Abstract:
:Endovascular aneurysm repair has enabled a broad population of patients with infrarenal abdominal aortic aneurysm to be treated by a less-invasive technique. However, endovascular aneurysm repair has therapeutic limitations, including the need for lifelong surveillance and a higher rate of secondary interventions than open repair. These outcomes can promote patient dissatisfaction and result in increased health care costs and associated morbidity and mortality. The primary reason for secondary interventions is continued abdominal aortic aneurysm sac enlargement due to endoleaks. Conventional endovascular aneurysm repair procedures do not address aortic branch vessels that are ligated during open repairs. Secondary measures to occlude these branch vessels have shown efficacy in limiting sac growth, but do not predictably eliminate the need for further interventions. Endovascular aneurysm sealing is a new technique that addresses some of the limitations of conventional endovascular repair. Endovascular aneurysm sealing secures the stent graft flow lumens within a biostable polymer. This stability prevents stent migration while also sealing branch vessels that are otherwise not addressed by other endovascular devices. This new approach to endovascular repair has shown early promise in reducing the rates of endoleak and need for secondary interventions, while opening up the possibility of durable endovascular repair to a more challenging type of anatomy.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Kostun ZW,Woo EYdoi
10.1053/j.semvascsurg.2016.06.004subject
Has Abstractpub_date
2016-03-01 00:00:00pages
50-54issue
1-2eissn
0895-7967issn
1558-4518pii
S0895-7967(16)30009-6journal_volume
29pub_type
杂志文章,评审abstract::Acute limb ischemia is one of the most potentially devastating but treatable diseases faced by the vascular surgeon. It is crucial to identify the ischemic process early, as the outcomes of early intervention can lead to limb salvage, whereas late recognition places the patient at risk for limb loss and potential mort...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.12.004
更新日期:2009-03-01 00:00:00
abstract::The traditional dogma of putting mobile patients with acute deep vein thrombosis into bed for several days has been challenged by some studies that showed a better clinical outcome with walking exercises under good compression. Repeated lung scans did not show an increased risk of new pulmonary embolism. There was a f...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2005.05.006
更新日期:2005-09-01 00:00:00
abstract::In recent years, vascular surgery fellowships have changed substantially to meet the requirements for interventional as well as open surgical training. Data from the Residency Review Committee for Surgery indicate that the average vascular fellow performed fewer than 15 interventional procedures in 2000, but that this...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2006.08.005
更新日期:2006-12-01 00:00:00
abstract::The development of carotid duplex scanning revolutionized the diagnosis of carotid artery disease. Continued advances in the technology as well as widespread experience with cartoid ultrasound have redefined the role this technology plays in the care of patients with carotid atherosclerosis. Recent clinical trials hav...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract::While open or endovascular techniques for treatment of the superficial femoral artery continue to dominate the care of most patients, there are clearly patients who benefit from a combination of these approaches. Typically these patients require treatment of more than a single level of disease. In these cases, endovas...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.11.006
更新日期:2008-12-01 00:00:00
abstract::The use of autologous femoral veins for in situ reconstruction of the aortoiliac segment is an effective technique to treat native aorta or prosthetic graft infections. The indications, technical details, and outcomes of this procedure are detailed. Graft infection involving the aortic segment, while rare, remains one...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2019.07.002
更新日期:2019-01-01 00:00:00
abstract::The continuing evolution of endovascular approaches to the repair of descending thoracic and thoracoabdominal aortic aneurysms necessitates careful evaluation of the safety and efficacy of these alternative therapies as they compare to the "gold standard" of open surgical repair. The purpose of this report is to prese...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.11.009
更新日期:2008-03-01 00:00:00
abstract::Tobacco abuse is a highly prevalent modifiable risk factor in vascular surgery patient populations. Despite the known benefits of smoking cessation, quitting smoking is difficult for most patients. Physician advice to stop smoking can help, though more intensive or multifactorial interventions have greater impact. Smo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2015.10.001
更新日期:2015-06-01 00:00:00
abstract::Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2010.05.001
更新日期:2010-09-01 00:00:00
abstract::The management of patients with thrombosed vein grafts remains a formidable challenge for all vascular surgeons. Management strategies will vary based on a variety of criteria including the patients' overall condition and symptoms, the interval and etiology of graft failure, and the pathological anatomy and availabili...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Constructing vascular access for hemodialysis causes changes in blood flow to the extremity, which can lead to distal ischemia. Ischemic steal syndrome is manifested by pain; weakness; pallor; and, in severe cases, ulceration and tissue loss. Severe ischemia, requiring reintervention, has an incidence of 4%, although ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.07.009
更新日期:2007-09-01 00:00:00
abstract::The decision to operate on a patient with an aortic aneurysm is based on the risk of aneurysm rupture versus the risk of aneurysm repair, within the context of the patient's overall life expectancy. Risk of rupture is still primarily based on the maximum aneurysm diameter, with some allowances made for factors that mo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.04.001
更新日期:2007-06-01 00:00:00
abstract::Early detection of abdominal aortic aneurysms potentially can save many lives by preventing aneurysm rupture. Screening programs, however, have yet to be proven as an efficient means of accomplishing this goal and improving overall life expectancy. Until more information is available, selective high-risk screening may...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.25491
