Laparo- and thoracoscopic aortic aneurysm neck optimization and treatment of potential endoleaks type IA and II in a porcine model
Abstract Background Endovascular repair of aortic aneurysms has a higher incidence of late complications, and open conversion (OC) associated with high mortality may be required. As alternatives to OCs, we propose minimal invasive laparo-/thoracoscopic approaches, either to control endoleaks after e...
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| Veröffentlicht in: | Annals of medicine and surgery 2016-02, Vol.5, p.5-10 |
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| creator | Kloster, Brian O Lund, Lars Lindholt, Jes S |
| description | Abstract Background Endovascular repair of aortic aneurysms has a higher incidence of late complications, and open conversion (OC) associated with high mortality may be required. As alternatives to OCs, we propose minimal invasive laparo-/thoracoscopic approaches, either to control endoleaks after endovascular repair, or to convert non-endovascular treatable cases due to a hostile neck anatomy by inserting a peri-aortic PTFE collar before endovascular repair. Such interventions may reduce complications and the necessity for OCs in the future. Methods In twelve pigs, were 10 had infra-/juxtrarenal AAAs, externally placed collars/aneuwraps around the proximal AAA neck and just below the left subclavian artery and division of the aortic side branches were carried out laparo-and thoracoscopically. Results For the laparoscopic and thoracoscopic procedures respectively, mean operative time was 143 ± 41 min and 86 ± 51 min and a mean of 2.6 and 2.25 aortic side branches were ligated/divided. For both procedures, the last half in the series were carried out significantly faster (p |
| doi_str_mv | 10.1016/j.amsu.2015.11.002 |
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As alternatives to OCs, we propose minimal invasive laparo-/thoracoscopic approaches, either to control endoleaks after endovascular repair, or to convert non-endovascular treatable cases due to a hostile neck anatomy by inserting a peri-aortic PTFE collar before endovascular repair. Such interventions may reduce complications and the necessity for OCs in the future. Methods In twelve pigs, were 10 had infra-/juxtrarenal AAAs, externally placed collars/aneuwraps around the proximal AAA neck and just below the left subclavian artery and division of the aortic side branches were carried out laparo-and thoracoscopically. Results For the laparoscopic and thoracoscopic procedures respectively, mean operative time was 143 ± 41 min and 86 ± 51 min and a mean of 2.6 and 2.25 aortic side branches were ligated/divided. For both procedures, the last half in the series were carried out significantly faster (p < 0.05) indicating a learning curve. Blood loss was minimal and no procedure related complications were seen. Conclusion Using these minimal invasive endoscopic approaches, it seems feasible to externally band aneurysm necks and ligate aortic side branches in a pig model. These procedures could potentially be considered as alternatives to OCs in controlling endoleaks and in improving the safety of endovascular interventions. As endoscopic aortic surgery is challenging a learning curve is expected. Practicing the described procedures using this model, can be used as a learning tool prior to similar interventions on humans.</description><identifier>ISSN: 2049-0801</identifier><identifier>EISSN: 2049-0801</identifier><identifier>DOI: 10.1016/j.amsu.2015.11.002</identifier><identifier>PMID: 26793311</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Animal model ; Aortic aneurysms ; Endoleaks ; Internal Medicine ; Learning curves ; Original Research ; Surgery ; Surgical training</subject><ispartof>Annals of medicine and surgery, 2016-02, Vol.5, p.5-10</ispartof><rights>The Authors</rights><rights>2015 The Authors</rights><rights>2015 The Authors 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-a1a1618fd43959e66fa8ed374045e4d8c53dc41da9348abdb37ab0638383bb73</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680631/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4680631/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27923,27924,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26793311$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kloster, Brian O</creatorcontrib><creatorcontrib>Lund, Lars</creatorcontrib><creatorcontrib>Lindholt, Jes S</creatorcontrib><title>Laparo- and thoracoscopic aortic aneurysm neck optimization and treatment of potential endoleaks type IA and II in a porcine model</title><title>Annals of medicine and surgery</title><addtitle>Ann Med Surg (Lond)</addtitle><description>Abstract Background Endovascular repair of aortic aneurysms has a higher incidence of late complications, and open conversion (OC) associated with high mortality may be required. As alternatives to OCs, we propose minimal invasive laparo-/thoracoscopic approaches, either to control endoleaks after endovascular repair, or to convert non-endovascular treatable cases due to a hostile neck anatomy by inserting a peri-aortic PTFE collar before endovascular repair. Such interventions may reduce complications and the necessity for OCs in the future. Methods In twelve pigs, were 10 had infra-/juxtrarenal AAAs, externally placed collars/aneuwraps around the proximal AAA neck and just below the left subclavian artery and division of the aortic side branches were carried out laparo-and thoracoscopically. Results For the laparoscopic and thoracoscopic procedures respectively, mean operative time was 143 ± 41 min and 86 ± 51 min and a mean of 2.6 and 2.25 aortic side branches were ligated/divided. For both procedures, the last half in the series were carried out significantly faster (p < 0.05) indicating a learning curve. Blood loss was minimal and no procedure related complications were seen. Conclusion Using these minimal invasive endoscopic approaches, it seems feasible to externally band aneurysm necks and ligate aortic side branches in a pig model. These procedures could potentially be considered as alternatives to OCs in controlling endoleaks and in improving the safety of endovascular interventions. As endoscopic aortic surgery is challenging a learning curve is expected. Practicing the described procedures using this model, can be used as a learning tool prior to similar interventions on humans.