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https://www.readbyqxmd.com/read/27923612/protocol-of-the-ktft-talk-study-to-reduce-racial-disparities-in-kidney-transplant-evaluation-and-living-donor-kidney-transplantation
#1
Kellee Bornemann, Emilee Croswell, Menna Abaye, Cindy L Bryce, Chung-Chou H Chang, Deborah S Good, Cathleen A Freehling Heiles, Mary Amanda Dew, L Ebony Boulware, Amit D Tevar, Larissa Myaskovsky
Living donor kidney transplantation (LDKT) is the optimal treatment for end-stage kidney disease (ESKD). The evaluation process for a kidney transplant is complex, time consuming, and burdensome to the ESKD patient. Also, race disparities exist in rates of transplant evaluation completion, transplantation, and LDKT. In December 2012 our transplant center implemented a streamlined, one-day evaluation process, dubbed Kidney Transplant Fast Track (KTFT). This paper describes the protocol of a two-part study to evaluate the effectiveness of KTFT at increasing transplant rates (compared to historical controls) and the TALK intervention (Talking About Live Kidney Donation) at increasing LDKT during KTFT...
December 3, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/27921203/treatment-of-uncomplicated-type-b-aortic-dissection
#2
REVIEW
Hitoshi Matsuda
Hospital mortality after the replacement of chronic type B aortic dissection is around 8-10% and adverse outcomes include paraplegia and stroke. However, the level of evidence for indication of thoracic endovascular aortic repair (TEVAR) for type B chronic aortic dissection is Class IIa. Results of the INSTEAD-XL trial have verified that preemptive TEVAR for uncomplicated type B aortic dissection improves prognosis. The indication for this procedure is reportedly a maximum aortic diameter >40 mm during the acute phase and a patent primary entry site in the thoracic aorta, while the optimal timing for TEVAR would be the subacute phase, from 2 weeks to 3-6 months after onset...
December 5, 2016: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27908812/original-off-label-endovascular-solution-to-occlude-false-lumen-rupture-in-chronic-type-b-aortic-dissection
#3
E M Marone, M Leopardi, L Bertoglio, D Mascia, R Chiesa
After Thoracic Endovascular Aortic Repair (TEVAR) for chronic type B aortic dissection (cTBD) the patency of the false lumen is quite common and its presence is associated with the risk of developing complications and is a predictor of death by aortic rupture. We report a case of a patient treated in emergency for the rupture of the false lumen in cTBD. He had previous TEVAR with persisting distal dissection and retrograde reperfusion of the false lumen. We performed an original endovascular treatment with graft relining and false lumen occlusion with a home-made "candy plug" obtained with two commercially available stent grafts...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908807/incomplete-expansion-of-chimney-stent-graft-during-chimney-thoracic-endovascular-aneurysm-repair-ch-tevar
#4
Athanasios Katsargyris, Domenico Spinelli, Kyriakos Oikonomou, Hozan Mufty, Eric Lg Verhoeven
PURPOSE: To report a technical complication during a chimney-thoracic endovascular aneurysm repair (Ch-TEVAR) procedure. CASE REPORT: A 77 year-old female patient underwent Ch-TEVAR for a symptomatic thoracic aortic aneurysm (TAA) with a short and angulated proximal neck. Deployment of the aortic stent-graft over the left subclavian artery (LSA) was followed by placement of a balloon expandable covered stent as a chimney for the LSA. Chimney deployment failed due to balloon perforation...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27906639/ultrasonography-in-the-diagnosis-of-asymptomatic-hyperuricemia-and-gout
#5
J G Puig, L M Beltrán, C Mejía-Chew, D Tevar, R J Torres
Sonography has detected urate deposits in 34%-42% of the patients with asymptomatic hyperuricemia. This may prompt reclassification of asymptomatic hyperuricemia into "asymptomatic gout" and consideration of urate lowering therapy (ULT) to resolve urate deposits. In patients with gout and no visible tophi, sonography has detected urate deposits in half of the patients. This may allow diagnosing "tophaceous gout" and influencing the serum urate target level, prophylaxis to avoid acute gout flares during ULT, and clinical follow-up...
