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Aortic arch branches

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https://www.readbyqxmd.com/read/27890843/total-endovascular-aortic-repair-in-a-patient-with-marfan-syndrome
#1
Mau Amako, Rafaëlle Spear, Rachel E Clough, Adrien Hertault, Richard Azzaoui, Teresa Martin Gonzalez, Jonathan Sobocinski, Stéphan Haulon
OBJECTIVE: To describe a total endovascular aortic repair with branched and fenestrated endografts in a young patient with Marfan syndrome and a chronic aortic dissection. Open surgery is the gold standard to treat aortic dissections in patients with aortic disease and Marfan syndrome. METHODS: In 2000, a 38-year-old man with Marfan syndrome underwent open ascending aorta repair for an acute type A aortic dissection. One year later, a redo sternotomy was performed for aortic valve replacement...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27885195/evaluation-and-influence-of-brachiocephalic-branch-re-entry-in-patients-with-type-a-acute-aortic-dissection
#2
Shota Yasuda, Kiyotaka Imoto, Keiji Uchida, Norihisa Karube, Tomoyuki Minami, Motohiko Goda, Shinichi Suzuki, Munetaka Masuda
BACKGROUND: Stanford type A acute aortic dissection (A-AAD) extends to the brachiocephalic branches in some patients. After ascending aortic replacement, a remaining re-entry tear in the distal brachiocephalic branches may act as an entry and result in a patent false lumen in the aortic arch. However, the effect of brachiocephalic branch re-entry concomitant with A-AAD remains unknown.Methods and Results:Eighty-five patients with A-AAD who underwent ascending aortic replacement in which both preoperative and postoperative multiple-detector computed tomography (MDCT) scans could be evaluated were retrospectively studied...
November 22, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27881689/acute-type-a-aortic-dissection-treated-using-a-tubular-stent-graft-in-the-ascending-aorta-and-a-multibranched-stent-graft-in-the-aortic-arch
#3
Tilo Kölbel, Christian Detter, Sebastian W Carpenter, Fiona Rohlffs, Yskert von Kodolitsch, Sabine Wipper, Herrmann Reichenspurner, E Sebastian Debus, Nikolaos Tsilimparis
PURPOSE: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. TECHNIQUE: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients...
November 23, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27863740/understanding-the-fluid-mechanics-behind-transverse-wall-shear-stress
#4
Yumnah Mohamied, Spencer J Sherwin, Peter D Weinberg
The patchy distribution of atherosclerosis within arteries is widely attributed to local variation in haemodynamic wall shear stress (WSS). A recently-introduced metric, the transverse wall shear stress (transWSS), which is the average over the cardiac cycle of WSS components perpendicular to the temporal mean WSS vector, correlates particularly well with the pattern of lesions around aortic branch ostia. Here we use numerical methods to investigate the nature of the arterial flows captured by transWSS and the sensitivity of transWSS to inflow waveform and aortic geometry...
November 11, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27860551/congenital-variants-and-anomalies-of-the-aortic-arch
#5
Kate Hanneman, Beverley Newman, Frandics Chan
Congenital variants and anomalies of the aortic arch are important to recognize as they may be associated with vascular rings, congenital heart disease, and chromosomal abnormalities, and can have important implications for prognosis and management. The purpose of this article is to review cross-sectional imaging techniques used in the evaluation of the aortic arch, describe the embryology and anatomy of the aortic arch system, discuss aortic arch variants and anomalies, and review other malformations of the aortic arch, including interrupted aortic arch, hypoplastic aortic arch, and aortic coarctation...
November 18, 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/27847062/preemptive-aneurysm-sac-embolization-for-thoracic-endovascular-aortic-repair-with-inadequate-proximal-landing-zone
#6
Jacky Y K Ho, Randolph H L Wong, Simon C Y Chow, Peter S Y Yu, Micky W T Kwok, Malcolm J Underwood, Simon C H Yu
Thoracic endovascular aortic repair (TEVAR) offers a less invasive treatment for aortic arch aneurysms. Clinical challenges arise when there is inadequate proximal landing for zone 1 TEVAR, such that a median sternotomy with total aortic debranching is required before stent deployment. The chimney technique was reported as an alternative approach to stent the arch branches and avoid sternotomy, but it was still associated with considerable chance of a type IA endoleak. We report a case of aortic arch aneurysm with an inadequate proximal landing for zone 1 TEVAR that was treated with debranching of head and neck vessels followed by TEVAR and preemptive and targeted coil embolization of the arch aneurysmal sac...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27843111/a-comprehensive-review-of-in-situ-fenestration-of-aortic-endografts
#7
REVIEW
M Glorion, R Coscas, R G McWilliams, I Javerliat, O Goëau-Brissonniere, M Coggia
OBJECTIVE: Despite technical advances of fenestrated and branched endografts, endovascular exclusion of aneurysms involving renal, visceral, and/or supra-aortic branches remains a challenge. In situ fenestration (ISF) of standard endografts represents another endovascular means to maintain perfusion to such branches. This study aimed to review current indications, technical descriptions, and results of ISF. METHOD: A review of the English language literature was performed in Medline databases, Cochrane Database, Web of Science, and Scopus using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines...
