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Endovascular redo aortic surgery

Budtz-Lilly, Jacob; Hongku, Kiattisak; Sonesson, Björn LU ; Dias, Nuno LU and Resch, Tim LU (2017) In Journal of Cardiovascular Surgery 58(6). p.854-860
Abstract

Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger abdominal aortic aneurysm necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing. This can be achieved with Palmaz stents, endoanchors, and extension with fenestrated or branched endovascular repair.... (More)

Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger abdominal aortic aneurysm necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing. This can be achieved with Palmaz stents, endoanchors, and extension with fenestrated or branched endovascular repair. Thoracic aortic coverage may be required, and revascularization of the left subclavian artery should be considered. Technical issues such as these, as well as target vessel cannulation and accommodation of the new graft within the previous implanted graft, require experience and careful planning. Distal extension can likewise resolve a failing repair, and this may require the use of internal iliac artery embolization or iliac-branch devices. Redo aortic operations are technically demanding and are carried out with increased risks. Improving technology, such as fusion imaging, should mitigate some of this risk and are recommended.

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author
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal, Aorta, Aortic aneurysm, Endovascular procedures
in
Journal of Cardiovascular Surgery
volume
58
issue
6
pages
7 pages
publisher
Edizioni Minerva Medica
external identifiers
  • scopus:85029717657
ISSN
0021-9509
DOI
10.23736/S0021-9509.17.10048-0
language
English
LU publication?
no
id
23c209e8-5f76-446f-8386-f1ac459f18d6
date added to LUP
2017-10-06 09:41:58
date last changed
2018-01-07 12:20:57
@article{23c209e8-5f76-446f-8386-f1ac459f18d6,
  abstract     = {<p>Endovascular redo aortic operations are a challenging undertaking. Techniques for treatment date almost as far back as the original open repair itself. Risk factors for failure following aortic repair include larger abdominal aortic aneurysm necks, severe neck angulation, as well as clinical variables such as age, family history, obesity and chronic obstructive pulmonary disease. The armamentarium of endovascular treatments is vast and increasing. Aside from provisional embolization of endoleaks or deferment to open repair conversion, attention should be directed toward obtaining adequate proximal and distal sealing. This can be achieved with Palmaz stents, endoanchors, and extension with fenestrated or branched endovascular repair. Thoracic aortic coverage may be required, and revascularization of the left subclavian artery should be considered. Technical issues such as these, as well as target vessel cannulation and accommodation of the new graft within the previous implanted graft, require experience and careful planning. Distal extension can likewise resolve a failing repair, and this may require the use of internal iliac artery embolization or iliac-branch devices. Redo aortic operations are technically demanding and are carried out with increased risks. Improving technology, such as fusion imaging, should mitigate some of this risk and are recommended.</p>},
  author       = {Budtz-Lilly, Jacob and Hongku, Kiattisak and Sonesson, Björn and Dias, Nuno and Resch, Tim},
  issn         = {0021-9509},
  keyword      = {Abdominal,Aorta,Aortic aneurysm,Endovascular procedures},
  language     = {eng},
  month        = {12},
  number       = {6},
  pages        = {854--860},
  publisher    = {Edizioni Minerva Medica},
  series       = {Journal of Cardiovascular Surgery},
  title        = {Endovascular redo aortic surgery},
  url          = {http://dx.doi.org/10.23736/S0021-9509.17.10048-0},
  volume       = {58},
  year         = {2017},
}