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CHAPTER 27 Aneurysm sac pressure measurement 215
graft failure. Biomech Model Mechanobiol 2005 Dec;
4(4): 221–234.
17 ElkouriS, Panneton JM, AndrewsJC, LewisBD,McKusick
MA, Noel AA, Rowland CM, Bower TC, Cherry KJ, Jr.,
Gloviczki P. Computed tomography and ultrasound in
follow-up ofpatients afterendovascular repair of abdom-
inal aortic aneurysm. Ann Vasc Surg 2004 May; 18(3):
271–279.
18 Dias NV, Ivancev K, Malina M, Hinnen JW, Visser M,
Lindblad B, Sonesson B. Direct intra-aneurysm sac pres-
sure measurement using tip-pressure sensors: In vivo and
in vitro evaluation. J Vasc Surg 2004 Oct; 40(4): 711–716.
19 Sonesson B, Dias N, Malina M, Olofsson P, Griffin D,
Lindblad B, Ivancev K. Intra-aneurysm pressure mea-
surements in successfully excluded abdominal aortic
aneurysm afterendovascular repair. JVasc Surg 2003 Apr;
37(4): 733–738.
20 Baum RA, Carpenter JP, Cope C, Golden MA, Velazquez
OC, Neschis DG, Mitchell ME, Barker CF, Fairman RM.
Aneurysm sac pressuremeasurements after endovascular
repair of abdominal aortic aneurysms. J Vasc Surg 2001
Jan; 33(1): 32–41.
21 Sonesson B, Dias N, Malina M, Olofsson P, Griffin D,
Lindblad B, Ivancev K. Intra-aneurysm pressure mea-
surements in successfully excluded abdominal aortic
aneurysm after endovascular repair. J Vasc Surg 2003; 37:
733–738.
22 Makaroun MS,Dillavou ED, Kee ST, Sicard G, Chaikof E,
Bavaria J, Williams D,Cambria RP, MitchellRS. Endovas-
cular treatment of thoracic aortic aneurysms: Results of
the phase II multicenter trial of the GORE TAG thoracic
endoprosthesis. J Vasc Surg 2005 Jan; 41(1): 1–9.
23 Dias NV, Ivancev K, Malina M, Resch T, Lindblad B,
Sonesson B. Intra-aneurysm sac pressure measurements
after endovascular aneurysm repair: Differences between
shrinking, unchanged, and expanding aneurysms with
and without endoleaks. J Vasc Surg2004 Jun; 39(6):1229–
1135.
24 Milner R, Verhagen HJ, Prinssen M, Blankensteijn JD.
Noninvasive intrasac pressure measurement and the in-
fluence oftype 2 and type 3endoleaks inan animalmodel
of abdominal aortic aneurysm. Vascular.2004 Mar; 12(2):
99–105.
25 Milner R, Ruurda JP, Blankensteijn JD. Durability and
validity of a remote, miniaturized pressure sensor in an
animal model of abdominal aortic aneurysm. J Endovasc
Ther 2004 Aug; 11(4): 372–377.
26 Ellozy SH, Carroccio A, Lookstein RA, Minor ME,
Sheahan CM, Juta J, Cha A, Valenzuela R, Addis MD,
Jacobs TS, Teodorescu VJ, Marin ML. First experience in
human beings with a permanently implantable intrasac
pressure transducer for monitoring endovascular repair
of abdominal aortic aneurysms. J Vasc Surg 2004 Sep;
40(3): 405–412.
27 Ellozy SH, Carroccio A, Lookstein RA, Jacobs TS,
Addis MD, Teodorescu VJ, Marin ML. Abdominal aortic
aneurysm sac shrinkage after endovascular aneurysm re-
pair: Correlationwith chronicsac pressure measurement.
J Vasc Surg 2006 Jan; 43(1): 2–7.
28 Dias NV, Ivancev K, Malina M, Resch T, Lindblad B,
Sonesson B. Intra-aneurysm sac pressure measurements
afterendovascular aneurysm repair: Differences between
shrinking, unchanged, and expanding aneurysms with
and without endoleaks. J Vasc Surg 2004; 39: 1229–1135.
