The Aorfix stent-graft to treat infrarenal abdominal aortic aneurysms with angulated necks and/or tortuous iliac arteries: midterm results.

Purpose: To present performance data on the use of the Aorfix stent-graft in patients with hostile infrarenal abdominal aortic aneurysm (AAA) anatomy.

Methods: A study protocol was designed to examine the safety and efficacy of the Aorfix endovascular stent-graft in AAA patients who had a proximal neck diameter between 18 and 30 mm, neck angulation between 60 degrees and 90 degrees , and/or severe iliac artery angulation/tortuosity. Between September 2005 and April 2009, 20 men (mean age 72.

In vitro analysis of modular aortic stent-graft failure.

Purpose: To investigate the theoretical forces involved in and the nature of fixation between the modular components of a variety of aortic stent-grafts.

Methods: An in vitro study of 6 aortic stent-grafts was performed using a tensometer. The modular stent-graft components were distracted until the iliac limb was completely separated from the main body.

Aorfix stent graft for abdominal aortic aneurysms reduces the risk of proximal type 1 endoleak in angulated necks: bench-test study.

Neck angulation (NA) is an important risk factor for type 1 proximal endoleaks following stenting of abdominal aortic aneurysms. The Aorfix (Lombard Medical, Oxon, UK) is a new flexible stent graft designed to overcome this issue. The aim of this study was to compare the endoleak flow rate (EFR) in relation to NA between the Aorfix and other manufactured stent grafts.

Durability of femorofemoral bypass grafting after aortouniiliac endovascular aneurysm repair.

Introduction: Endovascular aneurysm repair (EVAR) with aortouniiliac prostheses extends the morphologic range of aneurysms that can be treated and is potentially a more rapid and simple operation than bifurcated endovascular repair. It may, however, be limited by durability of the femorofemoral extra-anatomic bypass graft required to revascularize the contralateral lower limb. Previous studies of femorofemoral bypass grafts were performed almost exclusively in patients with occlusive disease.

Anatomical suitability of ruptured abdominal aortic aneurysms for endovascular repair.

Purpose: To assess the anatomical suitability of ruptured abdominal aortic aneurysms (AAA) for emergency endovascular repair.

Methods: All cases (46 patients [35 men; mean age 74 years, range 54-85]) in which computed tomographic angiography (CTA) confirmed AAA rupture over a 5-year period at our university hospital were reviewed for anatomical suitability for endovascular repair. Measurements were made by a radiologist experienced in anatomical assessment of CT criteria for elective endovascular aneurysm repair (EVAR).

Long-term renal function following endovascular aneurysm repair with infrarenal and suprarenal aortic stent-grafts.

Purpose: To determine in a retrospective analysis the incidence of renal impairment (RI) following endovascular repair (EVR) of abdominal aortic aneurysm (AAA), to assess the morbidity and mortality in endograft patients with preoperative RI, and to examine the impact of suprarenal stent-grafts on renal function.

Methods: From March 1994 to October 2001, 315 AAA patients (289 men; mean age 72.4+/-7.

Adjunctive procedures for the treatment of proximal type I endoleak: the role of peri-aortic ligatures and Palmaz stenting.

Purpose: To investigate the feasibility, efficacy, and long-term effects of peri-aortic ligatures and Palmaz stenting used to treat proximal type I endoleak after endovascular repair (EVR) of abdominal aortic aneurysm (AAA).

Methods: An 8-year single-center experience with proximal type I endoleak was reviewed; the records of the 55 identified cases were examined to ascertain the methods of treatment used. Among these, all 22 patients who were treated with peri-aortic ligatures and Palmaz stenting were segregated for analysis.

Color duplex ultrasonography of the superior mesenteric artery after placement of endografts with suprarenal stents.

After endovascular repair of abdominal aortic aneurysm with endografts with suprarenal stents, the proximal uncovered stent may cross the origin of the superior mesenteric artery. Effects on splanchnic circulation are unknown and may include development of stenosis at the vicinity of the stent. The criteria of high-grade superior mesenteric artery stenosis using color duplex ultrasonography have been previously reported.

Lessons learned from the long-term follow-up of a first-generation aortic stent graft.

