1
|
Ashkar S, Charbonneau P, Elkouri S. Inverted Ovation iX Limb to Treat an Isolated Common Iliac Artery Aneurysm. Vasc Specialist Int 2024; 40:1. [PMID: 38186264 PMCID: PMC10772719 DOI: 10.5758/vsi.230086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 11/26/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
In recent years, endovascular aneurysm repair has become the predominant method of managing abdominal aortic and common iliac artery aneurysms. Off-label use of different endovascular devices has allowed them to remain a viable option in many cases of atypical anatomy. Some studies have reported the use of iliac devices in an upside-down configuration when the common iliac artery aneurysm has a reverse-tapered morphology. However, the use of the Ovation iX (Endologix) limb in an upside-down configuration has not yet been reported. This limb offers a 14 mm distal end when inverted and offers good patency in the tortuous iliac morphology. This case report describes and illustrates the precise deployment of an inverted Ovation iX limb to treat an isolated common iliac artery aneurysm.
Collapse
Affiliation(s)
- Said Ashkar
- Faculty of Medicine, University of Ottawa, Ontario, Canada
| | - Philippe Charbonneau
- Division of Vascular Surgery, Centre Hospitalier de l’Université de Montréal, Québec, Canada
| | - Stephane Elkouri
- Division of Vascular Surgery, Centre Hospitalier de l’Université de Montréal, Québec, Canada
- Centre de recherche du Centre Hospitalier de l'Université de Montréal, Québec, Canada
| |
Collapse
|
2
|
Georgakarakos E, Koutsoumpelis A, Kostoglou P, Tasopoulou KM, Argyriou C. A Misdiagnosed Case of Endoleak Type-III Caused by Inadvertent Bilateral Limb Insertion in the Same Limb Gate of the Ovation Endograft. AORTA 2022; 10:35-37. [PMID: 35640586 PMCID: PMC9179207 DOI: 10.1055/s-0042-1743197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe an infrequent case of endoleak Type-III due to an unrecognized, inadvertent bilateral limb deployment into the same limb gate of the Ovation aortic endograft, accompanied by thrombosis and acute ischemia. The following computed tomography angiography revealed the open limb gate with the characteristic of radio-opaque polymer in the sealing rings. Intraoperative angiographies via the brachial route identified the open limb gate and facilitated the successful use of an occluding plug to manage the Type-III endoleak.
Collapse
Affiliation(s)
- Efstratios Georgakarakos
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Andreas Koutsoumpelis
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Panagiotis Kostoglou
- First University Surgical Department, University Hospital of Alexandropoulis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Kalliopi-Maria Tasopoulou
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Christos Argyriou
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| |
Collapse
|
3
|
Koussayer S, Abuduruk A. Endovascular management of contralateral gate maldeployment during EVAR: Case report of interventional technique. Int J Surg Case Rep 2021; 80:105637. [PMID: 33621726 PMCID: PMC7907802 DOI: 10.1016/j.ijscr.2021.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 02/07/2021] [Accepted: 02/07/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Endovascular repair of infra renal aortic aneurysm is becoming the preferable method of intervention compared to open surgery due to the lower early morbidity rates. One of the complications during the procedure is contra-lateral gate (CLG) maldeployment. Learning the endovascular salvage options is necessary to avoid the morbidities of open surgical conversion. PRESENTATION OF CASE we present a case of maldeployment during an endovascular exclusion of aortic aneurysm in a high cardiac risk patient for whom an endovascular management was successful. DISCUSSION We discuss the detailed technical aspect in managing CLG maldeployment in our case as well as variable options from literature. CONCLUSION Despite the available possibility to convert to open, there are multiple endovascular bail out alternatives to manage maldeployment that can be successfully performed by experienced interventionalist.
