David Nabi, MD, Erin H. Murphy, MD, Jimmy Pak, MD, Christopher K

Slides:

Advertisements

Similar presentations

Endoleak after endovascular aneurysm repair: Duplex ultrasound imaging is better than computed tomography at determining the need for intervention Greg.

Advertisements

Yehuda G. Wolf, MD, Bradley B. Hill, MD, W

The value of the initial post-EVAR computed tomography angiography scan in predicting future secondary procedures using the Powerlink stent graft Mitul.

Progressive growth of a pelvic collection five years after endovascular aneurysm repair: An atypical presentation of an asymptomatic contained rupture

Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD

Lee J. Goldstein, MD, Combiz Rezayat, MD, Gautam V

Victor J. Davila, MD, William Stone, MD, Audra A

The chimney procedure is an emergently available endovascular solution for visceral aortic aneurysm rupture Felix J.V. Schlösser, MD, PhD, John E. Aruny,

A new technique for reconstruction of the aortic bifurcation with saphenous vein panel graft Alexandros Mallios, MD, Benoit Boura, MD, Faris Alomran,

Hari R. Kumar, MD, Mark K. Eskandari, MD

A comparison between contrast-enhanced ultrasound imaging and multislice computed tomography in detecting and classifying endoleaks in the follow-up after.

Aortoduodenal fistula 5 years after endovascular abdominal aortic aneurysm repair with the Ancure stent graft Blaine J. Ruby, MD, Thomas H. Cogbill,

Clinical outcomes for endovascular repair of abdominal aortic aneurysm with the Seal stent graft Jeong Ho Kim, MD, Young Kwon Cho, MD, Tae-Seok Seo,

Aortic neck enlargement after endovascular aneurysm repair using balloon-expandable versus self-expanding endografts Janis Savlovskis, MD, Dainis Krievins,

Combined surgical and endovascular treatment of aortic arch aneurysms

Visceral embolus protection by catheters with balloon-inflatable tips during hybrid repair of thoracoabdominal aortic aneurysm Mojtaba Sadeghi-Azandaryani,

Peyman Benharash, MD, Jason T. Lee, MD, Oscar J

Novel technique for endovascular salvage of a folded aortic endograft

Christopher K. Zarins, MD, Rodney A. White, MD, Thomas J. Fogarty, MD

Role of type II endoleak in sac regression after endovascular repair of infrarenal abdominal aortic aneurysms Jared Kray, DO, Spencer Kirk, DO, Jan Franko,

Sang-Jun Park, MD, Mi-Na Kim, MD, Tae-Won Kwon, MD, PhD

Late conversion of aortic stent grafts

John W. Fehrenbacher, MD, Robert A. McCready, MD

Endoleak after endovascular aneurysm repair: Duplex ultrasound imaging is better than computed tomography at determining the need for intervention Greg.

Late Gore Excluder endoprosthesis fabric tear leading to abdominal aortic aneurysm rupture 5 years after initial implant Anand Dayama, MD, Nikolaos Tsilimparis,

Bruce A. Perler, MD, MBA Journal of Vascular Surgery

Nikolaos Tsilimparis, MD, PhD, E. Sebastian Debus, MD, PhD, Gustavo S

What is the clinical utility of a 6-month computed tomography in the follow-up of endovascular aneurysm repair patients? Michael R. Go, MD, Joel E. Barbato,

Endovascular repair of aortic arch false aneurysm with branched endograft Andrew Schiro, MD, MRCS, Ganesh Kuhan, MD, FRCS, Adam Pichel, MB, ChB, FRCA,

Endovascular rescue of long-term vascular graft implants and need for continuous surveillance Brian M. Leoce, BS, Herbert Dardik, MD, FACS, Phillip Bahramipour,

Bitubular graft as an adjunct for laparoscopic hybrid repair of an abdominal aortic aneurysm Raphaël Coscas, MD, Clément Capdevila, MD, Olivier Goeau-Brissonniere,

First report of a late type III endoleak from fabric tears of a Zenith stent graft Anders Wanhainen, MD, PhD, Rickard Nyman, MD, PhD, Mats-Ola Eriksson,

Niyant V. Patel, MD, Graham W. Long, MD, Zulfiqar F

Endovascular abdominal aortic aneurysm repair in a patient with Ehlers-Danlos syndrome Maseer A. Bade, MD, Luis A. Queral, MD, Dipankar Mukherjee, MD,

Endovascular repair of an iliac artery aneurysm in a patient with Ehlers-Danlos syndrome type IV Britt H. Tonnessen, MD, W. Charles Sternbergh, MD, Krishna.