29 Ohki T, Yadav J, Gargiuolo N et al. Preliminary results of
implantable wireless aneurysmpressuresensor in acanine
model: Will surveillance CT scan following endovascular
AAA repair become obsolete? J Endovasc Ther 2003: 10
(Suppl 1): 1–32.
30 Ohki T et al. Preliminary outcome of wireless pressure
sensing for EVAR (the APEX Trial) Society for Vascular
Surgery, Philadelphia, PA. June 18, 2005.
31 Dake MD, Miller DC, Semba CP, Mitchell RS, Walker
PJ, Liddell RP. Transluminal placement of endovascular
stent-grafts for the treatment of descending thoracic aor-
tic aneurysms. N Engl JMed 1994Dec 29; 331(26): 1729–
1734.
32 Cho JS, Haider SE, Makaroun MS.Endovascular therapy
of thoracicaneurysms: GoreTAG trial results. SeminVasc
Surg 2006 Mar; 19(1): 18–24.
33 Milner R, Kasirajan K, Chaikof EL. Future of Endograft
Surveillance. Sem Vasc Surg 2006 Jun; 19(2): 75–82.
https://t.me/med1917
Index
Note:page numbersin italics referto figures, those in boldrefer to tables.
abdominal aorta 37–9, 37–9
tortuosity 106
treatment 106–7
abdominal aortic aneurysms 16–17, 17
inflammatory 17
percutaneous repair 193–8
rupture 181–5
endovascular grafts 182–3
endovascular repair 184–5
hypotensive hemostasis 181–2, 182, 183
management protocol 183–4
see also abdominal stent grafts; endovascular repair
surveillance 210
abdominal coarctation 37
abdominal stent grafts 193, 210–12
follow-up 65–70
determinants of success 66
guidelines 68–9
imaging modalities 66–8
Alagille syndrome 37
AneuRx stent graft 193
Aneurysm Detection and Management (ADAM) study
177
aneurysms 6
abdominal aorta see abdominal aortic aneurysms
ascending aorta 13–14, 155–67, 156
case examples 156–64, 157–66
decision to treat 176–7, 177
management see abdominal stent grafts; endovascular
aortic repair; thoracic stent grafts
mycotic 17–18
small 175–80
thoracic aorta see thoracic aortic aneurysms
thoracoabdominal aortic 15–16, 15, 16
aneurysm sac pressure 209–14
CardioMems EndoSure wireless pressure sensor 211–12,
211, 212
Remon impressure sensor 210–11, 210
aorta
abdominal see abdominal aorta
anatomy 31–9
atherosclerosis 5
coarctation 36–7
diameter 38
double aortic arch 35–6, 36
hypoplasia 36
interruptionofarch36
left aortic arch 31–2, 32, 33, 34
midaortic syndrome 37
morphology 42
right aortic arch 32–5, 35
thoracic see thoracic aorta
tortuous 57–8, 58
see also aortic
aortic dissection 6–7, 51, 117–22
anatomic and hemodynamic changes 123, 124
branch artery obstruction 118–19, 119
diagnosis 120–1
mechanisms of 124, 125
complications 125, 125
false lumen
identification 119–20
rupture 117–18, 118
stability of 123
fenestration and stents 123–5
management 121–2, 121, 122
see also abdominal stent grafts; thoracic stent graphs
thoracic aorta 18–19, 18
aortic endostapling 169–72
device description 169–70, 170
future progress 172
mechanical bench testing 170
testing in human cadavers 172
in vivo testing 170
acute situations 170–2, 171
aortic trauma 20–1, 127–31, 135–40
anatomy 135
diagnosis 127–9, 128, 136
endografts in 129–31, 129, 130, 131
complications 131
endovascular repair 137–8, 141–9, 142
anatomic considerations 137–8, 143–4, 143
experience of 138–40, 139
results 146–8, 147, 148
as standard treatment 148–9, 149
young patients 144–6, 145, 146, 147
imaging 136
nonoperative management 136–7
open operative repair 136
clamp and sew technique 136
complications 136
distal aortic perfusion 136
217
