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Gore excluder

Edmund Kenneth Kerut, William F Campbell, Michael E Hall, Michael R McMullan
A patent foramen ovale (PFO) is implicated in several pathologic processes, including that of cryptogenic stroke (cCVA). Recent trials identify "high-risk" PFOs in patients with cCVA as likely to benefit from percutaneous closure. The younger the patient (<60 years old) the more likely a PFO may be attributable to the cCVA. The RoPE Score index helps determine the likelihood that an existing PFO is related to a cCVA. This may help guide the clinician and patient when contemplating percutaneous PFO closure...
October 10, 2018: Echocardiography
Alessia Giaquinta, Vincenzo Ardita, Ciro Ferrer, Clive B Beggs, Massimiliano Veroux, Matteo Barbante, Matteo Orrico, Piergiorgio Cao, Piefrancesco Veroux
PURPOSE: To assess early and midterm outcomes of iliac branch device (IBD) implantation without an aortic stent-graft for the treatment of isolated common iliac artery aneurysm (CIAA). METHODS: From December 2006 to June 2016, 49 isolated CIAAs in 46 patients were treated solely with an IBD at 7 vascular centers. Five patients were lost to follow-up, leaving 41 male patients (mean age 72.5±7.8 years) for analysis. Mean CIAA diameter was 39.1±10.5 mm (range 25-65)...
April 2018: Journal of Endovascular Therapy
Leonie T Jonker, Arne de Niet, Michel M P J Reijnen, Ignace F J Tielliu, Clark J Zeebregts
Currently, there is a wide range of commercially available endografts for infrarenal abdominal aortic aneurysm (AAA) repair. Results of long-term follow up after endovascular aneurysm repair (EVAR) are limited. Thereby, the durability of these endografts and the difference between manufacturers is not fully clear. In this review, studies with mid- and long-term results, with a minimum median follow up of 36 months per endograft, were included describing results with Cook Zenith� Flex� endograft (Cook Medical Inc...
August 14, 2018: Surgical Technology International
Ioannis A Tsolakis, Stavros K Kakkos, Chrysanthi P Papageorgopoulou, Peter Zampakis, Christina Kalogeropoulou, Spyros Papadoulas, George Lampropoulos, Konstantinos M Nikolakopoulos, Ioannis Ntouvas, Anastasia Kouri
OBJECTIVE: To compare two endograft types, the original GORE EXCLUDER AAA endoprosthesis (W. L. Gore & Associates, Flagstaff, Ariz) with the repositionable GORE EXCLUDER featuring the C3 delivery system, which allows repositioning of the proximal part of the graft to achieve accurate placement in relation to the renal arteries, in unselected patients with aortoiliac aneurysms. In a second nested, substudy we investigated the relative effect of the standard Gore and Gore Dryseal introducer sheaths on intraoperative transfusion needs...
August 11, 2018: Journal of Vascular Surgery
Po-Ying Lee, Po-Lin Chen, Chun-Che Shih, I-Ming Chen
In selected cases of endovascular aortic repair (EVAR) of an abdominal aortic aneurysm, such as patients with tortuous proximal aortic neck, achieving a successful cannulation can sometimes be difficult. Herein, we described a novel cross-wire technique to help overcome such anatomical variations. During the EVAR procedure among our 5 cases, the main body of the Gore Excluder Stent Graft was deployed through an ipsilateral guidewire. Because of a large angle between the contralateral guidewire and the contralateral short limb of the main body, a successful traditional cannulation was unfeasible...
July 24, 2018: Interactive Cardiovascular and Thoracic Surgery
Mohammed E Ghonem, Xun Yuan, Andreas Mitsis, Christoph A Nienaber
Marfan syndrome is a heritable connective tissue disorder affecting skeletal, ocular and cardiovascular systems. Cardiovascular manifestations comprise aneurysmal dilatation of aortic root, aortic dissection and rupture; peripheral arterial aneurysms have been reported in femoral, iliac and subclavian arteries with surgical reconstruction as the first-line therapeutic option. We report a Marfan patient with a symptomatic aneurysm of left subclavian artery in the intrathoracic retro-clavicular space; instead of open surgical resection, an endovascular solution was successfully applied by use of a flexible self-expanding stent-graft (W...
