000			05226nam a22008057a 4500
008			191010s20192019 xxu||||| |||| 00| 0 eng d
022			_a1526-6028
024			_a10.1177/1526602819873133 [doi]
040			_aOvid MEDLINE(R)
099			_a31478457
245			_aPatient-Specific Rehearsal Feasibility Before Endovascular Repair of Ruptured Abdominal Aortic Aneurysm.
251			_aJournal of Endovascular Therapy. 26(6):871-878, 2019 12.
252			_aJ Endovasc Ther. 26(6):871-878, 2019 12.
252			_zJ Endovasc Ther. :1526602819873133, 2019 Sep 03
253			_aJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
260			_c2019
260			_fFY2020
265			_saheadofprint
265			_sppublish
266			_d2019-10-10
268			_aJournal of Endovascular Therapy. :1526602819873133, 2019 Sep 03
520			_aPurpose: To evaluate the feasibility of a patient-specific rehearsal (PsR) before emergency endovascular aneurysm repairs (eEVAR) and its influence on the operation. Materials and Methods : From February 2016 to October 2016, 10 consecutive patients (mean age 75+/-7.4 years; 9 men) presenting with a ruptured abdominal aortic aneurysm (rAAA) suitable for standard EVAR were enrolled in the study. A 3-dimensional (3D) model of the abdominal aorta was generated on a virtual reality simulator based on the patient's computed tomography (CT) images. Following the patient-specific simulation setup, PsR was conducted during patient admission or in parallel with the preoperative eEVAR workup. Measured outcomes were PsR feasibility only in the first 4 patients and impact on operative performance thereafter (changes in device selection, the planning process, clinical outcomes, perioperative mortality, and complication rates). Technical metrics and timing of system setup, rehearsal, interval from patient arrival to the actual procedure, and eEVAR were recorded. Results: Mean time for 3D model creation was 21.3+/-7.8 minutes (range 13-37); there was a significant positive relationship between aortic neck diameter and segmentation time (p=0.003). The overall mean time for simulator setup and PsR was 54+/-14 minutes (range 37-80); PsR alone was completed in a mean 31+/-40 minutes (95% confidence interval -60 to -2.2). The actual eEVAR procedure duration was 69+/-16 minutes (range 45-90). No delay in the actual eEVAR procedure was registered owing to the PsR pathway. In 6 patients, preprocedure rehearsal induced changes in operative strategy, including device selection, main body introduction side, and/or deployment configuration. In 4 cases, rehearsal was performed twice to achieve optimal performance. Conclusion: PsR before eEVAR was feasible in all cases and caused no time delays in the actual eEVAR procedure. PsR optimized eEVAR planning by identifying optimal strategy for stent-graft component selection and deployment.
546			_aEnglish
650			_a*Aortic Aneurysm, Abdominal/su [Surgery]
650			_a*Aortic Rupture/su [Surgery]
650			_a*Blood Vessel Prosthesis Implantation
650			_a*Endovascular Procedures
650			_a*Patient-Specific Modeling
650			_a*Surgery, Computer-Assisted
650			_aAged
650			_aAged, 80 and over
650			_aAortic Aneurysm, Abdominal/dg [Diagnostic Imaging]
650			_aAortic Aneurysm, Abdominal/mo [Mortality]
650			_aAortic Aneurysm, Abdominal/pp [Physiopathology]
650			_aAortic Rupture/dg [Diagnostic Imaging]
650			_aAortic Rupture/mo [Mortality]
650			_aAortic Rupture/pp [Physiopathology]
650			_aBlood Vessel Prosthesis
650			_aBlood Vessel Prosthesis Implantation/ae [Adverse Effects]
650			_aBlood Vessel Prosthesis Implantation/is [Instrumentation]
650			_aBlood Vessel Prosthesis Implantation/mo [Mortality]
650			_aEndovascular Procedures/ae [Adverse Effects]
650			_aEndovascular Procedures/is [Instrumentation]
650			_aEndovascular Procedures/mo [Mortality]
650			_aFeasibility Studies
650			_aFemale
650			_aHumans
650			_aMale
650			_aModels, Anatomic
650			_aModels, Cardiovascular
650			_aOperative Time
650			_aPostoperative Complications/et [Etiology]
650			_aPrinting, Three-Dimensional
650			_aProsthesis Design
650			_aRisk Factors
650			_aStents
650			_aSurgery, Computer-Assisted/ae [Adverse Effects]
650			_aSurgery, Computer-Assisted/is [Instrumentation]
650			_aSurgery, Computer-Assisted/mo [Mortality]
650			_aTime Factors
650			_aTreatment Outcome
651			_aMedStar Union Memorial Hospital
656			_aVascular Surgery
657			_aJournal Article
700			_aCriado, Frank J
790			_aBleuler A, Chaykovska L, Criado FJ, Lachat M, Pakeliani D, Pecoraro F, Pfammatter T, Veith FJ
856			_uhttps://dx.doi.org/10.1177/1526602819873133 _zhttps://dx.doi.org/10.1177/1526602819873133
858			_yPakeliani, David _uhttps://orcid.org/0000-0001-7756-227X _zhttps://orcid.org/0000-0001-7756-227X
942			_cART _dArticle
999			_c10988 _d10988