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Endovascular aneurysm repair (EVAR) is a type of minimally-invasive endovascular surgery used to treat pathology of the aorta, most commonly an abdominal aortic aneurysm (AAA). When used to treat thoracic aortic disease, the procedure is then specifically termed TEVAR for "thoracic endovascular aortic/aneurysm repair."
Prior to the advent of endovascular aneurysm repair (EVAR), OAS was the only surgical treatment available for aortic aneurysms. The shift away from open aortic surgery towards endovascular surgery since 2003 has been driven by worse perioperative mortality associated with OAS, particularly in patients in relatively frail health. [2]
Similar to AAA, IAA occurs in the abdominal region. [1] IAA is closely associated and believed to be a response to and extensive peri-aneurysmal fibrosis, [ 2 ] which is the formation of excess fibrous connective tissue in an organ or tissue in a reparative or reactive process IAA accounts for 5-10% of aortic aneurysms.
Abdominal aortic aneurysm; CT reconstruction image of an abdominal aortic aneurysm (white arrows) Specialty: Vascular surgery: Symptoms: None, abdominal, back, or leg pain [1] [2] Usual onset: Over-50-year-old males [1] Risk factors: Smoking, hypertension, other cardiovascular disease, family history, Marfan syndrome [1] [3] [4] Diagnostic method
One review stated that up to 81% of people having abdominal aortic aneurysm rupture will die, with 32% dying before reaching a hospital. [ 6 ] According to a review of global data through 2019, the prevalence of abdominal aortic aneurysm worldwide was about 0.9% in people under age 79 years, and is about four times higher in men than in women ...
Early Morbidity and Mortality Within 30 days of hospitalization, morbidity and mortality after Bentall procedure are associated with complications stemming from cardiac arrhythmia, pneumonia, acute respiratory distress syndrome (ARDS), sepsis, graft infection, wound infection, neurologic/ cerebrovascular accident and stroke, hemorrhage/ bleeding, myocardial infarction, pericardial effusion ...
The goal may also be to avert complications of the aorta (rupture or dissection) in the treatment of aneurysm. Repair is a more recent alternative to replacement; in many instances replacement will be the only realistic option because of severe destruction of the valve. [6]
The first attempts were valvotomies, (i.e. cutting the valve while the heart is pumping). A ball valve prosthesis placed on the descending thoracic aorta (heterotopically) was developed by Hufnagel, Harvey and others to address aortic stenosis, but had disastrous complications. Later, with the innovation of cardiopulmonary bypass, the ball ...