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.

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

One-year results of the ANCHOR trial of EndoAnchors for the prevention and treatment of aortic neck complications after endovascular aneurysm repair

Vascular ◽  
2015 ◽  
Vol 24 (2) ◽  
pp. 177-186 ◽  
Author(s):  
William D Jordan ◽  
Manish Mehta ◽  
Kenneth Ouriel ◽  
Frank R Arko ◽  
David Varnagy ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Neck Length ◽  
Aortic Neck ◽  
Hostile Neck ◽  
Type Ia ◽  
Study Population ◽  
Neck Anatomy ◽  
One Year ◽  
Aneurysm Repair

Objectives EndoAnchors have been used to address proximal aortic neck complications including type Ia endoleaks and endograft migration after endovascular aortic aneurysm repair (EVAR). Methods The study population included 100 patients with one-year follow-up in the ANCHOR study. A primary cohort ( N = 73) comprised patients who underwent EndoAnchor implantation at the time of an initial EVAR and a Revision cohort ( N = 27) included patients treated remote from EVAR. A hostile neck was defined for neck length <10 mm, neck diameter >28 mm, angulation >60°, conical configuration or significant mural thrombus or calcium. Results Baseline anatomy included neck length of 17 ± 14 mm, diameter of 27 ± 5 mm, and angulation of 35 ± 18°; 83% of patients had hostile necks. Over 18 ± 4 months of clinical follow-up, six patients (6%) underwent aneurysm-related reinterventions. There were no aneurysm ruptures. Over 13 ± 2 months of imaging follow-up, freedom from type Ia endoleak was 95% in the Primary Arm and 77% in the Revision Arm ( P = .006). Aneurysm sacs regressed > 5 mm within one year in 45% of the Primary cases and in 25% of the Revisions. Aneurysm expansion > 5 mm occurred in one revision patient. Conclusion Despite a high frequency of hostile neck anatomy, proximal neck complications were relatively infrequent after EndoAnchor use.

scholarly journals The correlation of aortic neck length to early and late outcomes in endovascular aneurysm repair patients

2009 ◽  
Vol 50 (4) ◽  
pp. 738-748 ◽  
Author(s):  
Ali F. AbuRahma ◽  
John Campbell ◽  
Patrick A. Stone ◽  
Aravinda Nanjundappa ◽  
Akhilesh Jain ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Neck Length ◽  
Aortic Neck ◽  
Aneurysm Repair

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

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...

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