</description><subject>Animal model</subject><subject>Aortic aneurysms</subject><subject>Endoleaks</subject><subject>Internal Medicine</subject><subject>Learning curves</subject><subject>Original Research</subject><subject>Surgery</subject><subject>Surgical training</subject><issn>2049-0801</issn><issn>2049-0801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNp9Uk1r3DAQNaWlCWn-QA9Fx17savyhtaEEQujHwkIPzV2MpXGjXVtyJTmwPfaXV-6mIe2h6DADeu_N8N5k2WvgBXAQ7_YFTmEpSg5NAVBwXj7LzktedzlvOTx_0p9llyHsOefAm0qI9mV2VopNV1UA59nPHc7oXc7QahbvnEflgnKzUQydj2uxtPhjmJgldWBujmYyPzAaZ08cTxgnspG5gc0ups7gyMhqNxIeAovHmdj2-jd4u2Um0RLOK2OJTU7T-Cp7MeAY6PKhXmS3Hz_c3nzOd18-bW-ud7lqgMccAUFAO-i66pqOhBiwJV1tal43VOtWNZVWNWjsqrrFXvfVBnsuqja9vt9UF9nVSXZe-om0Sot6HOXszYT-KB0a-fePNXfym7uXtWiTDCSBtw8C3n1fKEQ5maBoHJNDbgkSNoK3XdcInqDlCaq8C8HT8DgGuFzjk3u5xifX-CSATPEl0punCz5S_oSVAO9PAEou3RvyMihDVpE2nlSU2pn_61_9Q1ejsUbheKAjhb1bvE3-S5ChlFx-XQ9ovR9o0umUaf4vo_zDLA</recordid><startdate>20160201</startdate><enddate>20160201</enddate><creator>Kloster, Brian O</creator><creator>Lund, Lars</creator><creator>Lindholt, Jes S</creator><general>Elsevier Ltd</general><general>Elsevier</general><scope>6I.</scope><scope>AAFTH</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160201</creationdate><title>Laparo- and thoracoscopic aortic aneurysm neck optimization and treatment of potential endoleaks type IA and II in a porcine model</title><author>Kloster, Brian O ; Lund, Lars ; Lindholt, Jes S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-a1a1618fd43959e66fa8ed374045e4d8c53dc41da9348abdb37ab0638383bb73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Animal model</topic><topic>Aortic aneurysms</topic><topic>Endoleaks</topic><topic>Internal Medicine</topic><topic>Learning curves</topic><topic>Original Research</topic><topic>Surgery</topic><topic>Surgical training</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kloster, Brian O</creatorcontrib><creatorcontrib>Lund, Lars</creatorcontrib><creatorcontrib>Lindholt, Jes S</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of medicine and surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kloster, Brian O</au><au>Lund, Lars</au><au>Lindholt, Jes S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparo- and thoracoscopic aortic aneurysm neck optimization and treatment of potential endoleaks type IA and II in a porcine model</atitle><jtitle>Annals of medicine and surgery</jtitle><addtitle>Ann Med Surg (Lond)</addtitle><date>2016-02-01</date><risdate>2016</risdate><volume>5</volume><spage>5</spage><epage>10</epage><pages>5-10</pages><issn>2049-0801</issn><eissn>2049-0801</eissn><abstract>Abstract Background Endovascular repair of aortic aneurysms has a higher incidence of late complications, and open conversion (OC) associated with high mortality may be required. As alternatives to OCs, we propose minimal invasive laparo-/thoracoscopic approaches, either to control endoleaks after endovascular repair, or to convert non-endovascular treatable cases due to a hostile neck anatomy by inserting a peri-aortic PTFE collar before endovascular repair. Such interventions may reduce complications and the necessity for OCs in the future. Methods In twelve pigs, were 10 had infra-/juxtrarenal AAAs, externally placed collars/aneuwraps around the proximal AAA neck and just below the left subclavian artery and division of the aortic side branches were carried out laparo-and thoracoscopically. Results For the laparoscopic and thoracoscopic procedures respectively, mean operative time was 143 ± 41 min and 86 ± 51 min and a mean of 2.6 and 2.25 aortic side branches were ligated/divided. For both procedures, the last half in the series were carried out significantly faster (p < 0.05) indicating a learning curve. Blood loss was minimal and no procedure related complications were seen. Conclusion Using these minimal invasive endoscopic approaches, it seems feasible to externally band aneurysm necks and ligate aortic side branches in a pig model. These procedures could potentially be considered as alternatives to OCs in controlling endoleaks and in improving the safety of endovascular interventions. As endoscopic aortic surgery is challenging a learning curve is expected. Practicing the described procedures using this model, can be used as a learning tool prior to similar interventions on humans.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>26793311</pmid><doi>10.1016/j.amsu.2015.11.002</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Animal model Aortic aneurysms Endoleaks Internal Medicine Learning curves Original Research Surgery Surgical training |
| title | Laparo- and thoracoscopic aortic aneurysm neck optimization and treatment of potential endoleaks type IA and II in a porcine model |
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