November 11, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27823595/status-of-branched-grafts-for-thoracic-aortic-arch-endovascular-repair
#8
REVIEW
W Anthony Lee
The aortic arch is one of the most anatomically complex segments of the thoracoabdominal aorta due the plurality of vital branch configurations, intrinsic and highly variable three-dimensional curvature, and involvement in a variety of thoracic aortic pathologies, such as aneurysmal degeneration, penetrating ulcer, and media wall dissection. Pathologies that extend the repair proximal to the left common carotid artery require more complex branch vessel management beyond a carotid-subclavian bypass. This article will review the current status of branched aortic arch endografts...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27818819/tortuous-common-carotid-artery-a-report-of-four-cases-observed-in-cadaveric-dissections
#9
Joe Iwanaga, Koichi Watanabe, Saga Tsuyoshi, Yoko Tabira, Koh-Ichi Yamaki
A tortuous common carotid artery poses a high risk of injury during tracheotomy. Preoperative diagnosis is therefore important to avoid serious complications. We found four cases of tortuous common carotid artery during an anatomical dissection course for students. The first case was a 91-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 2 was a 78-year-old woman who had bilateral tortuous common carotid arteries without arteriosclerosis. Case 3 was an 86-year-old woman who died from bladder cancer and who also had a right tortuous common carotid artery without arteriosclerosis...
2016: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/27798062/long-term-outcomes-of-complete-vascular-ring-division-in-children-a-36-year-experience-from-a-single-institution
#10
Phillip S Naimo, Tyson A Fricke, Julia S Donald, Elie Sawan, Yves d'Udekem, Christian P Brizard, Igor E Konstantinov
OBJECTIVES: Complete vascular rings are rare and cause tracheoesophageal compression. Following surgical division, some patients have persisting tracheomalacia. We aim to assess the long-term outcomes of complete vascular ring division. METHODS: All patients (n = 132) who underwent surgical division of a complete vascular ring between 1978 and 2014 were identified from the hospital database and retrospectively reviewed. RESULTS: Complete vascular rings consisted of a double aortic arch (n = 80), right aortic arch with an aberrant subclavian artery and left ligamentum arteriosum (n = 50), right aortic arch with mirror image branching and left ligamentum arteriosum (n = 1), and a left aortic arch with right descending aorta and right ligamentum arteriosum (n = 1)...
October 20, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27788849/outcomes-of-endovascular-repair-of-ascending-aortic-dissection-in-patients-unsuitable-for-direct-surgical-repair
#11
Zhenjiang Li, Qingsheng Lu, Rui Feng, Jian Zhou, Zhiqing Zhao, Junmin Bao, Xiang Feng, Jiaxuan Feng, Yifei Pei, Chao Song, Zaiping Jing
BACKGROUND: Stent grafting is a therapeutic option for patients who are unable to undergo urgent surgical repair of ascending aortic dissections. However, follow-up regarding outcomes is limited. OBJECTIVES: This study reports mid-term outcomes with endovascular repair for ascending aortic dissections in patients deemed high risk for open repair. METHODS: Between May 1, 2009 and January 31, 2011, 15 ascending aortic dissection patients (ages 45 to 78 years) ineligible for direct surgical repair underwent endovascular repair (1 acute dissection, 7 subacute dissections, and 7 chronic dissections) and were closely followed up for a median of 72 months (range 61 to 81 months)...
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27765887/total-aortic-arch-replacement-advantages-of-varied-techniques
#12
REVIEW
Ryan C Shelstad, Justin G Reeves, Katsuhiro Yamanaka, T Brett Reece
We review the operative techniques of aortic arch replacement. Aortic arch replacement presents several formidable challenges, as it requires arresting the circulation to the body and replacement of the brachiocephalic vessels with special consideration for protecting the central nervous system. Perfusion strategies, selective antegrade cerebral perfusion, and operative graft selection are key elements in aortic arch replacement surgery. Standard approaches include the island technique, the branched graft technique, and the "Spielvogel" trifurcated graft technique-each having its own advantages...
