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https://www.readbyqxmd.com/read/28715511/endovascular-treatment-of-genetically-linked-aortic-diseases
#1
D Böckler, K Meisenbacher, A S Peters, C Grond-Ginsbach, M S Bischoff
BACKGROUND: The most important structural proteins of the vascular wall are collagen and elastin. Genetically linked connective tissue diseases lead to degeneration, aneurysm formation and spontaneous dissection or rupture of arteries. The most well-known are Marfan syndrome, vascular Ehlers-Danlos syndrome (type IV), Loeys-Dietz syndrome and familial aortic aneurysms and dissections. OBJECTIVE: This review article addresses the current status of endovascular treatment options for important connective tissue diseases...
2017: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
https://www.readbyqxmd.com/read/28711399/restrictive-bare-stent-prevents-distal-stent-graft-induced-new-entry-in-endovascular-repair-of-type-b-aortic-dissection
#2
Yang Zhao, Yitian Chen, Mian Wang, Liang Zheng, Zilun Li, Guangqi Chang, Henghui Yin
OBJECTIVE: Distal stent graft-induced new entry (SINE) can occur after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. This study investigated the mechanism of distal SINE and its prevention using a restrictive bare stent (RBS) technique. METHODS: From January 2013 to December 2014, 68 consecutive type B aortic dissection patients received endovascular repair at our center. The RBS technique was used with distal oversizing (between the diameter of the thoracic stent graft and the descending aorta true lumen diameter at the level of the intended distal edge of the thoracic stent graft) >20%...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28701057/treatment-of-serious-complications-following-endovascular-aortic-repair-for-type-b-thoracic-aortic-dissection
#3
Zhao Liu, Yepeng Zhang, Chen Liu, Dian Huang, Ming Zhang, Feng Ran, Wei Wang, Tao Shang, Tong Qiao, Min Zhou, Changjian Liu
Objective This study aimed to describe treatment of serious complications after primary thoracic endovascular aortic repair (TEVAR) in type B aortic dissection. Methods From June 2008 to March 2016, serious complications occurred in 58 patients without Marfan syndrome who received TEVAR for type B aortic dissection. Results Complications included endoleak, distal true lumen collapse, retrograde dissection, stroke, stent-graft (SG) migration and mistaken deployment, lower limb ischaemia, and SG fracture. Treatment included endovascular repair, surgical procedures, or conservative medication...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28700467/early-and-midterm-outcomes-of-thoracic-endovascular-aortic-repair-tevar-for-acute-and-chronic-complicated-type-b-aortic-dissection
#4
Min-Hong Zhang, Xin Du, Wei Guo, Xiao-Ping Liu, Xin Jia, Yang-Yang Ge
Thoracic endovascular aortic repair (TEVAR) in the current era has been chosen as a dominant and minimally invasive treatment for complicated aorta dissection. This study aimed to assess safety and feasibility of TEVAR in acute and chronic type B aortic dissection.Between January 2011 and December 2013, 85 patients with complicated type B aortic dissection undergoing TEVAR were divided into acute aortic dissection (AAD) (n = 60) group and chronic aortic dissection (CAD) group (n = 25). Computed tomography was used to evaluate postoperative changes in maximal aortic diameter and true and false lumen diameters at 3 levels during a mean follow-up period of 26...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28699426/management-of-hemothorax-after-thoracic-endovascular-aortic-repair-for-ruptured-aneurysms
#5
Mila H Ju, Michael J Nooromid, Heron E Rodriguez, Mark K Eskandari
Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28693049/hybrid-repair-techniques-for-complex-aneurysms-and-dissections-involving-the-aortic-arch-and-thoracic-aorta
#6
Rami Tadros, Scott R Safir, Peter L Faries, Daniel K Han, Rajiv K Chander, James F McKinsey, Michael L Marin, Allan S Stewart, Sharif Ellozy
Aortic aneurysms involving the ascending aorta, aortic arch, and descending thoracic aorta have been a challenging entity to surgically treat for over 60 years. Despite the mortality of the disease, early open surgical procedures also had significant morbidity and mortality. The inherent risk in treating multiple anatomic segments simultaneously led to the innovation of the staged elephant trunk (ET) approach by Borst in 1983. To avoid the thoracotomy and associated complications related to the second stage of the procedure, an endovascular completion paradigm was begun by Volodos in 1991...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28683909/type-b-aortic-dissections-current-guidelines-for-treatment
#7
REVIEW
Daniel B Alfson, Sung W Ham
Stanford type B aortic dissections (TBADs) involve the descending aorta and can present with complications, including malperfusion syndrome or aortic rupture, which are associated with significant morbidity and mortality if left untreated. Clinical diagnosis is straightforward, typically confirmed using CT angiography. Treatment begins with immediate anti-impulse medical therapy. Acute TBAD with complications should be repaired with emergent thoracic endovascular aortic repair (TEVAR). Uncomplicated TBAD with high-risk features should undergo TEVAR in the subacute phase...