Collapse
Affiliation(s)
- Samer Koussayer
- Vascular Surgery Department, King Faisal Specialist Hospital and Research Center, Makkah Al Mukarramah Branch Rd, Al Mathar Ash-Shamali, 1121, P.O. Box: 3354, Riyadh, Saudi Arabia.
| | - Aseel Abuduruk
- Vascular Surgery, Taif University, College of Medicine Taif University, Alseteen Street, Alhaweyia, Al-Taif, 21944, B.O. Box 11099, Saudi Arabia.
| |
Collapse
|
4
|
Mazzaccaro D, Malacrida G, Amato B, Alessio Angileri S, Ierardi AM, Nano G. Preliminary experience with the use of ultra-low profile endografts. Diagn Interv Radiol 2018; 23:448-453. [PMID: 29097346 DOI: 10.5152/dir.2017.16523] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE We aimed to report a preliminary single-center experience of elective endovascular aortic repair (EVAR) using ultra-low profile (ULP) endografts of 14 F outer diameter. METHODS Data of 67 consecutive patients who underwent EVAR using either Ovation (group A, n=30) or Incraft (group B, n=37) endografts were retrospectively analyzed. RESULTS Aorto-iliac anatomy was significantly different between the two groups, as patients of group A had a greater thrombotic apposition on proximal aortic neck (thrombus thickness: 7.2±1 mm vs. 3.3±1.6 mm, P = 0.042; percentage of the circumference covered by thrombus: 45.2%±10.4% vs. 18.7%±10.6%, P = 0.0003), while patients of group B had a more angulated proximal neck in the coronal axis (35.9°±6.4° vs. 16.7°±5°, P = 0.012). Procedural success was 93.3% and 97.3%, respectively, in groups A and B. One patient in group A required an immediate conversion to open surgery for persistent occlusion of both iliac limbs. Another patient required implantation of a conical endograft with a femoro-femoral right-to-left bypass for occlusion of the contralateral gate during the cannulation. In group B, one intraoperative type Ia endoleak was immediately corrected. Neither deaths nor major adverse events were recorded within 30-days. During a median follow-up of 15.2 months (range, 1-56.7 months) two type Ia endoleaks in group A required open conversion after 12.1 and 40.5 months, respectively. Three patients in group B required a reintervention after 30 days. Neither deaths nor aortic ruptures were recorded during follow-up. CONCLUSION Both ULP endografts showed satisfying early and mid-term results.
Collapse
Affiliation(s)
- Daniela Mazzaccaro
- First Operative Unit of Vascular Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
| | | | | | | | | | | |
Collapse
|
5
|
Georgakarakos E, Tasopoulou KM, Koutsoumpelis A, Georgiadis GS. The Importance of Profunda Femoris Artery Justifies Further the Endovascular Approach in Critical Limb Ischemia. Ann Vasc Surg 2018; 49:318-319. [DOI: 10.1016/j.avsg.2017.11.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 11/25/2017] [Indexed: 11/17/2022]
|
6
|
Sirignano P, Mansour W, Pranteda C, Siani A, Accrocca F, d'Adamo A, Capoccia L, Speziale F. Real-Life Experience with Ovation Stent Graft: Lesson Learned from the First One Hundred Fifty Treated Patients. Ann Vasc Surg 2017; 45:253-261. [DOI: 10.1016/j.avsg.2017.06.140] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/16/2017] [Accepted: 06/18/2017] [Indexed: 12/16/2022]
|
7
|
Kontopodis N, Papadopoulos G, Galanakis N, Tsetis D, Ioannou CV. Improvement of patient eligibility with the use of new generation endografts for the treatment of abdominal aortic aneurysms. A comparison study among currently used endografts and literature review. Expert Rev Med Devices 2017; 14:245-250. [DOI: 10.1080/17434440.2017.1281738] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Nikolaos Kontopodis
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Greece
| | - George Papadopoulos
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Greece
| | - Nikolaos Galanakis
- Interventional Radiology Unit, Radiology Department, University of Crete Medical School, Heraklion, Greece
| | - Dimitrios Tsetis
- Interventional Radiology Unit, Radiology Department, University of Crete Medical School, Heraklion, Greece
| | - Christos V. Ioannou
