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https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#1
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28428522/-surgeon-modified-fenestrated-thoracic-endovascular-aortic-repair-for-the-treatment-of-aortic-aneurysm
#2
Kenichi Hashizume, Hideyuki Shimizu
Thoracic endovascular aortic repair( TEVAR) for thoracic aortic aneurysm has been established as a 1st-line therapy, especially in high-risk cases, with device improvements and the appearance of various procedures, but there are still cases of anatomical adaptation. On the other hand, several countermeasures have been developed, but there are no commercially available devices for fenestrated or branched stent grafts in Japan. Moreover, complications such as cerebral infarction, organ ischemia and bypass occlusion and infection are pointed out in popular debranch TEVAR...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28427320/the-role-of-inelastic-deformations-in-the-mechanical-response-of-endovascular-shape-memory-alloy-devices
#3
Lorenza Petrini, Alessandro Bertini, Francesca Berti, Giancarlo Pennati, Francesco Migliavacca
Nickel-titanium alloys are commonly adopted for producing cardiovascular minimally invasive devices such as self-expandable stents, aortic valves and stent-grafts. These devices are subjected to cyclic loads (due to blood pulsatility, leg or heart movements), that can induce fatigue fracture, and may also be subjected to very large deformations (due to crimping procedure, a tortuous physiological path or overloads), that can induce material yield. Recently, the authors developed a new constitutive model that considers inelastic strains due to not-completed reverse phase transformation (not all the stress-induced martensite turns back to austenite) or/and plasticity and their accumulation during cyclic loads...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28424038/a-novel-method-for-the-treatment-of-bilateral-hypogastric-aneurysms-using-hybrid-polytetrafluoroethylene-graft
#4
Sam Tyagi, D Pineda, H Zheng, M Dougherty, K Calligaro, D Troutman
Open aortic aneurysm repair in the setting of bilateral hypogastric aneurysms is technically challenging. We present a novel technique for open surgical repair for bilateral hypogastric aneurysms using the Gore hybrid vascular graft (GVHG; W. L. Gore and Associates Inc, Flagstaff, Arizona). The GVHG is an expanded polytetrafluoroethylene graft with a nitinol stent at 1 end designed for hemodialysis access. The GVHG has been also been used for aortic debranching and treatment of occlusive disease. We describe the first report using GVHG to repair hypogastric aneurysms...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28424037/aortic-customized-stent-graft-treatment-of-postnephrectomy-renal-pedicle-arteriovenous-fistula
#5
Francisco Manresa-Manresa, José María Sánchez-Rodríguez, Verónica Nacarino-Mejías, Javier Peiró de Las Heras, Juan Francisco Ponce-González
A postnephrectomy renal acquired arteriovenous fistula (AVF) is a rare clinical entity that may cause high-output heart failure. Most of the cases are identified time along after surgery. We present a case of a postnephrectomy renal AVF treated with aortic customized stent-graft.
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28412039/distal-left-main-trifurcation-disease-in-a-patient-with-porcelain-aorta
#6
Ulises Lopez-Peña, Francisco Garcia-Garcia, Rogelio Robledo-Nolasco, Ernesto Fernandez-Ceseña, Ricardo Borrego-Montoya, Neisser Morales
Coronary trifurcation lesions are a complex subset of lesions and are substantially more complex than bifurcations when treated with percutaneous coronary intervention (PCI) because of higher rates of acute periprocedural complications (dissection, myocardial infarction, acute vessel closure) and less effective long-term outcomes (stent thrombosis, restenosis) as compared to non-bifurcation lesions. We present the case of a 73-year-old man who was admitted to our hospital with symptomatic severe aortic stenosis who was found to have a distal left main trifurcation disease as well as porcelain aorta on work-up...
March 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#7
Jeremy L Irvan, James R Elmore, Sarah L Flora, Evan J Ryer
BACKGROUND: Emergency treatment of complex aortic pathology is challenging in the setting of a right-sided aortic arch. We report the successful treatment of a ruptured thoracic aortic aneurysm (TAA) in the setting of a Stanford type B aortic dissection (TBAD) and right-sided aortic arch. PRESENTATION OF CASE: The patient is a 66-year-old male with chronic kidney disease (CKD) admitted with right sided chest pain and hypotension. Computed tomography angiography (CTA) revealed a 5cm ruptured TAA in the setting of a TBAD and right-sided aortic arch...
