1
|
Saengprakai W, van Herwaarden JA, Georgiadis GS, Slisatkorn W, Moll FL. Clinical outcomes of hypogastric artery occlusion for endovascular aortic aneurysm repair. MINIM INVASIV THER 2017; 26:362-371. [DOI: 10.1080/13645706.2017.1326385] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Wuttichai Saengprakai
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | | | - George S. Georgiadis
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Vascular Surgery, ‘Democritus’ University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Worawong Slisatkorn
- Division of Cardio-thoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Frans L. Moll
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| |
Collapse
|
2
|
Chuter TA, Parodi JC, Lawrence-Brown M. Management of Abdominal Aortic Aneurysm: A Decade of Progress. J Endovasc Ther 2016. [DOI: 10.1177/15266028040110s611] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Since the world was first introduced to the concept of endovascular aneurysm repair by Parodi's landmark procedures in 1990, stent-grafts have assumed a prominent role in the management of abdominal aortic aneurysm. Most modern systems are trackable, accurate, and secure. The resulting endovascular procedure is safe, durable, effective, and versatile. Perhaps the most significant increment in the applicability of the endovascular technique was achieved by the development of bifurcated stent-grafts, which dispensed with inadequate distal aortic implantation sites. Additional branches and fenestrations now permit endovascular repair in cases of thoracoabdominal, pararenal, juxtarenal, and bilateral iliac aneurysms. These advances in device performance have been accompanied by a rapid dissemination of necessary skills, leading to the development of a new superspecialty of vascular therapy, with elements of vascular surgery, interventional radiology, and interventional cardiology.
Collapse
Affiliation(s)
| | - Juan C. Parodi
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | |
Collapse
|
3
|
Falkensammer J, Hakaim AG, Oldenburg WA, Neuhauser B, Paz-Fumagalli R, McKinney JM, Hugl B, Biebl M, Klocker J. Natural History of the Iliac Arteries after Endovascular Abdominal Aortic Aneurysm Repair and Suitability of Ectatic Iliac Arteries as a Distal Sealing Zone. J Endovasc Ther 2016; 14:619-24. [DOI: 10.1177/152660280701400503] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To investigate the natural history of dilated common iliac arteries (CIA) exposed to pulsatile blood flow after endovascular abdominal aortic aneurysm repair (EVAR) and the suitability of ectatic iliac arteries as sealing zones using flared iliac limbs. Methods: Follow-up computed tomograms of 102 CIAs in 60 EVAR patients were investigated. Diameter changes in CIAs ≤16 mm (group 1) were compared with changes in vessels where a dilated segment >16 mm in diameter continued to be exposed to pulsatile blood flow (group 2). Within group 2, cases in which the stent terminated proximal to the dilated artery segment (2a) were compared with those that had been treated with a flared limb (2b). Results: The mean CIA diameter increased by 1.0±1.0 mm in group 1 (p<0.001 versus immediately after EVAR) and by 1.5±1.7 mm in group 2 (p<0.001 versus immediately after EVAR) within an average follow-up of 43.6±18.0 months. Diameter increase was more pronounced in dilated CIAs (p=0.048), and it was not significantly different between groups 2a and 2b (p=0.188). No late distal type I endoleak or stent-graft migration associated with CIA ectasia was observed. Conclusion: Dilatation of the CIA is significant after EVAR, and it is more pronounced in ectatic iliac arteries. Although ectatic iliac arteries appear to be suitable sealing zones in the short term, continued follow-up is mandatory.
