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https://www.readbyqxmd.com/read/29156021/type-1a-endoleak-following-zone-1-and-zone-2-thoracic-endovascular-aortic-repair-effect-of-bird-beak-configuration
#1
Tomoaki Kudo, Toru Kuratani, Kazuo Shimamura, Tomohiko Sakamoto, Keiwa Kin, Kenta Masada, Takayuki Shijo, Kei Torikai, Koichi Maeda, Yoshiki Sawa
OBJECTIVES: Type 1a endoleak is one of the most severe complications after thoracic endovascular aortic repair (TEVAR), because it carries the risk of aortic rupture. The association between bird-beak configuration and Type 1a endoleak remains unclear. The purpose of this study was to analyse the predictors of Type 1a endoleak following Zone 1 and Zone 2 TEVAR, with a particular focus on the effect of bird-beak configuration. METHODS: From April 2008 to July 2015, 105 patients (mean age 68...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29152822/thoracic-endovascular-repair-versus-medical-management-for-acute-uncomplicated-type-b-aortic-dissection
#2
Tariq H Enezate, Jad Omran, Ashraf S Al-Dadah, Christopher White, Mitul Patel, Ehtisham Mahmud, Rossella Fattori, Jeffrey A Goldstein, Nilesh Goswami, William A Gray, Deepak L Bhatt
BACKGROUND: Current treatment options and outcomes for acute uncomplicated thoracic Type-B aortic dissection (TBAD) remain unclear between medical management (MED) and thoracic endovascular aortic repair (TEVAR). In this study we aim to compare both strategies in terms of all-cause mortality, aortic dilation, and aortic rupture. METHODS: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January 1990 through March 2017. Only studies comparing TEVAR to MED for acute uncomplicated TBAD were included...
November 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29147169/uncomplicated-acute-type-b-aortic-dissection-selection-guidelines-for-tevar
#3
Emilia Krol, Jean M Panneton
Traditionally, the surgical management of acute type B aortic dissections was reserved for patients with signs of malperfusion, rapid expansion, retrograde dissection or rupture. The adjunct of endovascular techniques has brought a paradigm shift, leaning towards preventing long term dissection complications. Multiple risk factors have been proposed to identify patients at risk for long term aortic complications. The patients, who are offered a prophylactic endovascular therapy for uncomplicated aortic dissection, should be selected carefully, and offered intervention by an experienced team in a high-volume center...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29143168/limited-influence-of-blunt-aortic-injuries-on-the-outcome-of-polytraumatized-patients-a-matched-pair-analysis
#4
A Omar, C Macke, M Winkelmann, E Beckmann, P Mommsen, C Schröter, C Krettek, Christian Zeckey
INTRODUCTION: Traumatic lesions of great vessels such as the aorta are life-threatening injuries. There is limited evidence about the influence of traumatic aortic injuries in multiple trauma patients in particular with regard to posttraumatic complications. The aim of this study was to evaluate the influence of blunt thoracic aortic injuries in multiple trauma patients compared to a multiple trauma cohort without this specific injury. In addition, the safety of Thoracic Endovascular Aortic Repair (TEVAR) in multiple trauma patients was analyzed...
November 15, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29137728/a-computational-model-for-false-lumen-thrombosis-in-type-b-aortic-dissection-following-thoracic-endovascular-repair
#5
Claudia Menichini, Zhuo Cheng, Richard G J Gibbs, Xiao Yun Xu
Thoracic endovascular repair (TEVAR) has recently been established as the preferred treatment option for complicated type B dissection. This procedure involves covering the primary entry tear to stimulate aortic remodelling and promote false lumen thrombosis thereby restoring true lumen flow. However, complications associated with incomplete false lumen thrombosis, such as aortic dilatation and stent graft induced new entry tears, can arise after TEVAR. This study presents the application and validation of a recently developed mathematical model for patient-specific prediction of thrombus formation and growth under physiologically realistic flow conditions...
November 11, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29136140/inaccurate-aortic-stent-graft-deployment-in-the-distal-landing-zone-incidence-reasons-and-consequences
#6
Mikolaj Berezowski, Julia Morlock, Friedhelm Beyersdorf, Marek Jasinski, Tomasz Plonek, Matthias Siepe, Martin Czerny, Bartosz Rylski
OBJECTIVES: The aim of this study was to investigate the accuracy of stent graft deployment in the distal landing zone (LZ) during thoracic endovascular aortic repair (TEVAR). Currently, TEVAR focuses on accurate stent graft deployment in the proximal LZ. Data on landing in the distal LZ are lacking. METHODS: Of 195 TEVAR patients (2005-16) with a non-dissected aortic pathology, 59 [median age 73 years (first quartile 68; third quartile 77), 20 women] patients had a distal LZ shorter than 40 mm...
