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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28633258/stepwise-total-aortic-repairs-with-fenestrated-endografts-in-a-patient-with-loeys-dietz-syndrome
#1
Kenichi Hashizume, Hideyuki Shimizu, Masanori Honda, Shinya Inoue, Hidenobu Takaki, Kanako Hayashi, Hiroaki Kaneyama
Loeys-Dietz syndrome (LDS) is a rare connective tissue disorder (CTD) caused by mutations in the gene encoding transforming growth factor-β receptors Ⅰ and Ⅱ. Patients with LDS manifest spontaneous aneurysms and dissections of the aorta and peripheral artery. We report a successful treatment with a hybrid endovascular repair for a rapidly expanding thoracoabdominal aneurysm in a 41-year-old woman affected by LDS. To overcome the difficulties of anatomical and surgical repair, we applied an original strategy using surgeon-modified fenestrated endografts...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28616351/hybrid-aortic-repair-with-antegrade-supra-aortic-and-renovisceral-debranching-from-ascending-aorta
#2
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/28616343/debranching-aortic-surgery
#3
REVIEW
Manuel Alonso Pérez, José Manuel Llaneza Coto, José Antonio Del Castro Madrazo, Carlota Fernández Prendes, Mario González Gay, Amer Zanabili Al-Sibbai
Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28596039/assessment-of-aortic-wall-thrombus-predicts-outcomes-of-endovascular-repair-of-complex-aortic-aneurysms-using-fenestrated-and-branched-endografts
#4
Mauricio Ribeiro, Gustavo S Oderich, Thanila Macedo, Terri J Vrtiska, Jan Hofer, Julia Chini, Bernardo Mendes, Stephen Cha
OBJECTIVE: The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden. METHODS: The clinical data of 301 patients treated for pararenal and thoracoabdominal aortic aneurysms (TAAAs) by F-BEVAR was reviewed. The study excluded 89 patients with extent I to III TAAA because of extensive laminated thrombus within the aneurysm sac...
June 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28594811/-successful-two-stage-surgical-treatment-of-a-thoracoabdominal-aortic-aneurysm-a-case-report
#5
V V Shlomin, D A Zverev, E D Zvereva, P D Puzdriak, P B Bondarenko, M L Gordeev
Presented herein is a clinical case report regarding hybrid or two-stage surgical treatment of a Crawford type II thoracoabdominal aortic aneurysm in an 87-year-old woman. For the first stage operation we performed open resection of the abdominal aortic aneurysm with aortofemoral bifurcation prosthetic repair and debranching of visceral and renal arteries. Several months thereafter, the second stage operation was performed, consisting in transcatheter exclusion of the thoracoabdominal aortic aneurysm with the help of two stent grafts...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28583733/treatment-strategy-based-on-the-natural-course-of-the-disease-for-patients-with-spontaneous-isolated-abdominal-aortic-dissection
#6
Ji-Hee Kang, Young-Wook Kim, Seon-Hee Heo, Shin-Young Woo, Yang-Jin Park, Dong-Ik Kim, Duk-Kyung Kim
OBJECTIVE: This study aimed to determine the natural history of spontaneous isolated abdominal aortic dissection (SIAAD) and to establish an optimal management strategy for patients with SIAAD. METHODS: We searched the database of thoracoabdominal computed tomography (CT) performed at a single institution from January 2003 to July 2016 using the keywords "aortic dissection" and "dissection AND aorta." Once a diagnosis of SIAAD was made, we investigated the initial clinical and morphologic features and aorta-related events for all patients and morphologic changes of the aortic dissection (AD) during the follow-up period for the patients who underwent follow-up CT scans...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28583193/a-modified-multiple-branched-graft-for-thoracoabdominal-aortic-aneurysm-repair
#7
Liang-Wan Chen, Xi-Jie Wu, Hua Cao, Xiao-Fu Dai
BACKGROUND: To reduce some problems of traditional graft, we devise a modified multiple branched graft for repair of Crawford extent II and III thoracoabdominal aortic aneurysm (TAAA). CASE PRESENTATION: We described a modified multiple branched graft for Crawford extent II and III thoracoabdominal aortic aneurysm (TAAA) repair in 8 patients, Which comprised a main graft and three branches, and the third branch was bifurcated into two limbs. CONCLUSIONS: Our initial experience demonstrated that this modified multiple branched graft may make the thoracoabdominal aortic aneurysm(TAAA) repair easier and safer...
