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chronic aortic dissection

Xin Li, Daniel Staub, Vasileios Rafailidis, Mohammed Al-Natour, Sanjeeva Kalva, Sasan Partovi
Ultrasound has been established as an important diagnostic tool in assessing vascular abnormalities. Standard B-mode and Doppler techniques have inherent limitations with regards to detection of slow flow and small vasculature. Contrast-enhanced ultrasound (CEUS) is a complementary tool and is useful in assessing both the macro- and microvascular anatomy of the aorta. CEUS can also provide valuable physiological information in real-time scanning sessions due to the physical and safety profiles of the administered microbubbles...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Ma XiaoHui, Wei Li, Guo Wei, Liu XiaoPing, Jia Xin, Zhang Hongpeng, Wang Lijun
Introduction Endovascular intervention involving the aortic arch, particularly in thoracic aortic dissection, remains challenging and controversial at current time when there is no commercially suitable grafts on most of the international markets. This study compared two endovascular treatments that maintain left subclavian artery perfusion using two modified techniques for type-B aortic dissection patients. Methods Consecutive cases utilizing chimney or in situ fenestration techniques to preserve left subclavian artery in type B AD from 2006 to 2015 in our single institution were retrospectively reviewed...
October 14, 2018: Vascular
Christopher J Goodenough, Tyler A Cobb, John B Holcomb
Resuscitative endovascular balloon occlusion of the aorta (REBOA) has become an increasingly popular alternative to emergency thoracotomy and aortic cross-clamping in patients with exsanguinating hemorrhage.1 This new capability is increasingly being used in non-trauma situations.2 3 This report demonstrates another novel use of REBOA for iatrogenic intra-abdominal hemorrhage. An 83-year-old man with multiple medical comorbidities and a history of chronic mesenteric ischemia was admitted to our institution for an elective mesenteric revascularization...
2018: Trauma surgery & acute care open
Huanyu Ding, Yuan Liu, Nianjin Xie, Ruixin Fan, Songyuan Luo, Wenhui Huang, Jie Li, Yi Zhu, Binquan Hu, Ling Xue, Jianfang Luo
OBJECTIVE: To report outcomes of the chimney technique for preservation of the left subclavian artery (LSA) in patients with type B aortic dissection (TBAD). METHODS: A retrospective analysis was performed of a prospectively maintained database from August 2012 to October 2017. Primary endpoints were 30 day and overall mortality. Secondary endpoints were technical success, type Ia endoleak, chimney stent occlusion, aortic rupture, stroke, spinal cord ischaemia, and re-intervention rate...
October 5, 2018: European Journal of Vascular and Endovascular Surgery
Jesse A Codner, Xiaoying Lou, Yazan M Duwayri, Edward P Chen, Jose N Binongo, Rena Moon, William D Jordan, Bradley G Leshnower
OBJECTIVE: Controversy exists about the optimal treatment of acute uncomplicated type B aortic dissection (auTBAD). Optimal medical therapy (OMT) provides excellent short-term outcomes, but long-term results are poor. Ideally, auTBAD patients who will fail to respond to OMT in the chronic phase could be identified and undergo thoracic endovascular aortic repair. The purpose of this study was to identify radiographic predictors of auTBAD patients who will fail to respond to OMT. METHODS: A review of the Emory aortic database from 2000 to 2017 identified 320 auTBAD patients initially treated with OMT...
October 3, 2018: Journal of Vascular Surgery
Michael W A Chu, Katie L Losenno, Luc A Dubois, Philip M Jones, Maral Ouzounian, Richard Whitlock, Francois Dagenais, Munir Boodhwani, Gopal Bhatnagar, Ahmad Poostizadeh, Zlatko Pozeg, Michael Moon, Bob Kiaii, Mark D Peterson
BACKGROUND: Hybrid aortic arch surgery has evolved to include several technical variations, with most including an off-label use of a conventional thoracic endograft. We describe the early clinical outcomes of the Thoraflex Hybrid graft specifically designed for the treatment of complex arch and proximal descending aortic disease. METHODS: Between January 2014 and April 2017, 40 consecutive patients (66±14 years, 45% female) underwent hybrid aortic arch and frozen elephant trunk (FET) repair with the multibranched Thoraflex Hybrid graft at 9 Canadian centers...
