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Aortic arch branches

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https://www.readbyqxmd.com/read/28740679/three-dimensional-printing-guided-precise-surgery-for-right-sided-aortic-arch-associated-with-kommerell-s-diverticulum
#1
Nan Chen, Kai Zhu, Hongqiang Zhang, Xiaoning Sun, Chunsheng Wang
Right-sided aortic arch associated with Kommerell's diverticulum is a rare congenital defect of aorta with complexity. The challenging surgical treatment calls for a direct and entire visibility of aorta and its branches which can be provided by the three-dimensional (3D) printing technique. A 42-year-old man with right-sided aortic arch, Kommerell's diverticulum and an aberrant left subclavian artery underwent the surgery with the guiding assistance of 3D printed model. The satisfying outcome suggests the novel combination of 3D printing technique and surgical procedure a promising perspective on treating complex aortic defect...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28734626/staged-treatment-of-mega-aortic-syndrome-using-the-frozen-elephant-trunk-and-hybrid-thoracoabdominal-repair
#2
Asimakis Gkremoutis, Andreas Zierer, Thomas Schmitz-Rixen, Ali El-Sayed Ahmad, Erhard Kaiser, Michael Keese, Thomas Schmandra
OBJECTIVE: We report our experience with a staged hybrid approach for the treatment of extended aortic disease, also known as "mega aortic syndrome." METHODS: A total of 15 patients (10 male, 5 female) underwent staged repair of the thoracoabdominal aorta, consisting of 3 separate stages (repair of ascending aorta and aortic arch using the frozen elephant trunk technique and hybrid thoracoabdominal repair with debranching of the renovisceral branches and stent graft implantation)...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28709623/endovascular-treatment-of-aortic-arch-aneurysm-with-a-single-branched-double-stage-stent-graft
#3
Augusto D'Onofrio, Michele Antonello, Mario Lachat, David Planer, Andrea Manfrin, Andrea Bagno, David Pakeliani, Franco Grego, Gino Gerosa
No abstract text is available yet for this article.
July 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28705446/a-novel-sax-stent-method-in-treatment-of-ascending-aorta-and-aortic-arch-aneurysms-evaluated-by-finite-element-simulations
#4
M C Arokiaraj, M De Beule, G De Santis
OBJECTIVES: A novel stent method to simplify treatment of proximal ascending aorta and aortic arch aneurysms was developed and investigated by finite element analysis. Therapy of ascending aortic and aortic arch aneurysms is difficult and challenging and is associated with various complications. METHODS: A 55mm wide×120mm long stent was designed without the stent graft and the stent was deployed by an endovascular method in a virtual patient-specific aneurysm model...
February 2017: J Med Vasc
https://www.readbyqxmd.com/read/28693049/hybrid-repair-techniques-for-complex-aneurysms-and-dissections-involving-the-aortic-arch-and-thoracic-aorta
#5
Rami Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, James F McKinsey, Michael L Marin, Allan S Stewart, Sharif Ellozy
Aortic aneurysms involving the ascending aorta, aortic arch, and descending thoracic aorta have been a challenging entity to surgically treat for over 60 years. Despite the mortality of the disease, early open surgical procedures also had significant morbidity and mortality. The inherent risk in treating multiple anatomic segments simultaneously led to the innovation of the staged elephant trunk (ET) approach by Borst in 1983. To avoid the thoracotomy and associated complications related to the second stage of the procedure, an endovascular completion paradigm was begun by Volodos in 1991...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28693048/the-use-of-branched-endografts-for-the-aortic-arch-in-the-endovascular-era
#6
Rami O Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, Cherrie Z Abraham, Michael L Marin, Allan S Stewart
The endovascular realm has steadily increased its footing in the treatment of the aorta and all of its territories since the foundational case in 1990 by Parodi. The aortic arch, however, continues to be one of the last bastions for treatment via open surgery, which remains the gold standard. Significant comorbidity and prior cardiac surgery prevent open surgery from being the only preferred option, allowing novel endovascular procedures to be considered. Since 1999, more advanced endovascular systems have been created by companies such as Cook Medical, Bolton Medical, Medtronic, Endospan, Gore Medical, and, recently, Kawasumi...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28689951/spot-stenting-of-supra-aortic-branch-vessels-for-residual-type-a-dissection
#7
Ciro Ferrer, Raffaele Grande, Luigi Venturini, Valerio Scarano Catanzaro, Gabriele Maritati, Luca di Marzo