November 9, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29130399/recent-trends-in-publications-of-us-vascular-surgery-program-directors
#7
Afsha Aurshina, Anil Hingorani, Amrit Hingorani, Ayisha Zainab, Natalie Marks, Sheila Blumberg, Enrico Ascher
Objective In order to examine the academic productivity of US vascular surgery program directors, the number of vascular publications listed in PubMed from 2001 to 2015 for US vascular surgery program directors was reviewed. We suggest that this can be used as a benchmark for academic productivity. Methods The names of the program directors were taken from the Accreditation Council for Graduate Medical Education (ACGME) website at two time points: December 2009 (Independent Programs) and December 2015 (Independent + Integrated)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29129854/update-on-the-therapeutic-strategy-of-type-b-aortic-dissection
#8
Shuichiro Kaji
Stanford type B aortic dissection (TBAD) is a life-threatening disease. Current therapeutic guidelines recommend medical therapy with aggressive blood pressure lowering for patients with acute TBAD unless they have fatal complications. Although patients with uncomplicated TBAD have relatively low early mortality, aorta-related adverse events during the chronic phase worsen the long-term clinical outcome. Recent advances in thoracic endovascular aortic repair (TEVAR) can improve clinical outcomes in patients with both complicated and uncomplicated TBAD...
November 10, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#9
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29121846/retrograde-ascending-dissection-after-thoracic-endovascular-aortic-repair-combined-with-the-chimney-technique-and-successful-open-repair-using-the-frozen-elephant-trunk-technique
#10
Koji Hirano, Toshiya Tokui, Bun Nakamura, Ryosai Inoue, Masahiro Inagaki, Yasumi Maze, Noriyuki Kato
The chimney technique can be combined with thoracic endovascular aortic repair (TEVAR) to both obtain an appropriate landing zone and maintain blood flow of the arch vessels. However, surgical repair becomes more complicated if retrograde type A aortic dissection occurs after TEVAR with the chimney technique. We herein report a case involving a 73-year-old woman who developed a retrograde ascending dissection 3 months after TEVAR for acute type B aortic dissection. To ensure an adequate proximal sealing distance, the proximal edge of the stent graft was located at the zone 2 level and an additional bare stent was placed at the left subclavian artery (the chimney technique) at the time of TEVAR...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29116203/association-of-thyroid-function-with-early-mid-term-aorta-related-adverse-events-and-readmissions-after-thoracic-endovascular-aortic-repair
#11
Nan Lu, Zhuoqiao He, Tan Xu, Xin Chen, Xianfeng Chen, Xiaojing Ma, Xuerui Tan
The prognosis of patients after thoracic endovascular aortic repair (TEVAR) is affected by several clinical characteristics. This study aimed to evaluate whether thyroid hormones predicts early (30 days) and mid-term (12 months) aorta-related adverse events (ARAE) and readmissions (ARAR) in patients after TEVAR. A total of 338 continuous patients who underwent TEVAR were included and stratified based on quartile of free thyroxine (FT4) levels examined before surgery. The relationship of FT4 levels with early or mid-term ARAE and ARAR were assessed using univariate and multiple logistic regression analysis...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29106452/acute-aortic-syndromes-diagnosis-and-management-an-update
#12
Eduardo Bossone, Troy M LaBounty, Kim A Eagle
Acute aortic syndromes (AAS) encompass a constellation of life-threatening medical conditions including classic acute aortic dissection (AAD), intramural haematoma, and penetrating atherosclerotic aortic ulcer. Given the non-specific symptoms and physical signs, a high clinical index of suspicion is necessary to detect the disease before irreversible lethal complications occur. In order to reduce the diagnostic time delay, a comprehensive flowchart for decision-making based on pre-test sensitivity of AAS has been designed by the European Society of Cardiology guidelines on aortic diseases and should be thus applied in the emergency scenario...
June 30, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29101994/acr-appropriateness-criteria-%C3%A2-thoracic-aorta-interventional-planning-and-follow-up
#13
Gregory Bonci, Michael L Steigner, Michael Hanley, Aaron R Braun, Benoit Desjardins, Ron C Gaba, Kenneth L Gage, Jon S Matsumura, Eric E Roselli, David M Sella, Richard Strax, Nupur Verma, Clifford R Weiss, Karin E Dill
Thoracic endovascular aortic repair (TEVAR) has undergone rapid evolution and is now applied to a range of aortic pathologies. Imaging plays a vital role in the pre- and postintervention assessment of TEVAR patients. Accurate characterization of pathology and evaluation for high-risk anatomic features are necessary in the planning phase, and careful assessment for graft stability, aortic lumen diameter, and presence of endoleak are paramount in the follow-up period. CTA is the imaging modality of choice for pre- and postintervention assessment, and MRA is an acceptable alternative depending on patient stability and graft composition...