Advanced Endovascular Therapy of Aortic Disease
Edited by Alan B. Lumsden, Peter H. Lin, Changyi Chen, Juan C. Parodi
Copyright © 2007 by Blackwell Publishing
https://t.me/med1917
218 Index
aortobronchial fistula 21
aortoesophageal fistula 21
aortography 54
arteriography 20
ascending aortic aneurysm 13–14, 155–67, 156
atherosclerosis 3, 11–13, 12
in aorta 5
and infection 5
lipids in 6
risk factors 5–6
stenotic 11
atherosclerotic degeneration 11–12
atherosclerotic ulceration 12–13, 12, 61–3
beak sign 120
Bolton Relay stent graft 91–4, 92, 93, 94
branch artery obstruction 118–19, 119
diagnosis 120–1
mechanisms of 124, 125
Michigan classification 118, 119
branched grafts 16
CardioMems EndoSure wireless pressure sensor 211–12,
211, 212
CEASAR trial 179
cerebrovascular accidents 79
Chlamydia pneumoniae 5
coarctation of aorta 36–7
color Duplex ultrasound 66
computed tomography angiography 45–7, 46, 47,66
helical 66
postoperative imaging 188
spiral 66
debranching techniques 58
delivery systems
Transport 91, 92
Xcelerant 87, 89
dissection see aortic dissection
diverticulum of Kommerell 32
double aortic arch 35–6, 36
echocardiography, transesophageal 48
Ehlers-Danlos syndrome 7, 13, 25
endografts
anatomic and hemodynamic changes 124–5
aortic trauma 129
collapse due to oversize in young patients 146, 149
complications 131
concerns relating to 129–31, 130, 131
logic for use 129
outcome 125
procedures 125
see also thoracic stent grafts
endoleaks 65, 66, 67–8, 79, 96
classification 187, 199–200
diagnosis 202
endotension 207
management 188–91, 189, 190, 199–207
type I 202–3, 203
natural history 200, 202
risk factors and prevention 200, 201
type II 203–6, 205, 206
types III and IV 206
endoprostheses see abdominal stent grafts; thoracic stent
grafts
endotension 199, 207
see also endoleaks
endothelium, role in plaque development 4
endovascular aortic repair 11, 14, 181–5
abdominal aortic aneurysm 184–5
aneurysm sac pressure 209–14
aortic trauma 137–8, 141–9, 142, 143–4, 143
experience of 138–40, 139
results 146–8, 147, 148
as standard treatment 148–9, 149
young patients 144–6, 145,
146, 147
imaging surveillance 187–8
impact of 178–9, 178, 179
percutaneous 193–8
Texas Heart Institute results 196–8, 197, 198
see also abdominal stent grafts; thoracic stent grafts
EUROSTAR thoracic registry 95–102
characterization of thoracic aortic disease 96
endoleaks 96
follow-up 98, 98–101
neurological sequelae 96–8, 97
outcomes 96
procedures 96
sample population 95–6
EVAR see endovascular arterial repair
Excluder stent graft 193
false lumen
identification of 119–20
rupture 117–18, 118
stability of 123
fatty streak 3–4
femoral artery, percutaneous repair 194–6, 195, 196
fenestrated (scalloped) grafts 15–16
fenestration 124
completion of procedures 125
fibrillin 7
fibrous cap 3
fibrous plaque 3–4
fibulin-5 7
flowvoid47
giant cell arteritis 13
Gore thoracic aortic graft 55, 75–82, 155
confirmatory trial 81–2
clinical materials 81
design 81
early outcome 81–2
objectives and hypotheses 81
device description 75, 76, 77
https://t.me/med1917
Index 219
pivotal trial 75–81
clinical materials 77–8, 78
early outcome 78–9, 79
follow-up 77
late outcome 79–81, 80, 81
objectives and hypotheses 75
operative data 78
study design 75, 77
hypotensive hemostasis 181–2
iliac arteries, small 57
imaging
aortic trauma 136
postoperative 66–8
preoperative 53–4, 54
infection, and atherosclerosis 5
