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Controversies in selecting an approach for aortic aneurysm repair – whether using an open approach or endovascular repair – will be discussed in the Thursday morning session, “Advances in Fenestrated and Branched EVAR (F/,B/EVAR) and Parallel Grafts for Complex AAAs and TAAAs; Related Controversies.”

“The session will focus on the analysis of the limitations of the techniques used for short necks and their utility in failed EVAR, which is an increasing phenomenon related to the older stent-graft types,” said session co-moderator Dr. Konstantinos P. Donas, assistant professor of vascular surgery at Münster University in Germany. Other comoderators are Dr. James F. McKinsey, professor of surgery at Mount Sinai Hospital System, and Dr. Frank J. Veith, professor of surgery at Cleveland Clinic and New York University.

Dr. Jean-Pierre Becquemin, professor of vascular surgery at the University of Paris XII, opens the session with a presentation of an evidence-based algorithm to determine which treatment is best for complex abdominal aortic aneurysms (AAA): F/EVAR, B/EVAR, Ch/EVAR or open repair. Dr. Matthew J. Eagleton, professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, will then describe when to choose F/ or B/EVAR and techniques for avoiding limb ischemia from prolonged sheath placement.

Dr. Konstantinos P. Donas


Trial results will then take center stage. Dr. Mario L. Lachat, professor at Zürich University Hospital, will report on 10-year experience of Ch/EVAR and other parallel grafts for AAAs and thoracoabdominal aortic aneurysms (TAAAs). Dr. Virendra I. Patel, chief of vascular surgery at New York-Presbyterian Hospital, will follow with a comparison of 30-day and 1-year results in Ch/EVAR and F/EVAR from the Vascular Quality Initiative registry.

Dr. Salvatore T. Scali’s talk of results from the PERICLES registry is one worth noting, Dr. Donas said. This talk will explore the optimal combination of chimney grafts and abdominal devices to prevent gutter endoleaks. Dr. Scali is an assistant professor of surgery at the University of Florida.

Before a panel discussion, Dr. Timothy A. Resch, associate professor of surgery at Lund University, will provide an overview of tips and tricks for F/EVAR, B/EVAR or open repair to treat failed EVAR.

The second half of the session continues with Dr. Sonia Ronchey, vascular surgeon at Hospital St. Philip Neri in Rome, will draw on PERICLES registry data to analyze outcomes of chimney grafts for type 1A endoleaks after EVAR. Then Dr. Arne G. Schwindt, of the department of vascular surgery at St. Franziskus Hospital in Münster, Germany, will explain techniques for using Onyx to repair gutter endoleaks after Ch/EVAR.

The appropriate number of chimney grafts in Ch/EVAR will be the subject of a debate between Dr. Jason T. Lee and Dr. Manish Mehta. Dr. Lee, director of endovascular surgery at Stanford University Medical Center, will argue that the number of endoleaks and complications is directly related to the number of chimney grafts. Dr. Mehta, professor of surgery at Albany Medical College, will take the position that Ch/EVAR can be done effectively with four chimney grafts – and then will explain how to do it correctly.

The last presentation of the session will concentrate on the Colt device, a new manifold multi-branched device, for treatment of TAAAs. Dr. Piotr Szopinski, professor of general and vascular surgery at the Medical University of Warsaw, will present. The EVAR session will wrap up with a second panel discussion.

“There is a need for a concept that includes all decision-making factors in the selection of the treatment option in complex abdominal diseases,” Dr. Donas said. “This concept will reflect the clinical reality more and the published experience less, and will allow a tailored approach for each case, including the operator’s, institution’s and patient´s characteristics.” 

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Controversies in selecting an approach for aortic aneurysm repair – whether using an open approach or endovascular repair – will be discussed in the Thursday morning session, “Advances in Fenestrated and Branched EVAR (F/,B/EVAR) and Parallel Grafts for Complex AAAs and TAAAs; Related Controversies.”

“The session will focus on the analysis of the limitations of the techniques used for short necks and their utility in failed EVAR, which is an increasing phenomenon related to the older stent-graft types,” said session co-moderator Dr. Konstantinos P. Donas, assistant professor of vascular surgery at Münster University in Germany. Other comoderators are Dr. James F. McKinsey, professor of surgery at Mount Sinai Hospital System, and Dr. Frank J. Veith, professor of surgery at Cleveland Clinic and New York University.

Dr. Jean-Pierre Becquemin, professor of vascular surgery at the University of Paris XII, opens the session with a presentation of an evidence-based algorithm to determine which treatment is best for complex abdominal aortic aneurysms (AAA): F/EVAR, B/EVAR, Ch/EVAR or open repair. Dr. Matthew J. Eagleton, professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, will then describe when to choose F/ or B/EVAR and techniques for avoiding limb ischemia from prolonged sheath placement.

Dr. Konstantinos P. Donas


Trial results will then take center stage. Dr. Mario L. Lachat, professor at Zürich University Hospital, will report on 10-year experience of Ch/EVAR and other parallel grafts for AAAs and thoracoabdominal aortic aneurysms (TAAAs). Dr. Virendra I. Patel, chief of vascular surgery at New York-Presbyterian Hospital, will follow with a comparison of 30-day and 1-year results in Ch/EVAR and F/EVAR from the Vascular Quality Initiative registry.