of this report is to describe the exclusion of the false lumen in a residual type A aortic dissection (TAAD) by the deployment of two covered stents: one in the right common carotid artery (RCCA) and one in the left subclavian artery (LSA). A 77-year-old female, already treated with ascending aorta replacement for acute TAAD, was referred to our center for a 97-mm post-dissection arch aneurysm. A computed tomography angiography (CTA) showed false lumen patency by reperfusion from secondary tears located at level of RCCA and LSA...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689484/transcatheter-aortic-valve-implantation-as-a-bailout-procedure-for-acute-aortic-valve-regurgitation-during-endovascular-arch-repair
#8
Adrien Hertault, Rachel E Clough, Thomas Modine, Jean-Luc Auffray, Mohamad Koussa, Stéphan Haulon
PURPOSE: To report emergent transcatheter aortic valve implantation (TAVI) to treat acute severe aortic regurgitation caused by valve cusp dysfunction following proximal migration of an endograft implanted in the ascending aorta during endovascular arch repair. CASE REPORT: A 65-year-old man had been previously treated with thoracic and fenestrated endografts in a 2-stage procedure for a chronic type B dissection. At 2-year follow-up, aneurysmal evolution of the distal arch led to development of a proximal type Ia endoleak...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28686325/rnf213-variants-in-a-child-with-phace-syndrome-and-moyamoya-vasculopathy
#9
Kala F Schilter, Jack E Steiner, Wendy Demos, Mohit Maheshwari, Jeremy W Prokop, Elizabeth Worthey, Beth A Drolet, Dawn H Siegel
Segmental infantile hemangiomas (IH) can be associated with congenital anomalies in a regional distribution. PHACE refers to large cervicofacial segmental IH in association with congenital anomalies of the aortic arch and medium-sized arteries of the head and neck, as well as structural anomalies of the posterior fossa and eye. A subset of PHACE patients have arterial anomalies that progress to moyamoya vasculopathy (MMV). MMV is defined as stenosis of the supraclinoid segment of the internal carotid arteries and/or their major branches, with subsequent development of a compensatory collateral vessel network...
July 7, 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28683907/endovascular-treatment-options-for-the-aortic-arch
#10
REVIEW
Akiko Tanaka, Anthony Estrera
Endovascular aortic repair to treat aortic arch abnormality has rapidly expanded in the last 2 decades, and surgeons now have options to treat patients who are poor candidates for open surgery. The devices and techniques should be tailored to the extension of the aortic abnormality and anatomy of the individual. Recent studies demonstrate promising results with branched endografts, but one of the major drawbacks of the devices is that considerable time is required to prepare the custom-made graft, which may not be available for emergent or urgent cases...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28647036/supra-aortic-interventions-for-endovascular-exclusion-of-the-entire-aortic-arch
#11
REVIEW
Terézia B Andrási, Marius Grossmann, Dieter Zenker, Bernhard C Danner, Friedrich A Schöndube
OBJECTIVE: Our aim was to analyze the outcomes of endovascular exclusion of the entire aortic arch (proximal landing in zone 0, distal landing in zone III or beyond, after Ishimaru) in which complete surgical debranching of the supra-aortic vessels (I), endovascular supra-aortic revascularization (chimney, fenestrated, or branched grafts) with partial surgical debranching (II), or total endovascular supra-aortic revascularization (III) was additionally performed. METHODS: Publications describing endovascular repair of the aortic arch (2000-2016) were systematically searched and reviewed...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28637170/neuroprotective-effect-of-pressure-oriented-flow-regulation-and-ph-stat-management-in-selective-antegrade-brain-perfusion-during-total-aortic-arch-repair
#12
Hisato Ito, Toru Mizumoto, Yasuhiro Sawada, Kazuya Fujinaga, Hironori Tempaku, Yasunori Yamamoto, Katsuhiro Tsutsui, Hideto Shimpo
OBJECTIVES: The aim of this study was to assess the safety and effectiveness of our selective antegrade brain perfusion (SABP) strategy, which is characterized by moderate hypothermic and low-pressure management under pH-stat using a completely closed cardiopulmonary bypass circuit with a single centrifugal pump. METHODS: Forty-nine consecutive patients (median age, 74) underwent total aortic arch replacement using a 4-branched graft. SABP was conducted with individual cannulation in all arch vessels...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28616352/aortic-polyaneurysmal-disease-case-report
#13
Lucas Alvarez García, Paula Vidal Fernández, Miguel Felipe García Gimeno, Miguel Angel González Arranz, Maria Emma González González, Diego López García, Salvador Tagarro Villalba, Santiago Rodríguez Camarero
We report a 78-year-old man who presents progression of his aneurysmatic pathology with previous abdominal infrarenal aortic surgery 20 years later. The computed tomography (CT) scan showed proximal degeneration of the infrarenal aorta, left iliac aneurysm and a new descending thoracic aneurysm close to the aortic arch. The surgical treatment was staged in two times due to the evolution of the aneurysm measures. First, the thoracic and the infrarenal aneurysms were covered each one with endoprosthesis. Four years later the iliac disease was solved with a branched specific iliac endograft...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616278/management-of-the-vertebral-artery-during-thoracic-endovascular-aortic-repair-with-coverage-of-the-left-subclavian-artery