2018: SAGE Open Medical Case Reports
Maximilian Stahl, Michelle DeVeaux, Theo de Witte, Judith Neukirchen, Mikkael A Sekeres, Andrew M Brunner, Gail J Roboz, David P Steensma, Vijaya R Bhatt, Uwe Platzbecker, Thomas Cluzeau, Pedro H Prata, Raphaël Itzykson, Pierre Fenaux, Amir T Fathi, Alexandra Smith, Ulrich Germing, Ellen K Ritchie, Vivek Verma, Aziz Nazha, Jaroslaw P Maciejewski, Nikolai A Podoltsev, Thomas Prebet, Valeria Santini, Steven D Gore, Rami S Komrokji, Amer M Zeidan
Most studies of immunosuppressive therapy (IST) in myelodysplastic syndromes (MDS) are limited by small numbers and their single-center nature, and report conflicting data regarding predictors for response to IST. We examined outcomes associated with IST and predictors of benefit in a large international cohort of patients with MDS. Data were collected from 15 centers in the United States and Europe. Responses, including red blood cell (RBC) transfusion independence (TI), were assessed based on the 2006 MDS International Working Group criteria, and overall survival (OS) was estimated by Kaplan-Meier methods...
July 24, 2018: Blood Advances
Takafumi Ouchi, Noriyuki Kato, Ken Nakajima, Takatoshi Higashigawa, Takashi Hashimoto, Shuji Chino, Hajime Sakuma
INTRODUCTION: Although endovascular therapy is becoming an alternative to open surgical repair of splenic artery aneurysms (SAAs), reports on the use of stent grafts for SAA repair are limited. We present our experience of endovascular therapy using a stent graft for the treatment of an SAA that had ruptured into the gastric lumen. We also reviewed 18 cases of stent graft repair for SAAs, including the present case. CASE REPORT: A 43-year-old man was admitted due to hematemesis...
January 1, 2018: Vascular and Endovascular Surgery
Dean J Arnaoutakis, Gaurav Sharma, Stuart Blackwood, Samir K Shah, Matthew Menard, C Keith Ozaki, Michael Belkin
BACKGROUND: Failure of endovascular aneurysm repairs (EVARs) requiring open conversion remains a major challenge. We analyzed indications for repair, operative strategies, and outcomes with a focus on iliac artery degeneration after endograft removal. METHODS: A prospective, institutional database was reviewed to identify patients who underwent explantation of a failed EVAR device. Demographics, reason for failure, operative details including extent of endograft removal, and complications/survival were examined...
June 15, 2018: Journal of Vascular Surgery
Mathew Wooster, Paul Armstrong, Martin Back
BACKGROUND: Maintenance of pelvic circulation has been connected to reduced risks of ischemic colitis, buttock claudication, erectile dysfunction, and spinal cord ischemia during the treatment of extensive aortoiliac aneurysmal disease. We evaluate the mid-to-late follow-up of a cohort of patients treated using 1 preservation technique, the endovascular external iliac artery (EIA) to internal iliac artery (IIA) bypass. METHODS: All patients undergoing elective retrograde EIA-IIA endovascular bypass at a single institution were retrospectively reviewed over a 10-year period from 2006 to 2016...
October 2018: Annals of Vascular Surgery
Takaaki Sugihara, Nathan W Werneburg, Matthew C Hernandez, Lin Yang, Ayano Kabashima, Petra Hirsova, Lavanya Yohanathan, Carlos Sosa, Mark J Truty, George Vasmatzis, Gregory J Gores, Rory L Smoot
The Hippo pathway effector, Yes-associated protein (YAP), is a transcriptional coactivator implicated in cholangiocarcinoma (CCA) pathogenesis. YAP is known to be regulated by a serine/threonine kinase relay module (MST1/2-LATS1/2) culminating in phosphorylation of YAP at Serine 127 and cytoplasmic sequestration. However, YAP also undergoes tyrosine phosphorylation, and the role of tyrosine phosphorylation in YAP regulation remains unclear. Herein, YAP regulation by tyrosine phosphorylation was examined in human and mouse CCA cells, as well as patient-derived xenograft (PDX) models...
October 2018: Molecular Cancer Research: MCR
William Shutze, Velipekka Suominen, William Jordan, Piergiorgio Cao, Steven Oweida, Ross Milner
BACKGROUND: The Gore Global Registry for Endovascular Aortic Treatment (GREAT) was designed to evaluate real-world outcomes after treatment with Gore aortic endografts used in a real-world, global setting. We retrospectively analyzed the GREAT data to evaluate the incidence and effects of noncylindrical neck anatomy in patients undergoing endovascular aortic aneurysm repair. METHODS: The present analysis included patients with data in the GREAT who had been treated with the EXCLUDER endograft from August 2010 to October 2016...
May 24, 2018: Journal of Vascular Surgery
Gian Franco Veraldi, Luca Mezzetto, Filippo Vaccher, Lorenzo Scorsone, Stefano Bonvini, Igor Raunig, Valentina Wassermann, Sebastiano Tasselli
BACKGROUND: This study aims at evaluating technical success and long-term results using Gore Excluder/C3 endoprosthesis in patients with narrow aortic bifurcation (NAB; inner aortic diameter < 18 mm). METHODS: Clinical and anatomical data were collected retrospectively from patients treated in 2 high-volume Italian vascular centers between 2005 and 2017. A total of 1325 endovascular aneurysm repair procedures were performed, of which 195 involved Excluder/C3 Gore endoprosthesis...
