- Evar Complications and The Power of Endovascular Solutions. [Journal Article]
- AVAnn Vasc Surg 2018 Feb 20
- We report the case of a 75 years old man submitted to traditional EVAR for infrarenal abdominal aortic aneurysm. He presented a late type II endoleak 6 months after operation, initially without sac e...
We report the case of a 75 years old man submitted to traditional EVAR for infrarenal abdominal aortic aneurysm. He presented a late type II endoleak 6 months after operation, initially without sac enlargement. One year later, a CT scan control demonstred a sac expansion > 10 mm, also responsible of a secondary proximal type I endoleak. The patient was submitted to transarterial embolization of lumbar arteries through left internal iliac artery, followed by type I endoleak correction with a proximal cuff deployment. Intraoperative angiography revealed no signs of endoleak. Six months later a sudden enlargement of the sac was detected, with evidence of type III endoleak, probably consequence of the lumbar arteries embolization, promptly corrected through an aorto-aortic endograft. In conclusion, even if a conservative approach for type II endoleak without sac enlargement is proposed, sometimes a sudden sac enlargement could be responsible of catastrophic events in absence of strict follow-up. The sac embolization during EVAR could reduce the incidence of type II endoleak during follow-up, with reoperation and hospital costs reduction.
- Aspirin use is associated with decreased radiologically-determined thrombus sac volume in abdominal aortic aneurysms. [Journal Article]
- VVascular 2018 Jan 01; :1708538118762214
- Introduction Formation and renewal of intramural thrombus is associated with inflammation, and contributes to the complexity of aneurysm repair. Current cardiovascular pharmacotherapy includes severa...
Introduction Formation and renewal of intramural thrombus is associated with inflammation, and contributes to the complexity of aneurysm repair. Current cardiovascular pharmacotherapy includes several inflammatory modulators such as aspirin, statins, clopidogrel, and angiotensin-converting enzyme inhibitors. The purpose of our study was to investigate the effect of these inflammatory modulators on radiographically-determined thrombus sac volume. Methods Pre-operative computed tomography scans were reviewed in patients who underwent elective infrarenal aortic aneurysm repair. Thrombus sac volume was obtained using a Hounsfield unit restricted region growth algorithm. Co-morbid conditions such as diabetes mellitus and post-operative complications were evaluated compared to thrombus sac volume. Receiver-operator characteristic curves were generated for thrombus sac volume and patients on the various cardiovascular pharmacotherapies. Results A total of 266 patients (mean age = 72.6 ± 0.6 years; mean thrombus sac volume = 58.7 (34.4-89.0) cm3) were identified. Acetylsalicylic acid use was associated with a decreased thrombus sac volume ≤50 cm3(AUC = 0.616, p = 0.013) whereas statins ( p = 0.26), angiotensin-converting enzyme inhibitors ( p = 0.46), and clopidogrel ( p = 0.62) had no correlation to thrombus sac volume. Diabetes mellitus was not associated with thrombus sac volume ( p = 0.31). Conclusion Acetylsalicylic acid use is associated with decreased thrombus sac volume in a patient population undergoing elective abdominal aortic aneurysms repair. The effect of acetylsalicylic acid over other anti-inflammatory and anti-platelet agents is possibly attributable to its distinct mechanism of cyclooxygenase-1 inhibition. Diabetes mellitus, a known correlate of aneurysm incidence, is not associated with thrombus burden. The potential to alter aneurysm thrombus volume, thereby affecting aneurysm morphology, may yield a more favorable aneurysmal repair.
- Neutrophil gelatinase-associated lipocalin and acute kidney injury in endovascular aneurysm repair or open aortic repair: a pilot study. [Journal Article]
- BMBiochem Med (Zagreb) 2018 Feb 15; 28(1):010904
- CONCLUSIONS: Our results suggest that uNGAL, sNGAL and bNGAL, after abdominal aortic surgery, are not suitable as early biomarkers of AKI.
