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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28939200/open-distal-fenestration-of-chronic-dissection-facilitates-endovascular-elephant-trunk-completion-late-outcomes
#1
Muhammad Aftab, Jay J Idrees, Frank Cikach, Jose L Navia, Donald Hammer, Eric E Roselli
BACKGROUND: Retrograde false lumen perfusion is a common mode of failure after stent grafting chronic aortic dissection. Open fenestration during the first-stage elephant trunk (ET) creates a landing zone for second-stage endovascular ET completion in patients with a false lumen aneurysm. Our objectives were to assess long-term safety and durability of this technique. METHODS: From 2007 to 2014, 56 patients with thoracoabdominal dissection and aneurysm underwent stage 1 ET and open fenestration...
September 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28939111/open-descending-thoracic-or-thoracoabdominal-aortic-approaches-for-complications-of-endovascular-aortic-procedures-19-year-experience
#2
Konstantinos Spiliotopoulos, Ourania Preventza, Susan Y Green, Matt D Price, Hiruni S Amarasekara, Brittany M Davis, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
OBJECTIVES: Endovascular aortic repair is increasingly being used to treat aneurysms, dissections, and traumatic injuries, despite its unknown long-term durability. We describe our 19-year experience with open descending thoracic and thoracoabdominal aortic repair after endovascular aortic repair. METHODS: Between 1996 and 2015, 67 patients were treated with open distal arch, descending thoracic, or thoracoabdominal aortic repair, or extra-anatomic bypass repair with aortic extirpation for complications after endovascular repair of the thoracic (n = 45, 67%) or abdominal (n = 22, 33%) aorta...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932974/japanese-perspective-in-surgery-for-thoracoabdominal-aortic-aneurysms
#3
Norihiko Shiiya, Naoki Washiyama, Kazumasa Tsuda, Ken Yamanaka, Daisuke Takahashi, Katsushi Yamashita, Kayoko Natsume, Yuki Takeuchi, Suguru Kubota, Yoshiro Matsui
OBJECTIVE: Operative mortality and morbidity after thoracoabdominal aortic surgery remain high. We report our strategy and outcomes, especially those of spinal cord protection. METHODS: Outcomes of 178 patients (age: 26-88 years) who underwent thoracoabdominal aortic replacement were retrospectively analyzed. 65 had aortic dissection, 14 had infected aneurysms, and 22 presented with rupture. Operations were non-elective in 24 and redo through re-thoracotomy in 21...
September 20, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28932545/effects-of-preemptive-cerebrospinal-fluid-drainage-on-spinal-cord-protection-during-thoracic-endovascular-aortic-repair
#4
Seungjun Song, Suk-Won Song, Tae Hoon Kim, Kwang-Hun Lee, Kyung-Jong Yoo
BACKGROUND: Spinal cord injury (SCI) is reported to occur in 3-12% of thoracic endovascular aortic repair (TEVAR) cases, but is a potentially preventable complication of TEVAR for thoracoabdominal pathologies. Although many strategies have been devised to reduce the incidence of SCI, the effectiveness of prophylactic cerebrospinal fluid drainage (CSFD) and left subclavian artery (LSA) revascularization remains controversial. METHODS: From 2012 to 2014, 162 patients underwent TEVAR at a single institution...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28902661/giant-thoracoabdominal-aortic-aneurysm
#5
Luca Di Marco, Domenico Attinà, Davide Pacini
: Aneurysms of the descending thoracic and thoracoabdominal aorta are life-threatening conditions. All aneurysms which have not yet had an indication for the treatment need regular follow-up to prevent rupture or dissection. We present a case of a patient with a giant aneurysm of the thoracoabdominal aorta who was denied both surgery and endovascular treatment.
September 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28888759/impact-of-iliac-artery-anatomy-on-the-outcome-of-fenestrated-and-branched-endovascular-aortic-repair
#6
Enrico Gallitto, Mauro Gargiulo, Gianluca Faggioli, Rodolfo Pini, Chiara Mascoli, Antonio Freyrie, Stefano Ancetti, Andrea Stella
OBJECTIVE: Fenestrated and branched endovascular aneurysm repair (FB-EVAR) is a valid option to treat juxtarenal and pararenal abdominal aortic aneurysms and thoracoabdominal aortic aneurysms. Because successful deployment depends on complex maneuvers, hostile iliac artery anatomy (HIA) can prejudice the FB-EVAR outcome. The aim of the study was to evaluate the impact of HIA on FB-EVAR outcome. METHODS: Between 2010 and 2015, all patients undergoing FB-EVAR were prospectively categorized according to iliac anatomy (friendly iliac artery anatomy [FIA] or HIA)...
