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• W4386688498 abstract "The use of intravascular ultrasound (IVUS) reduces contrast medium usage and radiation exposure during conventional endovascular aneurysm repair (EVAR). The aim of this study was to evaluate safety and efficacy of IVUS in detecting bridging stent graft (bSG) instability during fenestrated and branched EVAR (F/B-EVAR).This was a prospective observational multicentric study. The following outcomes were evaluated: (1) technical success of the IVUS in each bSG, (2) IVUS findings compared with intra-operative angiography, (3) incidence of post-operative computed tomography angiography (CTA) findings not detected with IVUS, and (4) absence of IVUS related adverse events. Target visceral vessel (TVV) instability was defined as any branch/fenestration issues requiring additional manoeuvre or re-intervention. Any IVUS assessment that detected stenosis, kinking, or any geometrical issue of the TVVs were considered to be branch instability. All procedures were performed in ad hoc hybrid rooms.Eighty patients (69% males; median age 72 years; interquartile range 59, 77 years) from four aortic centres treated with F/B-EVAR between January 2019 and September 2021 were included: 70 BEVAR (21 off the shelf; 49 custom made), eight FEVAR (custom made), and two F/B-EVAR (custom made), for a total of 300 potential TVVs. Two TVVs (0.7%) were left unstented and excluded from the analysis. The TVVs could not be accessed with the IVUS catheter in seven cases (2.3%). Furthermore, 17 (5.7%) TVVs could not be examined due to a malfunction of the IVUS catheter. The technical success of the IVUS assessment was 91.9% (274/298), with no IVUS related adverse events. Seven TVVs (2.5%) showed signs of bSG instability by means of IVUS, leading to immediate revisions. The first post-operative CTA at least 30 days after the index procedure was available in 268 out of the 274 TVVs originally assessed by IVUS. In seven of the 268 TVVs (2.6%) a re-intervention became necessary due to bSG instability.This study suggests that IVUS is a safe and potentially valuable adjunct imaging technology for intra-operative detection of TVV instability. Further long term investigations on larger cohorts are required to validate these promising results and to compare IVUS with alternative technologies in terms of efficiency, radiation exposure, procedural time, and costs." @default.
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• W4386688498 date "2023-09-01" @default.
• W4386688498 modified "2023-10-18" @default.
• W4386688498 title "Intravascular Ultrasound in Detection of Bridging Stent Graft Instability During Fenestrated and Branched Endovascular Aneurysm Repair Procedures: A Multicentre Study on 274 Target Vessels" @default.
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• W4386688498 doi "https://doi.org/10.1016/j.ejvs.2023.09.009" @default.
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