Abstract:
OBJECTIVE:Aortoaortic tube graft repair was the first technique used for the endovascular treatment of abdominal aortic aneurysms (AAAs). However, progressive changes in the morphology of the distal aortic neck may be responsible for procedural failure. This study examines the use of aortoaortic tube prostheses and analyzes the factors that contributed to their failure and the methods used for their subsequent repair. METHODS:During a 7-year period, 462 patients with abdominal aortic aneurysms underwent endovascular aortic aneurysm repair. Of these, 65 patients (14%) underwent treatment with aortoaortic tube endoprostheses. Aortoaortic tube prostheses used included Talent (n = 44) (Medtronic-Worldmedical, Sunrise, Fla), Vanguard (n = 8) (Boston Scientific, Natick, Mass), EVT/Ancure (n = 4) (Guidant, Menlo Park, Calif), and physician-fabricated (n = 9). All the tube graft procedures were performed in the operating room with fluoroscopic guidance. The average age of patients for aortoaortic tube grafts was 74.5 years, and 48 of the patients were men. Failure was defined as aneurysm expansion, any type I endoleak, or type II endoleak persistent after 6 months. RESULTS:No aneurysm ruptures or perioperative deaths were seen. Retrograde aneurysm perfusion from lumbar or inferior mesenteric arteries (type II endoleak) that persisted beyond 6 months was present in three patients. Proximal attachment site endoleaks were present in two patients. No distal implantation site endoleaks were present within 1 month of the initial endovascular repair; however, endoleaks at the distal attachment site developed in 12 patients subsequently and included all graft types (Talent, n = 6; Vanguard, n = 2; Ancure/EVT, n = 1; physician-fabricated, n = 3). The average time interval to failure was 12.9 months. Preoperative distal aortic neck length showed a significant correlation with the subsequent development of distal endoleak (endoleak, 16.6 +/- 6.8 versus no endoleak, 23.3 +/- 9.6; P =.03). Preoperative distal aortic neck diameter, however, did not show significance (23.8 +/- 5.2 versus 22.6 +/- 4.7; P = not significant). CONCLUSION:Endovascular aortoaortic tube grafts are vulnerable to failure even when initial exclusion of the aneurysm is successful. A significant association is seen between distal neck length and eventual failure. Because of the propensity toward eventual failure, the use of aortoaortic tube grafts in the infrarenal aorta cannot be recommended for typical fusiform aneurysms, even when an adequate distal neck appears to be present.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Faries PL,Briggs VL,Rhee JY,Burks JA Jr,Gravereaux EC,Carroccio A,Morrissey NJ,Teodorescu V,Hollier LH,Marin MLdoi
10.1067/mva.2002.123684subject
Has Abstractpub_date
2002-05-01 00:00:00pages
868-73issue
5eissn
0741-5214issn
1097-6809pii
S0741521402341259journal_volume
35pub_type
杂志文章abstract:OBJECTIVE:This study assessed the effect of cellular and humoral autoimmune response inhibition after immunization with β2-glycoprotein I (β2-GPI) and the effect of immunomodulation with interleukin (IL)-2 and IL-10 in the development of early atherosclerotic vascular lesion in a murine model. Atherosclerosis is increa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.05.096
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:This study explored the long-term outcomes of arteriovenous fistulas treated with vonapanitase (recombinant human elastase) at the time of surgical creation. METHODS:This was a randomized, double-blind, placebo-controlled trial of 151 patients undergoing radiocephalic or brachiocephalic arteriovenous fistula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2016.08.101
更新日期:2017-04-01 00:00:00
abstract::We present a hybrid endovascular approach to a 6.5-cm aneurysm of the right-sided aortic arch with an aberrant left subclavian artery arising from a Kommerell diverticulum, connected to the left pulmonary artery through the ligamentum arteriosum. The two-step procedure consisted of a bilateral carotid-subclavian bypas...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.04.065
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:Constrictive extracellular matrix (ECM) remodeling contributes significantly to restenosis after arterial reconstruction, but its molecular regulation is poorly defined. Hyaluronan (HA) accumulates within ECM at sites of injury where it is thought to facilitate smooth muscle cell (SMC) trafficking and collage...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.03.047
更新日期:2014-03-01 00:00:00
abstract::Peripheral arterial disease (PAD) is well recognized as a marker for systemic atherosclerosis. Platelets play an essential role in all stages of the disease, contributing to both thrombosis and the development of atherosclerosis. Medication regimens to optimize outcomes in both patients who are to undergo revasculariz...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2014.07.006
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:Intraoperative duplex scanning (IDS) after carotid endarterectomy (CEA) has been shown to reliably identify major defects either by significant changes in peak systolic velocities or by B-mode imaging. To evaluate whether IDS could also predict postoperative strokes in technically flawless CEAs, we analyzed sev...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.120044
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Black patients have a higher mortality rate than nonblacks after abdominal aortic aneurysm repair. We sought to understand the factors responsible for this racial disparity in the mortality rate after aneurysm repair. METHODS:The Medicare database (2001-2006) was used to identify 160,785 patients undergoing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.05.020
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:Randomized trials have shown an initial survival benefit of endovascular over conventional open abdominal aortic aneurysm repair but no long-term difference up to 6 years after repair. Longer follow-up may be required to demonstrate the cumulative negative impact on survival of higher reintervention rates ass...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2017.05.122
更新日期:2017-11-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119747
更新日期:2002-04-01 00:00:00
abstract::Peripheral arterial disease (PAD) is a highly prevalent public health problem associated with major detrimental effects on quality of life and functional status, and it is also the main cause of limb amputation. More importantly, PAD has been classified as a coronary artery disease equivalent, meaning that patients wi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2009.08.085