December 2016: Nucleosides, Nucleotides & Nucleic Acids
https://www.readbyqxmd.com/read/27905691/is-volume-important-in-aneurysm-treatment-outcome
#6
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27903477/simultaneous-endovascular-repair-for-thoracic-and-abdominal-aortic-pathologies-early-and-mid-term-results
#7
Yuanyuan Guo, Hongbo Cai, Bin Yang, Hui Jin
OBJECTIVES: To analyse information from a single clinical centre, evaluating early and mid-term results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for co-existing thoracic and abdominal aortic pathologies. METHODS: From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years, range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903475/technical-aspects-of-open-repair-for-degenerative-aneurysmal-evolution-despite-early-thoracic-endovascular-repair-of-type-b-aortic-dissection
#8
Sonia Aguir, Salma El Batti, Paul Achouh, Pierre Julia, Alain Bel, Jean-Noël Fabiani, Jean-Marc Alsac
: Closure of the proximal tear by Thoracic Endovascular Aortic Repair (TEVAR) at the acute phase appears to be an safe effective treatment to prevent aneurysmal degeneration type B dissection. However, it appears to be inefficient in up to a third of the patient. We report the technical aspects of our experience with patients undergoing secondary open repair after TEVAR for dissecting thoraco-abdominal aneurysm despite early closure proximal tear by TEVAR. METHODS: During a period of 5 years, 96 patients presenting acute Type B Aortic Dissections (TBAD) were treated by TEVAR and followed-up in our institution...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903474/functional-assessment-and-evaluation-of-outcome-after-endovascular-therapy-with-coverage-of-the-left-subclavian-artery-in-case-of-blunt-thoracic-aortic-injury
#9
A Gombert, D Kotelis, U M Griepenkerl, G Fraedrich, J Klocker, B Glodny, M J Jacobs, A Greiner, J Grommes
OBJECTIVE: Patients suffering blunt thoracic aortic injury (BTAI) can be treated by use of thoracic endovascular aortic repair (TEVAR). In this setting, the coverage of the left subclavian artery (LSA) is frequently necessary. Nevertheless, the functionality of the upper left extremity after TEVAR had been rarely analyzed. Thus this study intends to underline the safety of TEVAR as well as to determine the functionality of the left arm after coverage of the LSA. METHODS: All patients suffering from BTAI treated by endovascular means in three centers (Aachen [Germany], Maastricht [Netherlands] and Innsbruck [Austria]) between 1996 and 2009 were retrospectively analyzed...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903471/bovine-pericardium-as-new-technical-option-for-in-situ-reconstruction-of-aortic-graft-infection
#10
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVE: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infra-renal aorta using custom-made bovine pericardium grafts...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27891504/thoracic-aorta-aneurysm-repair-in-a-patient-with-a-solitary-kidney-hybrid-surgery-as-a-bailout-procedure
#11
Chris Bakoyiannis, Demetrios Moris, George Karaolanis, Nikolaos Patelis, Dimitrios Schizas, Sotirios Georgopoulos, Theodoros Liakakos
Thoracic endovascular aortic repair (TEVAR) is an emerging treatment option for thoracic aorta aneurysms (TAA). Endovascular access is a challenge. We present a novel TEVAR technique in a patient with single kidney and a 6.4 cm TAA. Attempting to place a sheath through iliac arteries was unsuccessful. The decision to proceed to hybrid TEVAR was made. The protection of the solitary kidney was achieved through axillo-femoral bypass, followed by an end-to-side anastomosis between the aorta and a bifurcated graft...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27887856/preoperative-thoracic-false-lumen-branches-relate-to-aortic-remodeling-after-thoracic-endovascular-aortic-repair-for-debakey-iiib-aortic-dissection
#12
