MARC details
000 -LEADER |
fixed length control field |
05028nam a22007217a 4500 |
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION |
fixed length control field |
170512s20172017 xxu||||| |||| 00| 0 eng d |
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER |
International Standard Serial Number |
0890-5096 |
040 ## - CATALOGING SOURCE |
Original cataloging agency |
Ovid MEDLINE(R) |
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC) |
PMID |
28479422 |
245 ## - TITLE STATEMENT |
Title |
Management of difficult access during EVAR. |
251 ## - Source |
Source |
Annals of Vascular Surgery. 44:77-82, 2017 Oct. |
252 ## - Abbreviated Source |
Abbreviated source |
Ann Vasc Surg. 44:77-82, 2017 Oct. |
253 ## - Journal Name |
Journal name |
Annals of vascular surgery |
260 ## - PUBLICATION, DISTRIBUTION, ETC. |
Year |
2017 |
260 ## - PUBLICATION, DISTRIBUTION, ETC. |
Manufacturer |
FY2017 |
266 ## - Date added to catalog |
Date added to catalog |
2017-05-24 |
501 ## - WITH NOTE |
Local holdings |
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007 |
520 ## - SUMMARY, ETC. |
Abstract |
CONCLUSIONS: EVAR can be successfully performed in patients with bilateral small iliac arteries. Adjunctive procedures might increase the technical success rate of EVAR in these patients, and should definitely be considered in patients with iliac arteries less than 5mm in diameter. Next generation and "low-profile" devices might minimize the need for adjunctive procedures and facilitate EVAR in these patients. |
520 ## - SUMMARY, ETC. |
Abstract |
Copyright � 2017. Published by Elsevier Inc. |
520 ## - SUMMARY, ETC. |
Abstract |
METHODS: Data from all patients undergoing EVAR at a tertiary academic medical center between 2009 and 2013 was collected retrospectively, including demographics, size of iliac arteries, type of device used, approach to managing difficult access, and outcomes. The median follow-up was 38 months. Difficult access (DA) was defined as iliac arteries with a diameter of less than 7mm bilaterally. Fenestrated and snorkel repairs were excluded. |
520 ## - SUMMARY, ETC. |
Abstract |
OBJECTIVES: To describe a large single institutional experience in managing challenging access situations during endovascular aneurysm repair (EVAR). |
520 ## - SUMMARY, ETC. |
Abstract |
RESULTS: Out of 400 EVARs performed during the study period, 191 (48%) were done in patients with DA. Of the DA patients, 35 (18.3%) underwent 42 adjuncts prior to introduction of the main body device: including 15 dilators, 11 balloon angioplasties, 9 Aortouniiliac (AUI) devices, 3 SoloPath sheaths, 1 retroperitoneal cutdown and 3 iliac stents. In another 29 patients, iliac stents were used to correct stenoses or kinks in the limbs after EVAR devices were deployed. The average diameter of the iliac artery used to deliver main body component was 4.6mm in the group of patients requiring adjuncts and 5.4mm in the remainder of the patients with small iliac arteries (p=.008). The median size of the main body device was 28mm. Two cases were aborted due to inability to deliver the device. Other complications included 7 (3.6%) iliac ruptures, 3(1.6%) instances of limb ischemia, and 5 (2.6%) patients needed early reoperation (within 30 days). Two patients (1%) had type I endoleaks at the conclusion of EVAR. During follow-up, 12 (6.3%) of patients required EVAR revisions. Seven patients (3.6%) had limb thrombosis which occurred only in patients who did not have adjective procedures during the initial EVAR. Limb thrombosis and rate of revisions in patients with DA were not significantly different from the rates observed in non-DA patients. Perioperative mortality after elective repairs was 1.6% in DA patients and 0% in non-DA patients (p=0.12). |
546 ## - LANGUAGE NOTE |
Language note |
English |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Aortic Aneurysm, Abdominal/su [Surgery] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Blood Vessel Prosthesis Implantation/ae [Adverse Effects] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Endovascular Procedures/ae [Adverse Effects] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Iliac Artery/su [Surgery] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
*Postoperative Complications/et [Etiology] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Aged |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Aged, 80 and over |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Aortic Aneurysm, Abdominal/dg [Diagnostic Imaging] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Aortic Aneurysm, Abdominal/mo [Mortality] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Blood Vessel Prosthesis |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Blood Vessel Prosthesis Implantation/is [Instrumentation] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Blood Vessel Prosthesis Implantation/mo [Mortality] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Endovascular Procedures/is [Instrumentation] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Endovascular Procedures/mo [Mortality] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Female |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Hospitals, University |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Humans |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Iliac Artery/dg [Diagnostic Imaging] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Male |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Middle Aged |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Philadelphia |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Postoperative Complications/dg [Diagnostic Imaging] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Postoperative Complications/mo [Mortality] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Postoperative Complications/su [Surgery] |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Prosthesis Design |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Reoperation |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Retrospective Studies |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Risk Factors |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Stents |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Tertiary Care Centers |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Time Factors |
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
Topical term or geographic name entry element |
Treatment Outcome |
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME |
Institution |
MedStar Washington Hospital Center |
656 ## - INDEX TERM--OCCUPATION |
Department |
Surgery/Vascular Surgery |
657 ## - INDEX TERM--FUNCTION |
Medline publication type |
Journal Article |
700 ## - ADDED ENTRY--PERSONAL NAME |
Local Authors |
Woo, Edward Y |
790 ## - Authors |
All authors |
Baig A, Carpenter JP, Etkin Y, Fairman RM, Foley PJ, Jackson BM, Wang GJ, Woo EY |
856 ## - ELECTRONIC LOCATION AND ACCESS |
DOI |
<a href="https://dx.doi.org/10.1016/j.avsg.2017.03.190">https://dx.doi.org/10.1016/j.avsg.2017.03.190</a> |
Public note |
https://dx.doi.org/10.1016/j.avsg.2017.03.190 |
942 ## - ADDED ENTRY ELEMENTS (KOHA) |
Koha item type |
Journal Article |
Item type description |
Article |