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https://www.readbyqxmd.com/read/29778610/a-decade-of-tevar-in-new-york-state-volumes-outcomes-and-implications-for-the-dissemination-of-endovascular-technology
#1
Jordan R Stern, Tianyi Sun, Jialin Mao, Art Sedrakyan, Andrew J Meltzer
INTRODUCTION: /Objectives: The purpose of this study was to characterize utilization and outcomes of TEVAR in New York State during the first decade of commercial availability, with respect to evolving indications, results, and costs. Of specific interest was evaluation of the volume-outcome relationship for this relatively uncommon procedure. METHODS: The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried to identify patients undergoing TEVAR from 2005-2014 for aortic dissection (AD), non-ruptured aneurysm (NRA), and ruptured aneurysm (RA)...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778597/microsurgical-clipping-of-ruptured-anterosuperior-projecting-anterior-communicating-artery-aneurysms-how-i-do-it
#2
Feng Xu, Nicholas C Bambakidis
In anterosuperior-projecting anterior communicating artery (ACoA) aneurysms, the aneurysm dome usually adheres to one or both proximal A2 segment, which may present technical difficulties. This video demonstrates microsurgical clipping of a ruptured anterosuperior-projecting AComA aneurysm. A 52-year-old male presented with a Hunt-Hess grade II subarachnoid hemorrhage (SAH). Computed tomography showed SAH in the basal cisterns, sylvian and interhemispheric fissures. Angiography demonstrated a wide-necked AComA aneurysm projecting anterosuperiorly...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29777291/growth-of-asymptomatic-intracranial-fusiform-aneurysms-incidence-and-risk-factors
#3
Jusun Moon, Young Dae Cho, Dong Hyun Yoo, Jeongjun Lee, Hyun-Seung Kang, Won-Sang Cho, Jeong Eun Kim, Li Zhang, Moon Hee Han
PURPOSE: Growth of intracranial fusiform aneurysms (IFA) may become clinically problematic through a mass effect or rupture. We investigated the growth rate and factors contributing to growth in asymptomatic untreated IFA. METHOD: As a retrospective review, we assessed patients diagnosed with asymptomatic IFA between August 2000 and September 2014, all untreated. No acute or symptomatic dissecting lesions were considered. Clinical and serial angiographic follow-up data were analyzed, defining growth as expansion > 2 mm in one or more dimensions...
May 18, 2018: Clinical Neuroradiology
https://www.readbyqxmd.com/read/29775770/treatment-of-ruptured-vertebral-artery-dissection-and-abdominal-hemorrhage-associated-with-segmental-arterial-mediolysis-using-endovascular-coil-embolization-va-dissection-associated-with-sam
#4
Taiki Isaji, Tomotaka Ohshima, Sigeru Miyachi, Naoki Matsuo, Reo Kawaguchi, Masakazu Takayasu
BACKGROUND: Segmental arterial mediolysis is a rare disease characterized by idiopathic noninflammatory vasculopathy involving small to medium arteries. Here, we report a case of ruptured cerebral and abdominal aneurysms, which were successfully treated using emergency endovascular coil embolization. CASE DESCRIPTION: A 45-year-old male suffered subarachnoid hemorrhage caused by the rupture of the right vertebral artery dissecting aneurysm, which was treated using emergency endovascular coiling...
May 15, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29770795/cytokines-as-biomarkers-of-inflammatory-response-after-open-versus-endovascular-repair-of-abdominal-aortic-aneurysms-a-systematic-review
#5
REVIEW
Diamantis I Tsilimigras, Fragiska Sigala, Georgios Karaolanis, Ioannis Ntanasis-Stathopoulos, Eleftherios Spartalis, Michael Spartalis, Nikolaos Patelis, Alexandros Papalampros, Chandler Long, Demetrios Moris
The repair of an abdominal aortic aneurysm (AAA) is a high-risk surgical procedure related to hormonal and metabolic stress-related response with an ensuing activation of the inflammatory cascade. In contrast to open repair (OR), endovascular aortic aneurysm repair (EVAR) seems to decrease the postoperative stress by offering less extensive incisions, dissection, and tissue manipulation. However, these beneficial effects may be offset by the release of cytokines and arachidonic acid metabolites during intra-luminal manipulation of the thrombus using catheters in endovascular repair, resulting in systemic inflammatory response (SIR), which is clinically called post-implantation syndrome...
