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152. Revascularization of occluded renal artery stent grafts after complex endovascular aortic repair and its impact on renal function

Author

Konstantinou, Nikolaos, Kölbel, Tilo, Dias, Nuno V, Verhoeven, Eric, Wanhainen, Anders, Gargiulo, Mauro, Oikonomou, Kyriakos, Verzini, Fabio, Heidemann, Franziska, Sonesson, Bjorn, Katsargyris, Athanasios, Mani, Kevin, Fernandez Prendes, Carlota, Gallitto, Enrico, Pfister, Karin, Ruffino, Maria Antonella, Tenorio, Emanuel R, Speziale, Francesco, Haulon, Stephan, Oderich, Gustavo S, Tsilimparis, Nikolaos, Konstantinou, Nikolaos, Kölbel, Tilo, Dias, Nuno V, Verhoeven, Eric, Wanhainen, Anders, Gargiulo, Mauro, Oikonomou, Kyriakos, Verzini, Fabio, Heidemann, Franziska, Sonesson, Bjorn, Katsargyris, Athanasios, Mani, Kevin, Fernandez Prendes, Carlota, Gallitto, Enrico, Pfister, Karin, Ruffino, Maria Antonella, Tenorio, Emanuel R, Speziale, Francesco, Haulon, Stephan, Oderich, Gustavo S, and Tsilimparis, Nikolaos

Abstract

BACKGROUND: Acute occlusion of renal bridging stent grafts after fenestrated/branched endovascular aortic repair (F/B-EVAR) is an acknowledged complication with high morbidity that often results in chronic dialysis dependence. The feasibility and effect of timely or late (≥6 hours of ischemia) renal artery revascularization has not been adequately reported. METHODS: We performed a retrospective, multicenter study across 11 tertiary institutions of all consecutive patients who had undergone revascularization of renal artery stent graft occlusions after complex EVAR. The end points were technical success, association between ischemia time and renal function salvage, interventional complications, mortality, and mid-term outcomes. RESULTS: From 2009 to 2019, 38 patients with 46 target vessels (TVs; eight bilateral occlusions) were treated for renal artery occlusions after complex EVAR (mean age, 63.5 ± 10 years; 63.2% male). Six patients had a solitary kidney (15.8%). Of the 38 patients, 16 (42.1%) had undergone FEVAR and 22 (57.9%) had undergone BEVAR. The technical success rate was 95.7% (44 of 46 TVs). The recanalization technique used was sole aspiration thrombectomy in 5.3%, aspiration thrombectomy and stent graft relining in 52.6%, and sole stent graft relining in 36.8%. The median renal ischemia time was 27.5 hours (range, 4-720 hours; interquartile range, 4-36 hours). Most patients (94.4%) had been treated after ≥6 hours of renal ischemia time, and 55.6% had been treated after 24 hours. In 14 patients (36.8%), renal function had improved after intervention (mean glomerular filtration rate improvement, 14.2 ± 9 mL/min/1.73 m2). However, 24 patients (63.2%) showed no improvement. Improvement of renal function did not correlate with the length of renal ischemia time. Of the 14 patients with bilateral renal artery occlusion or a solitary kidney, 9 experienced partial recovery of renal function and no longer required hemodialysis. In-hospital mortality was 2.6%. The

Published
2021
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154. Revascularization of occluded renal artery stent grafts after complex endovascular aortic repair and its impact on renal function

Author

Konstantinou, Nikolaos, primary, Kölbel, Tilo, additional, Dias, Nuno V., additional, Verhoeven, Eric, additional, Wanhainen, Anders, additional, Gargiulo, Mauro, additional, Oikonomou, Kyriakos, additional, Verzini, Fabio, additional, Heidemann, Franziska, additional, Sonesson, Bjorn, additional, Katsargyris, Athanasios, additional, Mani, Kevin, additional, Prendes, Carlota F., additional, Gallitto, Enrico, additional, Pfister, Karin, additional, Ruffino, Maria Antonella, additional, Tenorio, Emanuel R., additional, Speziale, Francesco, additional, Haulon, Stephan, additional, Oderich, Gustavo S., additional, and Tsilimparis, Nikolaos, additional

