Salomé Kuntz , Céline Deslarzes , Alexandre Than Vinh Nguyen , Alban Longchamp , Rosalinda D'Amico , Justine Longchamp , Anne Lejay , Nabil Chakfé , Sébastien Déglise
{"title":"Midterm Outcomes With the Nellix Endograft Alone or With Chimneys","authors":"Salomé Kuntz , Céline Deslarzes , Alexandre Than Vinh Nguyen , Alban Longchamp , Rosalinda D'Amico , Justine Longchamp , Anne Lejay , Nabil Chakfé , Sébastien Déglise","doi":"10.1016/j.ejvsvf.2024.06.001","DOIUrl":"10.1016/j.ejvsvf.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><p>Endovascular aneurysm sealing (EVAS) appeared to be an innovative alternative to conventional endovascular abdominal aortic aneurysm repair. However, high rates of midterm failure of EVAS led to withdrawal of the device from the market. The study aim was to report midterm outcomes of patients treated with EVAS alone or associated with chimneys (Ch-EVAS) and the management of their complications.</p></div><div><h3>Methods</h3><p>In this single centre study, all consecutive Nellix implants between 2013 and 2016 were included. The primary endpoint was device failure: (1) a triad of caudal migration of the Nellix stents >5 mm, separation of the endobags (>5 mm), and sac enlargement (>5 mm), with or without visible endoleak, (2) secondary aneurysm rupture, (3) surgical explant of the graft, or (4) any intervention for a type I endoleak. Overall mortality, aneurysm related mortality, and re-intervention rates were analysed.</p></div><div><h3>Results</h3><p>Fifty patients (male <em>n</em> = 43, female <em>n</em> = 7) were included. Median follow-up was 3.05 years (interquartile range [IQR] 0.52, 4.63) and follow up index was 0.51 (IQR 0.10, 0.88). Device failures occurred in 17 patients (34%). Overall and aneurysm related mortality rates during the follow up period were 30% and 13%. Fourteen (28%) patients required re-interventions. Five EVAS patients (17%) presented with complications. Type Ia endoleaks were managed by device explantation for three patients, and endovascular aneurysm repair in Nellix for two patients. Type Ib endoleaks were managed with an iliac branched device and limb extension. Nine Ch-EVAS patients (42.9%) presented with complications. Type Ia endoleaks were was managed by Nellix stent prolongation and renal extension, two multibranched thoraco-abdominal devices, and two device explantations. Type Ib endoleaks were managed by limb extension and stent complications by stent angioplasty and iliorenal bypass.</p></div><div><h3>Conclusion</h3><p>The midterm outcome of EVAS is poor. All patients who underwent EVAS implantation must be informed and should undergo frequent surveillance. Open repair and device explantation should be considered as the primary treatment.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 8-14"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000923/pdfft?md5=a79271d6e66dd286262de3c000d4bc23&pid=1-s2.0-S2666688X24000923-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142136558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Collaborative Vascular Research in Europe to Improve Care for Patients With Vascular Diseases: What Is Out There, and How to Participate?","authors":"Fabien Lareyre, Matthias Trenner","doi":"10.1016/j.ejvsvf.2024.05.009","DOIUrl":"10.1016/j.ejvsvf.2024.05.009","url":null,"abstract":"","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 5-6"},"PeriodicalIF":0.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24000893/pdfft?md5=e795e267c02860790770bbb4a365d5e7&pid=1-s2.0-S2666688X24000893-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141144174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Systematic Review of Femoral Artery Stent Fractures","authors":"Arielle Bellissard , Salomé Kuntz , Anne Lejay , Nabil Chakfé","doi":"10.1016/j.ejvsvf.2024.08.001","DOIUrl":"10.1016/j.ejvsvf.2024.08.001","url":null,"abstract":"<div><h3>Objective</h3><p>Primary stenting for long femoropopliteal (FP) lesions remains controversial because of the high risk of stent fracture (SF). This study aimed to summarise current knowledge on SF from randomised control trials about FP stenting.</p></div><div><h3>Methods</h3><p>A systematic review of the Medline database was performed by a combined strategy of MeSH terms: femoral artery, popliteal artery, stenting, and stent fracture. SF was classified according to a standard classification: 1 = single strut fracture; 2 = ≥ two struts fracture; 3 = type 2 with deformation; 4 = multiple struts fracture with acquired transection; 5, type 4 with gap in the stent body.</p></div><div><h3>Results</h3><p>The literature search identified 25 publications including covered stents (CSs; <em>n</em> = 3), drug eluting stents (DESs; <em>n</em> = 8), bare metal stents (BMS; <em>n</em> = 17), and bioabsorbable stents (<em>n</em> = 1). Data were extracted from 4 047 patients; mean age ± standard deviation was 68.9 ± 3.0 years and 69% were male. The median lesion length was 87.6 mm (interquartile range [IQR] 70.0, 149) with a median chronic total occlusion proportion of 36.8% (IQR 29.0, 56.5). In 208 patients treated with CS, SF rates ranged from none to 2.6% at 36 months with no clinical correlation. In 1 106 patients treated with DES, SF rates were relatively low in large cohorts, ranging from 0% at 12 months to 1.9% at 60 months. In smaller cohorts (under 100 patients per group), they ranged from 12.5% at six months to 46.7% at 12 months, with no clinical repercussion. In 1 610 patients treated with BMS, SF rates ranged from 2% to 32.7% at 12 months and from 2.9% to 48.9% at 24 months, with no clinical repercussion.</p></div><div><h3>Conclusion</h3><p>SF rates in large cohorts were low in CF and DES, and quite common in BMS, although none of them had clinical consequences. However, longer follow up and detailed, accurate reports are needed to assess eventual real clinical outcomes.</p></div>","PeriodicalId":36502,"journal":{"name":"EJVES Vascular Forum","volume":"62 ","pages":"Pages 48-56"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666688X24001382/pdfft?md5=32f3b60fece57fb23a506c1d930b4df9&pid=1-s2.0-S2666688X24001382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}