Explant analysis of AneuRx stent grafts: relationship between structural findings and clinical outcome Christopher K Zarins, MD, Frank R Arko, MD, Tami.

Pegge Halandras, MD, Ross Milner, MD Journal of Vascular Surgery

Outcome of common iliac arteries after straight aortic tube-graft placement during elective repair of infrarenal abdominal aortic aneurysms Réda Hassen-Khodja,

Christopher M. Faries, BA, Rami O. Tadros, MD, Paul S

The trifurcated endograft technique for hypogastric preservation during endovascular aneurysm repair David J. Minion, MD, Eleftherios Xenos, MD, Ehab.

Management of late main-body aortic endograft component uncoupling and type IIIa endoleak encountered with the Endologix Powerlink and AFX platforms

Outcomes of endovascular aneurysm repair with selective internal iliac artery coverage without coil embolization Konstantinos O. Papazoglou, MD, PhD,

Surgical versus endovascular treatment of traumatic thoracic aortic rupture Philippe Amabile, MD, Frédéric Collart, MD, Vlad Gariboldi, MD, Gilles Rollet,

Endovascular rescue of long-term vascular graft implants and need for continuous surveillance Brian M. Leoce, BS, Herbert Dardik, MD, FACS, Phillip Bahramipour,

Mid- and long-term device migration after endovascular abdominal aortic aneurysm repair: A comparison of AneuRx and Zenith endografts Britt H. Tonnessen,

Juan Carlos Jimenez, MD, Wesley S. Moore, MD, William J

Thoraflex Hybrid Endovascular Frozen Elephant Trunk Device for Treatment of Complex Aortic Arch Disease John H. Landau, Luc A. Dubois, Adam H. Power,

Successful endovascular repair of a ruptured abdominal aortic aneurysm in a patient with unfavorable anatomy Benjamin R. Grey, MB. ChB, MRCS, John S.

Endoleak as a predictor of outcome after endovascular aneurysm repair: AneuRx multicenter clinical trial Christopher K. Zarins, MDa, Rodney A. White,

Endovascular repair of bilateral common iliac artery aneurysms following open abdominal aortic aneurysm repair with preservation of both hypogastric arteries.

Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft Gary Lemmon, MD, Andrew Barleben, MD, Peter.

Sideways displacement of the endograft within the aneurysm sac is associated with late adverse events after endovascular aneurysm repair Evert J. Waasdorp,

One-year follow-up after total endovascular repair of a contained-ruptured thoracoabdominal aortic aneurysm with the sandwich technique Theodosios Bisdas,

Aortic type B dissection with acute expansion of iliac artery aneurysm in previous endovascular repair with iliac branched graft Raffaele Pulli, MD,

A hybrid approach using a composite endovascular and open graft procedure for a symptomatic common femoral aneurysm extending well above the inguinal.

An operative method for surgical revision of a late failure after endovascular repair of an abdominal aortic aneurysm Suhail Anwar, FRCS, Yousif Al-Khattab,

Totally laparoscopic explantation of migrated stent graft after endovascular aneurysm repair: A report of two cases Judith C. Lin, MD, Ralf Kolvenbach,

Jade S. Hiramoto, MD, Catherine K. Chang, MD, Linda M

Aortic neck enlargement after endovascular aneurysm repair using balloon-expandable versus self-expanding endografts Janis Savlovskis, MD, Dainis Krievins,

Diagnosis and relining techniques for delayed type IIIB endoleaks with the second- generation AFX endograft Gary Lemmon, MD, Andrew Barleben, MD, Peter.