May 17, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29768367/the-phenotypic-heterogeneity-of-patients-with-marfan-related-disorders-and-their-variant-spectrums
#6
Go Hun Seo, Yoon-Myung Kim, Eungu Kang, Gu-Hwan Kim, Eul-Ju Seo, Beom Hee Lee, Jin-Ho Choi, Han-Wook Yoo
Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS) are the connective tissue disorders characterized by aortic root aneurysm and/or dissection and various additional features. We evaluated the correlation of these mutations with the phenotypes and determined the clinical applicability of the revised Ghent criteria.The mutation spectrum and phenotypic heterogeneities of the 83 and 5 Korean patients with suspected MFS and LDS were investigated as a retrospective manner. In patients with suspected MFS patients, genetic testing was conducted in half of 44 patients who met the revised Ghent criteria clinically and half of 39 patients who did not meet these criteria...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29766010/single-stage-endovascular-treatment-of-a-penetrating-aortic-ulcer-with-a-concomitant-isolated-iliac-aneurysm
#7
Haidi Hu, Jianming Guo, Hualong Bai, Alan Dardik
Penetrating aortic ulcer (PAU) is an acute aortic syndrome that can proceed to life-threatening aortic dissection or even aortic rupture. Isolated iliac aneurysms are relatively rare and often asymptomatic due to their deep pelvic location but are frequently associated with high mortality with rupture. We report a case of a 68-year-old man with a symptomatic penetrating ulcer in the descending aorta and an asymptomatic right iliac aneurysm involving the common and internal iliac arteries. The patient was successfully treated by endovascular repair in a single-stage manner using stent grafts in the descending aorta and right common iliac artery after coil embolization of the right internal iliac artery...
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29765495/effect-of-the-antioxidant-lipoic-acid-in-aortic-phenotype-in-a-marfan-syndrome-mouse-model
#8
Maria C Guido, Victor Debbas, Vera M Salemi, Elaine R Tavares, Thayna Meirelles, Thaís L S Araujo, Patricia Nolasco, Julio C A Ferreira-Filho, Celso K Takimura, Lygia V Pereira, Francisco R Laurindo
Marfan syndrome (MFS) cardiovascular manifestations such as aortic aneurysms and cardiomyopathy carry substantial morbidity/mortality. We investigated the effects of lipoic acid, an antioxidant, on ROS production and aortic remodeling in a MFS mgΔloxPneo mouse model. MFS and WT (wild-type) 1-month-old mice were allocated to 3 groups: untreated, treated with losartan, and treated with lipoic acid. At 6 months old, echocardiography, ROS production, and morphological analysis of aortas were performed. Aortic ROS generation in 6-month-old MFS animals was higher at advanced stages of disease in MFS...