October 3, 2018: Annals of Thoracic Surgery
Goran Koracevic, Milan Stojkovic, Dragan Lovic, Milan Pavlovic, Tomislav Kostic, Marija Kutlesic, Sladjana Micic, Maja Koracevic, Milan Djordjevic
The intention of the paper is to give rationale and to suggest enlisting Cushing's syndrome (CS) amongst high cardiovascular (CV) risk conditions. A considerable amount of data refers to several-fold amplified mortality in CS. The causes are based on high occurrence of many CV risk factors in persons with CS (e.g., adiposity, arterial hypertension, dyslipidemia, as well as diabetes mellitus /DM/). Therefore, practically all individuals with CS have correspondingly the metabolic syndrome (MetSy), which is known as laden with high CV risk...
October 5, 2018: Current Vascular Pharmacology
Yusuke Takei, Keiichi Itatani, Shohei Miyazaki, Ikuko Shibasaki, Hirotsugu Fukuda
OBJECTIVES: The purpose of this study was to calculate the changes in the blood flow direction and volume in the aortic lumen and at the entry and re-entry sites using 4-dimensional (4D) phase-contrast magnetic resonance imaging (MRI) after performing entry closure with thoracic endovascular aortic repair for chronic DeBakey IIIb aortic dissection. METHODS: Aortic blood flow was analysed at 3 phases with 4D phase-contrast MRI in a single therapeutic DeBakey IIIb aortic dissection case...
September 17, 2018: Interactive Cardiovascular and Thoracic Surgery
Jennifer Chung, Maral Ouzounian
No abstract text is available yet for this article.
August 2, 2018: Journal of Thoracic and Cardiovascular Surgery
Simeng Zhang, Yanqing Chen, Qingsheng Lu
PURPOSE OF REVIEW: Retrograde type A aortic dissection (RTAD) is a fatal complication after endovascular therapy of type B aortic dissection and descending thoracic aneurysm disease. This review aims to elaborate this lethal complication, the potential risks of its incidence, and feasible approaches to lower the occurrence rate. RECENT FINDINGS: Many articles have shown lower incidence of RTAD in patients with thoracic aneurysm than those with aortic dissection...
November 2018: Current Opinion in Cardiology
Kenta Masada, Toru Kuratani, Kazuo Shimamura, Yoshiki Sawa
Thoracic endovascular aortic repair has become widely accepted as a useful, less invasive procedure for type B aortic dissections by covering the primary entry.1 However, depending on the location of the primary entry, it is often difficult to cover the entry from the true lumen without hybrid procedures.2 Here, we describe a successful endovascular treatment using a double-barreled endografting technique for chronic type B aortic dissection, which excludes the dilated false lumen by endografting into the false lumen without covering the primary entry...
September 1, 2018: Seminars in Thoracic and Cardiovascular Surgery
Yuki Ikeno, Yutaka Koide, Takashi Matsueda, Katsuhiro Yamanaka, Takeshi Inoue, Satoshi Ishihara, Shinichi Nakayama, Hiroshi Tanaka, Koji Sugimoto, Yutaka Okita
OBJECTIVES: The present study analyzed the prevalence of variations of the aortic arch branching in Japanese population, comparing patients with aortic arch disease with healthy controls. METHODS: Between from October 1999 and December 2015, 815 Japanese patients with aortic arch disease defined as aortic arch aneurysm (diameter ≥ 45 mm) and aortic dissection (group A) underwent aortic arch surgery in our institution. As a control group, 1506 traumatic screened patients were enrolled (group C)...