Collapse
Affiliation(s)
- Juergen Falkensammer
- Sections of 1 Vascular Surgery, Mayo Clinic Jacksonville, Florida, USA
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Albert G. Hakaim
- Sections of 1 Vascular Surgery, Mayo Clinic Jacksonville, Florida, USA
| | | | - Beate Neuhauser
- Sections of 1 Vascular Surgery, Mayo Clinic Jacksonville, Florida, USA
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria
| | | | - J. Mark McKinney
- Sections of Interventional Radiology, Mayo Clinic Jacksonville, Florida, USA
| | - Beate Hugl
- Sections of 1 Vascular Surgery, Mayo Clinic Jacksonville, Florida, USA
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Matthias Biebl
- Sections of 1 Vascular Surgery, Mayo Clinic Jacksonville, Florida, USA
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria
| | - Josef Klocker
- Sections of 1 Vascular Surgery, Mayo Clinic Jacksonville, Florida, USA
- Department of Vascular Surgery, Innsbruck Medical University, Innsbruck, Austria
| |
Collapse
|
4
|
Affiliation(s)
- Frank J. Criado
- Center for Vascular Intervention, Division of Vascular Surgery, The Union Memorial Hospital/MedStar Health, Baltimore, Maryland, USA
| |
Collapse
|
5
|
Curti T, Stella A, Rossi C, Galaverni C, Saccà A, Resta F, D'Addato M. Endovascular Repair as First-Choice Treatment for Anastomotic and True Iliac Aneurysms. J Endovasc Ther 2016; 8:139-43. [PMID: 11357973 DOI: 10.1177/152660280100800207] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To report our experience with the endovascular repair of iliac aneurysms secondary to aortoiliac bypass grafting. Methods: Thirteen patients (12 men; age range 62–86 years) with histories of aortoiliac reconstructions were treated with endovascular stent-grafts for 11 false and 2 true iliac aneurysms that averaged 5.2 cm in diameter (range 3.0–7.0). Via a percutaneous access and 9-F or 12-F sheaths, Passager or Wallgraft stent-grafts were delivered to exclude the aneurysms. Results: Twelve (92%) of 13 interventions were completed satisfactorily; 1 procedure for a true iliac aneurysm was converted to traditional bypass grafting. Two patients underwent additional surgical procedures. The average hospital stay for the patients with endovascular repairs only was 3 days (range 2–5). After a mean follow-up of 28 months (range 17–40), no complication or endoleak has been detected in any patient, and all endografts are patent. Conclusions: Endovascular repair is an effective treatment for secondary aneurysms arising after aortoiliac surgery. It is less invasive and involves a shorter hospital stay. Endovascular repair should be the first choice treatment for iliac aneurysms.
Collapse
Affiliation(s)
- T Curti
- Section of Vascular Surgery, University of Bologna, Azienda Ospedaliera di Bologna S. Orsola Malpighi, Italy.
| | | | | | | | | | | | | |
Collapse
|
6
|
Open Surgical Management of Hypogastric Artery during Aortic Surgery: Ligate or Not Ligate? Ann Vasc Surg 2015; 29:780-5. [DOI: 10.1016/j.avsg.2014.12.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2014] [Revised: 12/29/2014] [Accepted: 12/30/2014] [Indexed: 11/21/2022]
|
7
|
Chowdhury MM, Schiro A, Farquharson F, Smyth JV, Serracino-Inglott F, Murray D. Treatment of Aortoiliac Aneurysms With the Iliac Bifurcated Device for Preservation of Internal Iliac Artery Flow. Vasc Endovascular Surg 2013; 48:153-8. [DOI: 10.1177/1538574413509494] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: The iliac bifurcated device (IBD) is an innovative endovascular device for aortoiliac aneurysm repair. The objective of this study is to provide further evidence on the efficacy and safety of the device. Study Design: Case series study with retrospective analysis of prospectively collected nonrandomized data. Methods: Between 2007 and 2010, all consecutive IBD placements were analyzed. The main outcomes included (1) technical failure; (2) morbidity and mortality; and (3) late outcomes. Prospective follow-up was performed by interval computed tomography scanning. Results: In all, 27 consecutive patients had elective placement of 28 IBDs. Mean operating time was 251.1 ± 65.4 minutes, mean fluoroscopy time was 63.9 ± 27.2 minutes, and mean contrast volume used was 186.2 ± 106.7 mL. Periprocedural type I endoleak occurred in 2 patients. No aneurysm-related adverse events were recorded. Conclusion: We demonstrate that IBDs can be used in patients with aortoiliac aneurysms and are associated with satisfactory medium-term results as expressed by high patency and low reintervention rates.
