New unibody endologix endografts for the endovascular repair of abdominal aortic aneurysm 3-4-year safety followup At present, we have seen endovascular intervention of abdominal aortic aneurysm (EVAR) increase over surgical repair. However, the procedure is not free from complications, endoleak being the most frequent. Indeed, according to different series, it has a 20-25% incidence in AAA. Most…
Detection of Late Complications After EVAR
This work addressed the occurrence of complications after endovascular aortic aneurysm repair (EVAR) for the treatment of infrarenal abdominal aortic aneurysms in a cohort of 454 patients with a 5.2-year follow-up. About 25% of patients experience complications of some kind. As opposed to other studies, here, the vast majority of those complications were asymptomatic and had…
Anesthetic Modes and Their Impact on Elective Endoprostheses
This work supports previous observations on the mortality benefit of regional (and even local) anesthesia in patients who undergo elective endovascular aneurysm repair for the treatment of infrarenal abdominal aortic aneurysms. These benefits also translated into a shorter hospital stay, but not into less pulmonary complications, which is what previous studies had suggested. Minimally invasive…
EVAR with No Complications in Octogenarians: Survival Rate Identical to that of Healthy Octogenarians
This analysis reports (for the first time in the literature) that after the endovascular aortic aneurysm repair (EVAR) in octogenarians, survival rate is the same as that of their healthy counterparts. This is true provided the procedure does not present complications. If any, mortality results twice as high in this group. Using propensity score, researchers…
Surveillance after EVAR: When and How Long
It has been suggested that surveillance after endovascular abdominal aorta aneurysm repair (EVAR) should be for life, seeing as on one hand we are not sure how long these devices last (and they keep coming out), and on the other hand, there could be late complications, such as type 2 leaks. This is why the…
Vascular Surgeons of the Future in the Endovascular Era
The use of endovascular aneurysm repair (EVAR) for the treatment of infrarenal abdominal aortic aneurysms is widely spread, due to its minimally invasive approach, rapid recovery, and better short-term survival. Approximately 60% of all infrarenal abdominal aortic aneurysms (AAAs) repairs in Europe and 85% in the United States are by EVAR. A decade ago, we believed…
Are Abdominal Aortic Aneurysm Screening Programs Overstated?
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…
Post EVAR Contrast Enhanced Ultrasound Based Follow Up Reduces CT by 90%. Is It Safe Though?
This four-year retrospective analyzis has shown that contrast enhanced ultrasound based follow up protocol post endovascular aortic repair is safe and effective. Aneurysm related mortality, reintervention rate, sac retraction and endoleak detection resulted similar to that of CT based follow up protocols. In this study, doppler and enhanced contrast ultrasound were the main follow up…
Risk of Colonic Ischemia after Abdominal Aortic Aneurysm Repair
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…
Surprisingly, some patients won’t do as told and have less events
Today endovascular aneurysm repair (EVAR) is the preferred option to treat patients with abdominal aortic aneurysms, even though studies have shown reintervention rate is around 20% at 5 years. Consequently, guidelines recommend life EVAR surveillance imaging to identify and treat eventual leaks and prevent aneurysms from growing and eventually rupturing. There are several population and observational studies…
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