Reinterventions After Fenestrated and Branched Endovascular Aortic Aneurysm Repair
|
|
|
- Buck Thompson
- 5 years ago
- Views:
Transcription
1 Reinterventions After Fenestrated and Branched Endovascular Aortic Aneurysm Repair Andres Schanzer, MD Division of Vascular and Endovascular Surgery UMass Medical School June 15 th, 2018 PNEC, Seattle, WA
2 DISCLOSURE Andres Schanzer, MD No relevant financial relationship reported
3 Background Endovascular aneurysm repair (EVAR) Over last 25 years, EVAR has become the most common repair strategy for treatment of infrarenal aortic aneurysms. Limitations: Life-long surveillance to monitor for complications, e.g., type 1A endoleak, graft migration, proximal neck dilation Need for re-interventions
4 Background Fenestrated/branched EVAR (F/BEVAR) First described in 1990s; repair of more complex aneurysms with fenestrations and/or branches, using Physician-modified endografts (PMEG) Company manufactured devices (CMD) Limitations: Similar to EVAR With increased complexity, potential for additional types of re-interventions PMEG CMD
5 PRIMARY OBJECTIVE: To evaluate custom made devices and physician-modified FDA-approved devices for the treatment of patients with complex abdominal or thoracoabdominal aneurysms. External CRO, CEC, Imaging Lab.
6 Fenestrations Small (6x6mm) Large (8x8mm) Internal Branches Helical Down Up
7 Results Graft Type Percentage (n=202) 47 Comp an y Manufactu red Gr af t Ph ysi cian M odif ied Gr af t 155
8 Results Aneurysm Extent (n=202) Number of Patients Comm on I liac Aneur ysm Juxtar en al Aor tic Par arenal A orti c Aneur ysm Aneur ysm Type of Aneurysm T horacoabd omin al Aor tic Aneur ysm
9 Results Fenestrations (n=202) Total number of target arteries included = Number Of Patients Average: 3.3 target arteries per patient Number of Fenestrations or Scallops
10
11 Aims 1. To better understand re-interventions after F/BEVAR: Frequency, types, and indications Hospital resources utilized 2. To determine outcomes of these re-interventions: Technical success (i.e., was initial complication resolved?) Morbidity/mortality
12 Methods: Single-Institution Retrospective Review Prospectively-maintained database at UMass Memorial Center for Complex Aortic Disease 123 consecutive F/BEVAR (Nov 2010 Dec 2016) 31 (25%) 1 re-intervention 92 (75%) No re-intervention 35 months Mean follow-up 21 months time
13 Methods: Endpoints Primary endpoint Number of reinterventions Defined as any procedure related to: Aneurysm Device Target artery Access site Secondary endpoints Type Indication Timing Resource utilization Technical success Morbidity Mortality
14 Results: Cohort Characteristics Mean age 75 years 69% men No statistical differences in: Sex Age Comorbidities Tobacco use Family history Statistical differences in aneurysm: Complexity Urgency
15 Results: Aneurysm Complexity & Urgency 1 Reintervention N=31 No Reintervention N=92 P- value Aneurysm extent Thoracoabdominal & pararenal 21 (68%) 44 (48%) 0.05 Presentation Urgent symptomatic aneurysm 5 (16%) 4 (4.4%) 0.04
16 Results: Device Type & Configuration 1 Reintervention No Reintervention P-value (n=31) (n=92) Graft type, n (%) <.0001 Physician-modified endograft (PMEG) 21 (68%) 21 (23%) Company manufactured device (CMD) 10 (32%) 71 (77%) Number of target arteries incorporated in repair (a) 3.3 (0.79) 3.2 (0.92) 0.53 Number of stented fenestrations or branches (a) 2.7 (0.94) 2.7 (1.02) 0.93 Total number of bridging stents (a) 2.6 (1.3) 2.8 (1.2) 0.51 (a) mean (SD)
17 Results: Length of Stay 1 Reintervention (n=31) No Reintervention (n=92) P- value ICU length of stay (b) 0 (0, 2) 0 (0, 1) 0.43 Hospital length of stay (b) 3 (1, 4) 3 (1, 4) 0.66 (b) median (IQR)
18 Results: Re-intervention Indication Access site related 10% Other 9% Target artery stenosis/occlusion 30% Type 3 endoleak 28% Endoleak 51%
19 Results: Re-intervention Timing (42%) 23 (43%) (15%) 5 0 Per ioper ative, Days 0-30 E arly, Days M id- term, >180 days
20 Results: Re-intervention Type N=31 patients Stent placement 22 Angioplasty only 7 Translumbar coil or glue embolization 4 Access site artery thrombectomy 3 Aptus EndoAnchor placement 3 Endograft extension of proximal/distal seal 3 Thrombin injection of pseudoaneurysm 2 Aortic arch replacement 1 Aortic cuff bridge placement 1 Bypass surgery: SMA bypass 1 Axillobifemoral bypass 1 EIA to PFA bypass 1 Femoral to femoral bypass 1 Embolization of fenestration 1 Palmaz stent placement 1 Thrombectomy of iliac artery and distal bypass 1 Total 53
21 Results: Re-intervention Resource Utilization Procedure type Endovascular, percutaneous 68% Open 17% Endovascular, open exposure 15% Hospital course 27 (51%) required hospital admission 21 (40%) were outpatient 5 (9.4%) occurred during primary hospitalization attributed to F/BEVAR
22 Results: Re-intervention Outcome & Mortality Outcomes Technical success achieved in 30 of 31 (97%) patients One case was not resolved: SMA occlusion (n=1) Mortality 0-30 days: 4 (13%) deaths Aneurysm-related: SMA bypass (n=1) >30 days: 5 (16%) deaths All were non-aneurysm-related/non-re-intervention-related
23 Study Limitations Prospective cohort study, but some additional reintervention details were collected retrospectively Series includes all consecutive F/BEVAR cases performed since the inception of our endovascular complex aortic program à Learning curve Limited generalizability
24 In Summary Among 123 consecutive F/BEVAR, 25% of patients required at least one re-intervention over two years. The most common indications were type 3 endoleaks and target artery complications. While most re-interventions were successful and treated endovascularly, high-risk open procedures were required with associated morbidity and mortality.