#14
Jian Zhu, Er-Ping Xi, Shui-Bo Zhu, Gui-Lin Yin, Rong-Ping Wang, Yu Zhang
BACKGROUND: The application of thoracic endovascular aortic repair (TEVAR), a minimally invasive operation, in the aortic arch has been a challenge of cardiovascular surgery in recent years. This study aimed to investigate management of the vertebral artery with coverage of the left subclavian artery (LSA) during TEVAR. METHODS: From January 2007 to September 2014 in the Department of Cardiothoracic Surgery at Wuhan General Hospital of Guangzhou Military Region, 160 patients underwent LSA closure or partial coverage during TEVAR of an aortic lesion near the LSA...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28615114/experimental-assessment-of-physician-modified-proximal-scalloped-stent-graft-to-extend-proximal-landing-zone-in-the-aortic-arch
#15
E M Faure, I Khantalin, P A Peyron, L Canaud, C Marty-Ané, P Alric
OBJECTIVE/BACKGROUND: The aim of the study was to assess a model of physician modified scalloped stent graft (PMSG) on currently available thoracic aortic devices to extend the proximal landing zone in either zone 2, 1 or 0 of the aortic arch while preserving flow in the supra-aortic vessels on human cadaveric aorta. METHODS: Fresh human aortas were harvested at autopsy from adult subjects. A proximal scallop was made on the stent grafts based on direct measurements on the aortas to extend the proximal landing zone in zone 0 (n = 5), zone 1 (n = 5), and zone 2 (n = 5)...
June 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28602115/total-endovascular-treatment-of-aortic-arch-disease-using-an-arch-endograft-with-3-inner-branches
#16
Rafaëlle Spear, Rachel E Clough, Dominique Fabre, Blayne Roeder, Adrien Hertault, Teresa Martin Gonzalez, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
PURPOSE: To report early experience with a new endovascular graft developed for aortic arch aneurysm repair in patients unfit for open surgery. CASE REPORT: Three consecutive men (62, 74, and 69 years old) at high risk for open repair were treated for postdissection aortic arch aneurysms using a custom-made 3 inner branched endovascular graft. The 2 proximal branches are antegrade and perfuse the innominate artery and the left common carotid artery; the third branch is retrograde and perfuses the left subclavian artery...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28601330/acute-retrograde-type-a-aortic-dissection-morphologic-analysis-and-clinical-implications
#17
Paul D DiMusto, Brooks L Rademacher, Jennifer L Philip, Shahab A Akhter, Christopher B Goodavish, Nilto C De Oliveira, Paul C Tang
BACKGROUND: This study compares the morphology and outcomes of acute retrograde type A dissections (RTADs) with acute antegrade type A dissections (ATADs), and acute type B dissections. MATERIALS AND METHODS: From 2000 to 2016, there were 12 acute RTADs, 96 ATADs, and 92 type B dissections with available imaging. Dissections were characterized using computerized tomography angiography images. We examined clinical features, tear characteristics, and various morphologic measurements...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28597717/physician-modified-thoracic-stent-grafts-for-the-treatment-of-aortic-arch-lesions
#18
Ludovic Canaud, Toshio Baba, Thomas Gandet, Kouhei Narayama, Baris Ata Ozdemir, Tsuyoshi Shibata, Pierre Alric, Kiyofumi Morishita
PURPOSE: To evaluate outcomes of physician-modified thoracic stent-grafts for the treatment of aortic arch aneurysms. METHODS: A retrospective dual-center analysis was performed involving 36 patients (mean age 74.7±9 years, range 58-91; 27 men) with an aortic arch lesion who were treated between November 2013 and June 2016 using physician-modified thoracic stent-grafts. Half of the patients had a degenerative aneurysm; the remainder had type B dissection (n=9), traumatic transection (n=3), type Ia endoleak after previous endografting (n=5), or aortoesophageal fistula (n=1)...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#19
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28587564/how-to-confirm-catheterization-of-inner-branches-in-aortic-endografting-the-universal-flush-test
#20
Beatrice Fiorucci, Nikolaos Tsilimparis, Fiona Rohlffs, Franziska Heidemann, Eike Sebastian Debus, Tilo Kölbel
PURPOSE: To describe a quick, simple, and reliable technique to confirm successful catheterization of a branched thoracic endograft's inner branch. TECHNIQUE: Accurate cannulation of inner branches can be verified through insertion and mild retraction of a Universal Flush angiographic catheter, whose tip hooks the branch and slightly opens. CONCLUSION: The use of an angiographic catheter with a curved tip is a safe and easy procedure that can be adopted to check the correct position inside the branch of an endograft designed for treatment of the aortic arch...
June 1, 2017: Journal of Endovascular Therapy
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