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Spinal cord ischaemia

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https://www.readbyqxmd.com/read/29651329/ischaemia-of-the-medullary-cone-after-stent-graft-implantation-in-a-patient-with-abdominal-aortic-aneurysm-a-case-study
#1
Mariusz Wachowski, Michał Polguj, Janusz Ścibór, Agata Majos
Preoperative visualization of the Adamkiewicz artery - the vessel which is to a great extent responsible for supplying blood to the medullary cone - is an important step which must be taken before initiating restorative procedures in the aorta. We present a case of a 67-year-old patient who underwent an intravascular stent-graft implantation procedure, due to clinical signs of abdominal aortic aneurysm. Routine pre-operative computed tomography examination failed to demonstrate the Adamkiewicz artery. On the second day after the surgery, as a result of unexpected clinical deterioration, an magnetic resonance imaging examination of the lumbar spine was carried out...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29617826/long-term-outcomes-of-total-arch-replacement-with-the-non-frozen-elephant-trunk-technique-for-stanford-type-a-acute-aortic-dissection
#2
Yosuke Inoue, Hitoshi Matsuda, Atsushi Omura, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Junjiro Kobayashi
OBJECTIVES: Arch repair using the frozen elephant trunk (FET) technique has been utilized to treat Type A acute aortic dissection. In contrast, the long-term outcomes of the non-FET technique focus on the thrombosed false lumen (FL), and distal aortic reoperation rates remain unclear. The goal of our study was to investigate the efficacy and long-term outcomes of the non-FET technique as the benchmark. METHODS: We reviewed 518 patients with Type A acute aortic dissection in the last 20 years...
March 29, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29525741/spinal-cord-ischaemia-in-endovascular-thoracic-and-thoraco-abdominal-aortic-repair-review-of-preventive-strategies
#3
REVIEW
Martijn L Dijkstra, Tryfon Vainas, Clark J Zeebregts, Lotty Hooft, Maarten J van der Laan
INTRODUCTION: The incidence of spinal cord ischaemia (SCI) and subsequent paraplegia after thoracic endovascular aneurysm repair (TEVAR) and thoraco-abdominal endovascular aneurysm repair is estimated to be between 2.5% and 8%. The aim of this review is to provide an overview of SCI preventive strategies in TEVAR and thoraco-abdominal repair and recommend an optimal strategy. METHODS: Medline, Embase, and the Cochrane Library were searched for studies on TEVAR, thoraco-abdominal endovascular repair, and the use of SCI preventive measures...
March 7, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29506038/surgical-left-subclavian-artery-revascularization-for-thoracic-aortic-stent-grafting-a-single-centre-experience-in-101-patients
#4
Emma van der Weijde, Nabil Saouti, Jan Albert Vos, Selma C Tromp, Robin H Heijmen
OBJECTIVES: To evaluate the indications, perioperative strategy and postoperative outcome of surgical left subclavian artery (LSA) revascularization combined with thoracic endovascular aortic repair (TEVAR) covering the LSA. METHODS: Between 2000 and 2017, a total of 101 consecutive patients underwent surgical revascularization of the LSA prior to, concomitant or following TEVAR. Revascularization was performed through a small supraclavicular incision and consisted of a transposition or bypass graft, using intraoperative transcranial Doppler monitoring...
February 28, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29497851/resolution-of-traumatic-bilateral-vertebral-artery-injury
#5
REVIEW
Yutaka Igarashi, Takahiro Kanaya, Shoji Yokobori, Takeshi Tsukamoto, Hiroyuki Yokota
PURPOSE: Cerebrovascular ischaemia is a rare but serious complication of damage to the carotid or vertebral arteries in the neck caused by blunt injury to the neck. Screening for blunt cerebrovascular injury should be performed in patients with certain signs or symptoms and risk factors. We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3 months post-injury with antiplatelet and direct oral anticoagulant therapy...