Secondary interventions following endovascular abdominal aortic aneurysm repair using current endografts. A EUROSTAR report Roel Hobo, MSc, Jacob Buth,

Endoleaks after endovascular graft treatment of aortic aneurysms: Classification, risk factors, and outcome Reese A. Wain, MD, Michael L. Marin, MD,

Contrast-enhanced Duplex surveillance after endovascular abdominal aortic aneurysm repair: Improved efficacy using a continuous infusion technique Esteban.

Endovascular repair of abdominal aortic aneurysms in patients with congenital renal vascular anomalies David B. Kaplan, MD, Christopher C. Kwon, MD,

Sang-Jun Park, MD, Mi-Na Kim, MD, Tae-Won Kwon, MD, PhD

Endovascular repair of stent graft collapse by stent-protected angioplasty using a femoral-brachial guidewire Drosos Kotelis, MD, Ruben Lopez-Benitez,

Repair of juxtarenal para-anastomotic aortic aneurysms after previous open repair with fenestrated and branched endovascular stent grafts Donald J. Adam,

Surgical Technique of Total Arch Replacement for Failed Thoracic Endovascular Aortic Repair Yasunori Iida, MD, Yukio Obitsu, MD, Nobusato Koizumi, MD,

Michael P. Jenkins, MD, Stéphan Haulon, MD, PhD, Roy K

Open repair of abdominal aortic aneurysm in a centenarian

Presentation transcript:

Open surgical repair after failed endovascular aneurysm repair: Is endograft removal necessary? David Nabi, MD, Erin H. Murphy, MD, Jimmy Pak, MD, Christopher K. Zarins, MD Journal of Vascular Surgery Volume 50, Issue 4, Pages 714-721 (October 2009) DOI: 10.1016/j.jvs.2009.05.024 Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 1 Aortic neck plication. A, A band of Dacron graft is placed circumferentially around the infrarenal aortic neck and (B) secured to itself with 4-0 polypropylene suture. C, The band is then serially tightened and secured with additional sutures until a tight band is formed around the exterior of the aorta, compressing it against the endograft. Journal of Vascular Surgery 2009 50, 714-721DOI: (10.1016/j.jvs.2009.05.024) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 2 Partial endograft preservation. A, The aneurysm is exposed, and a band of Teflon felt fabric is wrapped around the aortic neck. The aorta is then clamped and opened. B, The proximal attachments of the endograft are removed from the aorta, (C) and the proximal stent is resected. D, A bifurcated Dacron graft is anastomosed to the remaining portion of the stent graft. The aneurysm sac is then closed over the repair. Journal of Vascular Surgery 2009 50, 714-721DOI: (10.1016/j.jvs.2009.05.024) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 3 The endograft main body or iliac limbs may be collapsed and inserted into the main body or iliac limbs of the Dacron surgical graft, respectively. A, The self-expanding nitinol stents (yellow arrow) of the endograft create an anastomotic seal. B, Several tacking sutures (blue arrow) are placed incorporating both the Dacron graft and distal endograft to ensure that there is no slippage of the junction. Journal of Vascular Surgery 2009 50, 714-721DOI: (10.1016/j.jvs.2009.05.024) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 4 A, Preoperative image of the patient from Fig 1 shows a proximal type I endoleak (blue arrow) unamenable to endovascular intervention. The patient underwent conversion with creation of a proximal aortic wrap allowing complete endograft preservation. B, The postoperative image demonstrates recreation of the proximal endograft seal by the aortic wrap (yellow arrow) and elimination of endoleak. Journal of Vascular Surgery 2009 50, 714-721DOI: (10.1016/j.jvs.2009.05.024) Copyright © 2009 Society for Vascular Surgery Terms and Conditions

Fig 5 Computed tomography (CT) scans of the same patient (A) before initial endovascular aneurysm repair (EVAR) and (B) after initial EVAR. Note on image (B) that while iliac fixation is maintained, there is a persistent type 1 endoleak associated with an angulated, reverse-funnel neck. On the CT scan image to the far right (C), completed after time of delayed conversion to open repair, note the absence of endoleak and preservation of the distal endograft. Journal of Vascular Surgery 2009 50, 714-721DOI: (10.1016/j.jvs.2009.05.024) Copyright © 2009 Society for Vascular Surgery Terms and Conditions