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Xu T, Jin Y, Tang T, Tong Y, Liu C, Qiao T, Zhou M, Yu T, Wang W, Zhang M, Ran F, Liu C, Wang C, Shi Y, Li W, Li X, Liu Z. Accurate Embolization for Endoleak after F-TEVAR of Thoracic Aortic Dissection by Detachable Coils. Vascular 2023:17085381231154354. [PMID: 37526208 DOI: 10.1177/17085381231154354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
OBJECTIVES To evaluate the efficacy and clinical outcomes of accurate embolization of endoleaks after fenestrated thoracic endovascular aortic repair (F-TEVAR) for thoracic aortic dissections. METHODS Twenty patients with endoleaks (17 type I and 3 type II) after fenestrated thoracic endovascular aortic repair (F-TEVAR) were embolized using detachable and ordinary coils. We assessed the success rate and complications of the operation, and its effects, through clinical and CT follow-up. RESULTS The mean clinical follow-up duration was 25.68 ± 11.07 months (3-44 months). During follow-up, all endoleaks were completely embolized and aortic remodeling was improved. Secondary endoleaks occurred in four patients who were embolized twice. No other complications or death were reported. CONCLUSION Embolization using detachable and ordinary coils is effective and safe for the treatment of endoleaks after fenestrated thoracic endovascular aortic repair.
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Affiliation(s)
- Tianze Xu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Yi Jin
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Tao Tang
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Yuanhao Tong
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Chen Liu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Tong Qiao
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Min Zhou
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Tong Yu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Wei Wang
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Ming Zhang
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Feng Ran
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Changjian Liu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Chao Wang
- Center for Composite Materials and Structures, Harbin Institute of Technology, PR China
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Australia
| | - Yinhuan Shi
- State Key Laboratory for Novel Software Technology, Nanjing University, China
| | - Wendong Li
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Xiaoqiang Li
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
| | - Zhao Liu
- Department of Vascular Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, China
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Abstract
Endoleak remains a significant challenge to endovascular aneurysm repair, particularly as evolving techniques and devices have allowed treatment of increasingly complex aneurysm anatomy with increasing number of device components. Intervention is recommended for both type I and III endoleaks due to their risk of rupture, and endovascular techniques are the favored modality with placement of a bridging endograft over the endoleak defect. Conversion to open surgical repair remains the definitive option in cases where less invasive methods have failed or are precluded. In this article, the authors review evidence on the etiology, incidence, diagnosis, and current techniques for type III endoleak management.
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Affiliation(s)
- Jordan B. Stoecker
- Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julia D. Glaser
- Division of Vascular Surgery and Endovascular Therapy, University of Pennsylvania Health System, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania
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Contemporary imaging methods for the follow-up after endovascular abdominal aneurysm repair: a review. Wideochir Inne Tech Maloinwazyjne 2019; 14:1-11. [PMID: 30766622 PMCID: PMC6372875 DOI: 10.5114/wiitm.2018.78973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/21/2018] [Indexed: 11/23/2022] Open
Abstract
Abdominal aortic aneurysm (AAA) is defined as a localized enlargement of the aortic cross-section where the diameter is greater than 3 cm or more than 50% larger than the diameter in a normal segment. The most important complication of AAA is rupture, which, if untreated, results in mortality rates of up to 90%. Conventional open surgical repair is associated with significant 30-day mortality. Endovascular aneurysm repair (EVAR) is a significantly less invasive procedure; it is related to a lower early mortality rate and a lower number of perioperative complications. Although EVAR is a minimally invasive technique, lifelong follow-up imaging is necessary due to possible late complications including endoleak, recurrent aneurysm formation, graft infection, migration, kinking and thrombosis. The total rate of complications after EVAR is estimated at approximately 30%, and the rate of complications that require intervention is 2–3%. Early detection and progression analysis of such situations is crucial for proper intervention.
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Nishiyama M, Uehara K, Matsuda H. Type IIIB endoleak caused by fabric erosion after thoracic endovascular aneurysm repair. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2018; 4:173-174. [PMID: 29942914 PMCID: PMC6012986 DOI: 10.1016/j.jvscit.2018.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 01/25/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Masayuki Nishiyama
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Kyokun Uehara
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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