Published
2021
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155. Carotid webs management in symptomatic patients

Author

Multon, Sébastien, primary, Denier, Christian, additional, Charbonneau, Phillippe, additional, Sarov, Mariana, additional, Boulate, David, additional, Mitilian, Delphine, additional, Mougin, Justine, additional, Chassin, Olivier, additional, Legris, Nicolas, additional, Fadel, Elie, additional, Haulon, Stephan, additional, and Fabre, Dominique, additional

Published
2021
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168. Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic Arch: An Expert Consensus Document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS)

Author

Czerny, Martin, Schmidli, Jürg, Adler, Sabine, van den Berg, Jos C, Bertoglio, Luca, Carrel, Thierry, Chiesa, Roberto, Clough, Rachel E, Eberle, Balthasar, Etz, Christian, Grabenwöger, Martin, Haulon, Stephan, Jakob, Heinz, Kari, Fabian A, Mestres, Carlos A, Pacini, Davide, Resch, Timothy, Rylski, Bartosz, Schoenhoff, Florian, Shrestha, Malakh, von Tengg-Kobligk, Hendrik, Tsagakis, Konstantinos, Wyss, Thomas R, Document Reviewers, Chakfe, Nabil, Debus, Sebastian, de Borst, Gert J, Di Bartolomeo, Roberto, Lindholt, Jes, Ma, Wei-Guo, Suwalski, Piotr, Vermassen, Frank, Wahba, Alexander, Wyler von Ballmoos, Moritz C, Czerny, Martin, Schmidli, Jürg, Adler, Sabine, van den Berg, Jos C., Bertoglio, Luca, Carrel, Thierry, Chiesa, Roberto, Clough, Rachel E., Eberle, Balthasar, Etz, Christian, Grabenwöger, Martin, Haulon, Stephan, Jakob, Heinz, Kari, Fabian A., Mestres, Carlos A., Pacini, Davide, Resch, Timothy, Rylski, Bartosz, Schoenhoff, Florian, Shrestha, Malakh, von Tengg-Kobligk, Hendrik, Tsagakis, Konstantino, Wyss, Thomas R., Document Reviewers, null, Chakfe, Nabil, Debus, Sebastian, de Borst, Gert J., Di Bartolomeo, Roberto, Lindholt, Jes S., Ma, Wei-Guo, Suwalski, Piotr, Vermassen, Frank, Wahba, Alexander, and Wyler von Ballmoos, Moritz C.

Subjects
Aortic arch, Endovascular repair, Open repair, cardiovascular system, Expert consensus document
Abstract

The last decade has substantially broadened treatment options for patients with thoracic aortic pathology involving the aortic arch. Traditionally, treatment of aortic arch pa- thology was a domain of open cardiac surgery. The advent of combined vascular and endovascular procedures opened a new fi eld thereby enabling treatment in previously operated on and in less fi t patients. As a subsequent technological leap, branched arch stent grafts became available and are currently gaining acceptance in the com- munity. Also, open surgery has substantially improved, and the increased use of right subclavian artery cannulation and selective antegrade cerebral perfusion (SACP) at warmer lower body circulatory arrest times together with improved monitoring of organ function has substantially contributed to excellent results in these still major operations. Still, neurological complications remain a major concern of all procedures addressing aortic arch pathology irrespective if open surgery or endovascular repair. The reduction of neurological complications to a minimum will be one of the major tasks of the future

Published
2019
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169. Late outcomes of different hypogastric stent grafts in aortoiliac endografting with iliac branch device: Results from the pELVIS Registry

