scholarly journals Impact of Dynamic Computed Tomographic Angiography on Endograft Sizing for Endovascular Aneurysm Repair

2009 ◽  
Vol 16 (5) ◽  
pp. 546-551 ◽  
Author(s):  
Jillis A. Pol ◽  
Maarten Truijers ◽  
J. Adam van der Vliet ◽  
Mark F. Fillinger ◽  
Steven P. Marra ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Aneurysm Repair

Ruptured AAA in a Patient with a Horseshoe Kidney: Emergent Treatment Using the Talent Acute Endovascular Aneurysm Repair Kit

2003 ◽  
Vol 10 (2) ◽  
pp. 240-243 ◽  
Author(s):  
Joep A.W. Teijink ◽  
Henk F. Odink ◽  
Bianca Bendermacher ◽  
Rob J.T.J. Welten ◽  
G. Otto Veldhuijzen van Zanten
Keyword(s):  
Endovascular Repair ◽  
Bypass Graft ◽  
Endovascular Aneurysm Repair ◽  
Horseshoe Kidney ◽  
Computed Tomographic Angiography ◽  
Emergency Setting ◽  
Computed Tomographic ◽  
Good General Condition ◽  
Tomographic Angiography ◽  
Aneurysm Repair

Purpose: To report emergent endovascular repair of a ruptured abdominal aortic aneurysm (AAA) in a patient with a horseshoe kidney. Case Report: A 78-year-old man with a horseshoe kidney presented with a contained rupture of a 72-mm AAA. After urgent computed tomographic angiography (CTA) documented the blood supply to the kidney and the suitability of the aneurysm for endovascular repair, the patient was given a local anesthetic. An aortomonoiliac stent-graft constructed from components provided in a Talent Acute Endovascular Aneurysm Repair Kit was inserted successfully. The procedure was completed with placement of a contralateral common iliac artery occluder and a femorofemoral bypass graft. No complications were encountered, and the patient was discharged with an excluded aneurysm on the fourth postoperative day. At 3 months, aneurysm exclusion was confirmed by CTA, and no endoleak was present; the retroperitoneal hematoma had disappeared. The patient remains in good general condition 8 months after treatment Conclusions: The advantages of endovascular aneurysm repair in the emergency setting can facilitate rapid recovery in patients with symptomatic or ruptured aneurysms, especially those having a horseshoe kidney.

Early Computed Tomographic Angiography after Endovascular Aneurysm Repair: Worthwhile or Worthless?

Vascular ◽  
2008 ◽  
Vol 16 (5) ◽  
pp. 253-257 ◽  
Author(s):  
Evert J. Waasdorp ◽  
Joost A. van Herwaarden ◽  
Rob H.W. van de Mortel ◽  
Frans L. Moll ◽  
Jean-Paul P.M. de Vries
Keyword(s):  
Stent Graft ◽  
Endovascular Aneurysm Repair ◽  
Computed Tomographic Angiography ◽  
Type I ◽  
Type Ii ◽  
Graft Thrombosis ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Aneurysm Repair

This study evaluated the value of computed tomographic angiography (CTA) early after an endovascular aneurysm repair (EVAR) in relation to CTA 3 months after EVAR. We retrospectively reviewed all elective EVAR patients with available postprocedural and 3-month follow-up CTAs who were treated between 1996 and 2006. CTAs were analyzed for EVAR-related complications in terms of endoleaks, migration, and stent graft thrombosis. Secondary procedures and other complications within a 4-month time interval after EVAR were noted and analyzed for any association with the postprocedural CTA. During the study period, 291 patients (275 men), with a mean age of 71 years, underwent elective EVAR. All had postprocedural and 3-month follow-up CTAs, which detected 93 (32%) endoleaks (8 type I, 84 type II, 1 type III) and 1 stent graft thrombosis. These findings resulted in four secondary interventions (one interposition cuff, two extension cuffs, one conversion). All reinterventions were successfully done in an elective setting. During the first 3 postoperative months, five other reinterventions were required for acute ischemia in four patients (three Fogarty procedures, one femorofemoral crossover bypass) or groin infection in one patient. Eight patients died, but none of the deaths were related to abdominal aortic aneurysm or EVAR (four cardiac, two pulmonary, one gastric bleeding, one carcinoma). At 3 months, 43 endoleaks (3 type I, 40 type II), 3 stent graft thromboses, and 1 stent graft migration were seen. In two patients (0.7%), a new endoleak was diagnosed compared with the postprocedural CTAs. In 287 (99%) of 291 patients, the postprocedural CTA did not influence our treatment policy in the first 3 months after EVAR. More than half of the early endoleaks were self-limiting, and new endoleaks were seen in only two patients (< 1%) at the 3-month follow-up CTA. After an uneventful EVAR procedure, it is safe to leave out the early postprocedural CTA.

