Endovascular approaches to complex aortic aneurysms
|PhD ceremony:||drs. A. de Niet|
|When:||January 08, 2020|
|Supervisors:||prof. dr. J.A.M. (Clark) Zeebregts, prof. dr. M. Reijnen|
|Where:||Academy building RUG|
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.