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endoleak management and postoperative surveillance following endovascular repair of internal carotid artery vascular diseases using Willis covered stent

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Journal of Interventional Medicine 2021年第4期4卷 212-218页

作者： Lin Ma Shuo Yan Hao Feng Jichong Xu Huaqiao Tan Chun Fang Department of Interventional Radiology Tongji HospitalSchool of MedicineTongji UniversityShanghaiChina

Background:To report the clinical results and experiences of endoleak management and postoperative surveillance following endovascular repair of internal carotid artery vascular diseases(ICAVDs)using Willis covered ***:Seventy-three patients with ICAVD who received Willis covered stent implantation between November 2013 and September 2018 were retrospectively *** clinical data of endoleak management and postoperative surveillance were ***:Seventy-three cases with ICAVD,including 57 aneurysms,11 carotid-cavernous sinus fistulas(CCF),and 5 surgical injuries,were all successfully installed with covered *** isolation of ICAVDs was achieved in 59 patients(80.8%),and endoleaks were observed in 14 patients(19.2%).Of the 14 patients with endoleaks,12 had type I endoleaks and 2 had type II;13 had aneurysms and one had CCF.10 patients with type I endoleaks received balloon dilatation,and 7 of them underwent a second stent-graft implantation after *** patient with type II endoleak received embolization of the branch artery,and another one received follow-up *** resolved in 6 patients and were minimal in 5 patients after balloon dilatation or the second stent *** the follow-up period,minor endoleaks spontaneously resolved in 4 patients and minimal endoleaks were still demonstrated in 4 patients without enlargement of residual lumen and ***:endoleaks are the major complication after endovascular repair of ICAVDs and represent one of the limitations of this *** the understanding and management of endoleaks can be beneficial in the clinical setting,including the popularization and application of this technique.

关键词： Covered stent Endovascular repair Internal carotid artery endoleak

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Rupture of an Infrarenal Aortic Aneurysm Due to a Secondary Type 1a endoleak Following Endovascular Aneurysm Sealing with the Nellix<sup>®</sup>Device

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Surgical Science 2019年第11期10卷 398-404页

作者： Kudla Dorothea Uhl Christian Zorger Niels Steinbauer Markus Topel Ingolf Department of Vascular Surgery Krankenhaus Barmherzige Brüder Regensburg Regensburg Germany Department of Diagnostic and Interventional Radiology Neuroradiology and Nuclear Medicine Krankenhaus Barmherzige Brüder Regensburg Regensburg Germany

Purpose: The Nellix endovascular aneurysm sealing (EVAS) system was introduced in 2010 for infrarenal abdominal aortic aneurysm (AAA) repair. So far one secondary type 1a endoleak resulting in rupture of the aneurysm has been reported. Case report: We present a case of a rupture of an infrarenal aortic aneurysm due to a secondary type 1a endoleak caused by stent migration 14 months after endovascular aneurysm sealing with a Nellix system. Conclusion: Strict adherence to anatomical requirements given by the instructions for use during patient selection and thorough post interventional surveillance may reduce the probability of secondary type 1a endoleaks. Furthermore, device design changes, especially concerning the configuration of the proximal part of the stent graft, have to be considered.

关键词： Endovascular Aneurysm Sealing Secondary Type 1a endoleak Rupture Abdominal Aortic Aneurysm

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Transarterial Embolization versus Translumber Embolization for Type Ⅱ endoleak after Endovascular Abdomi nal Aortic Aneurysm Repair:A Meta-Analysis

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Chinese Medical Sciences Journal 2020年第2期35卷 135-141页

作者： Xu Zhang Lei Ji Mengyin Chen Wei Wang Yuehong Zheng Department of Vascular Surgery Peking Union Medical College HospitalChinese Academy of Medical Science&Peking Union Medical CollegeBeijing 100730China

Objective Type II endoleak is the most common subtype of endoleak as a complication after endovascular aneurysm repair(EVAR).The efficacy of transarterial(TA)embolization and translumber(TL)embolization in the management of type II endoleak remains *** aim of this study is to compare the technical and clinical success between TA embolization andTL embolization for type II endoleak after *** The protocol was registered(CRD 42018114453)and the electronic databases(Pubmed,Embase,Web of Science,and Cochrane)were systematically searched till March *** search terms included EVAR,type II endoleak,and *** articles were read and extracted by two authors independently to include randomized control trails and retrospective studies that compared TA embolization and TL embolization in patients who developed type II endoleak after *** technical and clinical success rates were metaanalyzed with random effect *** A total of 6 articles with 268 patients and 290 type II endoleaks were *** pooled odds ratio(OR)of technical success rate for TA *** was 0.56(95%C7,0.10-3.18;P=0.51)and the pooled OR of clinical success rate for TA *** was 0.31(95%CI,0.07-1.29;P=0.11).As a limitation,6 articles were all retrospective studies which may lead to *** Both *** could be eflective procedure of embolizations to resolve the type II *** metaanalysis result indicated that TA embolization was not inferior toTL embolization in technical success and clinical success.

