tips and tricks for successful evar · tips and tricks for successful evar prof. fabio verzini ,...
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Tips and tricks for successful EVAR
Prof.FabioVerzini,MD,PhD,FEBVS
SectionofVascularSurgeryUniversityofPerugia,
S.Maria della MisericordiaHospital,Perugia,Italy
Disclosure
Speaker name: Fabio Verzini
.................................................................................
qI have the following potential conflicts of interest to report:
q Receipt of grants/research support
q Receipt of honoraria and travel support
from Cook, Gore, Medtronic
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Tostayoutoftroubles
• Patientselection
• Caseplanning
• Operation
• Qualitycontrol
Togetoutoftroubles
• Improvefixation/seal
• Outflowmanagement
• Endoleaks
Tostayoutoftroubles
• Patientselection
• Caseplanning
• Operation
• Qualitycontrol
>17mm, <32mm
Angle <60°-90°
>10mm
>20mm
>7mm<22mm >15mm
Male, 64 y.o.
62 mm AAA
CAD (previous CABG + PTCA)Chronic AF (warfarin)
Respiratory failure waiting for lung transplant
Tostayoutoftroubles
• Patientselection
• Caseplanning
• Operation
• Qualitycontrol
Pre-op planning
• CT-Angio 1 mm (4-6 weeks)
• MPR (Multiplanar reconstruction)
• MIP (Maximum intensity projection)
• Center line analysis
• Thoracic-abdominal Ct-Angio
CRA 10°
RAO 19°
LAO 0°
CRA 5°
Final Angio
6 months CT scan
Tostayoutoftroubles
• Patientselection
• Caseplanning
• Operation
• Qualitycontrol
• Localanesthesia• Percutaneousaccess• Intra-operativeimaging• Knowledgeofspecificgraftcharacteristics
• Localanesthesia
• Percutaneousaccess
• Percutaneousaccess
• Intra-operativeimaging
• Intra-operativeimaging
• Knowledgeofspecificgraftcharacteristics 22-34 mm
86 mm
94 m
m
49 m
m
Everymmofgraft/neckappositioncounts
Tostayoutoftroubles
• Patientselection
• Caseplanning
• Operation
• Qualitycontrol
• Qualitycontrol
• Qualitycontrol
• Qualitycontrol
• Qualitycontrol
Tips and tricks for successful EVAR
Prof.FabioVerzini,MD,PhD,FEBVS
SectionofVascularSurgeryUniversityofPerugia,
S.Maria della MisericordiaHospital,Perugia,Italy