- Novel Role of IL (Interleukin)-1β in Neutrophil Extracellular Trap Formation and Abdominal Aortic Aneurysms. [Journal Article]
- ATArterioscler Thromb Vasc Biol 2018 Feb 22
- CONCLUSIONS: Altogether, the results suggest a dominant role of IL-1β-induced NETosis in AAA formation.
- Comparative analysis of the outcomes of elective abdominal aortic aneurysm repair in England and Sweden. [Journal Article]
- BJBr J Surg 2018 Feb 22
- CONCLUSIONS: Mortality for elective AAA repair was initially poorer in England than Sweden, but improved over time alongside greater uptake of EVAR, and now there is no difference. Centres performing a greater proportion of EVAR procedures achieved better results in England.
- Endovascular approach in isolated abdominal aortic dissections. [Journal Article]
- VVascular 2018 Jan 01; :1708538118760941
- Background Here, we report the mid-term results of endovascular treatment of isolated dissection of the abdominal aorta, which is a very rare pathology. Materials and methods A total of 11 patients (...
Background Here, we report the mid-term results of endovascular treatment of isolated dissection of the abdominal aorta, which is a very rare pathology. Materials and methods A total of 11 patients (4 males (36.3%) and 7 females (63.6%)) aged 42-72 (mean, 60.3 ± 10.45) years with isolated dissection of the abdominal aorta underwent endovascular stent-graft treatment at our institution between August 2010 and September 2015. Eight patients were symptomatic, and the remaining three were asymptomatic. The asymptomatic patients had aortic aneurysms coexisting with dissection. Eight patients without aneurysm had spontaneous dissections, and the most common symptom was unresponsive abdominal pain. Results The mean abdominal aorta diameter was 46.7 ± 20.6 (range, 31.2-100.9) mm and the mean dissection length was 71.1 ± 47.3 (range, 17-162) mm. Aorto-bi-iliac stent grafts were used in all patients, and were placed successfully under spinal anesthesia in all but one (90.9%) patient. Occlusion developed in one patient due to compression of the aorto-bi-iliac graft. Right-left femoral-femoral bypass was performed in this patient, who could not be placed on the opposite side. In addition, the graft was placed in one patient using the left renal artery chimney technique. No intraoperative mortality occurred, and open surgery was not required. In addition, no death occurred and no additional intervention was required during the mean follow-up period of 25.5 ± 17.1 (range, 6-60) months. Conclusion Limited data regarding endovascular treatment of isolated dissection of the abdominal aorta are available in the literature. Based on data obtained in a limited number of patients, we consider endovascular aortic repair to be a good alternative to surgery due to its low morbidity and mortality rates.
- Patients Older Than 80 Years Can Reach Their Normal Life Expectancy After Abdominal Aortic Aneurysm Repair: A Comparison Between Endovascular Aneurysm Repair and Open Surgery. [Journal Article]
- JEJ Endovasc Ther 2018 Feb 01; :1526602818759757
- CONCLUSIONS: The patients in this study seemed to reach normal life expectancy in comparison to the age- and sex-matched general population with a similar cumulative survival in both study groups over 5 years of follow-up.
- Aortic retrograde type A aortic dissection following repair of a thoraco-abdominal aortic aneurysm. [Journal Article]
- JCJ Card Surg 2018; 33(2):116-117
- Participation in bowel screening among men attending abdominal aortic aneurysm screening. [Journal Article]
- BJBr J Surg 2018 Feb 21
- CONCLUSIONS: A substantial proportion of previous bowel screening non-responders subsequently returned a completed FOBT following a brief intervention with a nurse specialist. Attendance at non-bowel screening appointments may provide a valuable opportunity to improve bowel screening uptake.
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- Safety and Functionality of a Guidewire Fixator: Clinical Investigation of a New Endovascular Tool. [Journal Article]
- IInnovations (Phila) 2018 Feb 21
- CONCLUSIONS: Deployment was uneventful in all ten patients. Retrieval according to the intended instruction for use was performed in nine of the patients. In one patient, a coaxial catheterization was necessary. All devices withstood a retention force of 3 N.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.