2018: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/29758373/ruptured-vertebral-artery-dissecting-aneurysm-as-a-risk-factor-for-ocular-symptoms-accompanied-with-subarachnoid-hemorrhage
#9
Yosuke Moteki, Yasunari Niimi, Yoshikazu Okada, Takakazu Kawamata
OBJECTIVE: Although ruptured vertebral artery dissecting aneurysms (VADAs) are often associated with ocular symptoms, such as abducent nerve palsy and Terson's syndrome (TS), their frequency and risk factors in comparison with those associated with ruptured aneurysms in other locations have not been reported. METHODS: A total of 343 patients with non-traumatic subarachnoid hemorrhage were treated in our hospital from April 2002 to May 2016, among which 35 (10.2%) had VADA as the origin of hemorrhage...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29755088/-hybrid-repair-of-distal-arch-aortic-aneurysm-total-aortic-arch-repair-with-the-lupiae-vascular-graft-and-thoracic-endovascular-aortic-repair-report-of-two-cases
#10
Nobu Yokoyama, Daigo Shinoda, Mitsunori Nakano, Manabu Shiraishi, Satoshi Itoh
Surgical treatment for distal arch aortic aneurysm is generally invasive, and there is no definitive approach for it. We report 2 cases of men who was admitted for the treatment of aortic aneurysm. First case is a 78-year-old man. Two saccular aneurysm were observed on distal aortic arch and descending aorta by contrast-enhanced computed tomography. Two staged-repair was performed with using the Lupiae vascular graft and thoracic endovascular aortic repair(TEVAR). The postoperative course was uneventful, and he was discharged on day 21 after 1st operation...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755087/-successful-echo-guided-deployment-of-stent-graft-for-intraoperative-retrograde-aortic-dissection-and-rupture-report-of-a-case
#11
Naoki Kanemitsu, Takehiko Matsuo, Hiroaki Osada, Kazuo Yamanaka, Junichi Tazaki
We report a case of chronic dissecting thoracoabdominal aneurysm with intraoperative retrograde aortic dissection and rupture at proximal descending aorta, which was successfully treated by echoguided stent-graft insertion. An 82-year old male underwent thoracoabdominal aortic replacement for dilatation of infra-diaphragmatic aorta. Under F-F bypass, his thoracoabdominal aorta was replaced by a Dacron graft with 4-branches. After he weaned from F-F bypass, we found massive bleeding from proximal descending aorta...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755086/-total-arch-replacement-with-concomitant-thoracic-endovascular-aortic-repair-via-the-ascending-aorta-for-extended-thoracic-aneurysm-report-of-a-case
#12
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29753564/left-atrium-and-pulmonary-artery-compression-due-to-aortic-aneurysm-causing-heart-failure-symptoms
#13
Antonio José Lagoeiro Jorge, Wolney de Andrade Martins, Victor M Moutinho, Juliano M Rezende, Patricia Y Alves, Humberto Villacorta, Pedro F Silveira, Antonio A Couto
Patients with thoracic aortic aneurysm (TAA) are mostly asymptomatic and TAA is rarely related to heart failure (HF). We report the case of an 80-year-old female patient, with type A TAA without dissection, with right pulmonary artery and left atrium compression, who presented with HF, preserved ejection fraction and acute pulmonary edema.
May 9, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29751186/delayed-establishment-of-collateral-circulation-from-the-posterior-meningeal-artery-after-proximal-occlusion-of-the-posterior-inferior-cerebellar-artery-case-report-and-literature-review
#14
Kun Hou, Yunbao Guo, Baofeng Xu, Kan Xu, Jinlu Yu
BACKGROUND: Dissecting aneurysm on the posterior inferior cerebellar artery (PICA) is a very rare entity, endovascular embolization is often adopted. During procedure, if the parent artery is occluded, the distal PICA is usually supplied by the ipsilateral anterior inferior artery or the contralateral PICA. In extremely rare circumstances, the distal PICA can establish collateral circulation by transdural anastomosis with the posterior meningeal artery (PMA). CASE DESCRIPTION: A 29-year-old woman was admitted complaining of thunderclap headache, nausea, and vomiting for 3 hours...
May 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29749581/preconception-counseling-for-patients-with-thoracic-aortic-aneurysms
#15
REVIEW
Prashant Rao, Eric M Isselbacher
PURPOSE OF THE REVIEW: Acute aortic dissection is a potentially catastrophic cardiovascular emergency that is associated with a high mortality rate. Pregnancy, with its attendant hormonal and physiological changes, increases the risk of dissection in women with known thoracic aortic aneurysms. In this review, we highlight the importance of preconception counseling to help women with known thoracic aortic aneurysms better understand their risk of dissection and the heritable nature of thoracic aortic disease and its associated syndromes...