Collapse
Affiliation(s)
- Mohammed M. Chowdhury
- Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Andrew Schiro
- Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Finn Farquharson
- Department of Radiology, Manchester Royal Infirmary, Central Manchester Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - J. V. Smyth
- Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Ferdinand Serracino-Inglott
- Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - David Murray
- Department of Vascular and Endovascular Surgery, Manchester Royal Infirmary, Central Manchester Hospitals NHS Foundation Trust, Manchester, United Kingdom
| |
Collapse
|
8
|
Pieper CC, Meyer C, Verrel F, Schild HH, Wilhelm KE. Using the Multilayer Stent as a Supplement to EVAR in Combined Abdominal Aortic Aneurysm and Iliac Artery Aneurysm With Inadequate Distal Landing Zone—A Case Report. Vasc Endovascular Surg 2012; 46:565-9. [DOI: 10.1177/1538574412456306] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Combined abdominal aortic aneurysm (AAA) and iliac artery aneurysm (IAA) is a common condition. The recently approved Cardiatis Multilayer stent (Cardiatis, Isnes, Belgium) is an innovative stent system for peripheral aneurysm management that has been applied in several clinical cases. After deployment, the unique stent design reduces mean velocity and vorticity within the aneurysm sac, causing thrombus formation and thus exclusion of the aneurysm while the vessels branching from the aneurysm remain patent. We describe a case of combined AAA and IAA with successful endovascular aneurysm repair of the AAA and treatment of the internal iliac artery with the Cardiatis Multilayer stent at 12 months of follow-up.
Collapse
Affiliation(s)
| | - Carsten Meyer
- Department of Radiology, University of Bonn, Bonn, Germany
| | - Frauke Verrel
- Department of Surgery, University of Bonn, Bonn, Germany
| | - Hans H. Schild
- Department of Radiology, University of Bonn, Bonn, Germany
| | - Kai E. Wilhelm
- Department of Radiology, University of Bonn, Bonn, Germany
| |
Collapse
|
9
|
Končar IB, Markovic M, Colic M, Ilić N, Dragas M, Davidović LB. Endovascular Treatment of Bilateral Isolated Iliac Artery Aneurysm with a Kissing Stent Graft. Am Surg 2010. [DOI: 10.1177/000313481007601106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Igor B. Končar
- Clinic for Vascular and Endovascular Surgery Clinical Center of Serbia Belgrade, Serbia Faculty of Medicine University of Belgrade Belgrade, Serbia
| | - Miroslav Markovic
- Clinic for Vascular and Endovascular Surgery Clinical Center of Serbia Belgrade, Serbia Faculty of Medicine University of Belgrade Belgrade, Serbia
| | - Momcilo Colic
- Clinic for Vascular and Endovascular Surgery Clinical Center of Serbia Belgrade, Serbia Faculty of Medicine University of Belgrade Belgrade, Serbia
| | - Nikola Ilić
- Clinic for Vascular and Endovascular Surgery Clinical Center of Serbia Belgrade, Serbia Faculty of Medicine University of Belgrade Belgrade, Serbia
| | - Marko Dragas
- Clinic for Vascular and Endovascular Surgery Clinical Center of Serbia Belgrade, Serbia Faculty of Medicine University of Belgrade Belgrade, Serbia
| | - Lazar B. Davidović
- Clinic for Vascular and Endovascular Surgery Clinical Center of Serbia Belgrade, Serbia Faculty of Medicine University of Belgrade Belgrade, Serbia
| |
Collapse
|
10
|
Contemporary Management of Aorto-iliac Aneurysms in the Endovascular Era. Eur J Vasc Endovasc Surg 2009; 37:182-8. [DOI: 10.1016/j.ejvs.2008.11.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2008] [Accepted: 11/03/2008] [Indexed: 11/19/2022]
|
11
|
Criado FJ. The hypogastric artery in aortoiliac stent-grafting: is preservation of patency always better than interventional occlusion? J Endovasc Ther 2002; 9:493-4. [PMID: 12448444 DOI: 10.1177/152660280200900418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Frank J Criado
- Center for Vascular Intervention, Division of Vascular Surgery, Union Memorial Hospital/MedSTar Health, Baltimore, Maryland 21218, USA.