25 Conclusion F/BEVAR allows us to treat complex aortic aneurysm disease with a less invasive approach than open repair. However, F/BEVAR requires life-long surveillance and potential re-interventions, similar to the management of a chronic disease.
26 Future Research Future studies should be aimed at strategies to: Reduce type 3 endoleak Improve target artery patency Determine optimal device configuration of fenestrations and branches These are crucial next steps in the evolution of F/BEVAR.
27 Thank You
Current Status of EVAR for Infrarenal AAA. 31 st Annual Florida Vascular Society. PENN Surgery
Current Status of EVAR for Infrarenal AAA 31 st Annual Florida Vascular Society PENN Surgery No Disclosures Stent Grafts Design Related Differences What really matters? Modular Unibody Supported Unsupported
for Thoracoabdominal Aneurysms
Durability of F/BEVAR for Thoracoabdominal Aneurysms Athanasios Katsargyris, MD, Eric Verhoeven MD, PhD Department of Vascular and Endovascular Surgery Paracelsus Medical University, Nuremberg, Germany
Endovascular therapy for Ischemic versus Nonischemic complicated acute type B aortic dissection (catbad).
Endovascular therapy for Ischemic versus Nonischemic complicated acute type B aortic dissection (catbad). AS. Eleshra, MD 1, T. Kölbel, MD, PhD 1, F. Rohlffs, MD 1, N. Tsilimparis, MD, PhD 1,2 Ahmed Eleshra
When to use standard EVAR with EndoAnchors or CHEVAR in short-neck AAAs LINC ASIA 18
When to use standard EVAR with EndoAnchors or CHEVAR in short-neck AAAs JEAN-PAUL P.M. DE VRIES, DIRECTOR OF VASCULAR SURGERY ST.ANTONIUS HOSPITAL NIEUWEGEIN, THE NETHERLANDS. LINC ASIA-PACIFIC HongKong,
Ovation. Sean Lyden, MD Department Chair, Vascular Surgery Cleveland Clinic
Ovation Sean Lyden, MD Department Chair, Vascular Surgery Cleveland Clinic Disclosure Statement of Financial Interest Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement
FEVAR FIFTEEN YEARS OF EFFICIENCY E.DUCASSE MD PHD FEBVS CHU DE BORDEAUX
FEVAR FIFTEEN YEARS OF EFFICIENCY E.DUCASSE MD PHD FEBVS CHU DE BORDEAUX 2018 A BIT OF HISTORY First use of F-EVAR : 1990s Park et al. J Vasc Interv Radiol. 1996;7:819-823. Faruqi et al. J Endovasc Surg.