关键词： endoleak endovascular aneurysm repair embolization abdominal aortic aneurysm meta-analysis

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Safety and Efficacy of Endovascular Aortic Repair for Abdominal Aortic Aneurysms with a Hostile Neck Anatomy

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Current Medical Science 2023年第6期43卷 1221-1228页

作者： Zun-xiang KE Ge-zheng CHEN Ke HU Shan ZHANG Peng ZHOU Dian-xi CHEN Yi-qing LI Qin LI Chao YANG Department of Emergency Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China Department of Vascular Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan430022China

Objective This study aimed to investigate the safety and efficacy of endovascular aortic repair(EVAR)for the treatment of an abdominal aortic aneurysm(AAA)with a hostile neck anatomy(HNA).Methods From January 1,2015 to December 31,2019,a total of 259 patients diagnosed with an AAA who underwent EVAR were recruited into this *** on the morphological characteristics of the proximal neck anatomy,the patients were divided into the HNA group and the friendly neck anatomy(FNA)*** patients were followed up for up to 4 *** The average follow-up time was 1056.1±535.5 *** I endoleak occurred in 4 patients in the HNA group,and 2 patients in the FNA *** death nor intraoperative switch to open repair occurred in either *** time of the operation was significantly longer in the HNA group(FNA ***,99.2±51.1 min vs.117.5±63.8 min,P=0.011).There were no significant differences in short-term clinical success rate(P=0.228)or midterm clinical success rate(P=0.889)between the two *** overall mortality rate was 10.4%,and Kaplan-Meier survival analysis indicated that the two groups had similar cumulative survival rates at the end of the follow-up period(P=0.889).Conclusion EVAR was feasible and safe in patients with an AAA with a proximal *** early and midterm results were promising;however,further studies are needed to verify the long-term effectiveness of EVAR.

关键词： abdominal aortic aneurysm hostile aneurysm neck endovascular aortic repair endoleak prognosis

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Midterm results of periprosthetic coiling embolization in high-risk patients

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Journal of Interventional Medicine 2019年第4期2卷 160-163页

作者： Xiantao Li Yanyan Huang Pingfan Guo Vascular Surgery Department The First Affiliated Hospital of Fujian Medical UniversityFuzhouChina

Background:With increasing interest in the prevention of typeⅡendoleaks(EⅡ),the aim of this study was to report midterm results on the intraoperative coiling embolization of the periprosthetic aneurysmal sac in patients at high-risk of EⅡ.Methods:A retrospective review study was conducted with 124 patients with infrarenal abdominal aortic aneurysm who accorded with the inclusion criteria,including 66 patients who underwent standard endovascular aortic aneurysm repair(Group A)and 58 patients who underwent aneurysmal sac coiling embolization(Group B).Baseline data and follow-up results were ***:A mean of 2.84±1.45 coils(range 1-9)were used in Group *** general incidence of an EⅡwas 15.32%(19/124)at a mean follow-up time of 46.60±15.14 months,with 22.7%(15/66)in Group A and 6.9%(4/58)in Group B(χ~2=5.62;P=0.018).Logistic multivariate analysis revealed that the independent risk factors of an EII were no sac embolization and a sac volume≥128 cm^*** Kaplan-Meier subgroup analysis showed no difference in regard to the rate of freedom from EⅡbetween the two groups either with a larger or smaller ***:These results suggest that periprosthetic coiling embolization in patients at high-risk of EⅡis safe and effective in the prevention of EⅡ.The preventive effect seemed to be weakened when the sac volumes were taken into consideration at midterm follow-up.

关键词： Aortic aneurysm Abdominal Radiology Interventional endoleak Risk assessment

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Efficacy of Willis covered stent of intracranial pseudoaneurysms in the internal carotid artery: A systematic review and meta-analysis

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Journal of Acute Disease 2023年第5期12卷 173-178页

作者： Li Lin Shao-Wei Xiang Yan-Ling Sun Yuan Chen Zhe Wu Zhi-Feng Ning Ding-Wen Shen Xue-Qin Sima Qi-Qiang Wen Gui-Lai Wei Qing-Yong He Department of Biochemistry Basic School SchoolHubei University of Science and TechnologyXianning CityHubei Province 437100China The Third Surgery Department Enshi State Central HospitalEnshi StateHubei Province 445000China Department of Histology and Embryology Basic School SchoolHubei University of Science and TechnologyXianning CityHubei Province 437100China Department of Cardiothoracic Surgery Xianning Central HospitalHubei University of Science and TechnologyXianning CityHubei provinceProvince 437100China Department of Human Anatomy Basic School SchoolHubei University of Science and TechnologyXianning CityHubei Province 437100China Department of Parasite Basic School SchoolHubei University of Science and TechnologyXianning CityHubei Province 437100China Hubei University of Science and Technology Xianning CityHubei Province 437100China School of Physical Education Hubei University of Science and TechnologyXianning CityHubei Province 437100China

Objective:To evaluate the efficacy of a novel coated stent in the treatment of intracranial ***:MEDLINE,EMBASE,and PubMed databases were searched for literature published between 1990 and April 2022 according to PRISMA *** studies with≥10 patients reporting successful implantation of Willis covered stent,therapeutic effect,complications,and postoperative follow-up were *** combined incidence and corresponding 95%confidence intervals were assessed using a generalized linear mixed method and random effects ***:Five studies(116 patients with pseudoaneurysms)were *** experimental groups in the selected studies showed a combined technical success rate of 81.03%(OR=18.31,95%CI=9.39-35.69,I^(2)=79%,P<0.001).Clinical follow-up showed that the complete cure rate was as high as 94.4%after the follow-up(OR=106.81,95%CI=39.08-291.88,I^(2)=0%,P=0.71).Conclusions:Willis covered stent is feasible,safe,and effective in the treatment of intracranial pseudoaneurysm.

关键词： Intracranial pseudoaneurysms Willis covered stent Systematic review Meta-analysis Internal carotid artery endoleak Neurosurgery

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