Complications in Endovascular Surgery - Peri-Procedural Prevention and Treatment (Feb 2, 2021)_(0323554482)_(Elsevier)

As devices, technologies, and imaging techniques continue to evolve, today's endovascular surgical techniques have increased in both number and complexity. Complications in Endovascular Surgery provides a unique focus on potential complications encountered in the operating room, preparing you to anticipate the unexpected, identify the risk factors in individual procedures, and take steps to successfully manage complications when they occur. Helps you manage the surgical complications associated with image-guided interventional techniques used when treating patients with vascular disease, with clear descriptions of how to prevent problems and how to prevent catastrophic problems once a simple problem occurs. Provides a practical guide to device-specific tips and tricks from experts in the field, making this unique resource ideal for surgeons at all levels of training and practice. Features highly illustrated, consistent instructions that explain how to avoid and manage both common and uncommon complications. Covers EVAR, TEVAR, FEVAR, and other complex aortic work; as well as CAS, TCAR, complex LE endovascular procedures, and venous intervention-lysis/stenting. Includes tip boxes with key facts and technical recommendations, warning boxes that highlight safety precautions, and a troubleshooting guide for each procedure that helps you get back on track if things don't go exactly as planned. Enhanced eBook version included with purchase, which allows you to access all of the text, figures, and references from the book on a variety of devices Cover Complications in Endovascular Surgery Copyright Dedication List of Contributors Foreword Contents Introduction 1 Access Complications Introduction Risk Factors Ideal Puncture Site Groin Hematoma And Pseudoaneurysm Etiology and Clinical Presentation Diagnosis and Management Groin Hematoma Pseudoaneurysm Observation Ultrasound-Guided Compression Duplex-Guided Thrombin Injection Retroperitoneal Hemorrhage Clinical Presentation and Diagnosis Management Arteriovenous Fistula Diagnosis and Management Thrombosis Groin Infection References 2 Other Access Introduction General Issues Anatomy Pathology Location Guidance for Puncture Troubleshooting Access Site Complications Applicable to all Sites Access-site-specific issues Lower Extremity Access Superficial Femoral Artery Popliteal Artery Posterior Tibial, Anterior Tibial, and Peroneal Arteries Leg Grafts Upper Extremity Access Radial and Brachial Approach Axillary Carotid Artery References 3 Vascular Closure Devices for Small Arteriotomies: How to Avoid and Deal With Complications Introduction: Options For Achieving Hemostasis Complications Related to Active Vascular Closure Devices Access Site Considerations General Steps to avoiding complications with Active Vascular Closure Devices Ultrasound and Fluoroscopic Guidance for Arterial Access Preparing the Tract from Skin to Vessel Avoiding Infection Optimizing Patient Parameters Vascular Closure Device Selection Angio-Seal (Terumo Medical, Somerset, New Jersey) Angio-Seal Deployment Tips and Troubleshooting StarClose (Abbott Vascular, Abbott Park, Illinois) StarClose Deployment Tips and Troubleshooting Perclose (Abbott Vascular, Abbott Park, Illinois) Perclose Deployment Tips and Troubleshooting Mynx (Cardinal Health, Dublin, Ohio) Mynx Deployment Tips and Troubleshooting ExoSeal (Cardinal Health, Dublin, Ohio) ExoSeal Deployment Tips and Troubleshooting Celt (Vasorum) Celt Tips and Troubleshooting Tips Troubleshooting Dealing With Complications Failure of Hemostasis Hematoma Pseudoaneurysm Vascular Injury Vascular Occlusion Vascular Embolization of VCD Components Arterial Injury Infection Conclusions References 4 General Complications of EVAR Predicting Complication Systemic Complications Cardiovascular Complications