Aortic Neck Issues Associated Clinical Sequelae/Implications for Graft Choice
Aortic Neck Issues Associated Clinical Sequelae/Implications for Graft Choice Eric Verhoeven, MD, PhD, A. Katsargyris, MD Department of Vascular and Endovascular Surgery, Paracelsus Medical University,
Chungbuk Regional Cardiovascular Center, Division of Cardiology, Departments of Internal Medicine, Chungbuk National University Hospital Sangmin Kim
Endovascular Procedures for Isolated Common Iliac and Internal Iliac Aneurysm Chungbuk Regional Cardiovascular Center, Division of Cardiology, Departments of Internal Medicine, Chungbuk National University
Mid-term results of 300+ patients treated by endovascular aortic sealing (EVAS)
Mid-term results of 300+ patients treated by endovascular aortic sealing (EVAS) Jean-Paul P.M. de Vries Dept Vascular Surgery St. Antonius Hospital, Nieuwegein,The Netherlands On behalf of the DEVASS study
Robert F. Cuff, MD FACS SHMG Vascular Surgery
Robert F. Cuff, MD FACS SHMG Vascular Surgery Objectives To become familiar with the commercially available fenestrated EVAR graft Discuss techniques to increase success Review available data to determine
How to select FEVAR versus EVAR + endoanchors in short-necked AAAs
How to select FEVAR versus EVAR + endoanchors in short-necked AAAs Jean-Paul P.M. de Vries, Richte C.L. Schuurmann St. Antonius Hospital Nieuwegein, The Netherlands 21st Critical Issues Congress Nuernberg,
Anatomical challenges in EVAR
Anatomical challenges in EVAR M.H. EL DESSOKI, MD,FRCS PROFESSOR OF VASCULAR SURGERY CAIRO UNIVERSITY Disclosure Speaker name:... I have the following potential conflicts of interest to report: Consulting
MODERN METHODS FOR TREATING ABDOMINAL ANEURYSMS AND THORACIC AORTIC DISEASE
MODERN METHODS FOR TREATING ABDOMINAL ANEURYSMS AND THORACIC AORTIC DISEASE AAA FACTS 200,000 New Cases Each Year Ruptured AAA = 15,000 Deaths per Year in U.S. 13th Leading Cause of Death 80% Chance of
CUSTOM-MADE SCALLOPED THORACIC ENDOGRAFTS IN DIFFERENT HOSTILE AORTIC ANATOMIES
CUSTOM-MADE SCALLOPED THORACIC ENDOGRAFTS IN DIFFERENT HOSTILE AORTIC ANATOMIES A SERIES OF THREE CASE REPORTS Joel Sousa Department of Department of Angiology and Vascular Surgery Hospital S. João, Porto,
My personal experience with INCRAFT in standard and challenging cases
My personal experience with INCRAFT in standard and challenging cases G Pratesi, MD Vascular Surgery University of Rome Tor Vergata giovanni.pratesi@uniroma2.it Disclosure Speaker name: Giovanni Pratesi,
Off-the-Shelf Devices. Mark A Farber, MD FACS Director, Aortic Center Professor of Radiology and Surgery University of North Carolina
Off-the-Shelf Devices Mark A Farber, MD FACS Director, Aortic Center Professor of Radiology and Surgery University of North Carolina Disclosures Cook - Research Support, Consultant, Clinical Trials WL
Faculty Disclosure. Glue, Particulates, Thrombin, Coils and the Kitchen Sink for Type II Endoleak Management. Background.
Glue, Particulates, Thrombin, Coils and the Kitchen Sink for Type II Endoleak Management Faculty Disclosure I disclose the following financial relationships: UCSF Vascular Symposium 2013 Receive grant/research
Associate Professor Walter W. Buckley Endowed Chair in Research Cleveland Clinic Lerner College of Medicine-CWRU. Houston Aortic Symposium 2017
Matthew J. Eagleton, MD Associate Professor Walter W. Buckley Endowed Chair in Research Cleveland Clinic Lerner College of Medicine-CWRU Houston Aortic Symposium 2017 Aortica: Advisory Board Centerline
Abdominal and thoracic aneurysm repair
Abdominal and thoracic aneurysm repair William A. Gray MD Director, Endovascular Intervention Cardiovascular Research Foundation Columbia University Medical Center Abdominal Aortic Aneurysm Endografts
Endovascular Repair o Abdominal. Aortic Aneurysms. Cesar E. Mendoza, M.D. Jackson Memorial Hospital Miami, Florida
Endovascular Repair o Abdominal Aortic Aneurysms Cesar E. Mendoza, M.D. Jackson Memorial Hospital Miami, Florida Disclosure Nothing to disclose. 2 Mr. X AAA Mr. X. Is a 70 year old male who presented to
Treatment options of late failures of EVAS. Michel Reijnen Rijnstate Arnhem The Netherlands
Treatment options of late failures of EVAS Michel Reijnen Rijnstate Arnhem The Netherlands Disclosure Speaker name: Michel Reijnen I have the following potential conflicts of interest to report: Consulting
COMBINED TECHNIQUE CHIMNEY + FENESTRATED ENDOGRAFT FOR COMPLEX ANEURYSMS ERIC DUCASSE - MD PHD FEVBS CHU BORDEAUX
COMBINED TECHNIQUE CHIMNEY + FENESTRATED ENDOGRAFT FOR COMPLEX ANEURYSMS ERIC DUCASSE - MD PHD FEVBS CHU BORDEAUX DISCLOSURE SPEAKER NAME: PR. E. DUCASSE I HAVE THE FOLLOWING POTENTIAL CONFLICTS OF INTEREST
Residual Dissection and False Lumen Aneurysm After TEVAR
WHAT WOULD YOU DO? Residual Dissection and False Lumen Aneurysm After MODERATOR: MARK FARBER, MD PANEL: YAZAN DUWAYRI, MD; MATTHEW J. EAGLETON, MD; WILLIAM D. JORDAN Jr, MD; TILO KÖLBEL, MD, PhD; AND ERIC
Now that Endoanchors are Approved (and paid for) We have a Durable Solution to Short Necks That s so Easy!