June 5, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28579290/improved-outcomes-and-value-in-staged-hybrid-extent-ii-thoracoabdominal-aortic-aneurysm-repair
#8
Robert B Hawkins, J Hunter Mehaffey, Adishesh K Narahari, Amit Jain, Ravi K Ghanta, Irving L Kron, John A Kern, Gilbert R Upchurch
OBJECTIVE: Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared with traditional open repair over 10 years. METHODS: A prospectively collected database was used to identify all patients with an extent II TAAA undergoing repair at a single institution between 2005 and 2015...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28574051/-stagewise-hybrid-method-of-treating-a-patient-with-connective-tissue-dysplasia-aortic-aneurysm-and-distal-dissection
#9
É R Charchian, A A Skvortsov, D A Chakal, Z R Khachatrian
Presented herein is a clinical case report concerning the use of a hybrid technique in stagewise surgical management of a patient with distal dissection and an aneurysm of the thoracoabdominal portion of the aorta. The patient at high risk with the connective tissue dysplasia syndrome had a past medical history of prosthetic repair of the descending thoracic aorta with type-1 haemodynamic correction. Three years later, the findings of computed tomography demonstrated fenestration in the area of the distal anastomosis, a patent false channel, and an increase in the diameter of the unoperated thoracoabdominal portion of the aorta...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#10
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28528073/simple-identification-of-the-adamkiewicz-artery-in-extended-thoracoabdominal-aortic-aneurysm-repair
#11
Kyokun Uehara, Hitoshi Matsuda, Yosuke Inoue, Atsushi Omura, Yoshimasa Seike, Hiroaki Sasaki, Kenji Minatoya, Junjiro Kobayashi
Spinal cord injury remains a major adverse event of extended thoracic and thoracoabdominal aortic surgical procedures. Preoperative identification of the Adamkiewicz artery and prompt reattachment of the targeted intercostal arteries during operation should contribute to preventing spinal cord injury. In this report, we describe a simple and definite identification of the critical intercostal artery during extended descending and thoracoabdominal aortic surgical procedures.
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28527678/patient-reported-quality-of-life-after-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#12
Andrew J Meltzer, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The purpose of this study was to assess patient-reported physical and emotional well-being during follow-up after endovascular repair of TAAA. METHODS: All patients were treated in the context of a physician-sponsored investigational device exemption clinical study for patients at high risk for open TAAA repair. The SF-36 instrument was administered preoperatively, and at 1, 6, and 12 months. Results were analyzed using paired t-tests, with sub-group comparisons to assess impact of adverse events and technical results on quality of life...
May 17, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28526092/transapical-aortic-perfusion-using-a-deep-hypothermic-procedure-to-prevent-dissecting-lung-injury-during-re-do-thoracoabdominal-aortic-aneurysm-surgery
#13
Yuya Kise, Yukio Kuniyoshi, Mizuki Ando, Hitoshi Inafuku, Takaaki Nagano, Satoshi Yamashiro
BACKGROUND: Avoiding various complications is a challenge during re-do thoracoabdominal aneurysm surgery. CASE PRESENTATION: A 56-year-old man had undergone surgery for type I aortic dissection four times. The residual thoracoabdominal aortic aneurysm that had severe adhesions to lung parenchyma was resected. Since the proximal anastomotic site was buried in lung parenchyma, deep hypothermia was essential to avoid lung dissection and to protect the spinal cord during the proximal anastomosis...
May 19, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28514896/-snare-ride-a-bailout-technique-to-catheterize-target-vessels-with-unfriendly-anatomy-in-branched-endovascular-aortic-repair
#14
Marcelo Ferreira, Athanasios Katsargyris, Eduardo Rodrigues, Diego Ferreira, Rodrigo Cunha, Guilherme Bicalho, Gustavo Oderich, Eric L G Verhoeven
PURPOSE: To describe a novel endovascular bailout technique for successful completion of target vessel stenting during branched stent-graft repair of thoracoabdominal aortic aneurysms (TAAA) after encountering difficulties with standard catheterization techniques. TECHNIQUE: Technical difficulties when using fenestrated and branched grafts should be expected, especially in difficult anatomy or when an off-the-shelf device (eg, standard 4-branch device) is used that does not perfectly "match" the anatomy...