inflammation, and plaque formation 4
inflammatory aneurysm 17
interleukin-1 4
intramural hematoma 19–20, 20, 61–3
asymptomatic patients 63
management 61–2
predictors of disease progression 62–3
intravascular ultrasound 48–50, 49–51,54
Klippel-Feil syndrome 13
Laplace’s law 25
left aortic arch 31–2, 32, 33, 34
lipids 6
macroembolization 13
magnetic resonance imaging 47–8
postoperative 68
Marfan’s syndrome 7, 13, 15, 27
matrix metalloproteinases 4
metabolic syndrome 5
microembolization 12–13
midaortic syndrome 37
multidetector spiral computed tomography 67
mycotic aneurysms 17–18
neck, anatomy 41–2
osteogenesis imperfecta 13
paraplegia 19
risks of 43
penetrating atherosclerotic ulcers 61–3
percutaneous femoral artery repair 194–6, 195, 196
PIVOTAL trial 179
plaque
and blood flow 5
degeneration 4–5
development, role of endothelium 4
fibrous 3–4
inflammation and 4
rupture 4
platelet-derived growth factor 3
polycystic kidney disease 25
Powerlink stent graft 193
preoperative imaging 53–4, 54
Prostar XL device 194–6, 195, 196, 197
pseudoxanthoma elasticum 13
Remon impressure sensor 210–11, 210
right aortic arch 32–5, 35
risk factors 5–6
smoking 5–6, 28
spinal cord ischemia 78–9
statins 6
stenotic atherosclerosis 11
subclavian steal syndrome 11
supraceliac balloon 182
Takayasu’s disease 7–8, 13
macroscopic findings 8
microscopic findings 8
Talent stent g raft 85–9, 86
comparison with Valiant device 89
completion angiogram 87
flexibility 88
thoracic aorta 156
anomalies of 131
dissections 18–19, 18
see also aortic dissections
tortuosity 106
treatment 106–7
thoracic aortic aneurysms 13–15, 13–16, 25–9, 212–14, 213
ascending and arch 13–14
classification 26
descending 14–15, 14
etiology 25–7, 26
incidence 25
management see thoracic stent grafts
natural history 27–8
postoperative surveillance 187–91
results of treatment 28–9
thoracic stent grafts
access complications 43
advantages of 107
aortic morphology 42
Bolton Relay device 91–4
case planning 109–10
device position 42–3
device sizing 41, 55
diameter 55, 55, 56
difficult scenarios
debranching techniques 58
significant aortic tortuosity 57–8
small iliac arteries 57
dissections 112–13, 112, 113
follow-up 65–70
determinants of success 66
guidelines 68–9
imaging modalities 66–8
https://t.me/med1917
220 Index
thoracic stent grafts (cont.)
Gore thoracic aortic graft 55, 75–82, 155
length 55–7, 56, 57, 58
neck anatomy 41–2
paraplegia risk 43
patient selection 41–3, 109–10
preoperative preparation 110
Talent and Valiant devices 85–9
technique 110–11, 111
Zenith TX2 device 105–14, 108, 109
thoracoabdominal aortic aneurysms 15–16, 15, 16
TIMPs 6
transesophageal echocardiography 48
transforming growth factor β4
Transport delivery system 91, 92
trauma see aortic trauma
Turner’s syndrome 13, 25
ultrasound 48–50, 188
color Duplex 66
intravascular 48–50, 49–51,54
transesophageal echocardiography 48
Valiant stent graft 85–9
comparison with Talent device 89
Valor Trial 85–9
VCAM-1 4
William’s syndrome 37
Xcelerant delivery system 87, 89
young trauma victims, endovascular repair in 144–6
descending aortic injury 144–5, 145
endograft collapse due to oversize 146
femoral artery access 144
hemodynamic and anatomical considerations 145–6,
146
potential aortic growth 144
procedural-related complications 145
Zenith TX2 stent graft 105–14, 108, 109, 193
aortic dissection 112–13, 112, 113
clinical experience 113–14
https://t.me/med1917