September 3, 2018: General Thoracic and Cardiovascular Surgery
Steffan Frosi Stella, Thomas F Lindsay, Kong T Tan
Chronic type B aortic dissection with aneurysmal degeneration requiring intervention presents significant therapeutic challenges. Thoracic endovascular aortic repair with a fenestrated endograft is a feasible option, but false lumen branches without an adjacent re-entry or perforation in the septum can pose a significant challenge. We present two cases of fenestrated endovascular aneurysm repair for chronic type B aortic dissection in which a renal artery from the false lumen was cannulated by creating a "neofenestration" through the dissection flap using a radiofrequency PowerWire (Baylis Medical Inc, Montreal, Quebec, Canada) technique (Toronto PowerWire fenestration technique)...
August 31, 2018: Journal of Vascular Surgery
Ricardo Castro-Ferreira, Paulo Gonçalves Dias, Sérgio Moreira Sampaio, José Fernando Teixeira, Mario Lachat
A 59-year-old man was referred with complicated chronic type B aortic dissection. Despite the false lumen's being dominant in terms of caliber and limb perfusion, visceral arteries originated in a 9-mm true lumen. A staged approach was performed: open aortobi-iliac bypass with preservation of both lumens to the infrarenal aorta, with reinforcement of the aorta and anastomosis with Dacron (wrap technique); exclusion of the dissection by endografting all of the false lumen with three successive thoracic endoprostheses; and maintenance of true lumen perfusion using two periscopes with self-expanding nitinol stents...
September 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Hamdy Soliman, Mohammed N El-Ganainy, Reham M Darweesh, Sameh Bakhoum, Mohammed Abdel-Ghany
Aim and background: Open surgical repair for thoracic aortic diseases is associated with a high perioperative mortality and morbidity. Most of type B aortic dissections are uncomplicated and are medically treated which carries a high mortality rate. Thoracic endovascular aortic repair is the first-line therapy for isolated aneurysms of the descending aorta and complicated type B aortic dissection. The aim of this study is to test the safety of early thoracic endovascular aortic repair in patients with uncomplicated type B aortic dissection and patients with thoracic aortic aneurysms...
June 2018: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
Hiroshi Furukawa, Naoki Yamane, Takeshi Honda, Takahiko Yamasawa, Yuji Kanaoka, Kazuo Tanemoto
BACKGROUND: We retrospectively assessed the initial clinical role of preoperative frailty in surgical patients with Stanford type A acute aortic dissection (AAAD). METHODS: One hundred and fourteen consecutive patients who underwent emergent or urgent surgical interventions for AAAD in our institute between April 2000 and March 2016 participated in this retrospective study. Patients with more than three of the following six modalities were defined as being frail: age older than 75 years, preoperative requirement of assistance in daily living, body mass index less than 18...
August 22, 2018: General Thoracic and Cardiovascular Surgery
O V Kamenskaya, I Yu Loginova, A S Klinkova, A M Chernyavskiy, S A Alsov, D A Sirota, V V Lomivorotov, A M Karaskov
AIM: To evaluate the prognostic significance of oxygen supply to the brain in the risk of neurological complications in the early post operative period of surgical treatment of the ascending aorta and aortic arch. MATERIAL AND METHODS: The level of oxygenation (rSO2) in the right and left hemispheres was measured in 68 patients with ascending aorta and aortic arch chronic dissection. Before and in the nearest period after surgery, the patients underwent a clinical/instrumental neurological study...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Daniela Branzan, Andrej Schmidt
No abstract text is available yet for this article.
October 2018: European Journal of Vascular and Endovascular Surgery
Ahmed Sameh Eleshra, Woon Heo, Kwang-Hun Lee, Shin-Young Lee, Ha Lee, Suk-Won Song
We report a case of acute type I aortic dissection in which an emergency graft replacement of the ascending aorta and innominate artery was performed. We performed false lumen thrombosis through hybrid thoracic endovascular aortic repair to seal the primary entry tear, followed by false lumen obliteration at the level of the descending thoracic aorta, abdominal aorta, and right common iliac artery. Over a period of 4.5 years, we used Amplatzer vascular plugs and coils based on our computed tomography angiography follow-up protocol...
August 2018: Korean Journal of Thoracic and Cardiovascular Surgery
Grayson H Wheatley
No abstract text is available yet for this article.
July 20, 2018: Journal of Thoracic and Cardiovascular Surgery
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