March 1, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29471439/robot-assisted-ligation-of-bronchial-artery-could-be-an-alternative-to-embolization
#6
Bruno Pochulu, Omar Sarsam, Christophe Peillon, Jean-Marc Baste
A 37-year-old patient presented with a self-limiting episode of moderate haemoptysis. Contrast-enhanced chest computed tomography showed a tortuous and dilated right bronchial artery arising from the descending aorta at the level of T6. Therapeutic angiography was attempted, but in the presence of spinal artery arising from the bronchial artery in question, selective embolization was contraindicated due to risk of spinal cord ischaemia. After a multidisciplinary meeting, it was decided to attempt surgery to ligate this pathological artery...
March 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29462327/risk-factors-for-spinal-cord-ischaemia-after-thoracic-endovascular-aortic-repair
#7
Toshifumi Hiraoka, Tatsuhiko Komiya, Hiroshi Tsuneyoshi, Takeshi Shimamoto
OBJECTIVES: Spinal cord ischaemia (SCI) is a serious complication of thoracic endovascular aortic repair (TEVAR). The purpose of this study was to assess the incidence, risk factors, clinical manifestations of SCI after TEVAR and which type of patients could benefit from cerebrospinal fluid drainage. METHODS: A retrospective review was conducted for 175 patients who underwent TEVAR from January 2008 to July 2014. All patients were divided into groups with and without SCI, and they were compared to identify significant risk factors for SCI...
February 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29415193/ten-year-experience-of-the-thoraco-abdominal-aortic-aneurysm-treatment-using-a-hybrid-thoracic-endovascular-aortic-repair
#8
Takashi Shuto, Tomoyuki Wada, Shinji Miyamoto, Noritaka Kamei, Norio Hongo, Hiromu Mori
OBJECTIVES: The treatment of thoraco-abdominal aortic aneurysm continues to have a high mortality and paraplegia rate. In superaging societies, the methods of performing less invasive operations remain a major issue. We reviewed our 10-year experience in the treatment of thoraco-abdominal aortic aneurysm using a hybrid procedure of combined visceral reconstruction and thoracic endovascular aortic repair. METHODS: Sixty patients underwent a hybrid repair for the treatment of the thoraco-abdominal aortic aneurysm between 2007 and 2016...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29315369/patency-of-branch-vessels-reimplanted-during-thoraco-abdominal-aortic-replacement-implications-for-the-surgical-technique
#9
Sang Yoon Kim, Suryeun Chung, Dong Jung Kim, Jun Sung Kim, Cheong Lim, Kay-Hyun Park
OBJECTIVES: Reimplantation of branch vessels is an important component of thoraco-abdominal aortic aneurysm repair. The goal of this study was to assess the anatomical results of branch vessel reimplantation, which have rarely been investigated. METHODS: Among 168 patients who underwent computed tomography after thoraco-abdominal aortic aneurysm repair, the technique of branch vessel reimplantation and determination of their patency were investigated. Late computed tomographic images were available for 81 patients (mean interval 55...
January 5, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29313911/spinal-cord-injury-arising-in-anaesthesia-practice
#10
REVIEW
D W Hewson, N M Bedforth, J G Hardman
Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. The most serious causes of spinal cord injury - vertebral canal haematoma, spinal epidural abscess, meningitis and adhesive arachnoiditis - will be discussed in turn. For each condition, we draw attention to practical, evidence-based measures clinicians can undertake to reduce their incidence, or mitigate their severity...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29246434/endovascular-repair-of-acute-thoraco-abdominal-aortic-aneurysms
#11
Chiara Mascoli, Massimo Vezzosi, Andreas Koutsoumpelis, Mauro Iafrancesco, Aaron Ranasinghe, Paul Clift, Jorge Mascaro, Martin Claridge, Donald J Adam
OBJECTIVES: The outcome of endovascular repair (EVAR) for acute thoraco-abdominal aortic aneurysm (TAAA) is reported and the applicability of the t-Branch off the shelf (OTS) device is determined. METHODS: Interrogation of a prospectively maintained database identified all patients who underwent EVAR for acute TAAA between September 2012 (when the first non-elective t-Branch case was performed) and November 2015. Early and medium-term outcomes were analysed. Survival and re-intervention-free survival were calculated by Kaplan-Meier analysis...