Pulmonary Complications Renal Complications Deep vein thrombosis and pulmonary embolism Ischemic complications Spinal Cord Lower Extremity Colon Sedation complications Radiation complications Post-implantation syndrome Wound Infection References Further Reading 5 Gore Excluder Introduction Evolution of the Gore Excluder AAA Endoprosthesis Excluder with C3 Delivery System Deployment Step 1 Step 2 Step 3 Critical Technical Considerations, Potential Pitfalls, Troubleshooting Excluder with C3 Delivery System Failure Modes Clinical Application of the Excluder with C3 Delivery System Conclusion References 6 Complications of the Medtronic Endurant Stent Graft Background of the Medtronic Endurant Stent Graft Device Endurant Specific Complications Deployment and Tip Capture Tip Retrieval Limb Occlusions Conclusion References 7 Endologix Ovation Deployment Instructions for use (IFU) Polymer-related complications Type IA Endoleak Incomplete filling of chambers In-flow stenosis/Sealing ring in-folding Two limbs in one gate Difficult retrieval of the nose cone Distortion/crushing of the limbs References 8 Endologix AFX Deployment Instructions for use (IFU) Wire wrap Placement of components behind stent struts Type III endoleak AND component separation Difficult retrieval of the nose cone Malfunction of the contralateral wire Difficulty in delivering the proximal extension Malfunction of the control cord References 9 Graft-Specific Issues for EVAR: The Aorfix Endograft Introduction EVAR and Device-Specific Complications Technical Failure Endoleaks Type I Endoleak Type II Endoleak Type III and Type IV Endoleaks Stent-Graft Migration Unplanned Internal Iliac Artery (IIA) Occlusion Iliac Limb Occlusion Sac Expansion/Rupture Device Fracture Visceral Vessels Complications General Comments References 10 Nellix Isolated Migration Prevention Minimizing Distortion Forces Maximizing Supporting Forces Treatment Stent Relining Steps for Relining Type 1A Endoleak Prevention Treatment Coil and Liquid Embolics Proximal Extension with Covered Stents Plus Coil and Liquid Embolization Steps for Insertion of Proximal Extenders with Coil and Liquid Embolics Proximal Extension with Nellix System Steps for Proximal Extension with Nellix System Nellix Revisional CHIMNEY EVAS (ChEVAS): Proximal Extension with Nellix System and Parallel Grafts Steps for Nellix Revisional ChEVAS Type 1B Endoleak Steps for Treatment of Type 1B Endoleaks Aneurysm Expansion Limb Occlusion References 11 Vascutek (Bolton) TREO Endograft Introduction Device Information Preoperative Considerations Intraoperative Considerations Conclusions References 12 Grafts Outside the United States Introduction Descriptions of the devices Altura Anaconda INCRAFT E-vita and E-tegra E-liac References 13 Ruptured EVAR Complications References 14 Complications of Fenestrated Endovascular Aneurysm Repair Stent Graft Design Failure To Insert The Trunk Of A Modular Stent Graft Failure To Position The Trunk Of The Stent Graft At The Correct Level Failure to Position the Trunk Failure To Catheterize The Target Artery Failure To Deploy The Branch Branch Artery Injury Kinking Or Compression Of The Branch Visceral Ischemia Embolism Paraplegia Early Endoleak Late-Occurring Type I Endoleak Late-Occurring Type III Endoleak Late-Occurring Branch Occlusion Conclusion References 15 Complications With Branched Endovascular Devices Points Of Attention In Branched EVAR Device Planning Procedural Planning Operative Basics, Tips, and Tricks Ischemia Monitoring: Apply Invos and Meps Postoperative Management Conclusion References 16 Complications of EVAR With Snorkels, Chimneys, and Sandwich Techniques Background Preoperative Issues Choice of Device Intraoperative/Early Complications Technical Failure: Target Visceral Vessels Loss/Lesions/Early Occlusions Gutters/Proximal Type I Endoleak Access-Related Complications/Stroke Stenosis or Kinking of Visceral Stent Graft Stenosis