Now that Endoanchors are Approved (and paid for) We have a Durable Solution to Short Necks That s so Easy! David H. Deaton, MD Vascular Surgery / University of South Carolina / Palmetto Health Chief Medical
Durable outcomes. Proven performance.
Durable outcomes. Proven performance. GORE EXCLUDER AAA Endoprosthesis GORE EXCLUDER Iliac Branch Endoprosthesis GORE EXCLUDER AAA Endoprosthesis The most-studied* EVAR stent graft designed for durable
Toward Total Endovascular Therapy of the Aorta. Adam W. Beck, MD. Associate Professor of Surgery Division of Vascular Surgery and Endovascular Therapy
Toward Total Endovascular Therapy of the Aorta Adam W. Beck, MD Associate Professor of Surgery Division of Vascular Surgery and Endovascular Therapy University of Alabama at Birmingham Disclosures Grant
Is EVAS a proper choice in women?
Is EVAS a proper choice in women? CACVS 2018 Jan MM Heyligers, PhD, FEBVS Consultant Vascular Surgeon Elisabeth TweeSteden Hospital Tilburg The Netherlands Disclosures Consultant for Endologix DEVASS =Dutch
Animesh Rathore, MD, RPVI Sentara Vascular Specialists. Debate 4: Complex endovascular aortic repair will make open surgery obsolete
Animesh Rathore, MD, RPVI Sentara Vascular Specialists Debate 4: Complex endovascular aortic repair will make open surgery obsolete Definition Complex aortic pathology (aneurysms/dissection) Involvement
Standardization of the CHEVAR procedure: How a standard approach has improved outcomes. Prof Peter Holt St George s, London
Standardization of the CHEVAR procedure: How a standard approach has improved outcomes Prof Peter Holt St George s, London Disclosure Speaker name: Prof Peter Holt I have the following potential conflicts
Taming The Aorta. David Minion, MD Program Director, Vascular Surgery University of Kentucky Medical Center Lexington, Kentucky, USA
Taming The Aorta David Minion, MD Program Director, Vascular Surgery University of Kentucky Medical Center Lexington, Kentucky, USA Faculty Disclosure Consulting: Endologix, Cook 1 Objectives Review the
Type 1a Endoleak in hostile neck anatomies: Endoanchor can fix it! D. Böckler University Hospital Heidelberg, Germany
Type 1a Endoleak in hostile neck anatomies: Endoanchor can fix it! D. Böckler University Hospital Heidelberg, Germany Disclosures Speaker name: Dittmar Böckler I have the following potential conflicts
ENCORE, a Study to Investigate the Durability of Polymer EVAR with Ovation A Contemporary Review of 1296 Patients
ENCORE, a Study to Investigate the Durability of Polymer EVAR with Ovation A Contemporary Review of 1296 Patients The Ovation System is approved to treat infrarenal abdominal aortic aneurysms and is not
Bilateral use of the Gore IBE device for bilateral CIA aneurysms and a first interim analysis of the prospective Iceberg registry
Bilateral use of the Gore IBE device for bilateral CIA aneurysms and a first interim analysis of the prospective Iceberg registry Michel MPJ Reijnen, MD, PhD Department of Vascular Surgery, Rijnstate Hospital
Optimizing Accuracy of Aortic Stent Grafts in Short Necks
Optimizing Accuracy of Aortic Stent Grafts in Short Necks Venkatesh Ramaiah, MD, FACS Medical Director Arizona Heart Hospital Director Peripheral Vascular and Endovascular Research Arizona Heart Institute
Clinical trial and real-world outcomes of an endovascular iliac aneurysm repair with the GORE Iliac Branch Endoprosthesis (IBE)
Clinical trial and real-world outcomes of an endovascular iliac aneurysm repair with the GORE Iliac Branch Endoprosthesis (IBE) Jan MM Heyligers, PhD, FEBVS Consultant Vascular Surgeon The Netherlands
Influence of patient selection and IFU compliance on outcomes following EVAS
Influence of patient selection and IFU compliance on outcomes following EVAS LUNCH SYMPOSIUM LINC 2017 Jan MM Heyligers, MD, PhD, FEBVS Consultant Vascular Surgeon Elisabeth TweeSteden Hospital Tilburg,
Considerations for a Durable Repair
Considerations for a Durable Repair Eric Verhoeven, MD, PhD, A. Katsargyris, MD Department of Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany Disclosures William Cook
Performance of the conformable GORE TAG device in Type B aortic dissection from the GORE GREAT real world registry
University of Milan Thoracic Aortic Research Center Performance of the conformable GORE TAG device in Type B aortic dissection from the GORE GREAT real world registry Santi Trimarchi, MD, PhD Associate
THE ENDURANT STENT GRAFT IN HOSTILE ANEURYSM NECK ANATOMY
THE ENDURANT STENT GRAFT IN HOSTILE ANEURYSM NECK ANATOMY Patrice Mwipatayi FCS (SA), MMed, FRACS Professor of Vascular surgery Royal Perth Hospital, University of Western Australia, Perth, WA Co-Authors:
Hostile Neck During EVAR, The Role Of Endoanchores