December 2016: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27760812/analysis-of-risk-factors-for-early-type-i-endoleaks-after-thoracic-endovascular-aneurysm-repair
#13
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27749814/three-dimensional-time-of-flight-magnetic-resonance-angiography-detection-of-duplication-of-the-vertebral-artery-in-a-large-chinese-population
#14
Shuhua Li, Yunyun Li, Min Bai, Chuanchen Zhang
BACKGROUND The aim of this study was to investigate duplication of the vertebral artery (VA) using three-dimensional time-of-flight (3D TOF) magnetic resonance angiography (MRA) in a large study population to further our understanding of vascular variations. MATERIAL AND METHODS A retrospective analysis of 3D TOF-MRA data in 12 826 cases was performed. The occurrence rate of VA duplication was calculated and accompanied vascular anomalies were recoded. RESULTS Twenty-one VA duplication patients were found, with an occurrence rate of 0...
October 17, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27717508/rare-anatomical-variation-of-the-brachiocephalic-trunk-encountered-in-tracheostomy
#15
Heike Huempfner-Hierl, Thomas Hierl, Dirk Halama
Tracheostomy is a common procedure in head and neck surgery and emergency medicine to secure a patent airway. Surgeons should always be aware of anatomical variants of the branches of the aortic arch, which could lead to life-threatening complications. Open tracheostomy is the safest emergency procedure.
October 4, 2016: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/27695185/origin-of-the-left-subclavian-artery-as-the-first-branch-and-origin-of-the-right-subclavian-artery-as-the-fourth-branch-of-the-aortic-arch-with-crisscrossing-posterior-to-the-common-carotid-arteries
#16
Junlin Zhang, Joseph M Guileyardo, William C Roberts
We describe an aortic arch anomaly consisting of the origin of the left subclavian artery as the fourth branch and the right subclavian artery as the first branch off the aortic arch with crisscrossing of these two arteries anterior to the trachea without clinical consequences. This anomaly, to our knowledge, has not been reported previously.
October 2016: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/27694357/understanding-the-hybrid-stage-i-approach-for-hypoplastic-left-heart-syndrome
#17
Sharon L Cheatham, Grace M Deyo
Hybrid stage I palliation combines cardiothoracic surgery and interventional transcatheter procedures for treatment of hypoplastic left heart syndrome. The approach is an alternative to the Norwood procedure, the traditional first stage of surgical palliation. Hybrid stage I palliation involves placing bilateral branch pulmonary artery bands and a patent ductus arteriosus stent through a median sternotomy, performed without cardiopulmonary bypass. The purpose of the bands is to control blood flow to the lungs and protect the pulmonary bed while the stent sustains systemic cardiac output...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27684852/preoperative-evaluation-value-of-aortic-arch-lesions-by-multidetector-computed-tomography-angiography-in-type-a-aortic-dissection
#18
Fang Huang, Qiang Chen, Qing-Quan Lai, Wen-Han Huang, Hong Wu, Wei-Cheng Li
The purpose of this study was to preoperatively evaluate the value of aortic arch lesions by multidetector computed tomography (MDCT) angiography in type A aortic dissection (AD).From January 2013 to December 2015, we enrolled 42 patients with type A AD who underwent MDCT angiography in our hospital. The institutional database of patients was retrospectively reviewed to identify MDCT angiography examinations for type A AD. Surgical corrections were conducted in all patients to confirm diagnostic accuracy.In this study, the diagnostic accuracy of MDCT angiography was 100% in all 42 patients...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27671450/repair-of-chronic-aneurysmal-aortic-dissection-using-a-stent-graft-and-an-amplatzer%C3%A2-vascular-plug-a-case-study
#19
Yuji Kanaoka, Takao Ohki, Hirotsugu Ozawa
We report a case in which a stent graft and an Amplatzer® vascular plug (AVP) were effective for the treatment of chronic aneurysmal aortic dissection. The patient was a 52-year-old man. At 45 years of age, he developed acute aortic dissection, for which he underwent surgery four times with prosthetic graft replacement in the abdominal aorta, descending thoracic, ascending aorta (without neck branch reconstruction), and thoracoabdominal aorta with the reconstruction of the celiac, superior mesenteric and bilateral renal arteries...
September 23, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27641096/diffuse-large-b-cell-lymphoma-in-a-prosthetic-aortic-graft
#20
David Bell, David Marshman
We describe the case of a 70-year-old man with Marfan Syndrome who was found to have Diffuse Large B Cell Lymphoma (DLBCL) within an ascending aortic graft, his native aortic arch and arch vessels. Ten years previously he had undergone a Bentall's Procedure for a dilated aortic root. He presented with a left middle cerebral artery stroke. Computed tomography (CT) scan revealed multiple filling defects within the aortic arch and branch vessels suggestive of thrombus. Following the stroke, his neurological deficit improved...
August 31, 2016: Heart, Lung & Circulation
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