Endovascular Abdominal Aortic Aneurysm Repair Using Transvenous Intravascular US Catheter Guidance in Patients with Chronic Renal Failure |
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| Affiliation: | 1. Unit of Vascular and Interventional Radiology, Sackler Faculty of Medicine, Rabin Medical Center and Beilinson Hospital, Petach Tikva 49100, Israel;2. Department of Vascular Surgery, Sackler Faculty of Medicine, Rabin Medical Center and Beilinson Hospital, Petach Tikva 49100, Israel;1. Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China;2. Healthcare Sector, Siemens Limited China, Shanghai, China;3. Healthcare Sector, Siemens AG, Forchheim, Germany;1. Department of Radiology, University Hospitals Case Medical Center, Cleveland, OH 44106;2. Department of Hematology/Oncology, University Hospitals Case Medical Center, Cleveland, OH 44106;3. Department of Urology, University Hospitals Case Medical Center, Cleveland, OH 44106;4. Case Western Reserve University School of Medicine, 2109 Adelbert Road, Cleveland, OH 44106;5. Case Western Reserve University, 2109 Adelbert Road, Cleveland, OH 44106;6. The Centers for Dialysis Care, Shaker Heights, Ohio;1. Service de chirurgie cardiovasculaire et thoracique, Cardiovascular and Thoracique Surgery Department, CHU Francois Mitterrand, Dijon, France;2. Unité de chirurgie vasculaire, Vascular Surgery Department, CHU Rennes, Rennes, France;3. Service de chirurgie vasculaire, Vascular Surgery Department, Hôpital de la Timone, Marseille, France;4. Service de chirurgie vasculaire, Vascular Surgery Department, Institut du Thorax, CHU Nantes, Nantes, France;1. Department of Cardiology, La Paz University Hospital, Madrid, Spain;2. Department of Cardiology, Ramón y Cajal University Hospital, Madrid, Spain;3. Department of Pediatric Cardiology, La Paz University Hospital, Madrid, Spain |
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| Abstract: | PurposeTo describe the transvenous application of intracardiac echocardiography (ICE) for guidance during endovascular aortic repair (EVAR).Materials and MethodsEight patients with an infrarenal abdominal aortic aneurysm (AAA) and chronic renal failure were determined suitable for EVAR. The procedure was performed by deploying the transcaval and transiliac vein guidance of an ICE catheter to reduce the dosage of iodinated contrast medium. Multiple guidance parameters were assessed. The present study describes the EVAR procedure and postprocedure transabdominal ultrasound (US) follow-up results at 3–4 months.ResultsThe eight procedures were completed by using transvenous ICE guidance. No contrast medium was used in five patients, and 3–20 mL of isoosmolar contrast medium was administered in the other three. No endoleaks were detected by ICE immediately after stent deployment. One patient who had a single functioning kidney developed renal failure that was attributed to manipulation-related cholesterol embolization. That patient became dependent on dialysis and died 3.5 months after the procedure. No endoleaks were detected at 3–4-month US follow-up in the other seven patients.ConclusionsTransvenous ICE guidance is a promising method to reduce the dosage of iodinated contrast medium in patients with renal dysfunction undergoing EVAR. A prospective trial comparing this modality versus digital subtraction angiography guidance with iodinated contrast medium in terms of safety, accuracy, and long-term efficacy is recommended. |
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| Keywords: | AAA" },{" #name" :" keyword" ," $" :{" id" :" key0010" }," $$" :[{" #name" :" text" ," _" :" abdominal aortic aneurysm DSA" },{" #name" :" keyword" ," $" :{" id" :" key0020" }," $$" :[{" #name" :" text" ," _" :" digital subtraction angiography EVAR" },{" #name" :" keyword" ," $" :{" id" :" key0030" }," $$" :[{" #name" :" text" ," _" :" endovascular aortic aneurysm repair ICE" },{" #name" :" keyword" ," $" :{" id" :" key0040" }," $$" :[{" #name" :" text" ," _" :" intracardiac echocardiography |
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