Hostile Neck During EVAR, The Role Of Endoanchores Samer Koussayer, MD, FACS, RVT Prof, Al Faisal University Section Head and consultant Vascular & Endovascular Surgery Division King Faisal Specialist
An Overview of Post-EVAR Endoleaks: Imaging Findings and Management. Ravi Shergill BSc Sean A. Kennedy MD Mark O. Baerlocher MD FRCPC
An Overview of Post-EVAR Endoleaks: Imaging Findings and Management Ravi Shergill BSc Sean A. Kennedy MD Mark O. Baerlocher MD FRCPC Disclosure Slide Mark O. Baerlocher: Current: Consultant for Boston
EndoVascular Aneurysm Sealing (EVAS) with Nellix
1 2 EndoVascular Aneurysm Sealing (EVAS) with Nellix Designed to seal entire aneurysm with contained biostable polymer Non-modular design with complete fixation Expands endovascular patient eligibility
Predictors of abdominal aortic aneurysm sac enlargement after EVAR Longterm results from the ENGAGE Registry
Predictors of abdominal aortic aneurysm sac enlargement after EVAR Longterm results from the ENGAGE Registry D. Böckler Department of Vascular and Endovascular Surgery University Hospital Heidelberg Disclosure
Disclosures. EVAR follow-up: actual recommendation. EVAR follow-up: critical issues
Disclosures is it time to discuss individualized follow-up schemes based on preoperative anatomy and high quality completion angiography? Consultant / Speaker / Proctor Cook Cordis Medtronic Invatec W.L.
The Ventana Off-the-Shelf Graft for Pararenal AAA. Andrew Holden Associate Professor of Radiology Auckland Hospital
The Ventana Off-the-Shelf Graft for Pararenal AAA Andrew Holden Associate Professor of Radiology Auckland Hospital Disclosures Andrew Holden, MBChB, FRANZCR Investigator in Nellix and Ventana Trials Clinical
Endovascular Management of Thoracic Aortic Pathology Stéphan Haulon, J Sobocinski, B Maurel, T Martin-Gonzalez, R Spear, A Hertault, R Azzaoui
Endovascular Management of Thoracic Aortic Pathology Stéphan Haulon, J Sobocinski, B Maurel, T Martin-Gonzalez, R Spear, A Hertault, R Azzaoui Aortic Center, Lille University Hospital, France Disclosures
EVAR Revision Setting - How can Heli-FX EndoAnchors improve the outcomes?
D. Böckler Department of Vascular and Endovascular Surgery University Hospital Heidelberg EVAR Revision Setting - How can Heli-FX EndoAnchors improve the outcomes? Disclosures Speaker name: Dittmar Böckler
EVAR replaced standard repair in most cases. Why?
EVAR replaced standard repair in most cases. Why? Initial major steps in endograft evolution Papazoglou O. Konstantinos M.D. The story of a major breakthrough in vascular surgery 1991 Parodi introduces
Preliminary Data from the Gore EXCLUDER Thoracoabdominal Branch Endoprosthesis Early Feasibility Study
Preliminary Data from the Gore EXCLUDER Thoracoabdominal Branch Endoprosthesis Early Feasibility Study Mark A Farber, MD Professor of Surgery and Radiology Director, UNC Aortic Network University of North
Abdominal Aortic Aneurysm (AAA)
Abdominal Aortic Aneurysm (AAA) Vascular Workshop: Objectives Anatomy Keith VanHaltren Indications Technique Cases Abdominal Aorta: Normal Size Abdominal aortic aneurysm: Definition Normal diameter of
Jean M Panneton, MD Professor of Surgery Program Director Vascular Surgery Chief EVMS. Arch Pathology: The Endovascular Era is here
Jean M Panneton, MD Professor of Surgery Program Director Vascular Surgery Chief EVMS Arch Pathology: The Endovascular Era is here Disclosures Consultant: Cook Medical, Bolton Medical, Medtronic Inc, Volcano,
The Auckland Experience with the Nellix EVAS System. Andrew Holden, MBChB, FRANZCR
The Auckland Experience with the Nellix EVAS System Andrew Holden, MBChB, FRANZCR Disclosure Speaker name: Associate Professor Andrew Holden I have the following potential conflicts of interest to report:
Increased Flexibility of AneuRx Stent-Graft Reduces Need for Secondary Intervention Following Endovascular Aneurysm Repair
583 Increased Flexibility of AneuRx Stent-Graft Reduces Need for Secondary Intervention Following Endovascular Aneurysm Repair Frank R. Arko, MD; W. Anthony Lee, MD; Bradley B. Hill, MD; Paul Cipriano,
Challenges. 1. Sizing. 2. Proximal landing zone 3. Distal landing zone 4. Access vessels 5. Spinal cord ischemia 6. Endoleak
Disclosure I have the following potential conflicts of interest to report: Consulting: Medtronic, Gore Employment in industry Stockholder of a healthcare company Owner of a healthcare company Other(s)
Endoleaks after F-BEVAR How to Assess & Treat? Gustavo S. Oderich, MD Mayo Clinic Rochester, MN
Endoleaks after F-BEVAR How to Assess & Treat? Gustavo S. Oderich, MD Mayo Clinic Rochester, MN FACULTY DISCLOSURE Gustavo S. Oderich MD Consulting, DSMB, CEC* Cook Medical Inc., WL Gore, Lombardi Honoraria
Anatomical applicability of current off-the-shelf branched endografts in thoracoabdominal aortic aneurysms managed by open surgery.
