Search

Objectives: To study the safety and feasibility of the E-liac Stent Graft System® in patients with aorto/iliac aneurysms.Methods: A prospective multicentric European registry of patients receiving the E-liac Stent Graft System® was conducted. Endpoints of the study included the technical success as well as periprocedural events and 30-day endoleaks, reinterventions, internal and external iliac artery patency and mortality.Results: Between July 2014 and June 2016, a total of 45 patients (93% men, mean age 72 years, range 53-90 years) were enrolled at 11 sites in four European countries. Five patients received an isolated iliac treatment. Thirty-seven patients were treated with a combination of an abdominal stent graft and a unilateral E-liac and three in combination with bilateral E-liac. All E-liac Stent Grafts (48) were implanted in the intended position and the internal iliac arteries were successfully bridged. Two patients did not receive clinical success, due to endoleak type Ia of the aortic stent graft. At 30-day follow-up, clinical success rate was 96%. Three successful endovascular reinterventions were performed within the 30-day follow-up: one due to a type Ia endoleak in the common iliac artery, one due to type Ia endoleak of the aortic stent graft, and one due to bilateral lower limb claudication provoked by stent graft limb stenosis. At 30-day, a 100% survival rate and complete absence of pelvic or buttock ischemia/claudication were reported. Primary patency at 30 days was 100% for the internal iliac artery and 98% for the external iliac artery with an assisted patency of 100% in the latter.Conclusions: The high clinical success rate, low rates of device-related reinterventions (2%), and excellent patency rate demonstrate the safety and feasibility of the E-liac Stent Graft System. Long-term results are awaited to state efficacy and durability. Clinical Trials.gov. Identifier no. NCT02209194. [ABSTRACT FROM AUTHOR]

Purpose: Aortic stent-graft infection (SGI) entails a high mortality. Alirocumab is a monoclonal antibody to proprotein convertase subtilisin/kexin type 9 (PCSK9), approved for treatment of therapy-refractory hypercholesterolemia. Proprotein convertase subtilisin/kexin type 9 might play a role in infections. Case report: A 68-year-old male suffered from fatigue, fever, and back pain. Twelve months previously, a 4-fold-fenestrated aortic endoprosthesis was implanted because of an aortic aneurysm. Four months later, alirocumab 150 mg was initiated. Staphylococcus aureus grew in several blood cultures, and he received cefazolin and fosfomycin. Fludeoxyglucose positron emission tomography computed tomography indicated an infected endoprosthesis. Puncture of the periprosthetic space under antibiotic therapy revealed different strains of Staphylococcus epidermidis. The therapy was changed to dalbavancin. The patient died suddenly 11 days later after complaining about back pain for several days. No autopsy was carried out. Conclusions: The most probable cause of the patient's recurrent bacteremia with S aureus was an infection of the aortic prosthesis. Although this report is very speculative, it can be concluded that data about infections in patients under PCSK9 inhibitors should be collected systematically and more research is needed about the biological consequences of decreasing cholesterol to extreme low levels. [ABSTRACT FROM AUTHOR]

Different variations and anomalies are known of the abdominal visceral branches of the aorta, whereas concomitant variations including both renal and inferior phrenic arteries are exceedingly rare. We report the case of a 28-year-old female, presenting with stomachache, nausea and emesis. Computer tomography revealed a large common trunk consisting of the celiac trunk, both inferior phrenic and renal arteries and the superior mesenteric artery. Due to a hypoplastic aorta a wide Arc of Riolan was present. This is the first description of a unique variation of a common celiomesenteric-renal trunk, emphasizing the need for further classification of the visceral vascularity., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

The modality of treatment and the appropriate time point to treat type II endoleaks after endovascular repair of abdominal aortic aneurysms (EVAR) remain controversial issues. The purpose of the present study was to assess the efficacy of translumbar embolization of type II endoleaks after endovascular repair of aortic aneurysm repair. Eighty-four consecutive patients after EVAR were analyzed for the onset of type II endoleaks. Of these, five patients had experienced translumbar embolization after ineffective intraartrial approach to exclude the endoleak. A combination of several liquid embolic agents was used as sealant. Post-procedural contrast-enhanced ultrasound (CEUS) was used to document the outcome of the embolization. Translumbar embolization was successful in four patients. Complete sealing of the nidus was seen on CEUS 24 h after the procedure. In one patient with a duplication of the inferior vena cava, the procedure was aborted because an additional type Ib endoleak was found. The procedure was well tolerated by all patients. The translumbar approach to treat growing aneurysm sacs in patients with persistent type II endoleaks is safe and well tolerated. The immediate post-interventional outcome as documented on CEUS is promising. Long-term follow-ups are yet to be performed.