Objective: Late complications after previous endovascular aneurysm repair (EVAR) procedures include type I/III endoleaks causing aneurysm growth and rupture. We reviewed our results from the management of such complications with endovascular aneurysm sealing (EVAS) techniques.
Methods: Analysis of our prospectively maintained aneurysm database was performed (December 2013-May 2017). Primary outcomes were: (1) success of the procedure in excluding the primary complication, (2) perioperative mortality, (3) post-operative complications and (4) survival.
Results: Ten consecutive patients were treated for complications of EVAR procedures performed 2-12 years previously. All patients underwent EVAS with/without chimney grafts for 6 type Ia,1 type IIIb and 3 undetermined (but presumed type IIIb) endoleaks. Overall, 19 Nellix devices were used. The technical success with type Ia endoleaks was 100%. All sealed using proximal extension through chimney EVAS with 1 target vessel loss. There were no perioperative deaths. All but 1 type Ia endoleak remained eliminated at follow-up (range 2-29 months) as did the proven type IIIb endoleak. Two of the 3 undetermined endoleaks demonstrated continued sac expansion requiring surgical exploration by laparotomy, during which type II endoleaks were identified.
Conclusions: EVAS provides effective short-term treatment of type Ia/IIIb endoleaks after EVAR. However, late complications may occur due to disease progression.
Level Of Evidence: Level 4, case series.
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http://dx.doi.org/10.1007/s00270-018-1952-x | DOI Listing |
Front Cardiovasc Med
December 2024
Department of Cardiology, University Hospital 'St. Ekaterina', Medical University of Sofia, Sofia, Bulgaria.
Background: Formation of local type aortic aneurysm years after surgical repair of coarctation (CoA) occurs in 10% of patients independent of the surgical technique and is a potentially life-threatening condition if left untreated with a high risk of aortic rupture. Redo open surgery is associated with 14% in-hospital mortality and a high risk of complications. Endovascular treatment appears to be a feasible alternative with a high success rate and low morbidity and mortality, but data concerning long-term results is still mandatory.
View Article and Find Full Text PDFInterv Neuroradiol
January 2025
Department of Neurology, University of Chicago, Chicago, IL, USA.
We present a case of an adult patient with a large symptomatic fusiform basilar artery aneurysm. This video demonstrates the ease of deploying the new Pipeline™ Vantage Flow Diverter compared to the Flex model in the same vessel. The Flex and Vantage have different deployment techniques-as using the Flex maneuvering technique on the Vantage may damage the braid.
View Article and Find Full Text PDFAsian Cardiovasc Thorac Ann
January 2025
Department of Cardiovascular Surgery, Chiba University Hospital, Chiba, Japan.
Background: Endovascular abdominal aneurysm repair (EVAR) offers a less invasive approach to treating abdominal aortic aneurysms (AAA) compared to open repair. However, EVAR is associated with higher rates of reintervention. This study investigates the early and mid-term outcomes of patients who underwent late open conversion including aneurysmorrhaphy after EVAR at our institution.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Cardiovascular Surgery of The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, Zhejiang, 310000, China.
Interventional occlusion of Patent ductus arteriosus (PDA) is generally efficacious and complications such as delayed occluder displacement are infrequent. Herein, we report a case of 24-year-old female with a history of unsuccessful PDA closures, who subsequently experienced delayed occluder displacement into the left main pulmonary artery. Despite numerous unsuccessful catheter-based interventions, thoracic endovascular aortic repair (TEVAR) was successfully executed.
View Article and Find Full Text PDFExpert Rev Med Devices
January 2025
Long Beach Memorial Medical Center, MemorialCare Heart & Vascular Institute, Long Beach, CA, USA.
Introduction: Since the mid-1900s, techniques in the repair of aortic arch and thoracoabdominal aortic pathologies have drastically evolved. Open aortic surgical repair was once the sole option for both simple and complex aneurysmal degeneration. Today, a number of minimally invasive and hybrid approaches are now available to assist both the surgeon and patient in tackling this challenging problem.
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