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Title: Endovascular Aneurysm Repair and Sealing (EVARS): A Useful Adjunct in Treating Challenging Morphology: Response to Comments

Abstract

No abstract prepared.

Authors:
; ; ; ;  [1]
  1. The Royal Liverpool University Hospital, Liverpool Vascular and Endovascular Service (United Kingdom)
Publication Date:
OSTI Identifier:
22645475
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 8; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; MORPHOLOGY; REPAIR; VASCULAR DISEASES

Citation Formats

Harrison, Gareth J., E-mail: garethjamesharrison@yahoo.co.uk, Antoniou, George A., Torella, Francesco, McWilliams, Richard G., and Fisher, Robert K.. Endovascular Aneurysm Repair and Sealing (EVARS): A Useful Adjunct in Treating Challenging Morphology: Response to Comments. United States: N. p., 2016. Web. doi:10.1007/S00270-016-1363-9.
Harrison, Gareth J., E-mail: garethjamesharrison@yahoo.co.uk, Antoniou, George A., Torella, Francesco, McWilliams, Richard G., & Fisher, Robert K.. Endovascular Aneurysm Repair and Sealing (EVARS): A Useful Adjunct in Treating Challenging Morphology: Response to Comments. United States. doi:10.1007/S00270-016-1363-9.
Harrison, Gareth J., E-mail: garethjamesharrison@yahoo.co.uk, Antoniou, George A., Torella, Francesco, McWilliams, Richard G., and Fisher, Robert K.. 2016. "Endovascular Aneurysm Repair and Sealing (EVARS): A Useful Adjunct in Treating Challenging Morphology: Response to Comments". United States. doi:10.1007/S00270-016-1363-9.
@article{osti_22645475,
title = {Endovascular Aneurysm Repair and Sealing (EVARS): A Useful Adjunct in Treating Challenging Morphology: Response to Comments},
author = {Harrison, Gareth J., E-mail: garethjamesharrison@yahoo.co.uk and Antoniou, George A. and Torella, Francesco and McWilliams, Richard G. and Fisher, Robert K.},
abstractNote = {No abstract prepared.},
doi = {10.1007/S00270-016-1363-9},
journal = {Cardiovascular and Interventional Radiology},
number = 8,
volume = 39,
place = {United States},
year = 2016,
month = 8
}
  • An 81-year-old male with previous open abdominal aortic aneurysm repair presented with asymptomatic large pseudoaneurysms at both ends of an open surgical tube graft. Endovascular aneurysm sealing (EVAS) in combination with the iliac limbs of a standard endovascular aneurysm repair (EVAR) successfully excluded both pseudoaneurysms from circulation. We describe the combination of elements of EVAS and EVAR and have termed this endovascular aneurysm repair and sealing (EVARS). EVARS has the advantage of harnessing the benefits of endobag sealing in aortic necks unsuitable for standard EVAR whilst providing the security of accurate stent placement within short common iliac arteries. In conclusion,more » EVAS may be combined with standard endovascular iliac limbs and is a possible treatment option for pseudoaneurysm following open aneurysm repair.« less
  • No abstract prepared.
  • Purpose: To investigate the incidence, significance, and mechanism of stent-graft distortion after endovascular repair (EVR) of abdominal aortic aneurysm.Methods: EVR of abdominal aortic aneurysm was performed in 51 cases (49 modular, bifurcated; 2 tube). Thirty-two patients were followed for 6 or more months and had equivalent baseline and follow-up images which could be used to determine changes in graft configuration. Sac dimensions were measured using computed tomographic (CT) images and graft-related complications were recorded.Results: Amongst 32 patients evaluated on follow-up, there was graft distortion in 24. Distorted grafts were significantly (p= 0.002) associated with sac diameter reduction (mean 5 mm)more » and sac length reduction (mean 8.1 mm). All graft-related complications occurred in the limbs of eight distorted grafts, with a mean reduction of sac length in this group of 7.8 mm on reformatted CT images.Conclusion: There was a highly significant association between graft distortion and limb complications, and reduced sac dimensions.« less
  • The endovascular exclusion of an isolated iliac artery aneurysm is recognized as a safe and favorable alternative to open surgical repair, with low associated morbidity and mortality. It has particular advantages in the treatment of internal iliac artery aneurysm (IIAA) given the technical difficulties associated with open surgical repair deep within the pelvis. We describe the use of customized tapered stent-grafts in the exclusion of wide-necked IIAA in five male patients considered high-risk for conventional surgical repair, in whom the common and external iliac artery morphology precluded the use of standard endovascular devices. In each case, IIAA outflow was selectivelymore » embolized and the aneurysm neck excluded by placement of a customized tapered stent-graft across the internal iliac artery origin. This technique was extremely effective, with 100% technical success, no serious associated morbidity, and zero mortality. In all five patients sac size was stable or reduced on computed tomography follow-up of up to 3 years (mean, 24.4 months), with a primary patency rate of 100%. We therefore advocate the use of customized tapered stent-grafts as a further endovascular option in the management of IIAA unsuitable for conventional endovascular repair.« less
  • Nellix Endovascular Aneurysm Sealing (EVAS) system is a new concept and technology of abdominal aortic aneurysm (AAA) repair. Elective EVAS using Nellix device was performed for a 83-year-old man with AAA. 2-month post-EVAS CTA surveillance demonstrated mild enlargement of aneurysmal sac and separation of the EndoBags, but without detectable endoleak. The patient developed sudden AAA rupture with retroperitoneal hematoma at about 4 months after EVAS. We postulated that early enlargement of aneurysmal sac and separation of EndoBags of Nellix devices after EVAS, even without detectable endoleak, might indicate significant aneurysmal wall weakening with increased risk of later AAA rupture. To themore » best of the authors’ knowledge, this was the first reported case of aortic rupture after EVAS without detectable endoleak during and after the procedure.« less