Early Follow-Up After Endovascular Aneurysm Repair: Is the First Postoperative Computed Tomographic Angiography Scan Necessary?

2012 ◽  
Vol 19 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Kyriakos Oikonomou ◽  
Felipe C. Ventin ◽  
Kosmas I. Paraskevas ◽  
Peter Geisselsöder ◽  
Wolfgang Ritter ◽  
...  
Keyword(s):  
Endovascular Aneurysm Repair ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Tomographic Angiography ◽  
Aneurysm Repair

Aneurysm Sac Pressure Measurement with a Pressure Sensor in Endovascular Aortic Aneurysm Repair

Vascular ◽  
2006 ◽  
Vol 14 (5) ◽  
pp. 264-269 ◽  
Author(s):  
Lisandro Carnero ◽  
Ross Milner
Keyword(s):  
Imaging Techniques ◽  
Standard Of Care ◽  
Computed Tomographic Angiography ◽  
Current Standard ◽  
Pressure Sensing ◽  
Computed Tomographic ◽  
Radiologic Imaging ◽  
The Us ◽  
Tomographic Angiography ◽  
Aneurysm Repair

Aortic endograft surveillance is a necessity for the lifetime of a patient owing to the risk of endoleaks and device complications. The current standard of care for surveillance is radiologic imaging. The most commonly used modality is computed tomographic angiography. Magnetic resonance angiography and ultrasonography have also been used as surveillance tools. These imaging techniques have risks and limitations, and alternative surveillance tools are being investigated. Remote pressure sensing is a promising technology that can provide adjunctive support to the current imaging modalities. The technology is applicable to both abdominal and thoracic endograft implantation and surveillance. It has recently gained clearance from the US Food and Drug Administration for acute aneurysm exclusion during an abdominal endograft insertion. As more data are accumulated, it may be possible for remote pressure sensing to replace current imaging techniques as the sole modality for endograft surveillance.

Does the Type of Endograft Affect AAA Volume Change after Endovascular Aneurysm Repair?

2003 ◽  
Vol 10 (3) ◽  
pp. 406-410 ◽  
Author(s):  
Maarten J. van der Laan ◽  
Monique Prinssen ◽  
Daniel Bertges ◽  
Michel S. Makaroun ◽  
Jan D. Blankensteijn
Keyword(s):  
Volume Change ◽  
Endovascular Aneurysm Repair ◽  
Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Absolute Volume ◽  
Significant Difference ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Aneurysm Repair

Purpose: To compare thrombus volume changes in a longitudinal study over 2 years after endovascular aneurysm repair using the Ancure and Excluder endografts. Methods: In 2 institutions, all consecutive patients treated with a bifurcated Ancure or Excluder endograft were included in this retrospective comparison of computed tomographic angiography (CTA) data recorded and stored to disk postoperatively and at the 12 (12M) and 24-month (24M) follow-up examinations. In one institution, among 45 Ancure endograft patients, 35 (group A) had the 3 requisite scans available. In the second institution, 23 (group B) of 36 patients with the Excluder endograft were eligible for analysis. The proportional volume change was calculated at 12M and 24M and compared to the postoperative CT data. More than 10% shrinkage was considered significant. Results: In both groups, the median absolute volume changed significantly. In group A, significant shrinkage was found in 66% (23/35) at 12M and 74% (26/35) at 24M; in group B, 46% (10/23) had significant shrinkage at 12M as well as at 24M (p=0.027 for the difference between groups A and B at 24M). Statistical analysis of the proportional volume change showed a significant difference between the Ancure and the Excluder devices at 12M (p=0.009) and 24M (p=0.001). Multivariate analysis found aneurysm size (p<0.012) and endograft type (p=0.026) to be independently predictive of the absolute volume change. Conclusions: Sac volume shrinkage after endovascular aneurysm repair is less pronounced and less frequent with the Excluder endoprosthesis than with the Ancure endograft.

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