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This video/audio tutorial explains all the passage to obtain a correct pre-operative planning and sizing for ChEVAR.

This is a tutorial about performing on table standard EVAR fenestration and subsequent aneurysm repair in the present case the patient was unfit for surgery and had a large left accessory renal artery. He was treated with infrarenal surgeon modified endograft and accessory renal artery overstenting. Successful treatment and satisfying control CT scan

Totally percutaneous chimney technique for a juxtarenal impending rupture aneurysm using off-the-shelf brazilian devices in a fragile, comorbid patient. #casereport #chevar #pevar #juxtarenal

This is a round table discussion about CO2 during EVAR and complex EVAR in the framework of the annual meeting of Angiodroid in Bologna, Italy. In this round table discussion, 5 European experts present current evidence and their experience about the use of CO2 in the treatment of aortic diseases (s. chapters). Moreover, the panellists discuss all important benefits and drawbacks of the technique and present for the first time the study protocol of the prospective CO2 EVAR registry.

This presentation aims to highlight the usefulness of surgical drawing in practice. It sums up experiences, planning and real cases of the past 5 years of practice in vascular surgery. As I got tremendous positive feedback from patients, colleagues, GP’s, relatives and artists, I decided to share this experience with the vascular community.

This is a step by step video of the open surgical of an abdominal aortic aneurysm with a tube Dacron graft through a median laparotomy. In this video, you will learn the surgical exposure of the aneurysm, the clamping and opening of the aneurysm sac, how to deal with the lumbar arteries, the proximal and distal anastomosis and how to close the abdomen by the right way.

This is a recorded case of the new Altura stent graft (Lombard). The device has kept well-known features of previous EVAR devices such as active suprarenal fixation, a fabric graft, and a robust nitinol stent. The flexibility produced by the division of the main body has the potential to significantly improve many issues of EVAR performance.

Dr. Martin Björck (Uppsala University, Sweden) summarizes in this presentation all important clinical and therapeutic aspects of abdominal compartment syndrome after EVAR for ruptured abdominal aortic aneurysms (AAA). Moreover, the author discusses the clinical consequences of ACS and provides important recommendations about monitoring techniques and treatment.

Late open conversion after EVAR shows an increasing incidence and is mostly related to arterial degeneration and/or material fatigue. Dr. Michael Makaroun provides a unique overview of different techniques for the challenging open conversion for failed EVAR.

Dr. Benjamin Starnes (Seattle, WA, USA) demonstrates all important features of a well-organized and ‘busy’ aortic center and analyzes the added value of centralization of the aortic treatment. Moreover, Dr. Starnes summarizes all lessons learned during the establishment of the aortic center, which may help physicians to further optimize the EVAR outcomes in the treatment of ruptured AAAs.

63 y.o. patient treated in the emergency setting for ruptured AAA
Endovascular repair planned despite proximal hostile anatomy and left iliac aneurysm with thrombus.
procedure details:
-bilateral percutaneous access
-bifurcated endurant endograft implant (left hypogastric embolization)
-partial left renal artery coverage @ control angio (intentional aggressive deployment)
-renal stenting
-type Ia endoleak after renal stenting, persistent after re-ballooning
-endoleak correction with endoanchors

This is a complex case of a 74-year-old female with an acute onset of rest pain of the right limb. Previous Rx: primary stenting of both renal arteries, endovascular repair of both CIA in CERAB technique and fem-pop 1 bypass right limb.
During her current readmission, the CT-scan revealed a high-flow AV fistula of the right CFA, an abdominal aortic aneurysm (4.7 cm), an occluded stent in the right renal artery as well as an occluded fem-pop bypass. What would you do in this case?

Preloaded custom-made fEVAR (Cook) in a 63 y.o. male with pararenal abdominal aortic aneurysm 55 mm. This video shows all the procedural steps and the CT scan at 1 month.

– Chronic ischaemic heart disease with left ventricular apex aneurysm
– Left mild intermittent claudication 500 mt (Left common iliac artery chronic occlusion)
– COPD
– Chronic celiac artery occlusion

We used Begraft 10×37 in SMA, 8×27 for left renal and 7×18 in right renal.

We report a case of pararenal pseudoaneurysm endovascular correction with triple chimney technique and the following gutter embolization procedure

Key points:

-Previous fEVAR attempt (failed because of extremely tortuous accesses)
-Emergency procedure during the night
-Bilateral percutaneous femoral access
-Double axillary puncture on both sides
-Challenging endograft advancement on through and through guidewire
-Triple ChEVAR (SMA, RRA, LRA)
-Subsequent gutter embolization

Bilateral common iliac aneurysm endovascular repair with an iliac branched device in a 63 years old patient. This video demonstrates the procedural steps and the CT scan at 3 years of surveillance.
Notice: Intentional cross-leg because of short lowest renal to hypogastric distance.

Dr. Bisdas (Vascular Surgeon, Athens, Greece) performs a live implantation of the new TREO stent-graft (Terumo Aortic) for the treatment of an infrarenal AAA. In this video, you will see all the new features of the device and important intraprocedural steps for a successful EVAR. Furthermore, the panelists will discuss the need for a new EVAR endograft and they express their opinion about the TREO stent-graft. In the end, the operator answers questions about the aim and scope of Vascupedia.

“Who will do my aortic surgery when my time comes” was a common refrain among my mentors, only half jokingly. Now, the question has gained a sharpness. I think the tide will turn and the kids will do fine, but we all have to do a bit of reclamation, or open surgery will become the habit of strange eccentric artisans. I recommend calling up the retired surgeon and inviting them in for conferences and cases. Reprint masterwork atlases like Wiley’s. Connect with likeminded. Before it’s too late.