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https://www.readbyqxmd.com/read/29037013/angioplasty-stenting-and-other-potential-treatments-of-atherosclerotic-stenosis-of-the-intracranial-arteries-past-present-and-future
#1
REVIEW
Ashley Wabnitz, Marc Chimowitz
Although there is an intuitive appeal to treat symptomatic stenotic intracranial arteries with endovascular therapies such as angioplasty and stenting, current data from randomized trials show intensive medical therapy is far superior for preventing stroke. This is in large part due to the high risk of peri-procedural stroke from angioplasty and stenting. If angioplasty and stenting is to emerge as a proven treatment for intracranial stenosis, endovascular techniques will need to become much safer, identification of patients with intracranial stenosis who are at particularly high risk of stroke despite intensive medical therapy will need to be targeted, and well-designed randomized trials will be necessary to show endovascular therapy is superior to medical therapy in these high-risk patients...
September 2017: Journal of Stroke
https://www.readbyqxmd.com/read/29034041/successful-endovascular-repair-of-mycotic-aortic-pseudoaneurysm-followed-by-aortoesophageal-fistula
#2
Seiichi Yamaguchi, Hideki Ueda, Hisanori Fujita, Shigeyasu Takeuchi
Mycotic aneurysm of the aorta is a rare, but life-threatening pathology. In recent years, endovascular stent graft placement has been introduced as an effective alternative for treating infected aortic aneurysms. A 64-year-old woman with a history of paraplegia due to spinal cord injury was referred to our institute with fever and blood-tinged sputum. Computed tomography (CT) scan showed an 11-cm pseudoaneurysm arising from the proximal descending aorta, which was normal 1 month ago at the previous CT scan...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034038/catheter-directed-thrombolysis-in-the-treatment-of-acute-ischemia-in-lower-extremities-is-safe-and-effective-especially-with-concomitant-endovascular-treatment
#3
Lærke Urbak, Louise de la Motte, Peter Rørdam, Aamir Siddiqi, Henrik Sillesen
Objective: To evaluate the influence of pre-procedural characteristics on immediate and late results as well as the safety of catheter-directed thrombolysis (CDT) in acute ischemia of the lower extremity. Materials and Methods: A retrospective study comprising 249 patients treated by CDT from January 2006 to December 2012. Outcomes were primary patency, haemorrhagic complications, amputation and mortality. Results: Primary patency for CDT alone was 68%, for CDT plus endovascular treatment 87% and for successful CDT with supplementary surgery 62% giving an overall primary patency of 76%...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034026/invaginated-graft-insertion-anastomosis-for-a-type-ib-endoleak-at-the-supraceliac-aorta-following-thoracic-endovascular-aortic-repair
#4
Takashi Yamauchi, Suguru Kubota, Kosei Hasegawa
Open surgery for a type Ib endoleak after thoracic endovascular aortic repair is associated with some knacks and pitfalls, particularly in cases wherein the distal edge of a stent graft is located at just supraceliac aorta and the renovisceral segment and infrarenal aorta do not require surgical intervention. Here we describe the invaginated graft insertion technique to provide an easy and secure anastomosis in such clinical situations. This procedure may be feasible for anastomosis between a prosthetic vascular graft and a previously deployed stent graft when the location of the anastomosis is distant from the surface of the skin incision with a narrow and limited surgical view...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034025/replacement-of-the-thoracoabdominal-aorta-after-endovascular-abdominal-aneurysm-repair-for-ruptured-infected-aneurysm-a-case-report
#5
Nobuo Kondo, Kentaro Tamura, Taichi Sakaguchi, Genta Chikazawa, Hidenori Yoshitaka
