Image-guidance techniques and treatment approach optimization in the management of Type-II Endoleak after EVAR.
abdominal aortic aneurysm
aneurysm
aorta
endoleak
endovascular procedures
Journal
Annals of vascular surgery
ISSN: 1615-5947
Titre abrégé: Ann Vasc Surg
Pays: Netherlands
ID NLM: 8703941
Informations de publication
Date de publication:
21 Nov 2023
21 Nov 2023
Historique:
received:
12
06
2023
revised:
29
09
2023
accepted:
08
10
2023
medline:
24
11
2023
pubmed:
24
11
2023
entrez:
23
11
2023
Statut:
aheadofprint
Résumé
Over the past three decades EVAR emerged as the primary approach for abdominal aortic aneurysm management, however the occurrence of endoleak following endograft implantation imposes a high toll on patients and hospitals alike. The early diagnosis and appropriate treatment of endoleaks is associated with better outcomes, which calls for more advanced imaging and a standardized approach for endoleak diagnosis and management following EVAR. Although conventional strategy with non-targeted deployment of coils and embolic material in the aneurysm sac is considered to be the standard approach in many hospitals, it may not prove to be a viable option, given that it affects any further follow-up imaging in the event of sub-optimal therapy and consequent recurrence. Currently various imaging and image guidance tools are available to address this clinical challenge, utilizing a targeted approach to warrant optimal individualized, patient-tailored treatment for each case. We summarize our tertiary aortic referral center experience and describe strategies for optimal selection of various treatment approaches for Type-II Endoleak specifically. Including endovascular, percutaneous and laparoscopic approaches.
Sections du résumé
BACKGROUND
BACKGROUND
Over the past three decades EVAR emerged as the primary approach for abdominal aortic aneurysm management, however the occurrence of endoleak following endograft implantation imposes a high toll on patients and hospitals alike. The early diagnosis and appropriate treatment of endoleaks is associated with better outcomes, which calls for more advanced imaging and a standardized approach for endoleak diagnosis and management following EVAR. Although conventional strategy with non-targeted deployment of coils and embolic material in the aneurysm sac is considered to be the standard approach in many hospitals, it may not prove to be a viable option, given that it affects any further follow-up imaging in the event of sub-optimal therapy and consequent recurrence.
PURPOSE
OBJECTIVE
Currently various imaging and image guidance tools are available to address this clinical challenge, utilizing a targeted approach to warrant optimal individualized, patient-tailored treatment for each case. We summarize our tertiary aortic referral center experience and describe strategies for optimal selection of various treatment approaches for Type-II Endoleak specifically. Including endovascular, percutaneous and laparoscopic approaches.
Identifiants
pubmed: 37995905
pii: S0890-5096(23)00763-X
doi: 10.1016/j.avsg.2023.10.005
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023. Published by Elsevier Inc.