| |
Collapse
|
12
|
Yilmaz N, Peppelenbosch N, Cuypers PWM, Tielbeek AV, Duijm LEM, Buth J. Emergency treatment of symptomatic or ruptured abdominal aortic aneurysms: the role of endovascular repair. J Endovasc Ther 2002; 9:449-57. [PMID: 12223005 DOI: 10.1177/152660280200900411] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To report the initial experience with endovascular aortic repair (EVAR) in patients with ruptured or symptomatic abdominal aortic aneurysms (AAA) and to compare the results with conventional open surgery. METHODS Between May 1999 and December 2001, 24 patients (21 men; mean age 75 years, range 56-89) with ruptured or symptomatic AAA underwent EVAR using a specially designed aortomonoiliac endograft. Six patients were selected based on device and operator availability; the subsequent 18 patients were treated under a modified management protocol that offered stent-graft repair to all symptomatic AAA patients. The results of this new treatment protocol were analyzed on an intention-to-treat basis for the last 8 months of the study. The 30-day outcomes in all patients treated with emergency EVAR were compared with 40 consecutive, contemporaneous patients undergoing open surgery for symptomatic or ruptured AAA. RESULTS No early conversions to open surgery were performed. Significantly decreased operative blood loss and intensive care stay (p<0.05 for both) were observed in EVAR patients. The mortality rate for EVAR patients was 17% compared to 32% in conventionally treated patients (NS). Among patients with ruptured AAA, the 30-day mortality rates were 24% (4/17) and 41% (12/29) for EVAR and open surgery, respectively (NS). Of 26 unselected patients who were treated prospectively under the modified protocol, the majority (81%, 21/26) had anatomy suitable for endovascular repair; however, only 18 (69%) underwent EVAR owing to a short infrarenal neck (n=2) or device/operator unavailability (n=6). CONCLUSIONS EVAR is a feasible treatment in the majority of patients with ruptured or symptomatic AAA. The 30-day mortality appears to be similar between conventionally treated patients and those undergoing endovascular repair.
Collapse
Affiliation(s)
- Neval Yilmaz
- Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | | | | | | | | | | |
Collapse
|
13
|
Hinchliffe RJ, Hopkinson BR. A hybrid endovascular procedure to preserve internal iliac artery patency during endovascular repair of aortoiliac aneurysms. J Endovasc Ther 2002; 9:488-92. [PMID: 12223010 DOI: 10.1177/152660280200900417] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To demonstrate the feasibility of a hybrid endovascular procedure to preserve blood flow in the internal iliac arteries (IIA) during aortoiliac endografting. TECHNIQUE When aneurysmal dilatation makes the distal neck in the common iliac artery (CIA) too short for an adequate seal, the CIA bifurcation is exposed via an extraperitoneal approach after endograft deployment. Via an arteriotomy in the CIA, the distal end of the stent-graft is sutured to the CIA bifurcation under direct vision to preserve IIA blood flow. This approach has been successful in preserving IIA blood flow in 5 of 7 endograft procedures; in the other 2, IIA occlusion was a predictable event. CONCLUSIONS Direct suturing of an aortoiliac stent-graft to the CIA bifurcation via an extraperitoneal approach is a useful method of maintaining IIA perfusion. However, further study is required to identify patients at high risk of pelvic ischemia who would benefit from such intervention.
Collapse
Affiliation(s)
- Robert J Hinchliffe
- Department of Vascular and Endovascular Surgery, University Hospital, Nottingham, England, UK.
| | | |
Collapse
|
14
|
Clarke MJ, Pimpalwar S, Wyatt MG, Rose JD. Endovascular exclusion of bilateral common iliac artery aneurysms with preservation of internal iliac artery perfusion. Eur J Vasc Endovasc Surg 2001; 22:559-62. [PMID: 11735208 DOI: 10.1053/ejvs.2001.1511] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M J Clarke
- Department of Radiology, Freeman Hospital, Newcastle upon Tyne, UK
| | | | | | | |
Collapse
|