Routine use of an aortic balloon to resolve possible inflow stenosis induced by the inflatable ring fixation mechanism of the Ovation endograft

Purpose To investigate if the routine use of an aortic balloon within 15–30 min after Ovation stent graft ring inflation would resolve any inflow stenosis, which may reach 60 %, at the level of the sealing rings. Moreover, we estimated the potential hemodynamic compromise in these patients during re...

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Bibliographic Details
Published in:Radiologia medica 2016-11, Vol.121 (11), p.882-889
Main Authors: Ioannou, Christos V., Kontopodis, Nikolaos, Georgakarakos, Efstratios, Kehagias, Elias, Metaxa, Eleni, Lioudaki, Stella, Papaharilaou, Yannis, Tsetis, Dimitrios
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Aorta
Aortic Aneurysm, Abdominal - diagnostic imaging
Aortic Aneurysm, Abdominal - surgery
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - therapy
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation
Diagnostic Radiology
Endovascular Procedures
Female
Graft Occlusion, Vascular - diagnostic imaging
Graft Occlusion, Vascular - therapy
Hemodynamics
Humans
Image Interpretation, Computer-Assisted
Imaging
Inflow
Interventional Radiology
Male
Medicine
Medicine & Public Health
Middle Aged
Neuroradiology
Pressure drop
Prosthesis Design
Radiology
Retrospective Studies
Sealing
Stents
Tomography, X-Ray Computed
Treatment Outcome
Ultrasound
Vascular and Interventional Radiology
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Summary:Purpose To investigate if the routine use of an aortic balloon within 15–30 min after Ovation stent graft ring inflation would resolve any inflow stenosis, which may reach 60 %, at the level of the sealing rings. Moreover, we estimated the potential hemodynamic compromise in these patients during rest and exercise. Methods Following 3-dimensional reconstruction of AAA models, cross-sectional area of the infrarenal aorta just proximal the sealing mechanism ( A aort , R aort , respectively) and internal area at the site of stenosis ( A int , R int , respectively) were measured for 83. Forty-nine patients were managed without and 34 with an aortic balloon use. Pressure drop during rest and exercise was estimated. Results Technical success was 98 % and there were no perioperative deaths, one type-I endoleak, and 12 (14.5 %) type-II endoleaks. Median A int and R int were significantly reduced compared to A aort [55 % reduction, 143 (range 28–380) mm 2 vs 314 (range 177–531) mm 2 , P value
ISSN:0033-8362
1826-6983
DOI:10.1007/s11547-016-0671-0