Limited role for IVUS in the endovascular repair of aortoiliac aneurysms

Evan C. Lipsitz, T. Ohki, F. J. Veith, G. Berdejo, W. D. Suggs, R. A. Wain, M. Mehta, J. Valladares, J. McKay

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background. To determine the need for routine versus selective intraoperative IVUS during endovascular aortoiliac aneurysm (AIA) repair. Methods. One-hundred and eighty-eight endovascular AIA repairs performed over a 5-year period were reviewed and included in the study. Surgeon-made aorto-uni-femoral grafts (n=78) and industry-made bifurcated or tube grafts (n=110) were used. In the initial 51 cases IVUS was routinely performed. In the latter 137 cases IVUS was used selectively. In this group graft deformities suspected on completion angiography or pullback pressure measurements were treated with balloon dilatation and stenting. IVUS was then performed only in the presence of a persistent pressure gradient or inconclusive angiographic findings. Results. In the initial 51 cases IVUS revealed 20 lesions of which 8 were not initially detected angiographically and which required further treatment. In the latter 137 cases IVUS was necessary in only 1 case, and guided the treatment of an angiographically undetectable lesion. There have been no late episodes of graft compression, kinking, or thrombosis in the selective IVUS group. Conclusions. The use of pullback pressure measurements with a low threshold for angioplasty and stenting, especially in unsupported grafts, followed by the selective use of IVUS decreases the overall requirement for IVUS and its associated costs.

Original languageEnglish (US)
Pages (from-to)787-792
Number of pages6
JournalJournal of Cardiovascular Surgery
Volume42
Issue number6
StatePublished - 2001

Fingerprint

Aneurysm
Transplants
Pressure
Thigh
Angioplasty
Dilatation
Industry
Angiography
Thrombosis
Costs and Cost Analysis
Therapeutics

Keywords

  • Aortic aneurysm, abdominal, surgery
  • Blood vessel prosthesis implantation
  • Iliac aneurysm, surgery
  • Ultrasonography, interventional

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Lipsitz, E. C., Ohki, T., Veith, F. J., Berdejo, G., Suggs, W. D., Wain, R. A., ... McKay, J. (2001). Limited role for IVUS in the endovascular repair of aortoiliac aneurysms. Journal of Cardiovascular Surgery, 42(6), 787-792.

Limited role for IVUS in the endovascular repair of aortoiliac aneurysms. / Lipsitz, Evan C.; Ohki, T.; Veith, F. J.; Berdejo, G.; Suggs, W. D.; Wain, R. A.; Mehta, M.; Valladares, J.; McKay, J.

In: Journal of Cardiovascular Surgery, Vol. 42, No. 6, 2001, p. 787-792.

Research output: Contribution to journalArticle

Lipsitz, EC, Ohki, T, Veith, FJ, Berdejo, G, Suggs, WD, Wain, RA, Mehta, M, Valladares, J & McKay, J 2001, 'Limited role for IVUS in the endovascular repair of aortoiliac aneurysms', Journal of Cardiovascular Surgery, vol. 42, no. 6, pp. 787-792.
Lipsitz EC, Ohki T, Veith FJ, Berdejo G, Suggs WD, Wain RA et al. Limited role for IVUS in the endovascular repair of aortoiliac aneurysms. Journal of Cardiovascular Surgery. 2001;42(6):787-792.
Lipsitz, Evan C. ; Ohki, T. ; Veith, F. J. ; Berdejo, G. ; Suggs, W. D. ; Wain, R. A. ; Mehta, M. ; Valladares, J. ; McKay, J. / Limited role for IVUS in the endovascular repair of aortoiliac aneurysms. In: Journal of Cardiovascular Surgery. 2001 ; Vol. 42, No. 6. pp. 787-792.
@article{307d4254c209466ebfbb04006f518074,
title = "Limited role for IVUS in the endovascular repair of aortoiliac aneurysms",
abstract = "Background. To determine the need for routine versus selective intraoperative IVUS during endovascular aortoiliac aneurysm (AIA) repair. Methods. One-hundred and eighty-eight endovascular AIA repairs performed over a 5-year period were reviewed and included in the study. Surgeon-made aorto-uni-femoral grafts (n=78) and industry-made bifurcated or tube grafts (n=110) were used. In the initial 51 cases IVUS was routinely performed. In the latter 137 cases IVUS was used selectively. In this group graft deformities suspected on completion angiography or pullback pressure measurements were treated with balloon dilatation and stenting. IVUS was then performed only in the presence of a persistent pressure gradient or inconclusive angiographic findings. Results. In the initial 51 cases IVUS revealed 20 lesions of which 8 were not initially detected angiographically and which required further treatment. In the latter 137 cases IVUS was necessary in only 1 case, and guided the treatment of an angiographically undetectable lesion. There have been no late episodes of graft compression, kinking, or thrombosis in the selective IVUS group. Conclusions. The use of pullback pressure measurements with a low threshold for angioplasty and stenting, especially in unsupported grafts, followed by the selective use of IVUS decreases the overall requirement for IVUS and its associated costs.",
keywords = "Aortic aneurysm, abdominal, surgery, Blood vessel prosthesis implantation, Iliac aneurysm, surgery, Ultrasonography, interventional",
author = "Lipsitz, {Evan C.} and T. Ohki and Veith, {F. J.} and G. Berdejo and Suggs, {W. D.} and Wain, {R. A.} and M. Mehta and J. Valladares and J. McKay",
year = "2001",
language = "English (US)",
volume = "42",
pages = "787--792",
journal = "Journal of Cardiovascular Surgery",
issn = "0021-9509",
publisher = "Edizioni Minerva Medica S.p.A.",
number = "6",