September 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28887256/remote-ischemic-preconditioning-decreases-the-magnitude-of-hepatic-ischemia-reperfusion-injury-on-a-swine-model-of-supraceliac-aortic-cross-clamping
#7
G Martikos, A Kapelouzou, M Peroulis, A Paspala, D Athanasiadis, A Maheras, T D Liakakos, K Moulakakis, S Vasdekis, A M Lazaris
BACKGROUND: Temporary hepatic ischemia is inevitable during open aortic surgery when supraceliac clamping is necessary, as in thoracoabdominal or pararenal aneurysms. Remote ischemic preconditioning (RIPC) has been described as a potential protective means against ischemia - reperfusion injury (IRI) in various tissues including the liver. The aim of this experimental study was to detect the effect of RIPC on liver IRI in a model of supraceliac aortic cross-clamping. METHODS: An animal study was performed...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28882080/use-of-the-nellix-endovascular-aneurysm-sealing-system-in-combination-with-parallel-grafts-for-the-treatment-of-a-symptomatic-type-v-thoracoabdominal-aortic-aneurysm
#8
Chris Klonaris, Athanasios Katsargyris, Dimitris Athanasiadis, Theodor Liakakos
PURPOSE: To report endovascular treatment of a symptomatic type V thoracoabdominal aortic aneurysm (TAAA) using the combined techniques of endovascular aneurysm sealing and parallel stent-grafts. CASE REPORT: A 70-year-old man was referred with a symptomatic type V TAAA. The Nellix EndoVascular Aneurysm Sealing (EVAS) System was used in combination with 2 chimney grafts for the celiac artery (CA) and the superior mesenteric artery (SMA); one periscope graft perfused the right renal artery...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28875285/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-5-thoracic-aortic-surgery
#9
REVIEW
Hideyuki Shimizu, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
BACKGROUND: Although open aortic repair (OAR) is still considered to be a standard treatment for thoracic aortic diseases, the indications for thoracic endovascular treatment (TEVAR)/hybrid aortic repair (HAR) have expanded in recent years. The purpose of this study was to review the current status of treatment of thoracic aortic diseases in Japan. METHODS: Data for 2013 and 2014 concerning surgery for diseases of the thoracic/thoracoabdominal aorta were extracted from the Japan Cardiovascular Surgery Database (JCVSD)...
September 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28874089/outcome-of-surgeon-modified-fenestrated-branched-stent-grafts-for-symptomatic-complex-aortic-pathologies-or-contained-rupture
#10
Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Holger Diener, Sabine Wipper, E Sebastian Debus, Tilo Kölbel
PURPOSE: To analyze the outcome of surgeon-modified fenestrated and branched stent-grafts (sm-FBSG) in high-risk patients with symptomatic complex aortic pathology or contained rupture. METHODS: A single-center retrospective analysis was conducted of 21 consecutive patients (mean age 70 years, range 58-87; 16 men) treated with a sm-FBSG from April 2014 to September 2016. The indications included 11 thoracoabdominal and 10 pararenal aortic pathologies, which presented as symptomatic in 8 and as contained rupture in 13 patients...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28856583/thoracoabdominal-aortic-aneurysm-repair-open-endovascular-or-hybrid
#11
REVIEW
Joshua M Rosenblum, Edward P Chen
Successful repair of complex thoracoabdominal aortic aneurysms requires careful surgical planning based on anatomic and patient considerations. Not only are surgical considerations key, but also post-operative care, regardless of surgical approach, can dramatically impact both short- and long-term outcomes. While open repair has been the gold standard for decades, the technical challenges associated with operative repair, a specialty approach requisite for good outcomes, and the unique challenges in the post-operative care of these patients have given providers pause when considering operative intervention...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28836901/a-clinical-review-of-early-outcomes-from-contemporary-flow-modulation-versus-open-fenestrated-and-branch-technologies-in-the-management-of-thoracoabdominal-aortic-aneurysm
#12
Sherif Sultan, Edel P Kavanagh, Edward Diethrich, Victor Costache, Mohamed Sultan, Fionnuala Jordan, Niamh Hynes
Traditional therapeutic options for complex thoracoabdominal aneurysm include open repair, hybrid repair or endovascular repair (involving fenestrated or branched endografts). The Streamliner Multilayer Flow Modulator has been available for treatment of thoracoabdominal aneurysms since 2010. Its design permits blood flow to perfuse through the mesh in a modus that preserves collateral branch patency, while modulating turbulent to laminar flow within the device. The flow then stagnates over time within the surrounding aneurysm sac...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28818295/total-endovascular-treatment-for-extent-type-1-and-5-thoracoabdominal-aortic-aneurysms
#13
Gabriele Piffaretti, Federico Fontana, Marco Franchin, Alessandro Bacuzzi, Walter Dorigo, Patrizio Castelli, Matteo Tozzi
OBJECTIVE: The study objective was to describe the results of thoracic endovascular aortic repair with the intentional coverage of the celiac artery and distal supramesenteric landing zone for extent type 1 and type 5 thoracoabdominal aortic aneurysms. METHODS: Inclusion criteria were thoracic endovascular aortic repair with celiac artery coverage to treat elective or urgent extent type 1 and 5 thoracoabdominal aortic aneurysms. Primary end points were in-hospital and follow-up survival, freedom from aortic-related mortality, and freedom from reintervention...