Leipzig Interventional Course Update on clinical trials Tuesday, January 30 th, 2018 Anatomical applicability of current off-the-shelf branched endografts in thoracoabdominal aortic aneurysms managed by
Endovascular Repair of Aortic Arch/Thoracic Aneurysms: Bolton RelayBranch Device
Endovascular Repair of Aortic Arch/Thoracic Aneurysms: Bolton RelayBranch Device Luis A. Sanchez MD Gregorio A. Sicard Distinguished Professor of Surgery & Radiology Chief, Section of Vascular Surgery
Management of Endoleaks
Management of Endoleaks Murray Shames, MD Professor and Chief, Director Tampa General Hospital Aortic Program Vice Chair of Research, Dept. of Surgery Conflict of Interests: Speaker: Gore, Medtronic, Cook
Access More Patients. Customize Each Seal.
Access More. Customize Each Seal. The Least Invasive Path Towards Proven Patency ULTRA LOW PROFILE TO EASE ADVANCEMENT The flexible, ultra-low 12F ID Ovation ix delivery system enables you to navigate
Young-Guk Ko, M.D. Severance Cardiovascular Hospital, Yonsei University Health System,
Young-Guk Ko, M.D., Dangas G, J Am Coll Cardiol Intv 2012;5:1071 All-cause Mortality Dangas Severance G, J Am Coll Cardiovascular Cardiol Intv Hospital, 2012;5:1071 Yonsei University Health System Aneurysm-related
Lessons learned from Ch-EVAR for the treatment of. Miltos Matsagkas MD, PhD, FEBVS Professor of Vascular Surgery University of Thessaly
Lessons learned from Ch-EVAR for the treatment of pararenal AAAs Miltos Matsagkas MD, PhD, FEBVS Professor of Vascular Surgery University of Thessaly Ch-EVAR Ch-EVAR = Chimney-EVAR Placement of single
DISCLOSURES ISOLATED DTA LESION? TYPE B DISSECTIONS TREATMENT OPTIONS
Endovascular Repair of Aortic Arch Pathologies; What is available/possible in the U.S. in 2018? Kaiser Permanente Endovascular Symposium 6/2/18 Sukgu M Han, MD, MS Assistant Professor of Clinical Surgery
Hypogastric Preservation Using Retrograde Endovascular Bypass
Hypogastric Preservation Using Retrograde Endovascular Bypass Mathew Wooster MD, Adam Tanious MD, Brad Johnson MD, Murray Shames MD, Paul Armstrong MD, Martin Back MD Florida Vascular Society 30 th Annual
Thoracoabdominal Aorta: Advances and Novel Therapies
Thoracoabdominal Aorta: Advances and Novel Therapies Robert Meisner, MD FACS Sidney Kimmel Medical Center Assistant Professor of Surgery Vascular / Endovascular Surgeon at Lankenau Medical Center November
Case Report 1. CTA head. (c) Tele3D Advantage, LLC
Case Report 1 CTA head 1 History 82 YEAR OLD woman with signs and symptoms of increased intra cranial pressure in setting of SAH. CT Brain was performed followed by CT Angiography of head. 2 CT brain Extensive
BC Vascular Day. Contents. November 3, Abdominal Aortic Aneurysm 2 3. Peripheral Arterial Disease 4 6. Deep Venous Thrombosis 7 8
BC Vascular Day Contents Abdominal Aortic Aneurysm 2 3 November 3, 2018 Peripheral Arterial Disease 4 6 Deep Venous Thrombosis 7 8 Abdominal Aortic Aneurysm Conservative Management Risk factor modification
Conflicts of Interest. When and Why Complex EVAR in Tx of juxta/suprarenal AAA? Summary. Infrarenal EVAR for short necks 2y postop
When and Why Complex EVAR in Tx of juxta/suprarenal AAA? Tim Resch MD Vascular Center Skane University Hospital Conflicts of Interest COOK Medical - Consulting, Speakers Bureau, IP, Research support Medtronic
Free Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic
Free Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic Aneurysm History A 56-year-old gentleman, who had been referred
Endovascular Treatment of the Aorta with Fenestrated and Branched Grafts