A 73-year-old man underwent emergency endovascular abdominal aneurysm repair (EVAR) for a ruptured infected abdominal aortic aneurysm. Two years after EVAR, he was admitted with a spiking fever and left lower back pain. Computed tomography scan revealed not only recurrent graft infection with psoas abscess but also infection around the orifice of the superior mesenteric artery. Because conservative medical therapy with antibiotics could not control the infection, we performed complete removal of the infected stent graft, debridement of psoas abscess, and in situ replacement of the thoracoabdominal aorta using rifampicin-soaked prosthetic grafts, followed by the omental flap...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034023/retrograde-ascending-aortic-dissection-after-stent-grafting-for-stanford-type-b-aortic-dissection-with-severe-limb-ischemia
#6
Yoshiro Higuchi, Masato Tochii, Yoshiyuki Takami, Akihiro Kobayashi, Tsutomu Yanagisawa, Kentaro Amano, Yusuke Sakurai, Michiko Ishida, Hiroshi Ishikawa, Koji Hattori, Yasushi Takagi
We report a rare case of retrograde Stanford type A aortic dissection after endovascular repair for complicated Stanford type B aortic dissection. A 45-year-old man presented with a sudden onset of back pain and was transferred to our hospital. Computed tomography demonstrated acute Stanford type B aortic dissection with lower limb ischemia. Emergency endovascular surgery was planned for repair of the Stanford type B aortic dissection. The patient suddenly developed recurrent chest pain 10 days after the initial procedure...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034021/endovascular-repair-for-kommerell-s-diverticulum-and-right-sided-aortic-arch
#7
Kei Kazuno, Seiichiro Murata
A 74-year-old man with hoarseness was diagnosed with a right-sided aortic arch and Kommerell's diverticulum by computed tomography (CT). The diverticulum had a maximum diameter of 33 mm, and surgical intervention was chosen because of the possibility of rupture. A right common carotid to right subclavian artery bypass was constructed, stent-graft was placed after the branching of the right common carotid artery, and coil embolization of the diverticulum was performed via left brachial artery. No leaks were found on postoperative CT...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034018/bailout-endovascular-stent-grafting-for-an-ascending-aortic-pseudoaneurysm-using-an-infrarenal-aortic-extension-cuff
#8
Yasushi Matsumoto, Fuminori Kasashima, Kengo Kawakami, Masamitsu Endo
We report successful thoracic endovascular repair of a pseudoaneurysm rupture in the ascending aorta using infrarenal endovascular devices after an aortic valve replacement. Complete exclusion of the pseudoaneurysm was achieved with no endoleak or postoperative complications. Despite limitations of the current technology, this endovascular technique was a relatively less invasive, feasible lifesaving surgical option for the repair of a pseudoaneurysm of the ascending aorta with a diameter ≤32 mm.
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29033516/primary-endovascular-intervention-for-acute-mesenteric-ischemia-performed-by-interventional-cardiologists-a-single-center-experience
#9
Tsung-Yan Chen, Chih-Horng Wu, Wen-Feng Hsu, Lin Lin, Ren-Huei Wang, Chao-Lun Lai, Kuei-Chin Tsai, Li-Ta Keng, Chih-Cheng Wu, Mu-Yang Hsieh
The current standard care for acute mesenteric ischemia (AMEI) involves urgent revascularization and resection of the necrotic bowel. Since 2012, we have used an AMEI protocol of our own design, which focused on early treatment and allowed interventional cardiologists to become involved when interventional radiologist was not available. A total of 8 patients were treated, and two interventional cardiologists performed all the stenting procedures. The procedure success rate was 100% in patients with non-calcified lesions (6/8)...
July 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/29032862/endovascular-treatment-of-acute-tandem-occlusion-strokes-and-stenting-first-experience
#10
Süha Akpınar, Pınar Gelener
This study demonstrates the radiologic and clinical findings, etiologies and intervention strategy in 8 acute ischemic stroke patients with tandem occlusions. The mean age was 57 and mean NIHSS score was 19. Stent-assisted thrombectomy (SAT) was performed on all of the patients. Additionally, 6 patients underwent carotid artery stenting before SAT. Recanalization with TICI≥2b was attained in 7/8 patients. The 90thday median mRS was 2 and mortality was 1/8. The etiologies of the tandem occlusions were either extracranial high grade ICA stenosis/occlusion or cervical ICA dissection...