}

TY - JOUR

T1 - Limited role for IVUS in the endovascular repair of aortoiliac aneurysms

AU - Lipsitz, Evan C.

AU - Ohki, T.

AU - Veith, F. J.

AU - Berdejo, G.

AU - Suggs, W. D.

AU - Wain, R. A.

AU - Mehta, M.

AU - Valladares, J.

AU - McKay, J.

PY - 2001

Y1 - 2001

N2 - Background. To determine the need for routine versus selective intraoperative IVUS during endovascular aortoiliac aneurysm (AIA) repair. Methods. One-hundred and eighty-eight endovascular AIA repairs performed over a 5-year period were reviewed and included in the study. Surgeon-made aorto-uni-femoral grafts (n=78) and industry-made bifurcated or tube grafts (n=110) were used. In the initial 51 cases IVUS was routinely performed. In the latter 137 cases IVUS was used selectively. In this group graft deformities suspected on completion angiography or pullback pressure measurements were treated with balloon dilatation and stenting. IVUS was then performed only in the presence of a persistent pressure gradient or inconclusive angiographic findings. Results. In the initial 51 cases IVUS revealed 20 lesions of which 8 were not initially detected angiographically and which required further treatment. In the latter 137 cases IVUS was necessary in only 1 case, and guided the treatment of an angiographically undetectable lesion. There have been no late episodes of graft compression, kinking, or thrombosis in the selective IVUS group. Conclusions. The use of pullback pressure measurements with a low threshold for angioplasty and stenting, especially in unsupported grafts, followed by the selective use of IVUS decreases the overall requirement for IVUS and its associated costs.

AB - Background. To determine the need for routine versus selective intraoperative IVUS during endovascular aortoiliac aneurysm (AIA) repair. Methods. One-hundred and eighty-eight endovascular AIA repairs performed over a 5-year period were reviewed and included in the study. Surgeon-made aorto-uni-femoral grafts (n=78) and industry-made bifurcated or tube grafts (n=110) were used. In the initial 51 cases IVUS was routinely performed. In the latter 137 cases IVUS was used selectively. In this group graft deformities suspected on completion angiography or pullback pressure measurements were treated with balloon dilatation and stenting. IVUS was then performed only in the presence of a persistent pressure gradient or inconclusive angiographic findings. Results. In the initial 51 cases IVUS revealed 20 lesions of which 8 were not initially detected angiographically and which required further treatment. In the latter 137 cases IVUS was necessary in only 1 case, and guided the treatment of an angiographically undetectable lesion. There have been no late episodes of graft compression, kinking, or thrombosis in the selective IVUS group. Conclusions. The use of pullback pressure measurements with a low threshold for angioplasty and stenting, especially in unsupported grafts, followed by the selective use of IVUS decreases the overall requirement for IVUS and its associated costs.

KW - Aortic aneurysm, abdominal, surgery

KW - Blood vessel prosthesis implantation

KW - Iliac aneurysm, surgery

KW - Ultrasonography, interventional

UR - http://www.scopus.com/inward/record.url?scp=0035211622&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035211622&partnerID=8YFLogxK

M3 - Article

VL - 42

SP - 787

EP - 792

JO - Journal of Cardiovascular Surgery

JF - Journal of Cardiovascular Surgery

SN - 0021-9509

IS - 6

ER -