Objectives: To describe a new technique based on a different deployment of the Endurant Stent-Graft System (Medtronic Cardiovascular, Santa Rosa, CA) during endovascular aortic aneurysm repair to guarantee a more precise deployment in presence of severe neck angulation (SNA).
Technique: The "step-by-step" deployment technique consists of an alternate partial release of the main body and of the free-flow suprarenal stents to approximate the radiopaque markers of the graft fabric to the aortic wall, obtaining a more precise delivery, reducing the possibility of downward dislodgments along the external curve of the infrarenal angle and asymmetrical deployments in presence of SNA.
Conclusions: The "step-by-step" technique is a simple, safe, and effective graft-deployment method, which allows a very precise release in SNA and possibly achieves better results in the long-term period in such difficult anatomies.
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http://dx.doi.org/10.1016/j.avsg.2020.05.030 | DOI Listing |
Ann Vasc Surg
January 2025
Division of Vascular Surgery and Endovascular Therapy, Keck Medical Center of University of Southern California. 1520 San Pablo Street HCT 4300, Los Angeles, California, 90033. Electronic address:
Objectives: This study assessed the association between chronic obstructive pulmonary disease (COPD) severity and postoperative mortality among patients undergoing thoracic endovascular aortic repair (TEVAR) and complex endovascular aortic repair (CEVAR).
Methods: A retrospective review of the Vascular Quality Initiative database identified elective TEVAR and CEVAR cases from 2013-2022 with endograft proximal landing zone ≥2 for thoracic or complex abdominal aortic disease. Symptomatic disease, ruptures, and urgent/emergent surgeries were excluded.
Ann Vasc Surg
January 2025
Division of Vascular Surgery, University of South Florida College of Medicine, Tampa, Florida, USA. Electronic address:
Objective: Frailty has become an increasingly recognized perioperative risk stratification tool. While frailty has been strongly correlated with worsening surgical outcomes, the individual determinants of frailty have rarely been investigated in the setting of aortic disease. The aim of this study was to examine the determinants of an 11-factor modified frailty index (mFI-11) on mortality and postoperative complications in patients undergoing endovascular aortic aneurysm repair (EVAR).
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January 2025
Institute of Cardiac and Aortic Disorders, SRM Institutes for Medical Science (SIMS Hospitals), Chennai, India.
Background: Nonocclusive mesenteric ischemia (NOMI), a subtype of acute mesenteric ischemia, is primarily caused by mesenteric arterial vasoconstriction and decreased vascular resistance, leading to impaired intestinal perfusion.Commonly observed after cardiac surgery, NOMI affects older patients with cardiovascular or systemic diseases, accounting for 20-30% of acute mesenteric ischemia cases with a mortality rate of ∼50%. This review explores NOMI's pathophysiology, clinical implications in aortic dissection, and the unmet needs in diagnosis and management, emphasizing its prognostic significance.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Department of Vascular Surgery, Centre hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec. Electronic address:
Objectives: Optimal timing for intervention for abdominal aortic aneurysms remains unclear. Given the increased rupture risk with larger aneurysms, timely intervention is critical. This study sought to examine endovascular aortic aneurysm repairs (EVAR) delays across Canadian centers, focusing on potential differences related to geography, sex and race.
View Article and Find Full Text PDFAnn Vasc Surg
January 2025
Department of Vascular and Endovascular Surgery - Tertiary Aortic Center, Pitie-Salpêtrière University Hospital, 47-83 Bd de l'Hôpital, Paris, France; Sorbonne Université, Paris, France. Electronic address:
Objective: Chronic limb-threatening ischemia (CLTI) requires revascularization whenever it is possible. The great saphenous vein represents the surgical conduit of choice. However, it is not always available, in particular in multi-operated patients.
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