Objective: Endovascular repair (EVR) of abdominal aortic aneurysm (AAA) is being performed with increasing frequency worldwide. No studies have a complete follow-up of more than 4 years. Our study objective was to assess the long-term results and the durability of a first-generation stent graft with complete 7-year follow-up.

Stent-graft migration after endovascular repair of abdominal aortic aneurysm.

Purpose: To report the incidence of graft migration in patients after endovascular repair of abdominal aortic aneurysms (AAA) and assess the significance of neck diameter changes in patients with and without suprarenal stent implantation.

Methods: The medical records and imaging studies of 176 consecutive patients (175 men; median age 71 years, range 48-88) who had endovascular AAA repair with the Nottingham aortomonoiliac system were reviewed. The following parameters were recorded: preoperative neck diameter and length, presence of intraoperative and late graft migrations, time to onset of late migration, length of late migration, and neck diameter changes in patients with documented late graft migration.

The Zenith aortic stent-graft: a 5-year single-center experience.

Purpose: To evaluate the efficacy and midterm results of the Zenith stent-graft in the treatment of abdominal aortic aneurysms (AAA).

Methods: Since March 1994, 364 patients have undergone endovascular repair of infrarenal AAA. Of the 94 who were treated with the Zenith stent-graft from 1996 to 2002, 88 patients (82 men; mean age 72.

Endovascular exclusion of a ruptured pseudoaneurysm of the infrarenal abdominal aorta secondary to pancreatitis.

Purpose: To report the successful repair of a ruptured pseudoaneurysm of the infrarenal abdominal aorta secondary to pancreatitis.

Case Report: A 47-year-old man was admitted with abdominal pain due to an acute exacerbation of chronic alcoholic pancreatitis. He was found to have an infrarenal abdominal aortic aneurysm, which was confirmed by spiral computed tomography (CT), but there had been no evidence of aneurysm formation on a scan performed 1 year previously.

Colonic infarction following endovascular AAA repair: a multifactorial complication.

Purpose: To report a case of colonic infarction following endovascular abdominal aortic aneurysm (AAA) repair in a patient with both internal iliac arteries (IIA) unobstructed by the endograft.

Case Report: A 73-year-old man presented with blue toes as a result of emboli from a 6.4-cm AAA.

Type II endoleak: transperitoneal sacotomy and ligation of side branch endoleaks responsible for aneurysm sac expansion.

Purpose: To demonstrate aneurysm sac expansion in the face of a type II endoleak and its treatment with open ligation of multiple side branch endoleaks.

Case Report: An 81-year-old patient had undergone elective endovascular repair of a 6.3-cm infrarenal abdominal aortic aneurysm in September 1999.

A hybrid endovascular procedure to preserve internal iliac artery patency during endovascular repair of aortoiliac aneurysms.

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.

Endovascular repair of inflammatory abdominal aortic aneurysms.

Purpose: To report a single-center experience with endovascular repair of inflammatory abdominal aortic aneurysm (IAAA), with particular attention to the fate of the aneurysm sac, perianeurysmal fibrosis (PAF), and renal function.

Methods: A retrospective review of 350 patients undergoing endovascular aortic aneurysm repair during a 7-year period at University Hospital, Nottingham, identified 14 (4%) cases of IAAA confirmed either on preoperative spiral computed tomography (CT) or at laparotomy in attempted open aneurysm repair. All data were reviewed from a prospectively maintained database, hospital notes, and serial CT studies.

Nature and significance of endoleaks and endotension: summary of opinions expressed at an international conference.

Objective: Endoleaks and endotension are critically important complications of some endovascular aortic aneurysm repairs (EVARs). For the resolution of controversial issues and the determination of areas of uncertainty relating to these complications, a conference of 27 interested leaders was held on November 20, 2000.

Methods: These 27 participants (21 vascular surgeons, five interventional radiologists, one cardiologist) had previously answered 40 key questions on endoleaks and endotension.

Endovascular AAA repair: classification of aneurysm sac volumetric change using spiral computed tomographic angiography.

Purpose: To classify and analyze the volumetric changes seen on spiral computed tomographic angiography (CTA) following endovascular abdominal aortic aneurysm (AAA) repair.

Methods: Fifty patients (46 men; mean age 71 years, range 51-83) with >1 year of imaging follow-up were retrospectively selected. The volume of the aneurysm sac was calculated on standard CT workstations to obtain plots of volume changes over time.