Abdominal aortic aneurysms (AAA) are those of >3 cm aortic diameter. They run the risk of rupture and ensuing death by bleeding. In consequence, they are treated to repair the aneurysm before it ruptures. In this regard, the most relevant predictor of rupture is aneurysm diameter. That is, the greater the aneurysm, the greater the…
Fenestrated Endografts as Treatment for Type I Endoleak: What is the Price of Success?
Both fenestrated and branched endografts are effective to treat patients after failure of their initial endograft due to significant type I endoleak. This situation is costly both because of the devices themselves, and also due to the several endovascular and surgical procedures required. Failure of an endograft to treat an infrarenal abdominal aortic aneurysm due to…
SOLACI PERIPHERAL | Type Ib Endoleak Correction in Patient After Minimally Invasive Hybrid Treatment in Type A Aortic Disection
Here is a new SOLACI PERIPHERAL Case! In this opportunity, Dr. Daniel Zanuttini (Arg.) presents “Type Ib Endoleak Correction in Patient After Minimally Invasive Hybrid Treatment in Type A Aortic Disection”. This is the 8th clinical case presented by SOLACI Peripheral. The purpose of this space is to encourage and further the exchange of experiences…
Abdominal Aortic Aneurysm during the Pandemic: Should They Be Operated or Deferred?
Some European societies have recommended deferring the treatment of infrarenal abdominal aortic aneurysm (AAA) ≥5.5 cm during the COVID-19 pandemic. However, these documents have also suggested optimal deferral times, and everything must be adjusted according to the transmission risk/risk of rupture balance. Annual risk of rupture can be estimated based on a prospective cohort published by…
Which Type 2 Endoleaks Should We Intervene?
This work emphasizes the need to be conservative with type 2 endoleaks, and the need for long-term prospective information to learn about the advantages of intervention. The presence of type 2 endoleaks is associated with reintervention, as it was historically assumed that they increase the risk of sac rupture. However, this new research, published in…
Contralateral Occluded Carotid Defines Revascularization Strategy
A significative lesion to the carotid artery in addition to contralateral carotid occlusion is an obvious factor of high risk for a revascularization procedure. However, this might be true for surgery but not for carotid artery stenting according to this recent publication in JACC. The presence of contralateral carotid occlusion has been established as high…
Solution for Type 1A Endoleaks After Abdominal Endoprosthesis
Proximal type 1 endoleaks after endovascular abdominal aortic aneurysmal repair are challenging to solve, with no existing consensus on the proper solution. This work compared the most radical solution to the problem vs. a more conservative—though still challenging—option. The first one was the surgical explantation of the endoprosthesis with aortic reconstruction, while the more “conservative”…
Screening for Intracranial Aneurysm in Patients with Coarctation: Is It Cost-Effective?
Patients with a history of coarctation of the aorta have a higher prevalence of intracranial aneurysm and frequently suffer subarachnoid hemorrhage at younger ages than the general population. Read also: FREEDOM with FFR: Different Outcomes? Adding a screening stage at age 30—instead of just at ages 10 and 20—is cost-effective. Known data about the prognosis…
SOLACI PERIPHERAL | 5th Clinical Case: Abdominal Aortic Aneurysm with Hostile Neck
New clinical case from SOLACI PERIPHERAL! This time, we present a case featuring an abdominal aortic aneurysm with hostile neck. With this, we wrap up an intense year during which we published 5 clinical cases to deepen and stimulate the exchange between Latin American interventionist colleagues. Tell us what you think about this case using…
Aortic Aneurysms Treated with Endologix AFX Require Special Followup
An FDA document recently published reminds doctors and patients of the need of annual follow up of abdominal aortic aneurysm patients receiving Endologix AFX endoprostheses, with imaging, and for life. The reason behind this recommendation is the risk of type III leaks. In 2019, the FDA had alerted us against this issue after finding a…
Can We Lower the Cutoff Threshold in Abdominal Aortic Aneurysms?
A new diagnostic tool might change the classical abdominal aortic aneurysm (AAA) cutoff thresholds of 5.5 and 5 cm for men and women, respectively. The new ultrasound speckle tracking technology can study AAA wall motion in real time and has the potential to become the new standard for diagnostic and therapeutic decisions. This study looked…