Author

Verzini, Fabio, primary, Parlani, Gianbattista, additional, Varetto, Gianfranco, additional, Gibello, Lorenzo, additional, Boero, Michele, additional, Torsello, Giovanni Federico, additional, Donas, Konstantinos P., additional, Simonte, Gioele, additional, Austermann, Martin, additional, Inchingolo, Mirjam, additional, Bisdas, Theodosios, additional, Torsello, Giovanni, additional, Pratesi, Giovanni, additional, Barbante, Matteo, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Pratesi, Carlo, additional, Fargion, Aaron, additional, Masciello, Fabrizio, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, Schmidt, Andrej, additional, and Scheinert, Dirk, additional

Published
2020
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170. Vascular Surgery in Unreal Times

Author

Eilenberg, Wolf, primary, Busch, Albert, additional, Wagenhäuser, Markus, additional, Giannoukas, Athanasios, additional, Wanhainen, Anders, additional, Neumayer, Christoph, additional, and Haulon, Stephan, additional

Published
2020
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171. Results of Iliac Branch Devices in Octogenarians Within the pELVIS Registry

Author

Fargion, Aaron Thomas, primary, Masciello, Fabrizio, additional, Pratesi, Giovanni, additional, Torsello, Giovanni, additional, Donas, Konstantinos P., additional, Pratesi, Carlo, additional, Austermann, Martin, additional, Inchingolo, Mirjam, additional, Bisdas, Theodosios, additional, Pitoulias, Georgios A., additional, Taneva, Gergana T., additional, Dorigo, Walter, additional, Ippoliti, Arnaldo, additional, Barbante, Matteo, additional, Cao, Piergiorgio, additional, Ferrer, Ciro, additional, Verzini, Fabio, additional, Parlani, Gianbattista, additional, Simonte, Gioele, additional, Kölbel, Tilo, additional, Tsilimparis, Nikolaos, additional, Haulon, Stephan, additional, Branzan, Daniela, additional, Schmidt, Andrej, additional, and Scheinert, Dirk, additional

Published
2020
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178. Corrigendum to ‘European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms’ (European Journal of Vascular & Endovascular Surgery (2019) 57(1) (8–93), (S1078588418306981), (10.1016/j.ejvs.2018.09.020))

Author

Wanhainen, Anders, Verzini, Fabio, van Herzeele, Isabelle, Allaire, Eric, Bown, Matthew, Cohnert, Tina, Dick, Florian, van Herwaarden, Joost, Karkos, Christos, Koelemay, Mark, Kölbel, Tilo, Loftus, Ian, Mani, Kevin, Melissano, Germano, Powell, Janet, Szeberin, Zoltán, ESVS Guidelines Committee, de Borst, Gert J., Chakfe, Nabil, Debus, Sebastian, Hinchliffe, Rob, Kakkos, Stavros, Koncar, Igor, Kolh, Philippe, Lindholt, Jes S., Vega de Ceniga, M., Vermassen, Frank, Document reviewers, Björck, Martin, Cheng, Stephen, Dalman, Ronald, Davidovic, Lazar, Donas, Konstantinos, Earnshaw, Jonothan, Eckstein, Hans-Henning, Golledge, Jonathan, Haulon, Stephan, Mastracci, Tara, Naylor, Ross, Ricco, Jean-Baptiste, Verhagen, Hence, Wanhainen, A., Verzini, F., Van Herzeele, I., Allaire, E., Bown, M., Cohnert, T., Dick, F., van Herwaarden, J., Karkos, C., Koelemay, M., Kolbel, T., Loftus, I., Mani, K., Melissano, G., Powell, J., Szeberin, Z., ESVS Guidelines, Committee, de Borst, G. J., Chakfe, N., Debus, S., Hinchliffe, R., Kakkos, S., Koncar, I., Kolh, P., Lindholt, J. S., Vega de Ceniga, M., Vermassen, F., Document, Reviewer, Bjorck, M., Cheng, S., Dalman, R., Davidovic, L., Donas, K., Earnshaw, J., Eckstein, H. -H., Golledge, J., Haulon, S., Mastracci, T., Naylor, R., Ricco, J. -B., Verhagen, H., Surgery, and ACS - Atherosclerosis & ischemic syndromes

Abstract

The authors regret that the name of one of the co-author has been incorrectly spelt. Dr. Melina Vega de Ceniga should have been cited as “Vega de Ceniga M” The authors would like to apologise for any inconvenience caused.