May 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28513189/transcatheter-aortic-valve-implantation-the-transaortic-approach
#15
Simon Cy Chow, Gary Sh Cheung, Alex Pw Lee, Eugene B Wu, Jacky Yk Ho, Micky Wt Kwok, Peter Sy Yu, Innes Yp Wan, Malcolm J Underwood, Randolph Hl Wong
Background Transcatheter aortic valve implantation has been established as a safe and effective treatment option for patients at high or prohibitive surgical risk. However, some patients may not be suitable for the transfemoral approach due to severe iliofemoral disease or aneurysmal disease of the thoracoabdominal aorta. The aim of this case series was to evaluate the feasibility and clinical outcomes of the transaortic approach. Methods From May 2015 to June 2016, 5 patients (mean age 78.4 ± 3.9 years) with severe symptomatic aortic stenosis underwent transaortic transcatheter aortic valve implantation after a heart team discussion...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/28502540/trends-and-outcomes-in-endovascular-and-open-surgical-treatment-of-visceral-aneurysms
#16
Jason A Chin, Adele Heib, Cassius I Ochoa Chaar, Jonathan A Cardella, Kristine C Orion, Timur P Sarac
OBJECTIVE: Visceral artery aneurysms (VAAs) are rare but often repaired because of dire consequences of rupture. This is a population-based evaluation of chronologic trends in management, risk factors, and outcomes of endovascular and open therapy. METHODS: The 2003 to 2013 Agency for Healthcare Research and Quality (AHRQ) National Inpatient Sample (NIS) database was reviewed. Cases with primary diagnosis of VAA and undergoing endovascular or open repair were identified...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501656/perioperative-outcomes-of-open-versus-endovascular-repair-for-ruptured-thoracoabdominal-aneurysms
#17
Satinderjit S Locham, Joshua C Grimm, Isibor J Arhuidese, Besma Nejim, Tammam Obeid, James H Black, Mahmoud B Malas
OBJECTIVES: Open aneurysm repair (OAR) remains the gold standard for treating ruptured thoracoabdominal-aortic-aneurysms (TAAA). The aim of our study is to compare the 30-day post-operative outcomes among patients with ruptured TAAA undergoing OAR versus endovascular aneurysm repair. METHODS: Using the NSQIP database (2006-2015), we identified patients who underwent OAR and endovascular repair for a ruptured TAAA. Postoperative outcomes of interest included: mortality, renal failure, stroke, and cardiopulmonary complications...
May 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483620/clinical-outcomes-of-spinal-cord-ischemia-after-fenestrated-and-branched-endovascular-stent-grafting-during-total-endovascular-aortic-repair-for-thoracoabdominal-aortic-aneurysms
#18
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda, Hiroki Ohta, Soichirou Fukushima, Naoki Toya, Masayuki Hara
PURPOSE: In this single-center study, we assessed the clinical outcomes of fenestrated-endovascular aortic repair (f-EVAR) and branched EVAR on morbidity and mortality during total endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between July 2006 and June 2015, elective f-EVAR and multibranched EVAR (t-Branch) for TAAAs were performed in 99 patients at our institution [Crawford classification types I (7), II (13), III (6), IV (55), and V (18)]...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479427/inferior-mesenteric-artery-aneurysm-complicated-with-occluded-celiac-and-superior-mesenteric-artery-after-replacement-of-thoracoabdominal-aorta-for-chronic-dissected-thoracoabdominal-aortic-aneurysm
#19
Takashi Igarashi, Akihiro Yamamoto, Tsuyoshi Fujimiya, Shinya Takase, Hirono Satokawa, Hitoshi Yokoyama
We report a case of inferior mesenteric artery aneurysm after the replacement of the thoracoabdominal aorta for a chronic dissected thoracoabdominal aortic aneurysm in which the celiac artery and superior mesenteric artery were occluded. We performed the resection of the inferior mesenteric artery aneurysm and the revascularization of the superior mesenteric artery, inferior mesenteric artery, and the meandering artery. The patient's postoperative course was uneventful, without bowel ischemia. From the findings of intraoperative flow measurement of the visceral arteries, revascularization of the SMA was judged to be appropriate in this situation...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28464191/adjunct-perfusion-branch-for-reduction-of-spinal-cord-ischemia-in-the-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#20
Marwan Youssef, Oroa Salem, Fritz Dünschede, Christian F Vahl, Bernhard Dorweiler
No abstract text is available yet for this article.
May 2, 2017: Thoracic and Cardiovascular Surgeon
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