March 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28410923/infrarenal-endograft-clamping-in-late-open-conversions-after-endovascular-abdominal-aneurysm-repair
#8
Paolo Perini, Alessandro de Troia, Tiziano Tecchio, Matteo Azzarone, Claudio Bianchini Massoni, Pierfranco Salcuni, Antonio Freyrie
OBJECTIVE: The aim of this study was to report the technical aspects and outcomes of late open conversion (LOC) after endovascular aneurysm repair (EVAR) in a single center by using exclusively infrarenal clamping of the endograft as an alternative to suprarenal or supraceliac aortic clamping. METHODS: A retrospective analysis of EVAR requiring late explantation (>30 days) from January 1996 to October 2016 was performed. Patients' demographics, type of endograft, duration of implantation, reason for removal, extent of stent graft removal, type of reconstruction, 30-day mortality, postoperative complications, and long-term survival were obtained for analysis...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28410636/stent-and-leaflet-stresses-in-29-mm-second-generation-balloon-expandable-transcatheter-aortic-valve
#9
Yue Xuan, Kapil Krishnan, Jian Ye, Danny Dvir, Julius M Guccione, Liang Ge, Elaine E Tseng
BACKGROUND: Equipoise of transcatheter aortic valve replacement with surgical aortic valve replacement in intermediate-risk patients has been demonstrated. As transcatheter aortic valve replacement usage expands, questions regarding long-term durability become paramount. Valve design impacts durability with regions of increased leaflet stress being vulnerable to early failure. However, transcatheter aortic valve (TAV) leaflet stresses are unknown. The objective of this study was to determine stent and leaflet stresses of second-generation balloon-expandable TAV...
April 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28408933/endovascular-stent-grafting-for-aortic-arch-aneurysm-in-aortoiliac-occlusive-disease-following-aortic-arch-debranching-and-aortobifemoral-reconstruction
#10
Didem Melis Oztas, Cagla Canbay, Yilmaz Onal, Metin Onur Beyaz, Omer Ali Sayin, Mehmet Barburoglu, Mehmet Buget, Mesut Yornuk, Aziz Ari, Murat Ugurlucan, Bulent Acunas, Ufuk Alpagut, Enver Dayioglu
Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28405206/aortic-stenting-for-neonatal-coarctation-of-the-aorta-when-should-this-be-considered
#11
J Bugeja, D Cutajar, C Zahra, R Parascandalo, V Grech, J V DeGiovanni
No abstract text is available yet for this article.
July 2016: Images in Paediatric Cardiology
https://www.readbyqxmd.com/read/28401533/long-term-follow-up-of-fenestrated-endovascular-repair-for-juxtarenal-aortic-aneurysm
#12
I N Roy, A M Millen, S M Jones, S R Vallabhaneni, J R H Scurr, R G McWilliams, J A Brennan, R K Fisher
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) is increasingly being used for juxtarenal aortic aneurysms. The aim of this study was to review long-term results and assess the importance of changing stent-graft design on outcomes. METHODS: This was a retrospective review of all patients who underwent FEVAR within a single unit over 12 years (February 2003 to December 2015). Kaplan-Meier analysis of survival, and freedom from target vessel loss, aneurysm expansion, graft-related endoleak and secondary intervention was performed...
April 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28401193/intravascular-treatment-of-left-subclavian-artery-aneurysm-coexisting-with-aortic-coarctation-in-an-adult-patient
#13
Ryszard Pogorzelski, Tomasz Wołoszko, Sadegh Toutounchi, Patryk Fiszer, Ewa Krajewska, Wawrzyniec Jakuczun, Małgorzata M Szostek, Krzysztof Celejewski, Zbigniew Gałązka
Coexistence of aortic coarctation with aneurysm of subclavian artery is a uncommon situation and may require unusual treatment in patients. A 40-year-old patient diagnosed incidentally with left subclavian artery aneurysm coexisting with aortic coarctation. Patient was initially referred for hybrid treatment. Initially ostium of the left subclavian artery was covered with a stent-graft. Over a 30-month follow-up period aneurysm became thrombosed all the way up to the ostium of internal mammary artery. The patient did not present with neurological symptoms or signs of upper limb ischemia...
January 2017: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/28400487/vascular-anatomy-predicts-the-risk-of-cerebral-ischemia-in-patients-randomized-to-carotid-stenting-versus-endarterectomy
#14
Mandy D Müller, Frank J Ahlhelm, Alexander von Hessling, David Doig, Paul J Nederkoorn, Sumaira Macdonald, Philippe A Lyrer, Aad van der Lugt, Jeroen Hendrikse, Christoph Stippich, H Bart van der Worp, Toby Richards, Martin M Brown, Stefan T Engelter, Leo H Bonati
BACKGROUND AND PURPOSE: Complex vascular anatomy might increase the risk of procedural stroke during carotid artery stenting (CAS). Randomized controlled trial evidence that vascular anatomy should inform the choice between CAS and carotid endarterectomy (CEA) has been lacking. METHODS: One-hundred eighty-four patients with symptomatic internal carotid artery stenosis who were randomly assigned to CAS or CEA in the ICSS (International Carotid Stenting Study) underwent magnetic resonance (n=126) or computed tomographic angiography (n=58) at baseline and brain magnetic resonance imaging before and after treatment...
