The last available evidence suggests that open surgery should be the preferred treatment for intact descending thoracic aortic aneurysms. However, this study recently published in J Am Coll Cardiol, seems to have steered the wheel. In this study, open surgery was associated to increased early mortality and lower late mortality. Despite this long-term benefit, mean...
Abdominal Aortic Aneurysm (AAA) rupture rate in the UK justifies the current surveillance programs and bring ease to some physicians that at some point have cast a shadow on their efficacy. This study also endorses reference thresholds to intervene patients. In 2009, the UK National Health Service (NHS) implemented a AAA national surveillance scheme where...
Courtesy of Dr. Carlos Fava. Currently, one of our medical challenges is to conduct procedures requiring access with large introducer sheaths in a simpler way, without requiring surgical intervention and closing with percutaneous devices while maintaining procedural quality and safety. There are several devices, but they require a learning curve and the only information available comes...
With the remarkable drop in tobacco use across the world, also dropped mortality associated to abdominal aorta aneurysm rupture (AAA). All AAA screening programs have been designed decades ago, when the risk was higher. This is why we might need to rethink these programs, or at least design new randomized controlled studies to pave the...
This is the largest and most recent analyzis to show colonic ischemia is more frequent after open abdominal aortic aneurysm repair (2.1% a 3.6%), compared against endovascular repair (0.5% a 1%), especially in elective patients. Most cases presented within the first 7 days. The evidence is not enough to determine the cause behind the different...
While the endovascular repair of aortic aneurysms has steadily become the number one option for aneurysms in which necks are adequate and which meet the specifications of device manufacturers. New technologies have arisen. These advancements allowed the expansion of this indication to more complex anatomies, such as those involving a short neck, no neck, or...
Compared to surgery, endovascular repair of ruptured abdominal aorta aneurysms has better clinical results, survival and quality of life for patients (in addition to being cost-effective), according to mid-term outcomes of the IMPROVE study, recently published in the British Medical Journal. Even though the initial outcomes had not shown differences between both strategies in terms of...
Original title: Mortality from ruptured abdominal aortic aneurysms: clinical lessons from a comparison of outcomes in England and the USA. Reference: Karthikesalingam A et al. Lancet. 2014;383:963-969. Treatment strategy for rAAA patients may vary according to the different centers. This study analyzed in-hospital mortality, and mortality after intervention of all patients admitted with rAAA between 2005 and 2010...
Original title: Endovascular Treatment of Aorto-iliac Aneurysms: Four-year Results of Iliac Branch Endograft. Reference: G. Pratesi et al. Eur J Vasc Endovasc Surg. 2013 Jun;45(6):607-9. Iliac bifurcated devices have proven to be effective in treating common iliac aneurysms but the findings are based on small series, generally from a sole center experience. This multicenter registry included 85 patients...
Original title: The Single-centre Experience of the Supra-arch Chimney Technique in Endovascular Repair of Type B Aortic Dissections. Reference: Y. Zhu et al. European Journal of Vascular and Endovascular Surgery Volume 45 Issue 6 June/2013. Endovascular repair of type B aortic dissection (TEVAR) involving the arch, requires special techniques to preserve supra aortic vessels as fenestrated prostheses or...