of Native Visceral Vessels Early Mortality Follow-Up/Late Complications Endoleak from Gutters Acute Occlusion Of Visceral Stent Graft Disconnection Of The Visceral Stent Graft Prevention and Treatment References 17 Endoleaks Overview Type Ia Endoleaks Intraoperative Late Type Ib Endoleaks Type III Endoleak Type IV Endoleak Type V Endoleak (Endotension) Type II Endoleak References 18 Complications in Endovascular Thoracoabdominal Aortic Aneurysm Repair Target Vessel Dissection and Occlusion Prevention Treatment Embolization Perforation Stent Dislodgement/Migration Bird-Beak Configuration Prevention Treatment Retrograde Type A Aortic Dissection Prevention Treatment Inadvertent branch vessel coverage Prevention Treatment References 19 TAA Endoleaks Introduction Type I Endoleaks Type II Endoleaks Gutter Endoleaks Type III Endoleaks Types IV and V Endoleaks Persistent False Lumen Perfusion Following TEVAR for Thoracic Aortic Dissection References 20 Complications of TAG and Conformable TAG (CTAG) Thoracic Endoprosthesis Introduction TAG Endoprosthesis CTAG Endoprosthesis Maldeployment Migration Compression and Collapse Unintended Branch Vessel Occlusion Summary References 21 Device-Specific Issues With EVAR: Cook Introduction Endoleak Technical Considerations Access Site Complications Percutaneous Access Limb Kinking and Occlusion Device Migration Separation Of Components Additional Technical Considerations Conclusion References 22 Terumo Aortic Relay TEVAR Introduction Device Information Preoperative Considerations Intraoperative Considerations Conclusions Reference 23 Complication With Medtronic Thoracic Stent Endograft Introduction and Background Device Insertion and Deployment Bailout Techniques The Valiant Navion Conclusion References 24 Complications and Lessons Learned From Global Use of the Streamliner Multilayer Flow Modulator (SMFM) Device Introduction The Global Registry Surgical Technique Aneurysm Repair Technique Dissection Repair Technique SMFM Complications Preoperative Planning and Complications Aneurysm Size Infectious Aneurysms Landing Zones Perioperative Complications Inadequate Overlap Device Malexpansion Device Foreshortening Postoperative Complications Device Migration, Dislocation, and Collapse Stent Occlusion Endoleak Aneurysm Rupture Evidence-Based Recommendations Instructions for Use New Recommendations for IFU Conclusion References 25 Transcatheter Aortic Valve Replacement Transcatheter Aortic Valve Replacement Introduction Indications and Patient Selection Management Of Important Comorbidities Prior To TAVR Contra-Indications For TAVR Procedural Considerations, Equipment, and Technique For TAVR Alternatives To Transfemoral Access Perioperative Management and Adjunctive Therapies Complications Of TAVR Stroke Vascular Complications Arrhythmia Aortic Regurgitation Cardiac Trauma Valve Leaflet Thrombosis Conclusions References 26 Complications in the Endovascular Management of Aortic Dissection Introduction Tevar Versus Open Surgery Tevar Procedure Complications That May Be Encountered Intraoperatively Technical Recommendations For TEVAR Preoperative Carotid–Left-Subclavian Bypass TEVAR and Complicated TBAD (CTBAD) TEVAR and UCTBAD Multichanneled Aortic Dissection (MCAD) Predictors Of Progression Of Aortic Remodeling After TEVAR Conclusion References 27 Complications of Endovascular Septal Fenestration in the Management of Patients With Aortic Dissection Introduction Fenestration and Acute Aortic Dissection Complications Fenestration and Chronic Aortic Dissection Complications Conclusion References 28 Renal and Mesenteric Aneurysms Introduction Background Indications Endovascular Treatment Options Endovascular Treatment Techniques Renal Aneurysms Background Treatment Complications/Troubleshooting References 29 Mesenteric Embolization: Solid Organ, Pelvic Trauma, and GI Bleeding Introduction Particle Embolization (Gelfoam and Polyvinyl Alcohol) Procedure