August 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28683504/initial-experience-with-the-transapical-access-for-tevar
#8
Andreas H Mahnken, Marc Irqsusi, Walter Hundt, Rainer G Moosdorf
Background The endovascular approach has become a mainstay in the treatment of aortic aneurysms. While the transfemoral approach is most commonly used, it is often inaccessible due to a vascular pathology, such as occlusion, tortuosity or heavy calcifications. The transapical access provides an alternative approach. The goal of this study is to report the feasibility of the transapical approach for total endovascular repair of thoracic aortic aneurysms (TEVAR). Methods Three patients with thoracic aortic aneurysms with inaccessible femoral arteries underwent TEVAR via the transapical approach...
August 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28660196/endovascular-repair-of-traumatic-isthmic-ruptures-special-concerns
#9
REVIEW
Nikolaos Patelis, Athanasios Katsargyris, Chris Klonaris
Injury of the aortic isthmus is the second most frequent cause of death in cases of blunt traumatic injury. Conventional open repair is related to significant morbidity and mortality. Thoracic endovascular aortic repair (TEVAR) has increasing role in traumatic isthmic rupture, as it avoids the thoracotomy-related morbidity, aortic cross clamping, and cardiopulmonary bypass. Additionally to the technical difficulties of open repair, multi-trauma patients may not tolerate the manipulations necessary to undergo open surgery, due to concomitant injuries...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28660114/a-rare-complication-of-tevar-performed-for-complex-acute-stanford-b-aortic-dissection
#10
George Awad, Patrick Zardo, Hassina Baraki, Ingo Kutschka
Management of aortic dissection with a novel endovascular technique known as thoracic endovascular aortic repair (TEVAR) paired with surgical debranching as a less invasive alternative to conventional repair has gained widespread acceptance. However, experience for complicated, Stanford type B dissection involving the aortic arch is still limited.
January 2017: Thoracic and Cardiovascular Surgeon Reports
https://www.readbyqxmd.com/read/28654545/impact-of-pretransplant-bridging-locoregional-therapy-for-patients-with-hepatocellular-carcinoma-within-milan-criteria-undergoing-liver-transplantation-analysis-of-3601-patients-from-the-us-multicenter-hcc-transplant-consortium
#11
Vatche G Agopian, Michael P Harlander-Locke, Richard M Ruiz, Goran B Klintmalm, Srinath Senguttuvan, Sander S Florman, Brandy Haydel, Maarouf Hoteit, Matthew H Levine, David D Lee, C Burcin Taner, Elizabeth C Verna, Karim J Halazun, Rita Abdelmessih, Amit D Tevar, Abhinav Humar, Federico Aucejo, William C Chapman, Neeta Vachharajani, Mindie H Nguyen, Marc L Melcher, Trevor L Nydam, Constance Mobley, R Mark Ghobrial, Beth Amundsen, James F Markmann, Alan N Langnas, Carol A Carney, Jennifer Berumen, Alan W Hemming, Debra L Sudan, Johnny C Hong, Joohyun Kim, Michael A Zimmerman, Abbas Rana, Michael L Kueht, Christopher M Jones, Thomas M Fishbein, Ronald W Busuttil
OBJECTIVE: To evaluate the effect of pretransplant bridging locoregional therapy (LRT) on hepatocellular carcinoma (HCC) recurrence and survival after liver transplantation (LT) in patients meeting Milan criteria (MC). SUMMARY BACKGROUND DATA: Pre-LT LRT mitigates tumor progression and waitlist dropout in HCC patients within MC, but data on its impact on post-LT recurrence and survival remain limited. METHODS: Recurrence-free survival and post-LT recurrence were compared among 3601 MC patients with and without bridging LRT utilizing competing risk Cox regression in consecutive patients from 20 US centers (2002-2013)...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28651454/chimney-technique-in-supra-aortic-branch-reconstruction-in-china-a-systematic-and-critical-review-of-chinese-published-experience
#12
Yang Zhao, Yawei Shi, Mian Wang, Jin Cui, Yitian Chen, Liang Zheng, Henghui Yin, Guangqi Chang
BACKGROUND: The chimney graft (CG) technique has been proposed as a complete endovascular supra-aortic branch reconstruction for aortic pathologies. Due to the rapid growth of thoracic endovascular aortic repair (TEVAR) in China, we aimed to investigate the current data of the CG technique in this most populous country. METHODS: Studies of supra-aortic branch reconstruction using the CG technique from Chinese centers were collected and analyzed. RESULTS: A total of 294 patients from Chinese centers who underwent TEVAR with CGs were included...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28648482/comparison-of-intravascular-ultrasound-and-centerline-computed-tomography-determined-aortic-diameters-during-thoracic-endovascular-aortic-repair