Yang Yang Ge, Wei Guo, Nick Cheshire, Xiao Ping Liu, Xin Jia, Jiang Xiong, Xiao Hui Ma, Hong Peng Zhang
OBJECTIVE: This study evaluated the association between thoracic false lumen branches (TFLBs; dissected thoracic branches fed by a false lumen) and distal thoracic aortic enlargement (DTAE) after thoracic endovascular aortic repair (TEVAR) for DeBakey IIIb aortic dissection. METHODS: We retrospectively analyzed the records of 67 patients with DeBakey IIIb dissection initially treated with TEVAR between January 2011 and December 2013. Preoperative and postoperative computed tomography angiography images were reviewed to evaluate the number of preoperative TFLBs and aortic diameter change after TEVAR...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876516/predictors-of-aortic-growth-in-uncomplicated-type-b-aortic-dissection-from-the-acute-dissection-stent-grafting-or-best-medical-treatment-adsorb-database
#13
Arnoud V Kamman, Jan Brunkwall, Eric L Verhoeven, Robin H Heijmen, Santi Trimarchi
BACKGROUND: The high-risk patient cohort of uncomplicated type B aortic dissections (uTBADs) needs to be clarified. We compared uTBAD patients treated with best medical treatment (BMT), with and without aortic growth, from the Acute Dissection Stent Grafting or Best Medical Treatment (ADSORB) trial database. Furthermore, we looked for trends in outcome for aortic growth and remodeling after BMT and thoracic endovascular aortic repair (TEVAR) and BMT (TEVAR+BMT). METHODS: BMT patients with available baseline and a 1-year follow-up arterial computed tomography scan were identified...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27866141/transapical-aortic-stenting-an-initial-case-series
#14
Tamer G Ghazy, Ahmed S Ouda, Ahmed M Mashhour, Manuel Wilbring, Klaus Matschke, Utz W Kappert
AIMS: The standard approach for thoracic endovascular aortic repair (TEVAR) is transfemoral; however, calcifications and tortuosity of the access vessels might be so extensive as to increase the operative risk markedly or preclude the procedure. This study evaluates the transapical approach as an alternative route for TEVAR in such patients. METHODS AND RESULTS: From June 2011 to July 2013, the institution's interdisciplinary board for aortic diseases initially denied TEVAR for eight patients with thoracic aortic pathology due to extensive calcification and tortuosity of the distal vessels...
November 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27864460/use-of-the-octopus-endograft-technique-to-reconstruct-renovisceral-arteries-arising-from-the-false-lumen-of-a-rapidly-expanding-type-b-aortic-dissection-after-endovascular-repair
#15
Jiang Xiong, Yangyang Ge, Xiaoping Liu, Lijun Wang, Wei Guo
PURPOSE: To describe the use and 6-month outcomes of the octopus endograft technique to reconstruct renovisceral arteries arising from the false lumen (FL) of a type B aortic dissection after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 46-year-old man post TEVAR for type B aortic dissection was admitted with persistent back pain and a rapidly expanding residual dissection. The celiac and left renal arteries arose from the FL and the superior mesenteric artery from both lumens, with the FL as its main supply...
November 17, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27858166/traumatic-aortic-injury-does-the-anatomy-of-the-aortic-arch-influence-aortic-trauma-severity
#16
Jacek Wojciechowski, Lukasz Znaniecki, Kamil Bury, Kamil Chwojnicki, Jan Rogowski
PURPOSE: Traumatic aortic injury (TAI) is a rare but life-threatening type of injury. We investigate whether the anatomy of the aortic arch influences the severity of aortic injury. METHODS: This is a retrospective study of twenty-two cases treated with TEVAR for TAI in our department from 2009 to 2014. Aortic injury was assessed in accordance with the recommendations of the Society of Vascular Surgery. We measured the aortic arch angle and the aortic arch index, based on the initial angio-CT scan, in each of the analyzed cases...