October 2018: Annals of Vascular Surgery
Hai Lei Li, Yiu Che Chan, Stephen W Cheng
BACKGROUND: Aortic stent-graft infection (SGI) is rare but remains one of the most challenging and threatening complications. This systematic review aimed to identify the clinical features, treatment, and outcomes of endograft infection after abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). METHODS: A systematic literature review of all published literature from January 1991 to September 2016 on SGI was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses...
August 2018: Annals of Vascular Surgery
Mario D'Oria, Stefano Chiarandini, Marco Pipitone, Cristiano Calvagna, Francesco Riccitelli, Alice Rotelli, Francesca Zamolo, Filippo Griselli
BACKGROUND: Preservation of the residual hypogastric artery (HGA) in patients with previous endovascular aortic aneurysm repair (EVAR) may require complex operative strategies. We report an alternative technique to preserve the residual HGA with the Gore Excluder Iliac Branch endoprosthesis (IBE) in urgent situations. METHODS: We report the case of 2 high-risk patients (unfit for open surgery), with previous EVAR and exclusion of 1 HGA, treated in emergency setting...
August 2018: Annals of Vascular Surgery
Dominic P J Howard, Conor D Marron, Ediri Sideso, Phillip J Puckridge, Eric L G Verhoeven, James I Spark
OBJECTIVES: Aortic neck diameter is an independent anatomical feature that is poorly understood, yet potentially linked to proximal seal failure and adverse outcome following standard EVAR. The aim of this study was to assess whether large proximal aortic neck (LAN) diameter is associated with adverse outcome using prospectively collected individual patient data from The Global Registry for Endovascular Aortic Treatment (GREAT). METHODS: A total of 3166 consecutive patients, from 78 global centres, receiving Gore Excluder stent grafts for infrarenal abdominal aortic aneurysm repair between 2011 and 2017 were included...
August 2018: European Journal of Vascular and Endovascular Surgery
John E Eaton, Mette Vesterhus, Bryan M McCauley, Elizabeth J Atkinson, Erik M Schlicht, Brian D Juran, Andrea A Gossard, Nicholas F LaRusso, Gregory J Gores, Tom H Karlsen, Konstantinos N Lazaridis
BACKGROUND & AIMS: Improved methods are needed to risk stratify and predict outcomes in patients with primary sclerosing cholangitis (PSC). Therefore, we sought to derive and validate a new prediction model and compare its performance to existing surrogate markers. METHODS: The model was derived using 509 subjects from a multicenter North American cohort and validated in an international multicenter cohort (n=278). Gradient boosting, a machine based learning technique, was used to create the model...
May 9, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Leszek Lombarski, Przemysław Kunert, Marcin Skawiński, Marek Prokopienko, Zbigniew Lewandowski, Andrzej Marchel
OBJECTIVE: Vertebral artery medulla compression syndrome (VAMCS) is a very rare condition manifesting as different neurological focal deficits. The case of a 36-year-old male with symptomatic brainstem compression by vertebral artery (VA) treated by means of microvascular decompression (MVD) and a review of the literature is presented. CASE REPORT: On admission, a 36-year-old patient presented with hypoalgesia, hypothermesthesia and hemiparesis on the left side...
August 2018: Neurologia i Neurochirurgia Polska
Andreas S Peters, Johannes Hatzl, Moritz S Bischoff, Dittmar Böckler
BACKGROUND: Due to recent advances in endograft design and percutaneous access, technical success could be increased during endovascular aneurysm repair (EVAR). Beside EVAR, endovascular aneurysm sealing (EVAS) provides an alternative procedure to treat aneurysms. To compare the two methods, additional benchmark criteria should be evaluated: Screening time, dose area product (DAP), procedure time and contrast use. In this study these technical variables are analysed for EVAS vs. EVAR in comparable patient cohorts...
April 3, 2018: Journal of Cardiovascular Surgery
Rami O Tadros, Alex Sher, Martin Kang, Ageliki Vouyouka, Windsor Ting, Daniel Han, Michael Marin, Peter Faries
OBJECTIVE: The ideal treatment option for patients with complex aneurysm morphology remains highly debated. The aim of this study was to investigate the impact of endovascular aneurysm repair (EVAR) with active fixation on outcomes in patients with complex aneurysm morphology. METHODS: There were 340 consecutive patients who underwent EVAR using active fixation devices, 234 with active infrarenal fixation (AIF; Gore Excluder; W. L. Gore & Associates, Flagstaff, Ariz) and 106 with active suprarenal fixation (ASF; 85 Medtronic Endurant [Medtronic, Santa Rosa, Calif] and 21 Cook Zenith [Cook Medical, Bloomington, Ind])...
September 2018: Journal of Vascular Surgery
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