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Endovascular aortic aneurysm repair in patients with narrow aortas using bifurcated stent grafts is safe and effective  Veljko Strajina, MD, Gustavo S.

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Presentation on theme: "Endovascular aortic aneurysm repair in patients with narrow aortas using bifurcated stent grafts is safe and effective  Veljko Strajina, MD, Gustavo S."— Presentation transcript:

1 Endovascular aortic aneurysm repair in patients with narrow aortas using bifurcated stent grafts is safe and effective  Veljko Strajina, MD, Gustavo S. Oderich, MD, Javairiah Fatima, MD, Peter Gloviczki, MD, Audra A. Duncan, MD, Manju Kalra, MBBS, Mark Fleming, MD, Thanila A. Macedo, MD  Journal of Vascular Surgery  Volume 62, Issue 5, Pages e1 (November 2015) DOI: /j.jvs Copyright © 2015 Society for Vascular Surgery Terms and Conditions

2 Fig 1 Drawing demonstrates an aortouniiliac configuration with a femoral-femoral crossover. Reprinted by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

3 Fig 2 In patients with narrow aortic diameter, especially at the level of the contralateral cannulation gate, multiple strategies may be used for successful cannulation, such as (A) retrograde femoral cannulation and (B) using the up-and-over technique via the ipsilateral groin and snare through the contralateral groin or via an antegrade approach through brachial artery access. C, Once the contralateral gate is cannulated, prestent balloon dilatation is performed, (D) followed by bilateral kissing balloon angioplasty. Reprinted by permission of the Mayo Foundation for Medical Education and Research. All rights reserved. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

4 Fig 3 Fluoroscopy shows the contralateral gate using (A) retrograde femoral access, (B) up-and-over technique to cannulate contralateral gate, (C) prestent balloon dilatation, and (D) kissing-balloon angioplasty. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

5 Fig 4 Aortic lumen of the terminal aorta as seen on (A and B) three-dimensional reconstruction of the computed tomography angiogram and (C and D) axial cuts. Images demonstrate the (A and C) preoperative state and the (B and D) postoperative state after kissing-balloon angioplasty was performed. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

6 Supplementary Fig 1 (online only)
Overall patient (Pt) survival after bifurcated endovascular aortic aneurysm repair (B-EVAR) at 1, 5, and 8 years was 86% ± 4%, 75% ± 5%, and 44% ± 7%, respectively, compared with the expected survival of age-matched and gender-matched controls from the general Minnesota (MN) population (P = .77). Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

7 Supplementary Fig 2 (online only)
Freedom from reintervention is shown in patients who underwent endovascular aortic aneurysm repair (EVAR) with bifurcated (B-EVAR) devices. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

8 Supplementary Fig 3 (online only)
Primary patency is shown in patients who underwent endovascular aortic aneurysm repair (EVAR) with use of bifurcated (B-EVAR) devices. Journal of Vascular Surgery  , e1DOI: ( /j.jvs ) Copyright © 2015 Society for Vascular Surgery Terms and Conditions

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