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the outcome of infrapopliteal bypass when an adjuvant arteriovenous (AV) fistula was reconstructed as means of rescue as a result of poor runoff. The design was a retrospective multicenter case-control study. METHODS:Seventy-seven infrapopliteal vein bypasses required an a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2006.06.037
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:Ultrasonic measurement techniques for determining intima-media thickness and total arterial wall thickness have been described. The intima-media thickness measurements are currently in use in large epidemiologic trials. Intima-media thickness does not evaluate extramedial atherosclerotic change and so may not f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70051-6
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:Renal artery stent placement is a recognized treatment for patients with hemodynamically significant renal artery stenosis when medical therapy fails. Duplex ultrasound (DUS) is the primary method used for noninvasive assessment of renal artery patency. Arterial stents alter the compliance of the artery, whi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.066
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to acquire insight into the interpretation of intravascular ultrasound images of the abdominal aorta and to assess to what extent this technique can provide useful parameters for the endovascular treatment of patients with abdominal aortic aneurysm. STUDY DESIGN:This was a des...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70366-0
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the incidence, severity, and etiologic factors of the development of colon ischemia after endovascular aortoiliac aneurysm repair (EVAR). METHODS:During the last 9 years we performed 278 elective EVARs using a variety of grafts. To facilitate these repairs, one hypoga...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.119241
更新日期:2001-12-01 00:00:00
abstract::The 10-year experience of a single community was reviewed and a multivariate analysis was performed to determine the relative importance of clinical and environmental factors in mortality after ruptured abdominal aortic aneurysm resection. Ruptured aneurysms were repaired in 243 patients in six area hospitals (one uni...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.18639
更新日期:1990-04-01 00:00:00
abstract::A junior member of the vascular surgery faculty has done two robotic abdominal aneurysmectomies. Although he attended a standard 2-day training course conducted by the instrument manufacturer, performed several similar procedures in the animal laboratory, and read all the recent pertinent literature, technical errors ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.121817
更新日期:2002-02-01 00:00:00
abstract::A nonrandomized prospective clinical study was undertaken to evaluate the technique and efficacy of in vitro endothelial cell lining of synthetic grafts. Twenty-six patients (10 men and 16 women with a mean age of 68.4 years; range, 49 to 80 years) with end stage chronic peripheral vascular disease requiring reoperati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:The hemodynamic effects of carotid angioplasty with stent placement (CAS) on the collateral blood supply and on the regional cerebral blood flow (rCBF) have not been established. Recently, arterial spin-labeling (ASL) magnetic resonance imaging (MRI) has been introduced as the first method to quantify the ac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2006.11.067
更新日期:2007-06-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.111
更新日期:2011-04-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.175
更新日期:2011-01-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.043
更新日期:2018-12-01 00:00:00
abstract::Complete endovascular arch replacement by in situ fenestration technique requires maintenance of cerebral perfusion during the fenestration procedure by an extracorporeal femoral-carotid bypass. The bypass has the disadvantages of being invasive, requiring a pump, and shunting blood extracorporeally. This report descr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.04.064
更新日期:2012-10-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1067/mva.2002.124231
更新日期:2002-06-01 00:00:00
abstract:PURPOSE:Many viruses have evolved mechanisms to evade detection by the host immune system. The herpes simplex gene ICP47 encodes a protein that binds to the host antigen-processing transporter, inhibiting the formation of major histocompatibility complex class I (MHC-I) antigens in infected cells. MHC-I antigen express...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare 30-day postoperative mortality for patients undergoing endovascular repair of ruptured abdominal aortic aneurysm (rAAA) using locoregional vs general anesthesia. Unlike the open approach, endovascular repair of rAAA can be performed using either locoregional or gener...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.077
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Macrophages play a critical role in the initiation and progression of abdominal aortic aneurysm (AAA) and are classically distinguished into M1 "proinflammatory" and M2 "anti-inflammatory" macrophages. Topical application of elastase associated with transforming growth factor β (TGF-β) systemic neutralization...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.09.045
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:During endovascular aneurysm repair (EVAR), severely tortuous aortoiliac anatomy can alter the deployment and conformability of the endograft. The accuracy of treatment length measurements is commonly recognized to be affected by severe tortuosity. However, the exact mechanism of the postintervention length d...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.09.041
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:This retrospective review describes surgical management of atherosclerotic renovascular disease (RVD) in hypertensive adults with diabetes mellitus. METHODS:From July 1987 through July 1995, 54 consecutive hypertensive diabetics (mean 213/103 mm Hg; mean medications three drugs) requiring either insulin (16 pa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70194-5
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:We assessed the incidence and outcomes of graft-related secondary interventions (ie, open conversion or proximal or distal extensions) after elective thoracic endovascular aortic repair (TEVAR) for aneurysmal disease. METHODS:An institutional review of TEVAR for descending thoracic aortic aneurysms (DTAAs), ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.124
更新日期:2013-05-01 00:00:00