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Stent graft

Maciej Lesiak, Sylwia Zawada-Iwańczyk, Magdalena Łanocha, Aneta Klotzka, Michał Lesiak
Bioresorbable scaffolds (BRS) have been introduced to clinical practice to avoid some limitations associated with the presence of permanent metal prostheses in coronary arteries. Due to elimination of the natural vasomotion of the vessel and flow disturbance, stents impair endothelial function, increasing the risk of adverse events such as late and very late thrombosis or accelerated neoatherosclerosis. Additionally, the presence of metallic stents hinders non-invasive imaging of coronaries and may exclude the possibility of bypass graft anastomosis within the stented segment...
March 15, 2018: Minerva Cardioangiologica
Up Huh, Chung Won Lee, Seon Hee Kim, Chan Ik Park, Sung Woon Chung, Seunghwan Song, Chang Won Kim
Blunt abdominal aortic injury (BAAI) is extremely rare. Three known treatments of BAAI exist: medical treatment, conventional surgical treatment, and endovascular treatment. Outcomes of medical and conventional surgical treatments, such as bypass graft, thrombectomy, and intimal suture, were not satisfactory. A 47-year-old man presented with multiple injuries after a high-speed vehicular accident. He was diagnosed with the traumatic aortic injury to be an intra-mural hematoma in the bifurcation of the terminal aorta...
March 15, 2018: Cardiovascular and Interventional Radiology
Athanasios Katsargyris, Pablo Marques de Marino, Hozan Mufty, Luis Mendes Pedro, Ruy Fernandes, Eric L G Verhoeven
OBJECTIVES: Visceral arteries in fenestrated and branched endovascular repair (F/BEVAR) have been addressed by fenestrations or directional side branches. Inner branches, as used in the arch branched device, could provide an extra option for visceral arteries "unsuitable" for fenestrations or directional side branches. Early experience with the use of inner branches for visceral arteries in F/BEVAR is described. METHODS: All consecutive patients treated by F/BEVAR for complex abdominal aortic aneurysm (AAA) or thoraco-abdominal aneurysm (TAAA) using stent grafts with inner branches were included...
March 12, 2018: European Journal of Vascular and Endovascular Surgery
Simon P Overeem, Esmé J Donselaar, Jorrit T Boersen, Erik Groot Jebbink, Cornelis H Slump, Jean-Paul P M de Vries, Michel M P J Reijnen
PURPOSE: To assess the dynamic behavior of chimney grafts during the cardiac cycle. METHODS: Three chimney endovascular aneurysm repair (EVAR) stent-graft configurations (Endurant and Advanta V12, Endurant and Viabahn, and Endurant and BeGraft) were placed in silicone aneurysm models and subjected to physiologic flow. Electrocardiography (ECG)-gated contrast-enhanced computed tomography was used to visualize geometric changes during the cardiac cycle. Endograft and chimney graft surface, gutter volume, chimney graft angulation over the center lumen line, and the D-ratio (the ratio between the lengths of the major and minor axes) were independently assessed by 2 observers at 10 time points in the cardiac cycle...
March 1, 2018: Journal of Endovascular Therapy
Judit Karacsonyi, Ehrin J Armstrong, Huu Tam D Truong, Ryan Tsuda, Damianos G Kokkinidis, Jose Roberto Martinez-Parachini, Aya J Alame, Barbara A Danek, Aris Karatasakis, Michele Roesle, Houman Khalili, Imre Ungi, Subhash Banerjee, Emmanouil S Brilakis, Bavana V Rangan
BACKGROUND: The contemporary use and outcomes of excimer laser coronary atherectomy (ELCA) in percutaneous coronary intervention (PCI) are not well described. METHODS: We examined the baseline clinical and angiographic characteristics and procedural outcomes of 130 target lesions in 121 consecutive PCIs (n = 116 patients) in which ELCA was performed at three United States Department of Veterans Affairs (VA) medical centers between 2008 and 2016. RESULTS: Mean age was 68...
