Abstract:
:Recent reports have documented poor long-term results following endovascular aneurysm repair (EVAR) of large abdominal aortic aneurysms (AAA). EVAR of small AAAs may result in improved long-term results compared to large AAAs. It is not known whether the frequency of anatomic suitability for EVAR is increased for small compared to large AAAs. This study compared the anatomic suitability of large and small AAAs for EVAR in an unselected patient population. Radiology reports for all computed tomography (CT) scans in a single hospital over a recent 3-year period were reviewed. AAAs diagnosed by contrasted CT scans with cuts >7 mm were excluded. Suitability for EVAR was determined by neck diameter, length, and angulation. In addition, iliac diameters and common iliac distal landing zone lengths were determined. Computerized 3-dimensional (3D) reconstruction was used to measure neck angulation and total aortic tortuosity. One hundred ninety-one patients were found to have AAAs with adequate CT scans for evaluation. Suitability for EVAR was highest in patients with AAA diameters of 3-4 cm and declined with increasing size of the AAA. Dividing AAAs into sizes greater than or less than 5.5 cm revealed that small AAAs had significantly longer necks, less neck angulation, longer common iliac landing zones, and less total aortic tortuosity. Multivariable analysis revealed that maximal aortic diameter was the only independent predictor of suitability for EVAR (p = 0.005, odds ratio 1.67, CI 95% = 1.17 to 2.38). The odds ratio predicts that with each 1 cm increase in size, the likelihood of suitability decreased by 5.3-fold. Small AAAs have less complex anatomy with longer aortic necks, less neck angulation, and less tortuosity. The poor outcomes following the treatment of large AAAs is thought to be due to complex anatomy. EVAR of less anatomically challenging small AAAs may improve long-term outcomes.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Welborn MB 3rd,Yau FS,Modrall JG,Lopez JA,Floyd S,Valentine RJ,Clagett GPdoi
10.1177/153857440503900502keywords:
subject
Has Abstractpub_date
2005-09-01 00:00:00pages
381-91issue
5eissn
1538-5744issn
1938-9116journal_volume
39pub_type
杂志文章abstract::The technical success of an endovascular abdominal aortic aneurysm repair depends on the endograft exclusion of the aneurysm along with preservation of flow to major aortic branches, such as the renal or hypogastric artery. A proximally malpositioned aortic endograft may result in inadvertent renal artery occlusion, w...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440403800109
更新日期:2004-01-01 00:00:00
abstract::Reperfusion injury is the paradoxical and complex phenomenon of exacerbation of cellular dysfunction and increase in cell death after the restoration of blood flow to previously ischemic tissues. It involves biochemical and cellular changes causing oxidant production and complement activation, which culminates in an i...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574407304510
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abstract:PURPOSE:The snorkel technique is commonly used to preserve renal arteries in juxta renal aneurysm during endovascular repair. Herein, we present a patient who underwent bifurcated endograft implantation with snorkel technique for inferior mesenteric artery (IMA) in order to preserve the major source of bowel circulatio...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574418758597
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abstract:BACKGROUND:Hybrid procedures for thoracoabdominal aortic aneurysms (TAAA) have been previously described as an attractive alternative to open reconstruction. PATIENTS AND METHODS:Between 1999 and 2009, 16 patients with a median age of 67years underwent hybrid repair of a TAAA (Crawford type I: 3, type II: 3, type III:...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574409347390
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:The carotid sheath contains clinically important and vital anatomical neurogenic, vascular, and lymphatic structures that allow for a great variety of lesions. Vascular anomalies found in the carotid sheath are rarely reported and may be easily misdiagnosed as arterial aneurysms, neurogenic tumors, paragangl...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574419879849
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abstract::First-bite syndrome (FBS) is an infrequently encountered complication of parapharyngeal space surgery. Patients experience excruciating pain in the ipsiltateral parotid gland region at the first bite of each meal, which improves with subsequent mastication. This is thought to be due to parotid gland sympathetic denerv...
journal_title:Vascular and endovascular surgery
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abstract::Internal iliac artery aneurysms are a rare variant of aorto-iliac aneurysm disease. They are associated with high mortality if managed conservatively. Open surgery is associated with significant morbidity and mortality especially when performed for rupture. Endovascular stent coverage after feeding vessel embolization...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574410369387
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abstract:INTRODUCTION:Arterial pseudoaneurysms (PSAs) are the most common access site complication following transarterial catheter intervention. Ultrasound-guided injection of thrombogenic substances into perfused arterial PSAs followed by compression therapy is a well-established and less invasive treatment option than surgic...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574420934631
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abstract::Thoracic endografting offers many advantages over open repair. However, delivery of the device can be difficult and may necessitate adjunctive procedures. We describe our techniques for preserving perfusion to the left subclavian artery despite endograft coverage to obtain a proximal seal zone. We reviewed our experie...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574406293735
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abstract:OBJECTIVES:Patients referred for fenestrated/branched endovascular aortic repair (F/BEVAR) often present with a previous computed tomography angiogram (CTA), but it is unknown how recent the CTA must be to ensure accurate F/BEVAR planning. We sought to determine whether anatomic planning parameters change significantly...
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abstract::A 54-year-old male presented to the vascular service for an urgent inpatient consultation. During an infusaport removal, the catheter was accidentally disconnected and lost intravascularly within the left subclavian vein, with the tip still in the right ventricle. We report on a novel technique for removing such intra...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574413510624
更新日期:2014-01-01 00:00:00
abstract::Symptomatic internal carotid artery (ICA) occlusion with hemodynamic impairment remains a dismal disease when untreated. In this prospective, single-center, controlled study, we investigated the feasibility, safety, and long-term outcome of stenting by endovascular recanalization for patients with chronic ICA occlusio...
journal_title:Vascular and endovascular surgery
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abstract::Takayasu arteritis is a rare, chronic vasculitis of unknown etiology characterized by inflammation of the aorta and its main branches. Although Takayasu arteritis mostly affects women of childbearing age, there is a paucity in the literature on pregnancy associated with Takayasu arteritis. Pregnant patients are at inc...
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journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
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journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574408328662
更新日期:2009-06-01 00:00:00
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journal_title:Vascular and endovascular surgery
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更新日期:2011-08-01 00:00:00
abstract::Aneurysms of the superior mesenteric artery (SMA) are an uncommon but lethal entity, which must be treated expeditiously to avoid mortality and high incidence of ischemic small bowel complications. In the past 7 years the authors have treated 4 patients with a variety of types of aneurysms involving the SMA and its br...
journal_title:Vascular and endovascular surgery
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abstract::To assess the role of postoperative venography in patients treated with first rib resection and scalenectomy (FRRS) for effort thrombosis, a retrospective review was done to evaluate long-term venous patency in 84 patients treated at the Johns Hopkins Medical Institutions. Patients undergo venography 2 weeks postopera...
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journal_title:Vascular and endovascular surgery
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journal_title:Vascular and endovascular surgery
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更新日期:2008-12-01 00:00:00
abstract::Intraoperative infrainguinal autologous vein graft stenoses are common, and some authors advise revision of these stenoses. But the natural history of these lesions is not clear. This study was undertaken to determine the natural history of duplex-detected intraoperative stenoses with a nonrevision policy. Intraoperat...
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