#13
Sukgu M Han, Ramsey S Elsayed, Sung W Ham, Anuj Mahajan, Fernando Fleischman, Vincent L Rowe, Mark J Cunningham, Fred A Weaver
BACKGROUND: Accurate sizing of stent grafts during thoracic endovascular aortic repair (TEVAR) is critical for a successful outcome. Centerline measurements using three-dimensional reconstruction of preoperative computed tomography angiography (CTA) is the current standard for stent graft sizing. However, this technique is predicated on an idealized straightened aorta and does not account for the variability in the aortic diameter during the cardiac cycle or the overall status of the patient's volume...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#14
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647641/impact-of-left-subclavian-artery-revascularization-prior-to-thoracic-endovascular-aortic-repair-on-post-operative-cerebrovascular-hemodynamics
#15
Arnoud V Kamman, Jonathan L Eliason, David M Williams, Bo Yang, Frans L Moll, Santi Trimarchi, Kim A Eagle, Himanshu J Patel
OBJECTIVES: The impact of left subclavian artery (LSA) revascularization prior to thoracic endovascular aortic repair (TEVAR) on cerebrovascular flow is not well described. We studied bilateral vertebral and carotid artery flow characteristics before and after TEVAR, to evaluate the hemodynamic effects of LSA revascularization. METHODS: Seventy-four patients with mixed etiologies (mean age 70.9±10.5 years) underwent LSA revascularization and TEVAR (2006-2016) and had available pre- and post-operative carotid Duplex study available...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28640779/nonoperative-management-rather-than-endovascular-repair-may-be-safe-for-grade-ii-blunt-traumatic-aortic-injuries-an-eleven-year-retrospective-analysis
#16
Stephen M Spencer, Karen Safcsak, Chadwick P Smith, Michael L Cheatham, Indermeet S Bhullar
BACKGROUND: The Society of Vascular Surgery (SVS) guidelines currently suggest thoracic endovascular aortic repair (TEVAR) for grade II-IV and non-operative management (NOM) for grade I blunt traumatic aortic injury (BTAI). However, there is increasing evidence that grade II may also be observed safely. The purpose of this study was to compare the outcome of TEVAR and NOM for grade I-IV BTAI and determine if grade II can be safely observed with NOM. METHODS: The records of patients with BTAI from 2004 to 2015 at a Level I trauma center were retrospectively reviewed...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28633225/patient-specific-simulation-of-endovascular-thoracic-aortic-repair-initial-experience
#17
Liesbeth M Desender, Isabelle Van Herzeele, Zoran Rancic, Colin Bicknell, Ignatios Zairis, Frank E Vermassen, John H Rundback
PURPOSE: Endovascular thoracic aortic repair (TEVAR) has become the treatment modality of diverse aortic pathology. We report the use of patient-specific simulation using a dedicated PROcedure Rehearsal Studio (PRS) platform (Simbionix USA Corp, Cleveland, OH) before TEVAR and evaluate the feasibility and realism of this technology. DESCRIPTION: Virtual three-dimensional models of the patient's relevant anatomy were reconstructed from computed tomography data. PRS was used in 2 patients before TEVAR...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#18
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28616351/hybrid-aortic-repair-with-antegrade-supra-aortic-and-renovisceral-debranching-from-ascending-aorta
#19
José Antonio Del Castro-Madrazo, Margarita Rivas-Domínguez, Carlota Fernández-Prendes, Amer Zanabili Al-Sibbai, José Manuel Llaneza-Coto, Manuel Alonso-Pérez
Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616278/management-of-the-vertebral-artery-during-thoracic-endovascular-aortic-repair-with-coverage-of-the-left-subclavian-artery
#20
Jian Zhu, Er-Ping Xi, Shui-Bo Zhu, Gui-Lin Yin, Rong-Ping Wang, Yu Zhang
BACKGROUND: The application of thoracic endovascular aortic repair (TEVAR), a minimally invasive operation, in the aortic arch has been a challenge of cardiovascular surgery in recent years. This study aimed to investigate management of the vertebral artery with coverage of the left subclavian artery (LSA) during TEVAR. METHODS: From January 2007 to September 2014 in the Department of Cardiothoracic Surgery at Wuhan General Hospital of Guangzhou Military Region, 160 patients underwent LSA closure or partial coverage during TEVAR of an aortic lesion near the LSA...
May 2017: Journal of Thoracic Disease
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