November 17, 2016: Surgery Today
https://www.readbyqxmd.com/read/27856475/assessment-of-cardiovascular-remodelling-following-endovascular-aortic-repair-through-imaging-and-computation-the-core-prospective-observational-cohort-study-protocol
#17
Foeke J H Nauta, Arnoud V Kamman, El-Sayed H Ibrahim, Prachi P Agarwal, Bo Yang, Karen Kim, David M Williams, Joost A van Herwaarden, Frans L Moll, Kim A Eagle, Santi Trimarchi, Himanshu J Patel, C Alberto Figueroa
INTRODUCTION: Thoracic aortic stent grafts are orders of magnitude stiffer than the native aorta. These devices have been associated with acute hypertension, elevated pulse pressure, cardiac remodelling and reduced coronary perfusion. However, a systematic assessment of such cardiovascular effects of thoracic endovascular aortic repair (TEVAR) is missing. The CardiOvascular Remodelling following Endovascular aortic repair (CORE) study aims to (1) quantify cardiovascular remodelling following TEVAR and compare echocardiography against MRI, the reference method; (2) validate computational modelling of cardiovascular haemodynamics following TEVAR using clinical measurements, and virtually assess the impact of more compliant stent grafts on cardiovascular haemodynamics; and (3) investigate diagnostic accuracy of ECG and serum biomarkers for cardiac remodelling compared to MRI...
November 17, 2016: BMJ Open
https://www.readbyqxmd.com/read/27847066/a-successful-three-stage-surgical-treatment-for-aortoesophageal-fistula-after-thoracic-endovascular-aortic-repair-and-esophageal-stent-repair
#18
Lijian Cheng, Junming Zhu, Xiangyang Liu, Wei Liu, Haiou Hu, Jie Zhang, Jiexiong Liang, Lizhong Sun
A 39-year-old man with Stanford B aortic dissection was treated by thoracic endovascular aortic repair (TEVAR) and experienced an aortoesophageal fistula (AEF). After repeated TEVAR and esophageal stent implantation, the hematemesis did not cease although the whole thoracic descending aorta was covered by stents. A three-stage operation was performed, and an AEF 9 cm long was found during the operation. To our knowledge, this may be the largest AEF ever reported. The patient survived without adverse events.
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27847062/preemptive-aneurysm-sac-embolization-for-thoracic-endovascular-aortic-repair-with-inadequate-proximal-landing-zone
#19
Jacky Y K Ho, Randolph H L Wong, Simon C Y Chow, Peter S Y Yu, Micky W T Kwok, Malcolm J Underwood, Simon C H Yu
Thoracic endovascular aortic repair (TEVAR) offers a less invasive treatment for aortic arch aneurysms. Clinical challenges arise when there is inadequate proximal landing for zone 1 TEVAR, such that a median sternotomy with total aortic debranching is required before stent deployment. The chimney technique was reported as an alternative approach to stent the arch branches and avoid sternotomy, but it was still associated with considerable chance of a type IA endoleak. We report a case of aortic arch aneurysm with an inadequate proximal landing for zone 1 TEVAR that was treated with debranching of head and neck vessels followed by TEVAR and preemptive and targeted coil embolization of the arch aneurysmal sac...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27842771/drug-metabolism-drug-interactions-and-drug-induced-liver-injury-in-living-donor-liver-transplant-patients
#20
REVIEW
Swaytha Ganesh, Omar Abdulhameed Almazroo, Amit Tevar, Abhinav Humar, Raman Venkataramanan
Living donor liver transplant (LDLT) fills a critically needed gap in the number of livers available for transplant. However, little is known about the functional recovery of the liver in the donor and in the recipient after surgery. Given that both donor and recipients are treated with several drugs, it is important to characterize the time course of recovery of hepatic synthetic, metabolic, and excretory function in these patients. In the absence of data from LDLT, information on the effect of liver disease on the pharmacokinetics of medications can be used as guidance for drug dosing in LDLT patients...
February 2017: Clinics in Liver Disease
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