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Aneurysm Diameter (aneurysm + diameter)
Selected AbstractsThe iliac bifurcation device for endovascular iliac aneurysm repair: indications, deployment options and results at 1-year follow-up of 25 casesANZ JOURNAL OF SURGERY, Issue 11 2009Ravi L. Huilgol Abstract Background:, The iliac bifurcation device (William A Cook Australia, Brisbane, QLD, Australia) is a new endovascular device for iliac aneurysm repair. We review the indications for use, device characteristics, deployment options and the results of our case series. Methods:, The most common indication for deployment is endovascular aortic aneurysm repair (EVAR) with common iliac aneurysm repair. The standard deployment sequence can be adapted to increase the utility of the device. Data were collected prospectively. Follow-up was performed with plain X-ray, ultrasound and computed tomography (CT) scan. Results:, Between 2004 and 2007, 25 patients had their common iliac artery aneurysm repaired using the iliac bifurcation device. There were 23 male and 2 female patients. Median age was 75 years (range 60,85). The median follow-up was 12 months (range 1,38). Twenty-one procedures were combined with EVAR. The median abdominal aortic aneurysm diameter was 60 mm (range 31,97), and the median common iliac artery aneurysm diameter was 37 mm (range 24,71). Technical success was achieved in 100% of cases. There were no acute branch vessel occlusions. There was one early type I endoleak (4%). There was one death (4%) in the 30-day period post-procedure. There was one late type I endoleak (4%). Conclusions:, The iliac bifurcation device achieves endovascular common iliac artery aneurysm repair with preservation of internal iliac artery flow. There are multiple different applications of the device and complementary deployment techniques. High rates of technical success and low rates of branch vessel occlusion are possible. [source] Use of baseline factors to predict complications and reinterventions after endovascular repair of abdominal aortic aneurysm,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 8 2010L. C. Brown Background: It is uncertain which baseline factors are associated with graft-related complications and reinterventions after endovascular aneurysm repair (EVAR) in patients with a large abdominal aortic aneurysm. Methods: Patients randomized to elective EVAR in EVAR Trial 1 or 2 were followed for serious graft-related complications (type 2 endoleaks excluded) and reinterventions. Cox regression analysis was used to investigate whether any prespecified baseline factors were associated with time to first serious complication or reintervention. Results: A total of 756 patients who had elective EVAR were followed for a mean of 3·7 years, by which time there were 179 serious graft complications (rate 6·5 per 100 person years) and 114 reinterventions (rate 3·8 per 100 person years). The highest rate was during the first 6 months, with an apparent increase again after 2 years. Multivariable analysis indicated that graft-related complications increased significantly with larger initial aneurysm diameter (P < 0·001) and older age (P = 0·040). There was also evidence that patients with larger common iliac diameters experienced higher complication rates (P = 0·011). Conclusion: Graft-related complication and reintervention rates were common after EVAR in patients with a large aneurysm. Younger patients and those with aneurysms closer to the 5·5-cm threshold for intervention experienced lower rates. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Long-term surveillance with computed tomography after endovascular aneurysm repair may not be justified,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2009Mr S. A. Black Background: There is a common perception that a large number of secondary interventions are needed following endovascular aortic aneurysm repair. Methods: Prospective data were collected for a cohort of 417 consecutive elective patients undergoing infrarenal aortic endograft repair between April 2000 and May 2008. The rate of secondary interventions, associated morbidity and need for reintervention following surveillance imaging were analysed. Results: The male : female ratio was 11 : 1, median age 76 (range 40,93) years and median aneurysm diameter 6·1 (5·3,11) cm. The overall 30-day mortality rate was 1·7 per cent (seven of 417). Secondary interventions were performed in 31 patients (7·4 per cent), of which six (1·4 per cent) were detected by surveillance. Endoleaks requiring reintervention occurred in 12 patients (2·9 per cent; ten type I and two type III endoleaks). Limb ischaemia secondary to graft occlusion occurred in 17 patients (4·1 per cent); extra-anatomical bypass was needed in 15 patients (3·6 per cent) and the remaining two had an amputation. Graft explantation following late infection was required in two patients (0·5 per cent). Conclusion: Endoluminal repair of infrarenal aortic aneurysms can be performed with a low reintervention rate. The value of prolonged surveillance seems limited and current surveillance protocols may require revision. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Recommendations for screening intervals for small aortic aneurysms,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2003R. J. McCarthy Background: The aim was to determine the optimum rescreening interval for small abdominal aortic aneurysms (AAAs). Methods: Data from 12 years of population screening of 65-year-old men were analysed and 1121 small AAAs (less than 4·0 cm in initial diameter) were divided into groups: group 1 (2·6,2·9 cm; n = 625), group 2 (3·0,3·4 cm; n = 330) and group 3 (3·5,3·9 cm; n = 166). Expansion rate and the cumulative proportions to expand to over 5·5 cm, or require surgery, or rupture were calculated. Results: Expansion rate was related to initial aortic diameter: 0·09 cm per year in group 1, 0·16 cm per year in group 2 and 0·32 cm per year in group 3 (P < 0·001). Aneurysms in 2·4 per cent of patients in group 1 exceeded a diameter of 5·5 cm or required surgery within 5 years; there were no ruptures. In group 2, no aorta exceeded 5·5 cm but at 3 years 2·1 per cent had reached 5·5 cm and 2·9 per cent had required surgery. The rupture rate at 3 years was zero. In group 3, the aneurysm diameter exceeded 5·5 cm in 1·2 per cent of patients, but no patient required surgery or experienced rupture within 1 year; at 2 years 10·5 per cent of aneurysms had exceeded 5·5 cm in diameter or required surgery and 1·4 per cent had ruptured. Conclusion: The appropriate rescreening interval can be determined by initial aortic diameter in screened 65-year-old men. AAAs of initial diameter 2·6,2·9 cm should be rescanned at 5 years, those of 3·0,3·4 cm at 3 years and those of 3·5,3·9 cm at 1 year. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||