Recommendations: The Dos and Don’ts Temporary Agent—Gelfoam—Properties and Uses Semipermanent Agents: Properties and Uses Postembolization Complications Coil Embolization Procedure Recommendations: The Dos and Don’ts Postembolization Complications Liquid Embolization Agents Occlusion Devices Conclusion References 30 Complications in Angioplasty and Stenting of Mesenteric and Renal Artery Disease Introduction Mesenteric Angioplasty and Stenting Intraoperative Complications Access-Related Complications Branch Perforation and Mesenteric Hematoma Dissections and Thrombosis Stent Dislodgement, Fracture, and Compression Embolization Postoperative Medical Complications Renal Artery Angioplasty and Stenting Intraoperative Complications Access-Related Complications Perforation and Parenchymal Hematoma Dissections and Thrombosis Stent Dislodgement Embolization Postoperative Medical Problems Branch Instability After Fenestrated-Branched Endovascular Aortic Repair Conclusions References 31 Thrombolysis in Acute Limb Ischemia Introduction Acute Limb Ischemia Treatment Alternatives Surgery versus Catheter Intervention University of Pittsburgh Medical Center (UPMC) Experience Catheter-Directed Lysis Pharmacomechanical Thrombectomy AngioJet UPMC Experience Penumbra EndoWave Contraindications Complications Major Hemorrhage Minor Hemorrhage Compartment Syndrome Renal Failure and Myoglobinuria Embolism Clinical Case Outcomes Technical Success Limb Salvage Survival Conclusions References 32 Aortoiliac Interventions for Occlusive Disease Introduction Patient Preparation Crossing and Treating Aorto-iliac Lesions Crossing Direction and Access Site Re-Entry Technique and Stent Selection Concomitant Femoral Endarterectomy (Hybrid) Procedures Management of Complications Dissection Arterial Perforation Embolization References 33 Complications of Femoropopliteal Interventions for Occlusive Disease Introduction Patient Evaluation Arterial Access Femoral Interventions Endovascular Treatment Options Complications Perforation Dissection Embolization In-Stent Restenosis Conclusions References 34 Complications of Endovascular Repair of Popliteal Artery Aneurysms Introduction Specific Concerns Conclusion References 35 Tibial Interventions for Peripheral Arterial Disease Introduction Arterial Access Technique Retrograde Common Femoral Artery Access Antegrade Common Femoral Artery Access Retrograde Tibiopedal Access Management of Complications Treatment of Tibial Lesions Techniques Nonocclusive Tibial Stenosis Chronic Occlusions Tibial Bifurcation Lesions Management of Complications Dissection Vessel Perforation and Wire Fractures Embolic Disease Arteriovenous (AV) Fistula Conclusions References 36 Complications of Iliofemoral Thrombolysis and Stenting for Venous Disease Introduction Access for Catheter-Directed Thrombolysis Thrombolysis Complications from Venous Lysis Pharmacomechanical catheter-directed thrombolysis Complications following Percutaneous Pharmacomechanical Thrombectomy Stenting Complications following Stent placement Chronic Iliofemoral Venous Occlusions Central Venous Occlusions associated with intraluminal devices References 37 Complications of IVC Filters Introduction Filter Fracture IVC Filter Migration and/or Embolization Management IVC Thrombotic Occlusion Management Filter Tilt Management Filter Perforation Management Filter Retrieval Conclusion References 38 Complications of Endovenous Treatments, Including: Thermal, Nonthermal, Sclerotherapy, and Foam Ablations Introduction Thermal Ablations: Endovenous Laser Therapy And Radiofrequency Ablation Venous Thrombosis Prophylaxis and Lidocaine Toxicity Nonthermal Ablations: Liquid and Foam Sclerotherapy, Mechanical Occlusive Chemical Ablation, And Cyanoacrylate Glue Conclusions References 39 Arteriovenous Access: Fistula and Graft Intervention Endovascular Treatment In The Management Of Arteriovenous Access Considerations For Creation