Endovascular aneurysm sealing (EVAS) alone or in combination with chimney grafts (chEVAS) for treating complications of previous endovascular aneurysm repair (EVAR) procedures

Paraskevas, KI, Karouki, M, Rehman, A, Torella, F, McWilliams, RG, England, A ORCID: https://orcid.org/0000-0001-6333-7776 and Fisher, RK 2018, 'Endovascular aneurysm sealing (EVAS) alone or in combination with chimney grafts (chEVAS) for treating complications of previous endovascular aneurysm repair (EVAR) procedures' , CardioVascular and Interventional Radiology, 41 (7) , pp. 1015-1020.

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Abstract

Objective
Late complications after previous endovascular aneurysm repair (EVAR) procedures include type I/III endoleaks causing aneurysm growth and rupture. We reviewed our results from the management of such complications with endovascular aneurysm sealing (EVAS) techniques.
Methods
Analysis of our prospectively maintained aneurysm database was performed (December 2013–May 2017). Primary outcomes were: (1) success of the procedure in excluding the primary complication, (2) perioperative mortality, (3) post-operative complications and (4) survival.
Results
Ten consecutive patients were treated for complications of EVAR procedures performed 2–12 years previously. All patients underwent EVAS with/without chimney grafts for 6 type Ia,1 type IIIb and 3 undetermined (but presumed type IIIb) endoleaks. Overall, 19 Nellix devices were used. The technical success with type Ia endoleaks was 100%. All sealed using proximal extension through chimney EVAS with 1 target vessel loss. There were no perioperative deaths. All but 1 type Ia endoleak remained eliminated at follow-up (range 2–29 months) as did the proven type IIIb endoleak. Two of the 3 undetermined endoleaks demonstrated continued sac expansion requiring surgical exploration by laparotomy, during which type II endoleaks were identified.
Conclusions
EVAS provides effective short-term treatment of type Ia/IIIb endoleaks after EVAR. However, late complications may occur due to disease progression.

Item Type: Article
Schools: Schools > School of Health and Society > Centre for Health Sciences Research
Journal or Publication Title: CardioVascular and Interventional Radiology
Publisher: Springer
ISSN: 0174-1551
Related URLs:
Depositing User: Dr Andrew England
Date Deposited: 15 Jun 2018 12:42
Last Modified: 18 Nov 2019 12:45
URI: http://usir.salford.ac.uk/id/eprint/47043

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