March 15, 2018: Journal of Invasive Cardiology
Jared T Feyko, Peter Zmijewski, Cara Lyle, Allison Wilson, Luke Marone
We describe a 36-year-old woman who presented to our facility after sustaining a gunshot wound to the epigastric region. The gunshot resulted in injury to the left lobe of the liver and the twelfth thoracic vertebral body as well as in a through-and-through injury to the abdominal aorta at the level of the celiac axis. The vascular injury was managed successfully by placement of a thoracic stent graft with coverage of the celiac axis. This case demonstrates the feasibility of managing this uncommon injury with endovascular techniques...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Xin Yang, Xiang-Chen Dai, Jie-Chang Zhu, Yu-Dong Luo, Hai-Lun Fan, Zhou Feng, Yi-Wei Zhang, Fan-Guo Hu
Despite being widely used for several years, the endovascular aortic repair (EVAR) of a thoracoabdominal aneurysm (TAAA) remains challenging, particularly the revascularization of the abdominal aortic visceral branches. A 66-year-old male was admitted to hospital with abdominal bloating and pain. Computed tomographic angiography (CTA) confirmed a Crawford type III TAAA from the distal descending aorta to the suprarenal abdominal aorta that involved the celiac axis, accompanied with an occlusion of the left subclavian artery...
January 1, 2018: Journal of International Medical Research
Hyun-Chel Joo, Seung-Hyun Lee, Byung-Chul Chang, Sak Lee, Kyung-Jong Yoo, Young-Nam Youn
BACKGROUND: With the increasing use of endovascular aortic repair, secondary interventions after aortic stent grafting remain a concern. We retrospectively reviewed open conversion cases with complications following endovascular abdominal aortic repair (EVAR). METHODS: EVAR due to infra-renal abdominal aortic aneurysm (AAA) was performed in 566 patients between January 1994 and May 2015. A retrospective review of EVAR requiring late open conversion (>1 month after implant) was conducted...
March 12, 2018: Journal of Cardiovascular Surgery
S Gooran, A Javid, G Pourmand
One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor...
2018: International Journal of Organ Transplantation Medicine
Ugur Kaya, Abdurrahim Colak, Necip Becit, Munacettin Ceviz, Hikmet Kocak
Objective: In the present study, we aimed to retrospectively investigate the early and late results of different surgical treatment techniques applied in different age groups with coarctation of the aorta (CoA). Materials and Methods: Between January 2007 and February 2017, 26 patients (12 males, 14 females; mean age: 12.2±12.4 years; range: 29 days-34 years) who underwent surgery with the diagnosis of CoA were evaluated. Overall, 11 of these patients (42.3%) were in the infantile period, whereas 15 patients (57...
February 2018: Eurasian Journal of Medicine
Sonali Vadi, Vishal Peshattiwar
Fondaparinux, a pentasaccharide administered for heparin-induced thrombocytopenia (HIT), can lead to the occurrence of thrombocytopenia. This patient underwent aortic stent graft placement for Salmonella paratyphi A-infected abdominal aortic aneurysm. Fondaparinux was administered for anticoagulation that led to a dramatic decline in his platelet counts. Investigations revealed HIT profile, PF4/heparin by particle gel immunoassay to be positive. Fondaparinux, a prescribed anticoagulant for HIT can paradoxically predispose to thrombocytopenia...
February 2018: Indian Journal of Critical Care Medicine
Eugenio Pompeo, Ahmed Elkhouly, Andrea Ascoli Marchetti, Arnaldo Ippoliti
No abstract text is available yet for this article.
February 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Seraina Anne Dual, Alissa Muller, Stefan Boës, Oliver Brinkmann, Séline Steffanoni, Volkmar Falk, Mirko Meboldt, Marianne Schmid Daners, Simon Sündermann
PURPOSE: Less invasive left ventricular assist device implantation became feasible with the development of smaller devices. This study evaluated a sutureless aortic anastomosis device to facilitate the implant procedure. DESCRIPTION: The novel anastomotic device deploys and anchors an acute-angled stent in the aortic wall to create a sutureless outflow graft anastomosis in the ascending aorta. Four aortic anastomoses were performed on the beating hearts of two pigs without cross-clamping or cardiopulmonary bypass...
