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Endovascular Aortic Sealing of Infrarenal Abdominal Aortic Aneurysms with a Sac-anchoring Endograft

Boersen, J.T. (2015) Endovascular Aortic Sealing of Infrarenal Abdominal Aortic Aneurysms with a Sac-anchoring Endograft.

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Abstract:Endovascular aortic sealing (EVAS) is an innovative method to exclude infrarenal abdominal aortic aneurysms. The concept of EVAS is based on sealing of the aneurysm by polymer filling of endobags that surround the EVAS stents, thereby sac-anchoring the device in the aneurysm flow lumen. Flow is maintained by the EVAS stents. By sealing the entire aneurysm flow lumen type I and II endoleaks are potentially avoided. Filling of the endobags is pressure guided, aiming at an intended pressure of 180 mm Hg. A prefill with saline is performed to estimate fill volume of the endobags. If digital subtraction angiography (DSA) shows no endoleaks, the solution is aspirated and the endobags are filled with a similar volume of polymer, again until a pressure of 180 mm Hg is reached. Intraoperative DSA length measurements are performed to determine stent lengths. A calibration catheter is advanced over a stiff guide wire to compensate for eventual straightening of tortuous anatomy by the stents postprocedural. This thesis consists of three parts, including changes in aortoiliac anatomy post-EVAS, validation of preoperative calculations of aortic flow lumen volume to estimate endobag volumes and validation of preoperative aortoiliac length measurements to estimate stent lengths.
Item Type:Essay (Master)
Clients:
St. Antonius Ziekenhuis, Nieuwegein, the Netherlands
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:http://purl.utwente.nl/essays/66797
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