde type A dissection; n ¼ 1 aortic arch rupture) were required, and in the first 30 days, two patients died leading to a freedom from all-cause mortality of 97.7%. Endoleaks at 1 month were reported in 2.5% of patients (n ¼ 1 type Ia; n ¼ 1 type II).Conclusions: Access/deployment failures, MDEs, and endoleaks were rare in the first 30 days of the Valiant Evo clinical trial. The Valiant Navion thoracic stent graft system has shown encouraging 30-day results in this challenging cohort and trial patients will continue to be followed through 5 years. (J Vasc Surg 2019;70:1399-408.)

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Section: Discussionmentioning

confidence: 97%

Pivotal results for the Valiant Navion stent graft system in the Valiant EVO global clinical trial

Azizzadeh

Desai

Arko

et al. 2019

Journal of Vascular Surgery

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“…There are at least a few cases wherein 8-10 mm conduit grafts were anastomosed to iliac arteries. The use of conduit graft facilitates the feasibility of the procedure and significantly decreases the incidence of complication rates ( 9 , 10 ).…”

Section: Discussionmentioning

confidence: 99%

A Different Approach to Multilayer Flow Modulator Implantation in Aorta Aneurysm

Ovalı

Sevin²

2018

Anatol J Cardiol

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The Frequency of Parenchimatous Lesions in Patients with Traumatic Retroperitoneal Hematoma

Daniel

Sârbu

2020

ARS Medica Tomitana

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Objective: The retroperitoneum represent the anatomical region with the highest mortality rates, in which lesions in this region need special relevance. The aim of this study is to find out the frequency of different parenchimatous injuries related to different zones.Methods: In this retrospective study, all cases who presented to the emergency room and/or admitted to our center with retroperitoneal hematoma (RPH) complicated with parenchimatous lesions from January 2016 to December 2019 were included (4-years data). Data collected included age, hematoma zones, the production mechanisms, mortality, surgical interventions, parenchymatous lesions, complications and biochemical and hematological analysis (e.g. hemoglobin (Hb), hematocrit (Ht), platelets (PLT), leukocytes (Leu), aspartate aminotransferase level (AST), alanine aminotransferase level (ALT) and creatinine (Cr). All RPHs were diagnosed using computed tomography scan.Results: A total number of 119 RPH cases with parenchimatous lesions were included with a mean age of 45.56±2.52. The most common type of RPH was located in lateral zone (zone II) with 65 cases, followed by pelvic zone (zone III) with 36 cases. The main production mechanism for parenchimatous lesions was by road accident (n=57). The highest prevalence of parenchimatous lesions was seen in both lung and splenic lesions (n=54), followed by liver lesion (n=36) and kidney lesions (n=11), without any statistical significance. The complications showed a statistical significance when 2016 year was compare with 2018 (p=0.013). Regarding the biochemical and hematological analysis, a statistical significance was seen at PLT (when 2016 was compared with 2017, p=0.03 and 2018, p=0.008). Only 67 patients were treated by surgical interventions, and the highest mortality was registered in 2019 (n=11).Conclusion: There is a lack of evidence in the frequency of different parenchimatous lesions in RPH cases. We conclude on the basis of our study that mandatory exploration of zone II and III haematoma in parenchimatous lesions should be early diagnosed in order to reduce the morbidity and mortality of the patients.

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Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

Cited by 3 publications

References 14 publications

Pivotal results for the Valiant Navion stent graft system in the Valiant EVO global clinical trial

Pivotal results for the Valiant Navion stent graft system in the Valiant EVO global clinical trial

A Different Approach to Multilayer Flow Modulator Implantation in Aorta Aneurysm

The Frequency of Parenchimatous Lesions in Patients with Traumatic Retroperitoneal Hematoma

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