October 9, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29031986/endovascular-interventions-for-femoropopliteal-peripheral-artery-disease-a-network-meta-analysis-of-current-technologies
#11
REVIEW
Michael R Jaff, Teresa Nelson, Nicole Ferko, Melissa Martinson, Louise H Anderson, Sarah Hollmann
PURPOSE: To use network meta-analysis (NMA) to determine the optimal endovascular strategy for management of femoropopliteal peripheral artery disease (PAD) given the lack of multiple prospective randomized trials to guide treatment decisions. MATERIALS AND METHODS: NMA is a new meta-analytic method that permits comparisons among any 2 therapies by combining results of a collection of clinical trials conducted in the same or similar patient population. NMA was used to analyze data from 15 randomized controlled trials (RCTs) and 10 prospective, multicenter, single-arm trials (combined evidence [CE] NMA) that evaluated target lesion revascularization (TLR) for 5 endovascular strategies: bare metal stent (BMS), polymer-covered metal stent (CMS), drug-eluting stent (DES), drug-coated balloon (DCB) and percutaneous transluminal angioplasty (PTA)...
October 12, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29027096/new-innovations-in-drug-eluting-stents-for-peripheral-arterial-disease
#12
REVIEW
Roi Altit, William A Gray
PURPOSE OF REVIEW: The purpose of this paper was to provide a review of the burden of peripheral arterial disease; to examine older therapies and their limitations; and especially to highlight new treatment innovations as well as the data supporting their use. RECENT FINDINGS: Building on the success of paclitaxel in the prevention of restenosis in the peripheral circulation, the newest generation drug-eluting stent is presented, which combines paclitaxel with a polymer-allowing the drug to be eluted slowly over 12 months...
October 12, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/29023353/staged-repair-of-a-ruptured-thoracic-aortic-aneurysm-having-an-aorto-parenchymal-fistula
#13
Akihiro Yoshitake, Kazuma Okamoto, Mio Kasai, Hideyuki Shimizu
Ruptured thoracic aortic aneurysms, having aorto-bronchial or pulmonary parenchymal fistulations, are life-threatening conditions, and current surgical treatment results are not satisfactory. Herein, we describe a 69-year-old man with a ruptured thoracic aortic aneurysm and aorto-pulmonary parenchymal fistulation that was successfully treated using a staged repair. The first stage involved an emergency thoracic endovascular aortic repair for salvage and the second stage involved radical pulmonary parenchymal repair with removal of the stent graft and aortic reconstruction for long-term survival...
October 10, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29022827/descending-aortic-aneurysm-in-wiskott-aldrich-syndrome-options-for-repair
#14
Greta Wood, Karen Booth, Zahid Khan, Tina Biss, Chandrika Roysam, John Dark
We report open surgical repair of a previously stented descending thoracic aneurysm in a patient with Wiskott-Aldrich syndrome and a platelet count <10 × 10(9)·L(-1). The same patient was described previously in a report of the first endovascular stent in this form of vasculitis. We describe the pre- and intraoperative management, and suggest a change in strategy in this setting.
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29021314/augmented-3d-venous-navigation-for-neuroendovascular-procedures
#15
Raphaël Blanc, Robert Fahed, Pascal Roux, Stanislas Smajda, Gabriele Ciccio, Jean-Philippe Desilles, Hocine Redjem, Mikael Mazighi, Humain Baharvahdat, Michel Piotin
BACKGROUND: Endovascular venous access is increasingly used for the treatment of many cerebrovascular diseases. The quality of venous roadmapping through arterial injection can be problematic because of contrast media dilution, slow flow velocity, and unilateral opacification of the venous system. OBJECTIVE: To describe our experience with the VesselNavigator (Philips Healthcare, Best, The Netherlands) in performing live 3D roadmapping for intracranial venous procedures...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29021311/acute-ischemic-stroke-with-tandem-lesions-technical-endovascular-management-and-clinical-outcomes-from-the-escape-trial
#16
Zarina Assis, Bijoy K Menon, Mayank Goyal, Andrew M Demchuk, Jai Shankar, Jeremy L Rempel, Daniel Roy, Alexander Y Poppe, Victor Yang, Cheemun Lum, Dar Dowlatshahi, John Thornton, Hana Choe, Paul A Burns, Donald F Frei, Blaise W Baxter, Michael D Hill
BACKGROUND: Tandem occlusions of the extracranial carotid and intracranial carotid or middle cerebral artery have a particularly poor prognosis without treatment. Several management strategies have been used with no clear consensus recommendations. We examined subjects with tandem occlusions enrolled in the ESCAPE trial and their outcomes. METHODS: Data are from the ESCAPE trial. Additional data were sought on interventions for each subject. RESULTS: There were 54 (17%) subjects with tandem extracranial and intracranial occlusions...
