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Endovascular approaches to complex aortic aneurysms

PhD ceremony:Mr A. (Arne) de Niet
When:January 08, 2020
Supervisors:prof. dr. J.A.M. (Clark) Zeebregts, prof. dr. M. Reijnen
Where:Academy building RUG
Faculty:Medical Sciences / UMCG
Endovascular approaches to complex aortic aneurysms

This thesis focused on the clinical outcome of endografts designed for infrarenal and complex aneurysms, and the considerations of these endografts in relation to patients’ anatomy.

Chapter 2 gives an overview of the available endografts for infrarenal EVAR and Chapter 3 gives an overview of the available fenestrated endografts (FEVAR) for pararenal and suprarenal repair.

As discussed in chapter 4 age itself should not be a reason to withhold treatment with FEVAR. FEVAR is an expensive treatment compared to open surgical treatment, and a balance in cost-effectiveness, gained life years and gained quality adjusted life years has yet to be settled.

Two mainly used fenestrated endografts have a different effect on native patient anatomy. In Chapter 5 certain anatomic parameters are discussed, and these should be the main parameters to choose either of these fenestrated endografts.

The Fenestrated Anaconda endograft is reviewed in Chapter 6 and the global results are discussed in chapter 7. In very specific cases, a Fenestrated Anaconda cuff can be used. Half of the cases treated globally, with this fenestrated cuff are discussed in chapter 8.

Once an aneurysm extents to the thoracic aorta, a branched endograft (BEVAR) is used. The stents within these branches tend to slide outward. Chapter 9 discusses why a meticulous follow-up in patients treated with this endograft is necessary.