November 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29097043/incidence-and-risk-factors-for-retrograde-type-a-dissection-and-stent-graft-induced-new-entry-after-thoracic-endovascular-aortic-repair
#14
Tao Ma, Zhi Hui Dong, Wei Guo Fu, Da Qiao Guo, Xin Xu, Bin Chen, Jun Hao Jiang, Jue Yang, Zhen Yu Shi, Ting Zhu, Yun Shi, Bao Hong Jiang, Xiao Yun Xu
OBJECTIVE: Stent graft (SG)-induced new entry (SINE) and retrograde type A dissection (RTAD) are serious device-related complications occurring after thoracic endovascular aortic repair (TEVAR) for Stanford type B aortic dissection (TBAD) and may lead to endograft-related complications including retrograde dissection and death. The purpose of this study was to investigate the incidence and risk factors for the development of RTAD and SINE after TEVAR for TBAD and to identify the complications associated with this...
October 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29096576/endovascular-treatment-of-aortic-arch-lesions-using-scalloped-endografts
#15
Leopoldo Fernández-Alonso, Sebastián Fernández Alonso, Esther Martínez Aguilar, Estéfana Santamarta Fariña, Jordi Alegret Solé, Marina López San Martín, Margarita Atienza Pascual, Leopoldo Fernández-Domper, Roberto Centeno Vallepuga
OBJECTIVE: To present our early and midterm results using thoracic endovascular aortic repair (TEVAR) with a custom-made proximal scalloped stent graft to accommodate left common carotid artery (LCCA) and innominate artery (IA) in treating aortic lesions involving the arch. MATERIALS AND METHODS: Between February 2014 and April 2017, select patients presenting with aortic arch lesions and short proximal landing zone were treated by proximal scalloped Relay Plus stent grafts...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29089284/morphology-and-outcomes-of-total-endovascular-treatment-of-type-b-aortic-dissection-with-aberrant-right-subclavian-artery
#16
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...
October 28, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29078248/-management-of-endograft-infection-after-evar-and-tevar-a-case-series-and-literature-review
#17
Thomas Betz, Ingolf Töpel, Markus Steinbauer, Christian Uhl
Introduction Endograft infection after EVAR (Endovascular aortic repair) or TEVAR (Thoracic endovascular aortic repair) is a rare but severe complication with high mortality. As the number of patients with endovascular aneurysm repair has increased over the last decade, the number of patients with endograft infection might also have increased. However, no guideline defines the treatment of endograft infection. Diagnosis is difficult and depends on clinical symptoms, radiological imaging and blood cultures. Surgery with graft excision, debridement and revascularisation should be proposed...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29066151/comparison-of-thoracic-endovascular-aortic-repair-open-surgery-and-best-medical-treatment-for-type-b-aortic-dissection-a-meta-analysis
#18
Fu-Rong Li, Xiaoxiang Wu, Jinqiu Yuan, Jiangyun Wang, Chen Mao, Xianbo Wu
BACKGROUND: Treatments of type B aortic dissection (TBAD) include thoracic endovascular aortic repair (TEVAR), best medical treatment (BMT) and open surgery (OS). This meta-analysis was to compare these three strategies to evaluate which provides best outcomes. METHODS: We searched clinical trials that compared treatment strategies for TBAD. The outcomes measures were 30-day/in-hospital mortality, long-term survival rate, paraplegia or paraparesis, renal failure, rupture, stroke, late re-intervention, late rupture and aneurismal dilatation/expansion...
October 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29062457/late-type-iii-endoleak-after-thoracic-endovascular-aneurysm-repair-and-previous-infrarenal-stent-graft-implantation-a-case-report-and-review-of-the-literature
#19
Jerzy Leszczyński, Waldemar Macioch, Witold Chudziński, Zbigniew Gałązka
Thoracic endovascular aortic repair (TEVAR) effectively improved the results of thoracic aortic aneurysm treatment. TEVAR is a less invasive procedure that can be performed under local anesthesia with shorter hospital stay. The perioperative morbidity and mortality rates are lower for endovascular than open repair, but the rate of secondary interventions is higher for TEVAR. We report a case of an elderly man with synchronous abdominal and thoracic aortic aneurysms. A type III dangerous endoleak was recognized 3 years after TEVAR...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29049529/a-novel-method-for-prevention-of-stent-graft-induced-distal-re-dissection-after-thoracic-endovascular-aortic-repair-for-type-b-aortic-dissection
#20
Kenta Masada, Kazuo Shimamura, Tomohiko Sakamoto, Tomoaki Kudo, Takayuki Shijo, Koichi Maeda, Kei Torikai, Toru Kuratani, Yoshiki Sawa
OBJECTIVES: Stent graft-induced distal re-dissection (SIDR) is a burdensome complication after thoracic endovascular aortic repair (TEVAR) for Type B aortic dissection. We developed a novel method to prevent SIDR by placing a small-diameter short stent graft [Excluder Aortic Extender (Cuff)] at the distal landing zone (DLZ) and reviewed its effectiveness in this study. METHODS: Ninety patients who underwent TEVAR for Type B aortic dissection using commercially available devices between January 2008 and September 2016 were retrospectively reviewed...
July 31, 2017: Interactive Cardiovascular and Thoracic Surgery
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