Latest insights into Abdominal Aortic Aneurysms and endovascular repair

Proper treatment of abdominal aortic aneurysm (AAA) starts with the knowledge of the pathophysiology and identification of patients which are at increased risk for AAA development, and especially rupture. In this book all aspects of abdominal aortic aneurysms will be discussed in detail with focus on endovascular repair (EVAR). The field of EVAR is moving rapidly, with the introduction of the newest generation endografts, sophisticated pre- and post-EVAR imaging, as well as 3D navigation modalities to treat (complex) EVAR related complications. We are convinced that with this practical book the physicians in the vascular field will be sufficiently updated in order to optimize treatment of their AAA patients.
Contents
SCREENING FOR AAA
INTRODUCTION
SCREENING BY ULTRASONOGRAPHY
EVIDENCE FOR AAA SCREENING
CURRENT SCREENING PROGRAMS AROUND THE
SCREENING: STILL A MATTER OF DEBATE
CONCLUSIONS
RISK FACTORS FOR AAA GROWTH AND RUPTURE; MORE THAN DIAMETER ALONE
INTRODUCTION
AAA DIAMETER AND TIMING OF INTERVENTION
PATHOPHYSIOLOGY AND RISK FACTORS OF AAA
INTERACTION BETWEEN INTIMA AND INTRALUMINAL THROMBUS IN AAA
AORTIC WALL PATHOPHYSIOLOGY IN AAA
PHARMACOLOGICAL PATHWAYS AND POSSIBLE TREATMENT OPTIONS
CONCLUSIONS AND FUTURE DIRECTIONS
ASSOCIATION BETWEEN ABDOMINAL AORTIC ANEURYSM WALL BIOLOGY, RUPTURE RISK, AND POSTOPERATIVE EVENTS: THE VALUE OF BIOBANKS
INTRODUCTION
GENETIC COMPONENTS
PROTEASES
INFLAMMATION
VALUE OF BIOBANKS
ANEURYSM-EXPRESS BIOBANK
PREDICTION OF POSTOPERATIVE CARDIOVASCULAR
LOCAL VARIANCE IN AORTIC ANEURYSM WALL COMPOSITION AND RUPTURE RISK
CONCLUSIONS
AAA IMAGING AND PREOPERATIVE EVAR PLANNING; ESSENTIAL FOR EVAR SUCCESS
INTRODUCTION
AAA IMAGING
PREOPERATIVE EVAR PLANNING
CONCLUSIONS
INDICATIONS FOR EVAR: DO WE NEED TO FOLLOW INSTRUCTIONS FOR USE?
INTRODUCTION
DIFFERENCES AND TRENDS IN IFU
PROXIMAL NECK DIAMETER
PROXIMAL NECK LENGTH
PROXIMAL NECK ANGULATION
THROMBUS OR CALCIFICATION AT THE ATTACHMENT SITES
OVERSIZING
ILIAC ACCESS AND LANDING ZONE
THE KEYS FOR SUCCESSFUL IFU TRANSGRESSION
CONCLUSIONS
TIPS AND TRICKS FOR SUCCESSFUL EVAR
INTRODUCTION
PREPROCEDURAL PLANNING
ALTERNATIVE TECHNIQUES TO IDENTIFY KEY ANATOMICAL LANDMARKS
TECHNIQUE OF HYPOGASTRIC ARTERY EMBOLISATION
TECHNIQUE FOR DIFFICULT ILIAC ACCESS
CONCLUSIONS
UPDATE OF THE NEWEST GENERATION ENDOGRAFTS. WILL ANCHORING HOOKS, ENDOSTAPLES, AND INFLATABLE RINGS OR BAGS IMPROVE EVAR RESULTS?
INTRODUCTION
HOOKS, BARBS AND
COLUMNAR STRENGTH
PROFILE AND RISK FOR OBSTRUCTION
ENDOSTAPLING
INFLATABLE RINGS
SAC-SECURING ENDOGRAFT TECHNOLOGY
CONCLUSIONS
RESULTS OF EVAR AND OPEN SURGERY FOR INFRARENAL AAA
INTRODUCTION
ELECTIVE AAA REPAIR
URGENT RUPTURED AAA REPAIR
NEW PERSPECTIVES
CONCLUSIONS
TREATMENT OF JUXTARENAL AORTIC ANEURYSMS: OPEN REPAIR, FENESTRATED ENDOGRAFTS, CHIMNEY TECHNIQUE OR OTHER MODALITIES?
INTRODUCTION
OPEN REPAIR
FENESTRATED ENDOGRAFTS
CHIMNEY GRAFTS
OTHER TECHNIQUES
CONCLUSIONS
FOLLOW-UP AFTER EVAR, MODALITY AND FREQUENCY
INTRODUCTION
COMPLICATIONS AFTER EVAR
IMAGING MODALITIES
GRAFT INFECTION
LIMB OCCLUSION
FOLLOW-UP STRATEGY AND FREQUENCY
CONCLUSIONS
TREATMENT OF ENDOLEAKS POST-EVAR
INTRODUCTION
ENDOLEAK TYPES
DIAGNOSTIC STUDIES
NATURAL HISTORY OF UNTREATED ENDOLEAKS
PREDICTIVE FACTORS FOR THE DEVELOPMENT OF ENDOLEAKS
ENDOLEAK TREATMENT ALGORITHM
EMBOLISATION MATERIALS
COMPLICATIONS
FOLLOW-UP
CONCLUSIONS