Published
2020

181. In-vitroAssessments of Clot Elicitation by Thrombogenic Fibers vs. Embolization Coils

Author

Chaput, Oriane, Solt, Derek, Sukavaneshvar, Sivaprasad, Fenouil, Nathalie, Burg, Brian R., Pouletty, Philippe, Haulon, Stephan, and Fabre, Dominique

Abstract

Late and persistent type II endoleaks (EL2) following Endovascular Aneurysm Repair (EVAR) have been recognized as an independent and significant risk factor for aneurysm sac growth and secondary procedures. Solutions are available for treatment, with varying success rates; preventive perioperative sac embolization with coils appears safe and effective. The objective of this study is to compare whole blood coagulation elicited by a textile stent-graft equipped with thrombogenic, patented “Kardiozis” fibers (PKF) to that elicited by embolization coils in an in vitrostudy.The approach is to establish an equivalence between PKF and coils in a static model, then to compare clot elicitation by both materials in a perfused model aneurysm chamber subjected to EL2.The weight of clot elicited during exposure to blood was the primary measurement. In the static model, PKF and coils were soaked in blood for up to 90 minutes (N= 30) and elicited similar clotting. In the dynamic model, stent-grafts equipped with PKF or coils were exposed to blood flow inside an aneurysm model for up to 3h (N= 5), with generally higher clot weights for stent-grafts with PKF (non-significant). Complete thrombosis of the aneurysm model was observed in one experimental series (positive control and stent-graft with PKF).A stent-graft with PKF elicits at least as much clot as embolization coils dispersed in an aneurysm model chamber under continuous blood flow. PKF positioned on the outer wall of stent-grafts could have a similar action as coiling of the aneurysm sac during the index EVAR.

Published
2022
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190. Vascular Surgery in Unreal Times

Author

Eilenberg, Wolf, Busch, Albert, Wagenhaeuser, Markus, Giannoukas, Athanasios, Wanhainen, Anders, Neumayer, Christoph, Haulon, Stephan, Eilenberg, Wolf, Busch, Albert, Wagenhaeuser, Markus, Giannoukas, Athanasios, Wanhainen, Anders, Neumayer, Christoph, and Haulon, Stephan

Published
2020
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191. Corrigendum to 'European Society for Vascular Surgery (ESVS) 2019 Clinical Practice Guidelines on the Management of Abdominal Aorto-iliac Artery Aneurysms' [European Journal of Vascular & Endovascular Surgery 57/1 (2019) 8-93]