March 9, 2018: Annals of Thoracic Surgery
Kenneth Abreo, Adrian Sequeira
Stents are ubiquitously utilized in coronary and peripheral arterial disease. Interventional nephrologists, however, place stents in the venous outflow of the arteriovenous access. Stenosis is the predominant pathology that causes access dysfunction and will ultimately lead to thrombosis if uncorrected. Angioplasty and stent deployment are the current techniques available to combat stenosis. From initial bare metal stainless steel stents, the current generations of stents used are predominately covered nitinol stents...
March 1, 2018: Journal of Vascular Access
Jan Raupach, Jan Vales, Jan Vojacek, Petr Hoffmann, Miroslav Lojik, Katerina Kamaradova, Pavla Cabelkova, Vendelin Chovanec, Ondrej Renc, Antonin Krajina, Radovan Maly
An aggressive periaortic lymphoma could very rarely invade the aortic wall. We present a unique case of a patient with symptomatic thoracic aneurysm and imminent rupture due to the periaortic lymphoma, in which endovascular treatment using stent graft was applied. After stabilization of the aorta and histological confirmation of aggressive B-cell lymphoma by computed tomography-guided biopsy, the antilymphoma therapy was initiated. Despite the full treatment, the patient died 12 months later.
January 1, 2018: Vascular and Endovascular Surgery
Takayuki Shijo, Takashi Shirakawa, Masao Yoshitatsu, Keiji Iwata
Stent grafting for complex aortic anatomy remains a challenge. In particular, stent graft collapse (i.e. infolding) is possible when an excessive oversized device is needed. We describe a case of preoperative stent grafting simulation using a three-dimensional (3D) printed model for extensive aortic arch repair in a 69-year-old woman with multiple aneurysms combined with coarctation. The patient was scheduled to undergo staged hybrid repair. A stent graft larger than 28 mm in diameter was needed to deploy into a coarctation of 15 mm in diameter during the 2nd stage of the operation...
March 8, 2018: European Journal of Cardio-thoracic Surgery
Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
March 8, 2018: La Presse Médicale
Miriam Elisabeth Uhlmann, Corinna Walter, Fadi Taher, Markus Plimon, Jürgen Falkensammer, Afshin Assadian
OBJECTIVE: Because of its minimally invasive nature, percutaneous femoral access for endovascular aneurysm repair (pEVAR) is currently undergoing rapid popularization. Compared with surgical cutdown for femoral access (cEVAR), it offers the advantage of faster recovery after surgery as well as a reduction in wound complications. Despite proposed advantages, the method is largely considered uneconomical because of its reliance on costly closure devices. METHODS: There were 50 patients undergoing EVAR who were enrolled in this randomized prospective single-center trial...
March 8, 2018: Journal of Vascular Surgery
Konstantinos Tigkiropoulos, Fragiska Sigala, Diamantis I Tsilimigras, Demetrios Moris, Konstantinos Filis, Nikolaos Melas, Dimitrios Karamanos, Christos Kontogiannis, Ioannis Lazaridis, Nikolaos Saratzis
BACKGROUND: Blunt thoracic aortic injury (BTAI) is the second most common cause of death in trauma patients. Nowadays, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice due to lower rates of mortality, paraplegia and stroke. However, concerns have been raised whether graft implantation is related to the development of hypertension in the postoperative period. OBJECTIVES: To report short- and long-term outcomes of patients undergoing TEVAR for BTAIs at a tertiary hospital as well as investigate post-implant hypertension...
March 7, 2018: Annals of Vascular Surgery
Smita Kaushik, Warren J Gasper, Bala Ramanan, Shant M Vartanian, Linda M Reilly, Timothy A M Chuter, Jade S Hiramoto
OBJECTIVE: The purpose of this study was to evaluate the impact of prior aortic surgery on outcomes after multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAAs). METHODS: From July 2005 to October 2016, there were 153 patients who underwent elective endovascular repair of TAAA and PRAA using multibranched stent grafts. Data on demographics, procedural details, and outcomes were collected prospectively...
March 6, 2018: Journal of Vascular Surgery
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