Aortic Neck Dilatation and Graft Migration after Endovascular Aneurysm Repair with the Ovation Stent Graft

2020 ◽  
Vol 231 (4) ◽  
pp. S341
Author(s):  
Asma Mathlouthi ◽  
Andrew Barleben ◽  
Rebecca Ann Marmor ◽  
Hanaa Dakour-Aridi ◽  
Omar Al-Nouri ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aortic Neck ◽  
Aneurysm Repair ◽  
Graft Migration

Patient-Specific Simulation of Devices-Tissues Interactions for Endovascular Aneurysm Repair

2013 ◽  
Author(s):  
A. Duménil ◽  
J. Gindre ◽  
A. Kaladji ◽  
P. Haigron ◽  
D. Perrin ◽  
...  
Keyword(s):  
Stent Graft ◽  
Eligible Patient ◽  
Endovascular Aneurysm Repair ◽  
Length Of Hospital Stay ◽  
Patient Specific ◽  
Predictive Tool ◽  
Complex Anatomy ◽  
Aortic Neck ◽  
Fenestrated Stent Graft ◽  
Aneurysm Repair

The endovascular treatment of abdominal aortic aneurysm (EVAR) consists of inserting a delivery system through intravascular pathway and deploying one or several stent-grafts at the aneurysm site in order to exclude it. This procedure has proven to have a high success rate for eligible patient population and benefits in terms of reduced blood loss, intraoperative morbidity and length of hospital stay. As the selection criteria for EVAR extend progressively due to enhancements in the devices and delivery systems, clinicians are confronted with cases becoming increasingly difficult and demanding procedures with steep learning curve (aortic dissection, branched and fenestrated stent-graft, and complex anatomy with high tortuosity or short aortic neck). In this context patient-specific Finite Element Modeling (FEM) could provide a predictive tool to support endovascular device assessment and selection as well as intervention planning. Given the lack of dedicated solutions, the aim of this study was to assess the feasibility of simulating the main steps of EVAR procedure, from guidewire insertion to stent-graft deployment.

Influence of Different Self-Expanding Stent-Graft Types on Remodeling of the Aortic Neck After Endovascular Aneurysm Repair

2010 ◽  
Vol 17 (6) ◽  
pp. 677-684 ◽  
Author(s):  
Alexander Oberhuber ◽  
Alexander Schwarz ◽  
Martin H. Hoffmann ◽  
Oliver Klass ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aortic Neck ◽  
Aneurysm Repair

scholarly journals Stent graft migration after endovascular aneurysm repair: importance of proximal fixation

2003 ◽  
Vol 38 (6) ◽  
pp. 1264-1272 ◽  
Author(s):  
Christopher K Zarins ◽  
Daniel A Bloch ◽  
Tami Crabtree ◽  
Alan H Matsumoto ◽  
Rodney A White ◽  
...  
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Aneurysm Repair ◽  
Graft Migration

scholarly journals The Correlation of Aortic Neck Length to Late Outcomes After Endovascular Aneurysm Repair With the Ovation Stent Graft

2020 ◽  
Vol 72 (1) ◽  
pp. e72-e73
Author(s):  
Asma Mathlouthi ◽  
Andrew Barleben ◽  
Omar Al-Nouri ◽  
Mahmoud B. Malas
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Neck Length ◽  
Aortic Neck ◽  
Aneurysm Repair

scholarly journals Midterm Results of Proximal Aneurysm Sealing With the Ovation Stent-Graft According to On- vs Off-Label Use

2017 ◽  
Vol 24 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Gianmarco de Donato ◽  
Francesco Setacci ◽  
Luciano Bresadola ◽  
Patrizio Castelli ◽  
Roberto Chiesa ◽  
...  
Keyword(s):  
Stent Graft ◽  
Morphological Changes ◽  
Endovascular Aneurysm Repair ◽  
Neck Length ◽  
Off Label ◽  
Aortic Neck ◽  
Type Ia ◽  
Instructions For Use ◽  
Aneurysm Repair

Purpose: To compare the use of the Ovation stent-graft according to the ≥7-mm neck length specified by the original instructions for use (IFU) vs those treated off-label (OL) for necks <7 mm long. Methods: A multicenter retrospective registry (TriVascular Ovation Italian Study) database of all patients who underwent endovascular aneurysm repair with the Ovation endograft at 13 centers in Italy was interrogated to identify patients with a minimum computed tomography (CT) follow-up of 24 months, retrieving records on 89 patients (mean age 76.4±2.4 years; 84 men) with a mean follow-up of 32 months (range 24–50). Standard CT scans (preoperative, 1-month postoperative, and latest follow-up) were reviewed by an independent core laboratory for morphological changes. For analysis, patients were stratified into 2 groups based on proximal neck length ≥7 mm (IFU group, n=57) or <7 mm (OL group, n=32). Outcome measures included freedom from type Ia endoleak, any device-related reintervention, migration, and neck enlargement (>2 mm). Results: At 3 years, there was no aneurysm-related death, rupture, stent-graft migration, or neck enlargement. There were no differences in terms of freedom from type Ia endoleak (98.2% IFU vs 96.8% OL, p=0.6; hazard ratio [HR] 0.55, 95% CI 0.02 to 9.71 or freedom from any device-related reintervention (92.8% IFU vs 96.4% OL, p=0.4; HR 2.42, 95% CI 0.34 to 12.99). In the sealing zone, the mean change in diameters was −0.05±0.8 mm in the IFU group and −0.1±0.5 mm in the OL group. Conclusion: Use of the Ovation stent-graft in patients with neck length <7 mm achieved midterm outcomes similar to patients with ≥7-mm-long necks. These midterm data show that the use of the Ovation system for the treatment of infrarenal abdominal aortic aneurysm is not restricted by the conventional measurement of aortic neck length, affirming the recent Food and Drug Administration–approved changes to the IFU.

