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Editor's Choice – Focused Update on Patients Treated with the Nellix EndoVascular Aneurysm Sealing (EVAS) System from the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm Clinical Practice Guidelines

Title: Editor's Choice – Focused Update on Patients Treated with the Nellix EndoVascular Aneurysm Sealing (EVAS) System from the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm Clinical Practice Guidelines
Authors: the ESVS AAA Guidelines Writing Committee; the ESVS Guidelines Steering Committee; Boyle, Jonathan R.; Tsilimparis, Nikolaos; Van Herzeele, Isabelle; Tulamo, Riikka Maaria
Contributors: HUS Neurocenter; Clinicum; Department of Surgery; Verisuonikirurgian yksikkö
Publisher Information: W.B. Saunders Ltd
Publication Year: 2024
Collection: Helsingfors Universitet: HELDA – Helsingin yliopiston digitaalinen arkisto
Subject Terms: Abdominal aortic aneurysm; Endoleak; Endovascular Aneurysm Sealing; EVAS; Guidelines; Nellix; Surgery; anesthesiology; intensive care; radiology
Description: Objective: After alerts on EndoVascular Aneurysm Seal (EVAS) failure were raised, the European Society for Vascular Surgery (ESVS) Abdominal Aortic Aneurysm (AAA) Clinical Practice Guidelines Writing Committee (WC) initiated a task force with the aim to provide guidance on surveillance and management of patients with implanted EVAS devices. Methods: Based on a scoping review of risk for late serious aortic-related adverse events in patients treated with EVAS for AAA, the ESVS AAA Guidelines WC agreed on recommendations graded according to the European Society of Cardiology (ESC) grading system. Results: EVAS has a very high incidence of late endograft migration resulting in proximal type 1 endoleak with risk of rupture, requiring open conversion with device explantation. The reported mortality rate for elective explantation varies between 0% and 14%, while acute conversion for rupture has a very dismal prognosis with a 67 – 75% mortality rate. Conclusion: It is recommended that all patients in whom a Nellix device has been implanted should be identified, properly informed, and enrolled in enhanced surveillance. If device failure is detected, early elective device explantation should be considered in surgically fit patients. ; Peer reviewed
Document Type: review
File Description: application/pdf
Language: English
Relation: https://hdl.handle.net/10138/570832; 85147867187; 000957600600001
Availability: https://hdl.handle.net/10138/570832
Rights: cc_by ; info:eu-repo/semantics/openAccess ; openAccess
Accession Number: edsbas.43358359
Database: BASE