Endovascular Abdominal Aortic Aneurysm Repair (EVAR)
This section provides a comprehensive procedural report for endovascular abdominal aortic aneurysm repair (EVAR) procedure with up-to-date explanatory notes, synopsis of the indications and contraindications, and potential complications in an organized an
- PDF / 107,380 Bytes
- 6 Pages / 504.567 x 720 pts Page_size
- 90 Downloads / 219 Views
76
Bedros Taslakian
Abbreviations
AAA EVAR IMA SMA ACT
Abdominal aortic aneurysm Endovascular abdominal aortic aneurysm repair Inferior mesenteric artery Superior mesenteric artery Activated clotting time
INTRODUCTION Abdominal aortic aneurysm (AAA) is an abnormal dilatation of the abdominal aorta greater than 50 % of the normal proximal segment, or dilatation greater than 3 cm. Factors associated with development of AAA include smoking, increasing age, coronary artery disease, hypercholesterolemia, peripheral vascular disease, hypertension, connective tissue disorders, and family history. Continuous expansion of AAAs results in an increased risk of rupture and distal embolization. Risk factors for AAA rupture include aneurysm size, rate of expansion, poorly controlled hypertension, chronic obstructive pulmonary disease, and smoking. Surgical repair of AAA has traditionally been the standard of care. Endovascular abdominal aortic aneurysm
B. Taslakian (&) Department of Radiology, New York University Langone Medical Center, 660 First Ave, New York, NY 10016, USA e-mail: [email protected]
repair (EVAR) is now an established safe alternative therapy. Fenestrated and branching endovascular grafts have increased the indications for EVAR when the anatomical arrangements are suboptimal for a straight EVAR such as neck length 1 cm increase in diameter in 12 months) • Asymptomatic fusiform aneurysm with a diameter of >5.5 cm for men; >5.0 cm for women
© Springer International Publishing Switzerland 2016 B. Taslakian et al. (eds.), Procedural Dictations in Image-Guided Intervention, DOI 10.1007/978-3-319-40845-3_76
331
332
• AAA with penetrating atherosclerotic ulcer or saccular aneurysm (pseudoaneurysm) twice the diameter of normal infrarenal aorta • Inflammatory AAAs • Smaller AAAs with concomitant iliac aneurysms requiring repair • Smaller AAAs with associated thrombotic/ embolic complications • Ideal anatomic inclusion criteria are: – Proximal neck length (segment of aorta between the origin of the lowest renal artery and superior aspect of the aneurysm): 15 mm or greater – Proximal neck diameter: 33 mm or under depending on the endograft device – Proximal neck angulation:
Data Loading...