May 10, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29748101/results-from-the-study-to-assess-outcomes-after-endovascular-repair-for-multiple-thoracic-aortic-diseases-summit
#16
Nikolaos Tsilimparis, Sebastian Debus, Min Chen, Qing Zhou, Mary-Margaret Seale, Tilo Kölbel
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) is currently the treatment of choice for most diseases of the descending thoracic aorta. Using data from the Study to Assess Outcomes After Endovascular Repair for Multiple Thoracic Aortic Diseases (SUMMIT) study we investigated the outcomes of TEVAR for different aortic diseases and risk factors associated with the outcomes. METHODS: The SUMMIT study included aggregated data of 521 TEVAR patients from five Cook-sponsored multicenter trials evaluating thoracic endografts of the Zenith platform (William Cook Europe, ApS, Bjaeverskov, Denmark)...
May 7, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29747323/-efficacy-of-bare-metal-stent-for-treating-focal-coronary-artery-aneurysm-complicating-with-severe-stenosis-in-single-coronary-artery
#17
S B Qiao, J Li, J G Cui, J S Yuan, S W Liu, J Zhao, F H Hu, W X Yang, H B Liu, Z W Sun, R L Gao
Objective: To investigate the efficacy of bare metal stent for treating focal coronary artery aneurysm complicating with severe stenosisin single coronary artery. Methods: This retrospective analysis was performed in 7 patients who were diagnosed as local coronary artery aneurysm complicating with severe stenosis(≥70%) in single coronary artery and treated with bare metal stent during the period from December 2012 to June 2015 in Fuwai Hospital. All 7 patients were male with age of (62±11) years old. During the interventional operation, the narrow parts were pre-expanded,and all patients received bare metal stents implantation to cover aneurysms...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29741225/prediction-of-vascular-abnormalities-on-ct-angiography-in-patients-with-acute-headache
#18
Imanda M E Alons, Ben F J Goudsmit, Korné Jellema, Marianne A A van Walderveen, Marieke J H Wermer, Ale Algra
OBJECTIVES: Patients with acute headache increasingly undergo CT-angiography (CTA) to evaluate underlying vascular causes. The aim of this study is to determine clinical and non-contrast CT (NCCT) criteria to select patients who might benefit from CTA. METHODS: We retrospectively included patients with acute headache who presented to the emergency department of an academic medical center and large regional teaching hospital and underwent NCCT and CTA. We identified factors that increased the probability of finding a vascular abnormality on CTA, performed multivariable regression analyses and determined discrimination with the c-statistic...
May 9, 2018: Brain and Behavior
https://www.readbyqxmd.com/read/29733918/complication-rate-of-intraarterial-treatment-of-severe-cerebral-vasospasm-after-subarachnoid-hemorrhage-with-nimodipine-and-percutaneous-transluminal-balloon-angioplasty-worth-the-risk
#19
Daniela Adami, Joachim Berkefeld, Johannes Platz, Jürgen Konczalla, Waltraud Pfeilschifter, Stefan Weidauer, Marlies Wagner
BACKGROUND AND PURPOSE: Delayed cerebral ischemia (DCI) is a complication of aneurysmal subarachnoid hemorrhage (SAH). Arterial cerebral vasospasm (CVS) is discussed as the main pathomechanism for DCI. Due to positive effects of per os nimodipine, intraarterial nimodipine application is used in patients with DCI. Further, percutaneous transluminal balloon angioplasty (PTA) is applied in focal high-grade spasm of intracranial arteries. However, clinical benefits of those techniques are unconfirmed in randomized trials so far, and complications might occur...
May 4, 2018: Journal of Neuroradiology. Journal de Neuroradiologie
https://www.readbyqxmd.com/read/29730347/extra-anatomic-bypass-of-a-complex-adult-coarctation-how-i-do-it
#20
EDITORIAL
Eric N Feins, Arminder S Jassar, Luis F Tapias, Eric M Isselbacher, Thoralf M Sundt
Complex adult coarctations associated with arch hypoplasia and aneurysms require a range of surgical approaches depending upon anatomy. Extra-anatomic bypass is an important strategy that enables the surgeon to avoid the risks of extensive dissection/mobilization. Extra-anatomic bypass can be accomplished from the ascending to lower descending thoracic aorta via an intra-pericardial route lateral to the right atrium and posterior to the IVC; however, this approach incompletely addresses post-stenotic aneurysmal disease...
May 3, 2018: Annals of Thoracic Surgery
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