January 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29102345/a-case-report-paediatric-surfer-s-myelopathy
#12
Rebecca Scatchard, Joao Alves Rosa, Philippa Bowen, Alex Mortimer, Peta M Sharples, Andrew L Lux
Surfer's myelopathy was first described by Thompson et al., in 2004.1 It is a rare cause of sudden spinal cord injury that occurs in the absence of direct trauma to the spinal area in novice healthy surfers. We present the case of the youngest patient we are aware of to be diagnosed with surfer's myelopathy following actual surfing. A clear aetiology for surfer's myelopathy has not previous been described. However, the hypothesis that there is ischaemia to the lower spinal cord is supported by our case, where we present the first clear angiographic evidence of the occlusion of the great anterior radicular artery of Adamkiewicz in a patient diagnosed with surfer's myelopathy...
January 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29089284/morphology-and-outcomes-of-total-endovascular-treatment-of-type-b-aortic-dissection-with-aberrant-right-subclavian-artery
#13
Min Zhou, Xueqin Bai, Yong Ding, Yonggang Wang, Changpo Lin, Dong Yan, Zhenyu Shi, Weiguo Fu
OBJECTIVES: To characterize the morphology of type B aortic dissection with aberrant right subclavian artery (ARSA) and present early and midterm outcomes of total endovascular treatment for affected patients. METHODS: From January 2010 to December 2015, patients with ARSA and type B aortic dissection treated with total endovascular techniques were enrolled. The angle of the aortic arch was measured on pre-operative CTA. Sixty age and gender matched normal aortic arch patients with type B aortic dissection served as controls...
December 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29063730/fibroblast-growth-factors-in-the-management-of-spinal-cord-injury
#14
REVIEW
Yulong Zhou, Zhouguang Wang, Jiawei Li, Xiaokun Li, Jian Xiao
Spinal cord injury (SCI) possesses a significant health and economic burden worldwide. Traumatic SCI is a devastating condition that evolves through two successive stages. Throughout each of these stages, disturbances in ionic homeostasis, local oedema, ischaemia, focal haemorrhage, free radicals stress and inflammatory response were observed. Although there are no fully restorative cures available for SCI patients, various molecular, cellular and rehabilitative therapies, such as limiting local inflammation, preventing secondary cell death and enhancing the plasticity of local circuits in the spinal cord, were described...
January 2018: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29049608/acute-administration-of-oestradiol-or-progesterone-in-a-spinal-cord-ischaemia-reperfusion-model-in-rats
#15
Leonardo Pessoa Cavalcante, Sueli Gomes Ferreira, Daniel Romano Pereira, Sergio Rodrigues de Moraes, Rafael Simas, Paulina Sannomiya, Ana Cristina Breithaupt-Faloppa, Luiz Felipe Pinho Moreira
OBJECTIVES: Despite research into protective pharmacological adjuncts, paraplegia persists as a dreaded complication after thoracic and thoracoabdominal aortic interventions. Reports on gender-related neurological outcomes after ischaemic and traumatic brain injuries have led to increased interest in hormonal neuroprotective effects and have generated other studies seeking to prove the neuroprotective effects of the therapeutic administration of 17β-oestradiol and of progesterone. We hypothesised that acute administration of oestradiol or progesterone would prevent or attenuate spinal cord ischaemic injury induced by occlusion of the descending thoracic aorta...
