Background: We hypothesized that the immediate postoperative imaging features would be associated with early regression of flow-diverted aneurysms. We compared the imaging features from digital subtraction angiography and spin echo T2-weighted magnetic resonance imaging between those with early total regression and partial regression.
Methods: A total of 30 consecutive patients with large and giant aneurysms were treated with pipeline embolization devices and divided into 2 groups according to the follow-up angiographic findings at 3-6 months. Of the 30 patients, 20 had had total or near total regression and 10 had had partial regression of the aneurysmal sac. The baseline characteristics, percent area of stagnated iodine contrast agent on anteroposterior and lateral angiographic views just after installation of the pipeline device, and median, minimal, and 10-percentile signal intensity of the aneurysmal sac on T2-weighted spin echo images 1 day after the procedure were compared between the 2 groups.
Results: A comparison of the demographic data between the 2 groups showed no significant differences. The volume of the treated aneurysmal sac also did not differ significantly (2559.28 ± 3021.45 mm vs. 2551.76 ± 6550.58 mm; P = 0.455). The total or near total regression group had a larger percent area of iodine stagnation on the lateral angiographic view compared with the partial regression group (52.26% vs. 23.35%; P = 0.002). The median, minimal, and 10-percentile signal intensity of the volume of interest were higher in the total or near total regression group than in the partial regression group (1.29 vs. 0.93 [P = 0.025]; 0.07 vs. 0.00 [P = 0.042]; 0.57 vs. 0.24 [P = 0.005]).
Conclusions: The percent area of contrast media stagnation on lateral angiograms and the median, minimal, and 10th-percentile signal intensity of the volume of interest of treated aneurysmal sacs on T2-weighted images can be used to predict early regression of aneurysmal sacs.
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http://dx.doi.org/10.1016/j.wneu.2020.05.047 | DOI Listing |
J Vasc Surg Cases Innov Tech
April 2025
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Adverse iliofemoral anatomy represents a unique challenge for endovascular aortic aneurysm repair (EVAR). This report describes a transaxillary EVAR in a patient with severe iliofemoral occlusive disease and an infrarenal aortic aneurysm. A reversely mounted Gore Excluder graft was advanced and deployed in the infrarenal aorta using the left axillary artery.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Objective: This study aimed to compare treatment outcomes between graft replacement and aneurysmorrhaphy with ligation of the aortic side branches for type 2 endoleaks after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms.
Methods: We retrospectively analyzed multicenter data of patients who underwent open surgical conversion, including graft replacement or aneurysmorrhaphy with ligation of the aortic side branches (graft preservation) for the treatment of type 2 endoleaks between 2007 and 2022. The endpoints were postoperative complications, 30-day mortality, overall survival, and reintervention or sac expansion after open surgical conversion.
Eur J Vasc Endovasc Surg
January 2025
Vascular Unit, 5th Department of Surgery, Medical School, Aristotle University of Thessaloniki, Hippokratio Hospital, Thessaloniki, Greece. Electronic address:
J Clin Med
January 2025
Vascular and Endovascular Surgery Division, Department of General Surgery and Surgical Specialties, Policlinico Umberto I, "Sapienza" University of Rome, Viale del Policlinico 155, 00161 Rome, Italy.
A type 2 endoleak (EL2) remains the most prevalent complication of endovascular aortic repair (EVAR) for an abdominal aortic aneurysm (AAA). We conducted a retrospective, single-center analysis, including patients who underwent embolization for an isolated EL2 after EVAR. The study population was stratified into two groups: Group A, consisting of patients whose EL2 resolved after the first embolization procedure, and Group B, consisting of those with refractory EL2 (rEL2).
View Article and Find Full Text PDFJ Neurointerv Surg
January 2025
Department of Neurosurgery, Division of Neuroendovascular Surgery, Medical University of South Carolina, Charleston, South Carolina, USA
Background: The elderly population (≥80 years) were underrepresented in recent trials of endovascular thrombectomy (EVT) for anterior circulation large vessel occlusion acute ischemic stroke (LVO-AIS) with low Alberta Stroke Program Early CT Score (ASPECTS) (≤5).
Methods: This study analyzed data from a prospectively maintained database of 37 thrombectomy centers. The primary cohort of the study comprised patients with LVO-AIS aged ≥80 who underwent EVT with ASPECTS≤5 from 2013 to 2023.
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