Author

Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Brain, Regenerative Medicine and Stem Cells, Wanhainen, Anders, Verzini, Fabio, Van Herzeele, Isabelle, Allaire, Eric, Bown, Matthew, Cohnert, Tina, Dick, Florian, van Herwaarden, Joost, Karkos, Christos, Koelemay, Mark, Kölbel, Tilo, Loftus, Ian, Mani, Kevin, Melissano, Germano, Powell, Janet, Szeberin, Zoltán, Esvs Guidelines Committee, Guidelines Committee, de Borst, Gert J, Chakfe, Nabil, Debus, Sebastian, Hinchliffe, Rob, Kakkos, Stavros, Koncar, Igor, Kolh, Philippe, Lindholt, Jes S, Vega de Ceniga, M, Vermassen, Frank, Document Reviewers, Reviewers, Björck, Martin, Cheng, Stephen, Dalman, Ronald, Davidovic, Lazar, Donas, Konstantinos, Earnshaw, Jonothan, Eckstein, Hans-Henning, Golledge, Jonathan, Haulon, Stephan, Mastracci, Tara, Naylor, Ross, Ricco, Jean-Baptiste, Verhagen, Hence, Zorgeenheid Vaatchirurgie Medisch, Circulatory Health, Brain, Regenerative Medicine and Stem Cells, Wanhainen, Anders, Verzini, Fabio, Van Herzeele, Isabelle, Allaire, Eric, Bown, Matthew, Cohnert, Tina, Dick, Florian, van Herwaarden, Joost, Karkos, Christos, Koelemay, Mark, Kölbel, Tilo, Loftus, Ian, Mani, Kevin, Melissano, Germano, Powell, Janet, Szeberin, Zoltán, Esvs Guidelines Committee, Guidelines Committee, de Borst, Gert J, Chakfe, Nabil, Debus, Sebastian, Hinchliffe, Rob, Kakkos, Stavros, Koncar, Igor, Kolh, Philippe, Lindholt, Jes S, Vega de Ceniga, M, Vermassen, Frank, Document Reviewers, Reviewers, Björck, Martin, Cheng, Stephen, Dalman, Ronald, Davidovic, Lazar, Donas, Konstantinos, Earnshaw, Jonothan, Eckstein, Hans-Henning, Golledge, Jonathan, Haulon, Stephan, Mastracci, Tara, Naylor, Ross, Ricco, Jean-Baptiste, and Verhagen, Hence

Published
2020

194. Cerebral microbleeds following thoracic endovascular aortic repair.

Author

Eilenberg, Wolf, Bechstein, Matthias, Charbonneau, Philippe, Rohlffs, Fiona, Eleshra, Ahmed, Panuccio, Giuseppe, Bhangu, Jagdeep Singh, Fiehler, Jens, Greenhalgh, Rodger M., Haulon, Stephan, and Kölbel, Tilo

Subjects
ENDOVASCULAR surgery, ANTERIOR cerebral artery, POSTERIOR cerebral artery, THORACIC aorta, WHITE matter (Nerve tissue), CEREBRAL revascularization
Abstract

Background: Stroke and neurological injury are a complication of thoracic endovascular aortic repair (TEVAR). Cerebral microbleeds (CMBs) are common in patients with white matter damage to the brain secondary to chronic vasculopathy. The aim of this study was to examine the occurrence of CMBs after TEVAR, and to evaluate their association with patient and procedural factors. Methods: Patients who underwent TEVAR between September 2018 and January 2020 in two specialist European aortic centres were analysed. All patients underwent postoperative susceptibility-weighted MRI. The location and number of CMBs were identified, and analysed with regard to procedural aspects, clinical outcome, and Fazekas score as an indicator of pre-existing vascular leucoencephalopathy. Results: Some 91 patients were included in the study. A total of 1531 CMBs were detected in 58 of 91 patients (64 per cent). In the majority of affected patients, CMBs were found bilaterally (79 per cent). Unilateral CMBs in the right or left hemisphere occurred in 16 and 5 per cent of patients respectively (P<0.001). More CMBs were found in the middle cerebral than in the vertebrobasilar/posterior and anterior cerebral artery territories (mean(s.d.) 3.35(5.56) versus 2.26(4.05) versus 0.97(2.87); P=0.045). Multivariable analysis showed an increased probability of CMBs after placement of TEVAR stent-grafts with a proximal diameter of at least 40 mm (odds ratio (OR) 6.85, 95 per cent c.i. 1.65 to 41.59; P=0.007) and in patients with a higher Fazekas score on postoperative T2-weighted MRI (OR 2.62, 1.06 to 7.92; P=0.037). Conclusion: CMBs on postoperative MRI are common after endovascular repair in the aortic arch. Their occurrence appears to be associated with key aspects of the procedure and pre-existing vascular leucoencephalopathy. [ABSTRACT FROM AUTHOR]

Published
2022
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