Health

What devices are currently commercially available in the United States for EVAR, and how do they differ? Current FDA-approved devices include the Cook Zenith, the Endologix Powerlink, the Gore Excluder, the Medtronic AneuRx, and the Medtronic Talent. Except for the unibody Powerlink platform, all platforms are modular in design. Each manufacturer offers a slightly different …

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What are the results of the major EVAR studies? The EVAR 1 trial showed a 3% lower initial mortality for EVAR, with a persistent reduction in aneurysm-related death at 4 years. Improvement in overall late survival was not shown. Similarly, the DREAM trial observed an initial mortality advantage for EVAR, but overall 1-year survival was …

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What are the major studies that have looked at the outcomes of EVAR? The major randomized controlled studies include (1) the Dutch Randomized Endovascular Aneurysm Management (DREAM) trial, (2) the EVAR versus open repair in patients with abdominal aortic aneurysm randomized controlled trial (EVAR trial 1), and (3) the EVAR and outcome in patients unfit …

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What are some of the complications related to EVAR? Complications of EVAR include endoleak, continued enlargement or pressurization of the aneurysm sac without endoleak, delayed aneurysm rupture, graft migration, graft limb occlusion, graft infection, stent-graft structural breakdown, and groin or access complications.

What follow up imaging tests do patients treated with EVAR undergo? Patients require lifelong imaging surveillance to monitor for endoleak, aneurysm expansion, and graft integrity. Imaging follow-up after EVAR is usually performed by periodic contrast-enhanced computed tomography (CT). The typical regimen is a baseline CT study at 1 month, with a follow-up study at 6 …

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Endoleak and its different types What is an endoleak? What are the different types of endoleaks, and how are they treated? An endoleak is persistent blood flow into the aneurysmal sac after placement of a stent graft. A type I endoleak results from poor attachment to the vessel wall. It can be caused by poor …

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How are most abdominal aortic aneurysm detected, and what is the role of screening? Symptomatic aneurysms manifest with back, abdominal, buttock, groin, testicular, or leg pain. Most AAAs are asymptomatic, however. AAAs can be easily detected via ultrasonography (US), which has been shown to be cost-effective in targeted, high-risk patients. If AAA ruptures, the mortality …

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