title: Patient selection for endovascular sac sealing of abdominal aortic aneurysm.
abstract: Endovascular sealing is a developing technique for treatment of abdominal aortic aneurysm that draws on novel concepts utilizing polymer filling of endobags within the aorto-iliac lumen. The morphologic indications and patient selection, while similar to those of endovascular aneurysm repair, differ in some regards. The Instructions for Use for the Nellix sealing device may expand the indications for aneurysm treatment and are closely scrutinized in this article. The authors draw on current evidence and their own experience and opinion in the discussion around appropriate patient selection and its influence on outcomes after endovascular aneurysm sealing. A recommendation for stricter adherence to Instructions for Use in the early phase of clinical experience is made, with acknowledgement that the natural evolution of endovascular aneurysm sealing may involve more challenging cases.
authors.affiliation: Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Prescot Street, Liverpool L78XP, UK. Electronic address: robert.fisher@rlbuht.nhs.uk.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Fisher
authors.affiliation: Liverpool Vascular and Endovascular Service, Royal Liverpool University Hospital, Prescot Street, Liverpool L78XP, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Torella
authors.affiliation: Department of Radiography, University of Salford, Salford, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: England
authors.affiliation: Department of Radiology, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Richard G
authors.initials: RG
authors.lastname: McWilliams
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000592:standards; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality / Q000592:standards; D000072226:Computed Tomography Angiography; D057867:Endoleak / Q000209:etiology / Q000517:prevention & control; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality / Q000592:standards; D019983:Guideline Adherence; D006801:Humans; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011356:Product Labeling; D011474:Prosthesis Design; D012307:Risk Factors; D015607:Stents / Q000592:standards; D016896:Treatment Outcome