Endovascular Treatment of the Aorta with Fenestrated and Branched Grafts Eric LG Verhoeven,MD, PhD, A. Katsargyris, MD Vascular and Endovascular Surgery, Paracelsus Medical University, Nuremberg, Germany
Retrograde Embolization of a Symptomatic Hypogastric Artery Aneurysm
Retrograde Embolization of a Symptomatic Hypogastric Artery Aneurysm Andrew Unzeitig MD Piedmont Atlanta Hospital Georgia Vascular Society 2017 Annual Meeting Lake Oconee, Georgia Disclosures None Case
Santi Trimarchi, MD, PhD Vascular Surgeon Thoracic Aortic Research Center, Director IRCCS Policlinico San Donato University of Milan
The Gore GREAT Registry: Update about a real life data collection Santi Trimarchi, MD, PhD Vascular Surgeon Thoracic Aortic Research Center, Director IRCCS Policlinico San Donato University of Milan Disclosures
Three year experience with multilayer stent in the treatment of thoracoabdominal aneurysms no evidence for aneurysm stabilization
Three year experience with multilayer stent in the treatment of thoracoabdominal aneurysms no evidence for aneurysm stabilization Thomas Larzon, MD, PhD Head of Vascular Surgery Dept of Cardiothoracic
Patient selection in Hostile Necks and how. to prevent endoleaks a word of caution
Patient selection in Hostile Necks and how to prevent endoleaks a word of caution P M Kasprzak, K. Pfister Department of Vascular Surgery Endovascular Surgery University Hospital Regensburg, Germany Conflict
Ultrasound Evaluation after EVAR: (Trying to) Let the CAT Scan Out of the Bag
Ultrasound Evaluation after EVAR: (Trying to) Let the CAT Scan Out of the Bag Joseph-Vincent V. Blas, MD Division of Vascular Surgery Department of Surgery Greenville Health System University of South
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when?
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when? Prof. Olgierd Rowiński II Department of Clinical Radiology Medical University of Warsaw Disclosure Speaker name: Olgierd
Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience
Arch Repair with the Bolton Medical RelayBranch Thoracic Stent-graft system: Multicenter experience Joost van Herwaarden, MD, PhD University Medical Center, Utrecht Disclosure I have the following potential
History of the Powerlink System Design and Clinical Results. Edward B. Diethrich Arizona Heart Hospital Phoenix, AZ
History of the Powerlink System Design and Clinical Results Edward B. Diethrich Arizona Heart Hospital Phoenix, AZ Powerlink System: Unibody-Bifurcated Design Long Main Body Low-Porosity Proprietary eptfe
EVAS How does this Impact EVAR Therapy
EVAS How does this Impact EVAR Therapy John S. Lane III, MD, FACS Professor and Acting Chief of Vascular Surgery University of California, San Diego PNEC, 2017 Endologix products and associated components
Treating very short necks ( 4mm <10mm) using the Endurant stent graft + EndoAnchors: 1-year results and current insights
Treating very short necks ( 4mm
Improving Endograft Durability with EndoAnchors
Improving Endograft Durability with EndoAnchors William D. Jordan, Jr., M.D. John E. Skandalakis Chair in Surgery Professor and Chief Division of Vascular Surgery and Endovascular Therapy Emory University
Abdominal Aortic Aneurysms. A Surgeons Perspective Dr. Derek D. Muehrcke
Abdominal Aortic Aneurysms A Surgeons Perspective Dr. Derek D. Muehrcke Aneurysm Definition The abnormal enlargement or bulging of an artery caused by an injury or weakness in the blood vessel wall A localized
EVAS using Nellix in my practice Where are we today?