October 11, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29017791/preoperative-thoracic-false-lumen-branches-are-predictors-of-aortic-enlargement-after-stent-grafting-for-debakey-iiib-aortic-dissection
#17
Feng Liu, Yang Yang Ge, Wei Guo, Xiao Ping Liu, Xin Jia, Jiang Xiong, Xiao Hui Ma
OBJECTIVE: The study objective was to assess the effect of preoperative thoracic false lumen branches on thoracic aortic enlargement along the stent graft after thoracic endovascular aortic repair for DeBakey IIIb aortic dissection. METHODS: From January 2011 to December 2013, 67 patients who underwent thoracic endovascular aortic repair for DeBakey IIIb aortic dissection were retrospectively investigated. We assessed preoperative thoracic false lumen branches and diameter measurements at the level of the tracheal carina...
September 15, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29017198/aggressive-treatment-of-cerebral-venous-sinus-thrombosis-cvt-with-stent-retrievers-and-local-thrombolysis-why-we-need-a-registry
#18
Christina Maria Kowoll, Hannah Lockau, Franziska Dorn, Christian Dohmen
Purpose Anticoagulation is the first-line therapy for cerebral venous sinus thrombosis (CVT). Endovascular treatment is increasingly applied in patients deteriorating despite anticoagulation with extensive thrombosis or contraindications for anticoagulation. Experience with stent retrievers in CVT is limited. Results We present three cases of severe CVT treated with stent-retrievers, thrombus aspiration and local thrombolysis. In two patients with extensive thrombosis, a partial recanalization was achieved, but only one of them showed significant improvement...
October 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28994833/the-efficacy-and-safety-of-endovascular-recanalization-of-occluded-large-cerebral-arteries-during-the-subacute-phase-of-cerebral-infarction-a-case-series-report
#19
Kangning Chen, Xianhua Hou, Zhenhua Zhou, Guangjian Li, Qu Liu, Li Gui, Jun Hu, Shugui Shi
BACKGROUND: Intravenous tissue plasminogen activator with or without mechanical thrombectomy during the acute phase are approved therapies for ischaemic stroke. Due to the short treatment time window (<6 hours) and often treatment failure, these patients would still have an intracranial arterial occlusion (IAO). It is unclear whether these patients can benefit from subsequent interventional recanalizationof their occluded artery in the subacute phase. In this retrospective study, we have examined the efficacy and safety in patients who have received either percutaneous transluminal angioplasty (PTA) or percutaneous transluminal angioplasty and stenting (PTAS) for IAO in the subacute phase of their stroke...
September 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28994804/biodegradable-magnesium-stent-treatment-of-saccular-aneurysms-in-a-rat-model-introduction-of-the-surgical-technique
#20
Edin Nevzati, Jeannine Rey, Daniel Coluccia, Donato D'Alonzo, Basil Grüter, Luca Remonda, Javier Fandino, Serge Marbacher
The steady progess in the armamentarium of techniques available for endovascular treatment of intracranial aneurysms requires affordable and reproducable experimental animal models to test novel embolization materials such as stents and flow diverters. The aim of the present project was to design a safe, fast, and standardized surgical technique for stent assisted embolization of saccular aneurysms in a rat animal model. Saccular aneurysms were created from an arterial graft from the descending aorta.The aneurysms were microsurgically transplanted through end-to-side anastomosis to the infrarenal abdominal aorta of a syngenic male Wistar rat weighing >500 g...
October 1, 2017: Journal of Visualized Experiments: JoVE
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