Embolization therapy for type 2 endoleaks after endovascular aortic aneurysm repair: imaging-based predictive factors and clinical outcomes on long-term follow-up

PURPOSETo evaluate the technical, radiological, and clinical outcomes after type 2 endoleak (T2EL) embolization in patients with a growing aneurysm sac after endovascular aortic aneurysm repair (EVAR). Additionally, to determine clinical and imaging-based factors for outcome prediction after embolization of a T2EL.METHODSA single-institution, retrospective analysis was performed of 60 patients who underwent a T2EL embolization procedure between September 2005 and August 2016 to treat a growing aneurysm sac diameter following EVAR. The patients’ electronic medical records and all available pre- and post-embolization imaging were reviewed. Statistical analysis methods included logistic regression models for binary outcomes, proportional odds models for ordinal outcomes, and linear regression models for continuous outcomes. The Kaplan–Meier method was used to estimate the overall survival probability.RESULTSTechnical, radiological, and clinical success rates after T2EL embolization were 95% (n = 57), 26.7% (n = 16), and 76.7% (n = 46), respectively. Persistent aneurysm sac expansion was found in 31 patients (51.7%). Unsharp or blurred T2EL delineation on pre-interventional computed tomography (CT) was a predictive factor for a post-embolization persistent visible endoleak and persistent growth of the aneurysm sac (P = 0.025). Median survival after T2EL embolization was 5.35 years, with no difference observed between patients with persistent sac expansion compared with patients with stable or decreased sac diameter.CONCLUSIONProgression of the aneurysm sac diameter was observed in half the study patients, despite technically successful T2EL embolization. Unsharp or blurred T2EL delineation on pre-interventional CT seemed to be an imaging-based predictor for a persistent T2EL and progressive aneurysm sac growth after embolization

Charcot foot attacks in a non-transplanted Diabetes Mellitus population: the importance of corticosteroids as a causative factor

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Epidemiology an early management of acute Charcot foot in a tertiary diabetic foot clinic in Belgium

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Internal carotid artery dissection coincides with celiac artery dissection

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Syme amputation, a limb saving alternative with preservation of mobility in a middle-aged population with limited impaired bloodflow

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Stent graft infection in the lower limb

Pore wound healing can occur after limb amputation.status: publishe

Mid- to Long-Term Outcome Results of the Ovation Stent Graft

BACKGROUND: To report mid-term to long-term outcome data for endovascular aortic repair using the Ovation stent-graft system (Endologix, Santa Rosa, CA) in a single university center. METHODS: All patients treated with the Ovation stent graft between February 2012 and January 2019 were included. Patient demographics, anatomical and operative details, as well as follow-up data including complications, need for further interventions, and mortality were analyzed. RESULTS: A total of 74 patients (93% males; mean age, 74.5 years) were treated with the Ovation stent graft. The median maximal aortic diameter was 60 mm (range, 36-100). Sixty-two of 74 patients (83.8%) were considered to have a hostile neck. About 33% had a (reversed) conical neck, 59% had circumferential neck calcification (>50%), and 39% had significant neck thrombus (>50%). Technical success rate was 91.89%. Despite additional measures, 4 patients had a persistent type Ia endoleak on completion angiography, of which 3 disappeared on the first postoperative computed tomography angiography. Mean follow-up duration was 31.62 months ± 21.3 (range, 0-72.74 months). Twenty-four patients had a follow-up time of at least 36 months. Freedom from reintervention at 1, 2, 3, and 5 years was 92.7%, 90.8%, 80.1%, and 80.1%, respectively. Estimated freedom from mortality at 1, 2, 3, and 5 years was 96.8%, 95.0%, 87.3%, and 68.5%, respectively. No late type Ia or type III endoleak was detected during follow-up. No aneurysm-related mortality was seen. CONCLUSIONS: Our mid- to long-term experience with the Ovation stent-graft system demonstrates safe and durable results without late type Ia or type III endoleak.status: publishe

ePTFE grafts compared with vein grafts in femoropopliteal and femorocrural bypasses: 1- and 2-year results

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Arterioureteral Fistula. An Unusual Cause of Aortofemoral Bypass Infection. A Case Report

We report a case of arterioureteral fistula after aortobifemoral bypass surgery and prolonged bilateral double J stents due to ureteral stenosis.status: publishe