更新日期:2001-09-01 00:00:00
abstract::Endovascular treatment of thoracic aortic pathology (ETAP) has been under development for over a decade. Only recently has one device been approved in the United States for treatment of descending thoracic aortic aneurysms. The length of this development process is due to multiple device and deployment system modifica...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2005.11.003
更新日期:2006-03-01 00:00:00
abstract::Although numerically far less than claudicants, patients with critical leg ischemia (CLI) demand a disproportionately large commitment both in medical effort and economically and represent the major workload for vascular surgical units. The incidence and prevalence of CLI is approximately 500 to 1,000/million/year. Th...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::The main focus when discussing acute or chronic mesenteric ischemia is on occlusive disease, arterial or venous. This article reviews present knowledge on mesenteric nonocclusive hypoperfusion syndromes. The following three clinical entities are reviewed: (1) Intraabdominal hypertension (IAH), or abdominal compartment...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2009.12.009
更新日期:2010-03-01 00:00:00
abstract::Popliteal artery aneurysms are the most common peripheral aneurysm. They are associated with concomitant contralateral popliteal aneurysms and abdominal aortic aneurysms. Patients with unrecognized aneurysms may present with acute limb ischemia and potential for limb loss. Use of preoperative lytic therapy to improve ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2005.09.009
更新日期:2005-12-01 00:00:00
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journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.02.005
更新日期:2007-03-01 00:00:00
abstract::For generations, the use of techniques to defer skin pressure and protect the lower-extremity wound has been a cardinal goal to achieve therapeutic success and healing. Choosing the appropriate postoperative offloading device or shoe is often difficult, as it is challenging to merge optimal mechanical protection with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.10.002
更新日期:2014-03-01 00:00:00
abstract::Aortic infection is an uncommon but life-threatening condition. Conservative medical treatment is insufficient in many cases because of the high risk of persistent infection, aortic rupture, and death. Conventional open surgical treatment consists of extensive tissue debridement, complete removal of the infected prost...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.10.009
更新日期:2011-12-01 00:00:00
abstract::Vascular surgeons well versed in peritoneal dialysis applications understand the importance of this modality among the limited options afforded to patients in renal failure. Peritoneal and hemodialysis strategies are interdependent and should be considered in concert. Careful assessment often shows that patients with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1997-09-01 00:00:00
abstract::The relative merits of aortomonoiliac and bifurcated stent-graft configurations depend on the patient's arterial anatomy and clinical status. Aortomonoiliac stent-grafts are simple to make, simple to insert, and versatile. They are most useful when the iliac artery anatomy is severely distorted and the patient is old,...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract:UNLABELLED:A variety of intraoperative imaging and assessment techniques can be used during carotid endarterectomy (CEA) to evaluate the technical results of the arterial repair. However, the necessity of utilizing these techniques routinely in every case, and the actual ability of these studies to improve the outcomes...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.10.003
更新日期:2007-12-01 00:00:00
abstract::The vascular surgeon, in the absence of effective medical options for the treatment of atherosclerosis, has in the past assumed primary responsibility for the care of patients with peripheral vascular disorders. During the past two decades, management of these patients has become increasingly complex, the direct resul...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::Management of venous ulceration has evolved tremendously during the last 2 decades. There has been considerable progress in our understanding of the pathophysiology, hemodynamics, venous imaging, and therapeutic options for venous ulcers, including endovenous ablation, iliac vein stenting, and vein-valve repair techni...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2015.07.002
更新日期:2015-03-01 00:00:00
abstract::The recent endovascular aneurysm repair (EVAR) 1 and 2 and Dutch Randomized Endovascular Aneurysm Management (DREAM) trials addressed management of abdominal aortic aneurysms (AAAs) larger than 5.5 cm in diameter. The DREAM and EVAR 1 trials randomized patients appropriate for open repair between endovascular repair (...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2006.03.001
更新日期:2006-06-01 00:00:00
abstract::Innominate and subclavian artery lesions run a wide spectrum of disease manifestation and treatment options. Since the first surgical treatment, multiple variances have been attempted with the desire to maintain high long-term patency rates while reducing perioperative morbidity and mortality. The advent of endovascul...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.04.001
更新日期:2011-03-01 00:00:00
abstract::Radiotherapy (XRT) plays a prominent role in the therapy of a variety of malignancies. Improved survival for malignancies treated with XRT has produced a growing subset of patients who present several years later with arterial occlusive disease in the irradiated field. Establishing a presumptive diagnosis of radiation...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0895-7967(03)00026-7
更新日期:2003-09-01 00:00:00
abstract::Several techniques have been developed and clinically applied to reduce the spinal cord ischemia complications that follow thoracoabdominal aortic aneurysm (TAA) repair. Hypothermia as a protective adjunct is a concept that has been used throughout the evolution of cardiac and central aortic surgery. Because experimen...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::It is estimated that 20% to 40% of the patients who survive the acute phase of aortic dissection will develop significant aneurysmal dilatation of the descending thoracic or thoracoabdominal aorta. Aortic dissection has long been considered a risk factor for mortality and neurologic deficit following surgical repair o...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2002.33088
更新日期:2002-06-01 00:00:00