July 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28808903/clinical-outcomes-of-aortic-repair-in-young-adult-patients-with-acta2-mutations
#14
Yoshimasa Seike, Kenji Minatoya, Hiroaki Sasaki, Hiroshi Tanaka, Tatsuya Itonaga, Yosuke Inoue, Hiroko Morisaki, Takayuki Morisaki, Hatsue Ishibashi-Ueda, Junjiro Kobayashi
OBJECTIVES: Actin, alpha-2, smooth muscle, aorta (ACTA2) mutations are one of the major causes of familial thoracic aortic aneurysms and dissections. The aim of this study was to review our clinical results of young adult patients with aortic disease caused by ACTA2 mutations. METHODS: We reviewed the medical records of 251 patients (<50 years old) who underwent surgery for thoracic aortic diseases between 2004 and 2014. Among them, nine patients (3.5%) had ACTA2 mutations...
August 14, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28800994/perioperative-management-of-endovascular-thoracoabdominal-aortic-aneurysm-repair
#15
REVIEW
Alexander C P Fort, Lori A Rubin, Andrew J Meltzer, Darren B Schneider, Adam D Lichtman
No abstract text is available yet for this article.
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28766813/acute-exacerbation-of-chronic-disseminated-intravascular-coagulation-associated-with-thoracoabdominal-aortic-aneurysm-after-tooth-extraction
#16
Shunsuke Hino, Akio Takeda, Takahiro Kaneko, Norio Horie, Tetsuo Shimoyama
OBJECTIVE: To present a rare case of persistent bleeding from the tooth extraction socket in a patient with chronic disseminated intravascular coagulation (DIC). BACKGROUND: Acute exacerbation of chronic DIC occurs by various trigger factors. CLINICAL REPORT: The patient's chronic DIC in association with thoracoabdominal aortic aneurysm was activated by tooth extraction, resulting in persistent bleeding from the socket. CONCLUSION: Patients with chronic DIC may have persistent bleeding following tooth extraction...
September 2017: Gerodontology
https://www.readbyqxmd.com/read/28747079/endovascular-repair-of-a-thoracoabdominal-aortic-aneurysm-with-a-patient-specific-fenestrated-branched-stent-graft
#17
Bernardo C Mendes, Lawrence E Greiten, Gustavo S Oderich
PURPOSE: To describe the technical aspects of a thoracoabdominal aortic aneurysm (TAAA) repair using a patient-specific fenestrated-branched stent-graft. TECHNIQUE: The technique is demonstrated in a 69-year-old man with a 6.2-cm asymptomatic type III TAAA. A patient-specific fenestrated-branched stent-graft was designed with 2 down-going directional branches for the celiac and superior mesenteric arteries and 2 reinforced fenestrations for the renal arteries. The procedure was performed under general anesthesia and included sequential stenting of the celiac, superior mesenteric, and bilateral renal arteries...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28739454/parallel-grafts-used-in-combination-with-physician-modified-fenestrated-stent-grafts-for-complex-aortic-aneurysms-in-high-risk-patients-with-hostile-anatomies
#18
Joseph Touma, Dorian Verscheure, Marek Majewski, Pascal Desgranges, Frederic Cochennec
OBJECTIVE: To evaluate the feasibility and early outcomes of complex aortic aneurysm repair in high risk patients with hostile anatomies using both parallel stents and physician-modified stent-graft (PMSG) techniques to address the renovisceral arteries METHODS: Consecutive patients with complex suprarenal (SRA) and thoracoabdominal aortic aneurysms (TAAA) undergoing endovascular repair using combined parallel stents technique and PMSG between September 2013 and November 2015 were evaluated...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28734626/staged-treatment-of-mega-aortic-syndrome-using-the-frozen-elephant-trunk-and-hybrid-thoracoabdominal-repair
#19
Asimakis Gkremoutis, Andreas Zierer, Thomas Schmitz-Rixen, Ali El-Sayed Ahmad, Erhard Kaiser, Michael Keese, Thomas Schmandra
OBJECTIVE: We report our experience with a staged hybrid approach for the treatment of extended aortic disease, also known as "mega aortic syndrome." METHODS: A total of 15 patients (10 male, 5 female) underwent staged repair of the thoracoabdominal aorta, consisting of 3 separate stages (repair of ascending aorta and aortic arch using the frozen elephant trunk technique and hybrid thoracoabdominal repair with debranching of the renovisceral branches and stent graft implantation)...
June 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28715514/i-swot-as-instrument-to-individually-optimize-therapy-of%C3%A2-thoracoabdominal-aortic-aneurysms-effective-norm-compliant-and-meeting-the-needs
#20
A Sachweh, Y von Kodolitsch, T Kölbel, A Larena-Avellaneda, S Wipper, A M Bernhardt, E Girdauskas, C Detter, H Reichenspurner, C R Blankart, E S Debus
BACKGROUND: Guidelines summarize medical evidence, they identify the most efficient therapy under study conditions and recommend this therapy for use. The physician now has the challenge to translate a therapy that is efficient under laboratory conditions to a patient who is an individual person. To accomplish this task the physician has to make sure that (I) the ideal typical therapy is applicable and effective in this individual patient taking the special features into consideration, that (II) therapy is compliant with the norm including guidelines, laws and ethical requirements (conformity) and that (III) the therapy meets the patient's needs...
2017: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
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