- Vascular Surgery Unit, Department of Cardiothoracic and Vascular Surgery, University of Crete Medical School, Heraklion, Greece
| |
Collapse
|
8
|
Colvard B, Georg Y, Chakfe N, Swanstrom L. Current aortic endografts for the treatment of abdominal aortic aneurysms. Expert Rev Med Devices 2016; 13:475-86. [PMID: 26959727 DOI: 10.1586/17434440.2016.1162709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Endovascular Aneurysm Repair is a widely adopted method of treatment for patients with abdominal aortic aneurysms. The minimally invasive approach offered with EVAR has become popular not only among physicians and patients, but in the medical device industry as well. Over the past 25 years the global market for aortic endografts has increased rapidly, resulting in a wide range of devices from various companies. Currently, there are seven endografts approved by the FDA for the treatment of abdominal aortic aneurysms. These devices offer a wide range of designs intended to increase inclusion criteria while decreasing technical complications such as endoleak and migration. Despite advances in device design, secondary interventions and follow-up requirements remain a significant issue. New devices are currently being studied in the U.S. and abroad and may significantly reduce complications and secondary interventions.
Collapse
Affiliation(s)
| | - Yannick Georg
- b Department of Vascular Surgery , CHU Strasbourg , Strasbourg , France
| | - Nabil Chakfe
- b Department of Vascular Surgery , CHU Strasbourg , Strasbourg , France
| | | |
Collapse
|
9
|
Georgakarakos E, Ioannou CV, Georgiadis GS, Storck M, Trellopoulos G, Koutsias S, Lazarides MK. The ovation abdominal stent graft for the treatment of abdominal aortic aneurysms: current evidence and future perspectives. Expert Rev Med Devices 2016; 13:253-62. [DOI: 10.1586/17434440.2016.1147949] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
10
|
Georgakarakos E, Schoretsanitis N, Souftas VD, Argyriou C, Moustafa E, Georgiadis GS, Lazarides MK. Emergent conversion of the Ovation Stent Graft System to aortouniiliac modification via occlusion of a unilateral internal iliac artery with a stentgraft as a bailout solution. Vascular 2015; 23:440-3. [DOI: 10.1177/1708538115585072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To present a case of inadvertent collapse of the contralateral limb gate caused by misorientation during the deployment of the Ovation Abdominal Stent Graft System in a narrow aortic lumen and the bailout conversion to aortouniiliac modification, using a covered stent to exclude the orifice of the internal iliac artery (IIA). Technique description Despite the repeated efforts from the femoral and brachial site, the collapsed/occluded contralateral limb gate could not be catheterized. In order to exclude successfully the orifice of the IIA, an oversized stentgraft was placed immediately at the common-to-external iliac artery (CIA-EIA) transition followed by peripheral ligation of the latter. The procedure was completed with crossover femorofemoral bypass. Conclusion Occlusion the IIA orifice with an oversized stentgraft in the CIA-EIA transition can be considered as a safe, simple, fast, and efficient bailout maneuver, followed by EIA ligation and crossover bypass.
Collapse
Affiliation(s)
- Efstratios Georgakarakos
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece
| | - Nikolaos Schoretsanitis
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece
| | - Vasileios D Souftas
- Interventional Radiology Unit, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Chris Argyriou
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece
| | - Erchan Moustafa
- 2nd Department of Surgery, “Democritus” University of Thrace, Medical School, University Hospital of Alexandroupolis, Dragana, Greece
| | - George S Georgiadis
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece
| | - Miltos K Lazarides
- Department of Vascular Surgery, “Democritus” University of Thrace, University Hospital of Alexandroupolis, Dragana, Greece
| |
Collapse
|