EVAS using Nellix in my practice Where are we today? Prof. dr. Michel MPJ Reijnen Department of Vascular Surgery, Rijnstate Hospital Arnhem Faculty of Science and Technology, University of Twente The Netherlands
SANWICH TECHNIQUE TO REDUCE COMPLICATIONS WHEN TREATING BILATERAL INTERNAL ILIAC ARTERY
SANWICH TECHNIQUE TO REDUCE COMPLICATIONS WHEN TREATING BILATERAL INTERNAL ILIAC ARTERY TRAN TRA GIANG.MD Interventional cardiovascular department Hanoi Heart Hospital, Hanoi, Viet Nam Nothing to Disclose
Important Update to Field Safety Notice Nellix EndoVascular Aneurysm Sealing System Updated Instructions for Use (IFU)
October 6, 2017 Important Update to Field Safety Notice Nellix EndoVascular Aneurysm Sealing System Updated Instructions for Use (IFU) Dear Physician, This notification is to provide you with further information
Reimbursement Guide Zenith Fenestrated AAA Endovascular Graft
MEDICAL Reimbursement Guide Zenith Fenestrated AAA Endovascular Graft Disclaimer: The information provided herein reflects Cook s understanding of the procedure(s) and/or device(s) from sources that may
Mid-term results from ANCHOR: How does this data influence the treatment algorithm for hostile EVAR anatomies
Mid-term results from ANCHOR: How does this data influence the treatment algorithm for hostile EVAR anatomies Jean-Paul P.M. de Vries Head Department of Surgery, University Medical Centre Groningen The
symptomatic aneurysms or aneurysms that grow >1cm/yr
1. Elective repair for aneurysm >5.5 cm, symptomatic aneurysms or aneurysms that grow >1cm/yr 2. Ruptured AAA Aneurysm Detection and Management Study (ADAM) and UK Small Aneurysm Trial early open surgery
NEW INNOVATIONS IN ENDOLEAK MANAGEMENT
DISCLOSURES NEW INNOVATIONS IN ENDOLEAK MANAGEMENT Kelley HodgkissHarlow, MD, RPVI, FACS Vascular and Endovascular Surgery Kaiser Permanente, San Diego Nothing to disclose GOALS BACKGROUND Background Surveillance
How to Categorize the Infrarenal Neck Properly? I Van Herzeele Dept. Thoracic and Vascular Surgery, Ghent University, Belgium
How to Categorize the Infrarenal Neck Properly? I Van Herzeele Dept. Thoracic and Vascular Surgery, Ghent University, Belgium Disclosure Speaker name: Isabelle Van Herzeele I have the following potential
Prof. Franco Grego. Predictors of endoleak type II risk, in the era of prevention with aneurysm sac filling
UNIVERSITY OF PADUA DEPARTMENT OF VASCULAR AND ENDOVASCULAR SURGERY Director: Prof. F. GREGO Predictors of endoleak type II risk, in the era of prevention with aneurysm sac filling during EVAR Prof. Franco
6. Endovascular aneurysm repair
Introduction The standard treatment for aortic aneurysm, open repair, involves a large abdominal incision and cross-clamping of the aorta. In recent years, a minimally invasive technique, endovascular
Percutaneous Approaches to Aortic Disease in 2018
Percutaneous Approaches to Aortic Disease in 2018 Wendy Tsang, MD, SM Assistant Professor, University of Toronto Toronto General Hospital, University Health Network Case 78 year old F Lower CP and upper
Ralf R. Kolvenbach. Verbund Katholischer Kliniken Gefäßzentrum Augusta Krankenhaus Düsseldorf
Ralf R. Kolvenbach Verbund Katholischer Kliniken Gefäßzentrum Augusta Krankenhaus Düsseldorf Endograft migration Stent no longer above renal artery 15 mm migration 6 Mos Do we really need any adjuncts
Percutaneous Axillary Artery Access For Branch Grafting for complex TAAAs and pararenal AAAs: How to do it safely
Percutaneous Axillary Artery Access For Branch Grafting for complex TAAAs and pararenal AAAs: How to do it safely Daniela Branzan, MD, Department of Vascular Surgery University Hospital Leipzig Disclosure
Aortic Arch pathology options: Open,Hybrid, fenestration, Chimney or branched stent-graft?
Aortic Arch pathology options: Open,Hybrid, fenestration, Chimney or branched stent-graft? Chang Shu, M.D., Ph.D Vascular Surgery Center National Center for Cardiovascular Diseases. Fuwai Hospital, CAMS
Management of Endoleaks. Michael Meuse, M.D Vascular and Interventional Radiology 12/14/09
Management of Endoleaks Michael Meuse, M.D Vascular and Interventional Radiology 12/14/09 Endoleak Failure to totally exclude the abdominal aortic aneurysm (AAA) from continued perfusion and pressurization
Volume 3 (2017) Issue 1 ISSN Abstract. Keywords fenestrated after open repair; Pararenal abdominal aortic aneurysm.
Open Journal of Clinical & Medical Case Reports Volume 3 (2017) Issue 1 ISSN 2379-1039 Fenestrated stent-graft after previous open surgical repair of abdominal aortic aneurysm: case report and review of
Current Status of Abdominal Aortic Stent Grafts. John R. Laird Professor of Medicine Director of the Vascular Center UC Davis Medical Center
Current Status of Abdominal Aortic Stent Grafts John R. Laird Professor of Medicine Director of the Vascular Center UC Davis Medical Center Autumn Greetings Disclosure Statement of Financial Interest Within
US clinical trial update on the Gore Excluder iliac branch endoprosthesis (IBE)
US clinical trial update on the Gore Excluder iliac branch endoprosthesis (IBE) Robert Y. Rhee, MD Chief, Vascular and Endovascular Surgery Director, Maimonides Aortic Center Maimonides Medical Center
Insights from the PROTAGORAS/PERICLES Registries: impact on ChEVAR results
Insights from the PROTAGORAS/PERICLES Registries: impact on ChEVAR results Konstantinos P. Donas, Giovanni Torsello Department of Vascular Surgery St. Franziskus Hospital Münster, Germany Disclosure Speaker