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Tilo Kölbel German Aortic Center Dpt. of Vascular Medicine University Heart Center Hamburg Friday Afternoon EVAR

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Page 1: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Tilo Kölbel

German Aortic Center

Dpt. of Vascular Medicine

University Heart Center Hamburg

Friday Afternoon EVAR

Page 2: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Disclosures

Research-grants, travelling, proctoring

speaking-fees, IP, royalties with Cook Medical.

Consultant with Philips

Speaking fees from Getinge

IP, Consultant with Terumo Aortic

Shareholder Mokita-Medical GmbH

Page 3: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

25.08.2016

Male, 72y

Referral OSH for symptomatic 7cm AAA

AAA known 2y under US-FU

Left sided abdominal pain for 2d

Art hypertension, non-smoker

AAA 5.2 cm, left CIA 2.6cm, right CIA 2.2cm,

Right HA 4.3cm, left HA 4.8cm,

Page 4: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

CT 16.08.2016

Page 5: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

CT 16.08.2016

Page 6: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 7: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

OP 26.08.2016

Staged plan:

1. EVAR, coiling inf. gluteal a.,

IBD left to sup. gluteal a.,

Landing r. CIA 2x24mm ZSLE

2. coiling sup. gluteal a.,

IBD right to inf. gluteal a.

Page 8: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

OP 26.08.2016

Page 9: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 10: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 11: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 12: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 13: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 14: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 15: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 16: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 17: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 18: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 19: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 20: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Graft-edge Renu

Page 21: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 22: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 23: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 24: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 25: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 26: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 27: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 28: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 29: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 30: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 31: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 32: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Postop

OR time 8:10 h

Fluoro-time 135min;

DAP 28929 cGy/cm2

116ml Visipaque 270

Postop course unremarkable

2d IMC

Abdominal pain relieved

Crea 1.0 mg/dl

Page 33: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Postop CT 31.08.2017

Page 34: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Postop CT 31.08.2017

Page 35: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Open repair 05.09.2016

Exclusion right HA-aneurysm

Retroperitoneal access

CIA to gluteal bifurcation with

6mm Dacron-graft

EIA side-arm with 6mm

Dacron-graft

Page 36: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

CT 13.09.2016

Page 37: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

CT 13.09.2016

Page 38: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Discharge 14.09.2016

No claudication

Crea 1.3 mg/dl

Page 39: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

FU 05.10.2016

Ambulatory pain both hips from 80m

Hometrainer 20min without pain

BP stabile

ABP Index bil.>1

CTA planned April 2017

Page 40: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,
Page 41: Friday Afternoon EVAR · 25.08.2016 Male, 72y Referral OSH for symptomatic 7cm AAA AAA known 2y under US-FU Left sided abdominal pain for 2d Art hypertension, non-smoker AAA 5.2 cm,

Tilo Kölbel

German Aortic Center

Dpt. of Vascular Medicine

University Heart Center Hamburg

Friday Afternoon EVAR


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