Dr. Salvatore T. Scali’s talk of results from the PERICLES registry is one worth noting, Dr. Donas said. This talk will explore the optimal combination of chimney grafts and abdominal devices to prevent gutter endoleaks. Dr. Scali is an assistant professor of surgery at the University of Florida.

Before a panel discussion, Dr. Timothy A. Resch, associate professor of surgery at Lund University, will provide an overview of tips and tricks for F/EVAR, B/EVAR or open repair to treat failed EVAR.

The second half of the session continues with Dr. Sonia Ronchey, vascular surgeon at Hospital St. Philip Neri in Rome, will draw on PERICLES registry data to analyze outcomes of chimney grafts for type 1A endoleaks after EVAR. Then Dr. Arne G. Schwindt, of the department of vascular surgery at St. Franziskus Hospital in Münster, Germany, will explain techniques for using Onyx to repair gutter endoleaks after Ch/EVAR.

The appropriate number of chimney grafts in Ch/EVAR will be the subject of a debate between Dr. Jason T. Lee and Dr. Manish Mehta. Dr. Lee, director of endovascular surgery at Stanford University Medical Center, will argue that the number of endoleaks and complications is directly related to the number of chimney grafts. Dr. Mehta, professor of surgery at Albany Medical College, will take the position that Ch/EVAR can be done effectively with four chimney grafts – and then will explain how to do it correctly.

The last presentation of the session will concentrate on the Colt device, a new manifold multi-branched device, for treatment of TAAAs. Dr. Piotr Szopinski, professor of general and vascular surgery at the Medical University of Warsaw, will present. The EVAR session will wrap up with a second panel discussion.

“There is a need for a concept that includes all decision-making factors in the selection of the treatment option in complex abdominal diseases,” Dr. Donas said. “This concept will reflect the clinical reality more and the published experience less, and will allow a tailored approach for each case, including the operator’s, institution’s and patient´s characteristics.” 

 

Controversies in selecting an approach for aortic aneurysm repair – whether using an open approach or endovascular repair – will be discussed in the Thursday morning session, “Advances in Fenestrated and Branched EVAR (F/,B/EVAR) and Parallel Grafts for Complex AAAs and TAAAs; Related Controversies.”

“The session will focus on the analysis of the limitations of the techniques used for short necks and their utility in failed EVAR, which is an increasing phenomenon related to the older stent-graft types,” said session co-moderator Dr. Konstantinos P. Donas, assistant professor of vascular surgery at Münster University in Germany. Other comoderators are Dr. James F. McKinsey, professor of surgery at Mount Sinai Hospital System, and Dr. Frank J. Veith, professor of surgery at Cleveland Clinic and New York University.

Dr. Jean-Pierre Becquemin, professor of vascular surgery at the University of Paris XII, opens the session with a presentation of an evidence-based algorithm to determine which treatment is best for complex abdominal aortic aneurysms (AAA): F/EVAR, B/EVAR, Ch/EVAR or open repair. Dr. Matthew J. Eagleton, professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, will then describe when to choose F/ or B/EVAR and techniques for avoiding limb ischemia from prolonged sheath placement.

Dr. Konstantinos P. Donas


Trial results will then take center stage. Dr. Mario L. Lachat, professor at Zürich University Hospital, will report on 10-year experience of Ch/EVAR and other parallel grafts for AAAs and thoracoabdominal aortic aneurysms (TAAAs). Dr. Virendra I. Patel, chief of vascular surgery at New York-Presbyterian Hospital, will follow with a comparison of 30-day and 1-year results in Ch/EVAR and F/EVAR from the Vascular Quality Initiative registry.

Dr. Salvatore T. Scali’s talk of results from the PERICLES registry is one worth noting, Dr. Donas said. This talk will explore the optimal combination of chimney grafts and abdominal devices to prevent gutter endoleaks. Dr. Scali is an assistant professor of surgery at the University of Florida.

Before a panel discussion, Dr. Timothy A. Resch, associate professor of surgery at Lund University, will provide an overview of tips and tricks for F/EVAR, B/EVAR or open repair to treat failed EVAR.

The second half of the session continues with Dr. Sonia Ronchey, vascular surgeon at Hospital St. Philip Neri in Rome, will draw on PERICLES registry data to analyze outcomes of chimney grafts for type 1A endoleaks after EVAR. Then Dr. Arne G. Schwindt, of the department of vascular surgery at St. Franziskus Hospital in Münster, Germany, will explain techniques for using Onyx to repair gutter endoleaks after Ch/EVAR.

The appropriate number of chimney grafts in Ch/EVAR will be the subject of a debate between Dr. Jason T. Lee and Dr. Manish Mehta. Dr. Lee, director of endovascular surgery at Stanford University Medical Center, will argue that the number of endoleaks and complications is directly related to the number of chimney grafts. Dr. Mehta, professor of surgery at Albany Medical College, will take the position that Ch/EVAR can be done effectively with four chimney grafts – and then will explain how to do it correctly.

The last presentation of the session will concentrate on the Colt device, a new manifold multi-branched device, for treatment of TAAAs. Dr. Piotr Szopinski, professor of general and vascular surgery at the Medical University of Warsaw, will present. The EVAR session will wrap up with a second panel discussion.

“There is a need for a concept that includes all decision-making factors in the selection of the treatment option in complex abdominal diseases,” Dr. Donas said. “This concept will reflect the clinical reality more and the published experience less, and will allow a tailored approach for each case, including the operator’s, institution’s and patient´s characteristics.” 

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