April 11, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28397722/long-term-outcomes-of-primary-percutaneous-coronary-intervention-with-second-generation-drug-eluting-stents-in-st-elevation-myocardial-infarction-patients-caused-by-very-late-stent-thrombosis
#15
Chen He, Yuan-Liang Ma, Chuang-Shi Wang, Lin Jiang, Jia-Hui Zhang, Yi Yao, Xiao-Fang Tang, Bo Xu, Run-Lin Gao, Jin-Qing Yuan
BACKGROUND: The ST-segment elevation myocardial infarction (STEMI) patients due to stent thrombosis (ST) remain a therapeutic challenge for a clinician. Till date, very few researches have been conducted regarding the safety and effectiveness of primary percutaneous coronary intervention (PCI) with second-generation drug-eluting stents (DES) for STEMI caused by very late ST (VLST). This retrospective study evaluated the safety, efficacy, and outcomes of primary PCI with second-generation DES for STEMI due to VLST compared with primary PCI for STEMI due to de novo lesion...
April 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28396934/clinical-impact-of-stent-implantation-for-coarctation-of-the-aorta-with-associated-hypoplasia-of-the-transverse-aortic-arch
#16
W H Lu, Chun-Po Steve Fan, Rajiv Chaturvedi, Kyong-Jin Lee, Cedric Manlhiot, Lee Benson
The aim of this study was to explore the clinical impact of transverse aortic arch hypoplasia (TAH) after stent implementation for isthmal coarctation of the aorta (CoA). From a retrospective chart review, 51 children (median age 11.1 years) were identified who had TAH and a CoA stent implanted between 10/1995 and 4/2015. Arm-leg cuff blood pressure measurements, echocardiographic arch imaging, and 24-h ambulatory blood pressure monitoring, prior to and after stent implantation, were reviewed. At catheterization, peak systolic gradients across the CoA's were 25 mmHg before and 4 mmHg after stent implantation...
April 10, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28395872/outcomes-of-antegrade-stent-graft-deployment-during-hybrid-aortic-arch-repair
#17
Seyed Hossein Aalaei-Andabili, Salvatore Scali, Charles Klodell, Teng Lee, Philip Hess, Tomas Martin, Adam Beck, Robert Feezor, Mahmoud Alhussaini, George Arnaoutakis, Thomas Beaver
BACKGROUND: Complex aortic arch disease can be a formidable challenge and is often treated with a two-stage elephant trunk technique. We examined our experience with hybrid arch repair with combined zone 0 stent graft deployment. METHODS: A retrospective review was conducted of all patients who underwent type 2 hybrid arch replacement and zone 0 antegrade endovascular stent graft deployments at a single university center from June 2010 to August 2015. RESULTS: The review included 48 patients, 25 (52%) elective and 23 (48%) nonelective, with a mean ± SD age of 64 ± 11 years...
April 7, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28395657/avoidable-costs-of-stenting-for-aortic-coarctation-in-the-united-kingdom-an-economic-model
#18
Maximilian Salcher, Alistair Mcguire, Vivek Muthurangu, Marcus Kelm, Titus Kuehne, Huseyin Naci
BACKGROUND: Undesirable outcomes in health care are associated with patient harm and substantial excess costs. Coarctation of the aorta (CoA), one of the most common congenital heart diseases, can be repaired with stenting but requires monitoring and subsequent interventions to detect and treat disease recurrence and aortic wall injuries. Avoidable costs associated with stenting in patients with CoA are unknown. METHODS: We developed an economic model to calculate potentially avoidable costs in stenting treatment of CoA in the United Kingdom over 5 years...
April 10, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28390920/systematic-review-of-results-of-kissing-stents-in-the-treatment-of-aortoiliac-occlusive-disease
#19
REVIEW
Erik Groot Jebbink, Suzanne Holewijn, Cornelis H Slump, Jan-Willem Lardenoije, Michel M P J Reijnen
OBJECTIVES: The goal of this review is to give an overview of current results and role of the kissing stent (KS) technique in AIOD treatment. BACKGROUND: Endovascular treatment of aortoiliac occlusive disease (AIOD) involving the aortic bifurcation is challenging. The gold standard is open surgery with patency rates up to 90% at 5 years, but has considerable morbidity and mortality. The KS technique was introduced as an alternative. METHODS: The Cochrane guidelines were used to assure a systematic method...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390918/dynamic-geometric-analysis-of-the-renal-arteries-and-aorta-following-complex-endovascular-aneurysm-repair
#20
Brant W Ullery, Ga-Young Suh, John J Kim, Jason T Lee, Ronald L Dalman, Christopher P Cheng
INTRODUCTION: Aneurysm regression and target vessel patency during early and mid-term follow-up may be related to the effect of stent graft configuration on the anatomy. We quantified geometry and remodeling of the renal arteries and aneurysm following fenestrated (F-) or snorkel/chimney (Sn-) endovascular aneurysm repair (EVAR). METHODS: 29 patients (mean age, 76.8±7.8 years) treated with F- or Sn-EVAR underwent computed tomography angiography at pre-op, post-op, and follow-up...
April 5, 2017: Annals of Vascular Surgery
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