Endoleaks: current concepts and treatments

2021 ◽  
Author(s):  
Zia Ur Rehman
Keyword(s):  
Stent Graft ◽  
Treatment Options ◽  
Endovascular Aneurysm Repair ◽  
Aneurysm Rupture ◽  
Special Situation ◽  
Type V ◽  
Aneurysm Repair ◽  
Benign Course ◽  
Selection Of

Endoleaks are the most common complications following endovascular aneurysm repair. Depending upon their origin, there are five types of endoleaks, types I-V, which can also be classified as direct and indirect endoleaks. Direct endoleaks type 1 and III have higher risk of aneurysm rupture due to rapid sac expansion, and require immediate correction.  Indirect endoleaks types II, IV and V have a relatively benign course compared to direct endoleaks. Most of them resolve with time and very few of them need interventions upon sac enlargement. Type V endotension is a special situation where there is sac enlargement despite no demonstrable endoleak. Proper planning and appropriate selection of stent-graft can prevent most of these endoleaks. With improvement in stent-graft technology, the incidence of endoleaks has been reduced. The current narrative review was planned to describe the pathophysiology, risk factors and treatment options for each type of endoleak. Continuous...

scholarly journals Endovascular Aneurysm Sealing of a Collapsed and Thrombosed Aortic Stent-Graft With Renovisceral Chimney Stent-Grafts

2018 ◽  
Vol 26 (1) ◽  
pp. 72-75
Author(s):  
Fabien Lareyre ◽  
Claude Mialhe ◽  
Carine Dommerc ◽  
Juliette Raffort
Keyword(s):  
Stent Graft ◽  
Mesenteric Artery ◽  
Endovascular Aneurysm Repair ◽  
Stent Grafts ◽  
Aortic Thrombosis ◽  
Aortic Stent Graft ◽  
Aneurysm Repair ◽  
Stent Graft Implantation ◽  
Graft Implantation

Purpose: To report the use of the Nellix endovascular aneurysm sealing (EVAS) system in the management of proximal stent-graft collapse associated with thrombosis following endovascular aneurysm repair (EVAR). Case Report: A 76-year-old man was admitted for proximal collapse of an aortic extension following bifurcated AFX stent-graft implantation associated with chimney grafts in both renal arteries and the superior mesenteric artery 1 month prior. Imaging identified thrombosis of the aortic stent-graft and the iliac limbs. A Nellix EVAS was placed into the AFX stent-graft to recanalize the aneurysm lumen and address the aortic thrombosis. There was no endoleak, and the renovisceral chimney stent-grafts remained patent over a follow-up of 25 months. Conclusion: While further studies are required to generalize its use, EVAS appears to be feasible in the management of aortic stent-graft collapse.

scholarly journals EndoAnchors Minimize Endoleaks in Chimney-Graft Endovascular Repair of Juxtarenal Abdominal Aortic Aneurysms

2019 ◽  
Vol 46 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Edgar Luis Galiñanes ◽  
Eduardo A. Hernandez-Vila ◽  
Zvonimir Krajcer
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Graft Thrombosis ◽  
Complex Anatomy ◽  
Aortic Neck ◽  
Abdominal Aortic ◽  
Type Ia ◽  
Aneurysm Repair ◽  
Chimney Graft

Juxtarenal abdominal aortic aneurysms (AAAs) are difficult to treat because they often have little or no proximal aortic neck. Patients with this complex anatomy are not usually candidates for an endovascular aneurysm repair (EVAR). Chimney-graft EVAR has been introduced, but type Ia endoleak is a typical risk. We have begun using EndoAnchors to determine whether this risk can be reduced. From July 2013 through July 2014, we used the chimney-graft EVAR technique in 5 patients whose juxtarenal AAAs had a short or no proximal aortic neck. During the procedure, we implanted EndoAnchors as needed. Postprocedurally, at 30 days, and through end of follow-up (duration, 11–18 mo), all patients had patent endografts without type Ia endoleak (our primary endpoint), visceral stent-graft thrombosis, or renal complications. One patient who received 4 chimney grafts had a postprocedural type II endoleak, which was treated with embolization. We found it feasible to use EndoAnchors with the chimney-graft technique to prevent type Ia endoleaks in the treatment of juxtarenal AAAs. Further studies are needed to validate this adjunctive technique and to determine its durability.

Sign in / Sign up

Export Citation Format

Share Document