Of Access What Are the Requirements for Arteriovenous Access? Endovascular Treatment of Arteriovenous Access Access Stenosis versus Thrombosis Management of the Thrombosed Access Using Endovascular Techniques Arteriovenous Access Stenosis versus Arteriovenous Access Occlusion Balloon Angioplasty for Treatment of Arteriovenous Access Stenoses Stents for Treatment of Dialysis Access Covered Stents for Treatment of Dialysis Access Drug-Coated Balloons for Treatment of Dialysis Access Conclusions References 40 Central Venous Stenosis Associated With Arteriovenous Access Introduction Presentation, Diagnosis, and Treatment Complications Inability to Cross the Lesion Perforation Stent Fracture Recoil/Lack of Success Stent Malposition, Migration, and Embolus Completely Occluded Out-Flow Conclusions References 41 Catheter Issues Introduction References 42 Complications of ECMO and IABP Introduction Intra-Aortic Balloon Pump Extracorporeal Membrane Oxygenation References 43 Angiography Introduction Selection of Access Site and Approach Access Complications Contrast-Related Complications Radiation Exposure Conclusion References 44 Complications Associated With Carotid Artery Stenting Introduction Procedural Planning Access Difficulties Crossing Preocclusive Stenotic Lesions Problems Associated with Embolic Protection Transient Intraoperative Neurologic Compromise Intraoperative Hemodynamic Instability Carotid Artery Spasm Cerebral Hyperperfusion Syndrome Intracranial Hemorrhage Stroke Restenosis Conclusion References 45 Embolic Protection Issues Introduction Types of Embolic Protection: Proximal, Distal, and Complete Flow Reversal Stenting and Angioplasty of the Brachiocephalic and Subclavian Arteries Common Complications Avoiding Complications Getting Out of Trouble Acknowledgments References 46 Complications Specific to Closed and Open Cell Nitinol Stents in Carotid Artery Stenting Introduction Complications Early Complications Late Complications Complication Avoidance Conclusions References 47 Carotid Stent: Device-Specific Complications With the Wallstent Introduction Endoluminal stent coverage Classification of carotid stent complication Other Types of Late Complications Avoiding and Correcting Complications References 48 Transcarotid Artery Revascularization With the ENROUTE Transcarotid Neuroprotection System Procedure Complications Pitfalls References 49 Subclavian Steal Introduction Procedural Overview Complication Avoidance And Management Embolism In-Stent Thrombosis Vessel Lumen Dissection Stent Malpositioning Conclusion Acknowledgments References 50 Complications in the Endovascular Treatment of Intracranial Arteriovenous Malformations Introduction Common Complications Avoiding Complications Treatment Paradigm Getting Out of Trouble Conclusion Acknowledgments References 51 Complication of Endovascular Treatment of Intracranial Stenosis Introduction Pathophysiology of Strokes in Intracranial Stenosis Treatment Endovascular Procedures Complications with Endovascular Therapy of ICS Current and Future Directions Conclusions References 52 Complications in the Endovascular Treatment of Intracranial Aneurysms Introduction Coiling Thromboembolic Complications Hemorrhagic Complications/Intraprocedural Aneurysm Rupture Early Hemorrhagic Complications Coil Migration Stent-Assisted/Balloon-Assisted Coiling Thromboembolic Complications Coil Stretching Flow Diversion Hemorrhagic Complications Endoleak Conclusion Acknowledgments References 53 Acute Ischemic Stroke Introduction Access-related Complications Thromboembolic Complications Embolization of New Territories Reperfusion Injury/Reperfusion Hemorrhage/Hemorrhagic Conversion Complication Avoidance Vasospasm, Dissection, and Arterial Perforation Vasospasm Vasospasm Avoidance and Management Dissection Dissection Avoidance and Management Perforation Perforation Avoidance and Management Conclusion Acknowledgments References Index