September 26, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28958025/spinal-ischaemia-after-thoracic-endovascular-aortic-repair-with-left-subclavian-artery-sacrifice-is-there-a-critical-stent-graft-length
#16
Fabian A Kari, Babak Saravi, Sonja Krause, Luisa Puttfarcken, Karin Wittmann, Katharina Förster, Bartosz Rylski, Sven Maier, Ulrich Göbel, Matthias Siepe, Martin Czerny, Friedhelm Beyersdorf
OBJECTIVES: Thoracic endovascular aortic repair (TEVAR) is used for treatment of thoracic aortic pathologies, but the covered stent graft can induce spinal ischaemia depending on the length used. The left subclavian artery contributes to spinal cord collateralization and is frequently occluded by the stent graft. Our objective was to investigate the impact of covered stent graft length on the risk of spinal ischaemia in the setting of left subclavian artery sacrifice. METHODS: Twenty-six pigs (German country race, mean body weight 36 ± 4 kg) underwent simulated descending aortic TEVAR via left lateral thoracotomy, with left subclavian artery and thoracic segmental artery occlusion in normothermia...
August 24, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28902822/assessing-the-effect-of-endoprosthetic-repair-of-the-thoracic-portion-on-aortic-remodelling-after-surgical-correction-for-debakey-type-i-dissection
#17
V V Bazylev, M G Shmatkov, D A Zakharov, Z A Morozov
OBJECTIVE: The purpose of the study was to evaluate the influence of endoprosthetic repair of the aortic thoracic portion on remodelling of the descending aorta in patients after the surgical stage of correction for DeBakey type I aortic dissection. PATIENTS AND METHODS: The authors retrospectively analysed a group of 12 patients (9 men and 3 women) subjected to endoprosthetic repair of the aortic thoracic portion after previously performed surgical correction of the ascending aorta and its braches...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28856332/3d-image-fusion-to-localise-intercostal-arteries-during-tevar
#18
G Koutouzi, C Sandström, P Skoog, H Roos, M Falkenberg
PURPOSE: Preservation of intercostal arteries during thoracic aortic procedures reduces the risk of post-operative paraparesis. The origins of the intercostal arteries are visible on pre-operative computed tomography angiography (CTA), but rarely on intra-operative angiography. The purpose of this report is to suggest an image fusion technique for intra-operative localisation of the intercostal arteries during thoracic endovascular repair (TEVAR). TECHNIQUE: The ostia of the intercostal arteries are identified and manually marked with rings on the pre-operative CTA...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/28591766/elective-frozen-elephant-trunk-procedure-using-the-e-vita-open-plus-prosthesis-in-94-patients-a-multicentre-french-registry
#19
Jean-Philippe Verhoye, Reda Belhaj Soulami, Olivier Fouquet, Vito Giovanni Ruggieri, Adrien Kaladji, Jacques Tomasi, Michel Sellin, Fadi Farhat, Amedeo Anselmi
OBJECTIVES: Our goal was to evaluate the operative outcomes of the frozen elephant trunk technique using the E-Vita Open Plus® hybrid prosthesis in chronic aortic arch diseases and report clinical and radiological outcomes at the 1-year follow-up. METHODS: As determined from a prospective multicentre registry, 94 patients underwent frozen elephant trunk procedures using the E-Vita Open Plus hybrid device for the treatment of chronic aortic conditions, including 50% chronic aortic dissections, 40% degenerative aneurysms and 10% miscellaneous indications...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28548204/endovascular-treatment-for-ruptured-abdominal-aortic-aneurysm
#20
REVIEW
Stephen Badger, Rachel Forster, Paul H Blair, Peter Ellis, Frank Kee, Denis W Harkin
BACKGROUND: An abdominal aortic aneurysm (AAA) (pathological enlargement of the aorta) is a condition that can occur as a person ages. It is most commonly seen in men older than 65 years of age. Progressive aneurysm enlargement can lead to rupture and massive internal bleeding, which is fatal unless timely repair can be achieved. Despite improvements in perioperative care, mortality remains high (approximately 50%) after conventional open surgical repair. Endovascular aneurysm repair (EVAR), a minimally invasive technique, has been shown to reduce early morbidity and mortality as compared to conventional open surgery for planned AAA repair...
May 26, 2017: Cochrane Database of Systematic Reviews
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