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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/29206004/outcomes-of-endovascular-aortic-repair-in-the-modern-era
#1
Jacob Budtz-Lilly, Anders Wanhainen, Kevin Mani
Monitoring outcomes following endovascular aortic repair (EVAR) is critical. Although evidence from randomized controlled trials has solidified the role of EVAR, the analysis of outcomes and "real-world" data has uncovered limitations, improved the selection of appropriate patients, and underscored the importance of instructions for use. Subsequent studies demonstrated the learning curve of EVAR and gradual improvement of outcomes over time. Outcomes analyses will continue to play an important role, particularly as technological growth of endovascular therapy has enabled treatment of more complex aneurysm pathologies and patients...
December 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29204357/an-infected-thoracoabdominal-aortic-aneurysm-mimicking-the-symptoms-of-urinary-tract-infection-a-case-report
#2
Takahisa Yamashita, Makoto Morozumi, Morihiro Higashi, Shuji Momose, Jun-Ichi Tamaru
No abstract text is available yet for this article.
January 2018: Urology Case Reports
https://www.readbyqxmd.com/read/29198629/aortic-replacement-after-tevar-diameter-correction-with-modified-use-of-the-siena-prosthesis
#3
Arminder Jassar, Maximilian Kreibich, Julia Morlock, Stoyan Kondov, Johannes Scheumann, Fabian A Kari, Bartosz Rylski, Matthias Siepe, Alexander Jonaszik, Cornelius Keyl, Frank Humburger, Friedhelm Beyersdorf, Martin Czerny
BACKGROUND: To report a new technique for diameter correction in patients after thoracic endovascular aortic repair (TEVAR) with large stent-grafts using the Vascutek Siena 4-branch collared prosthesis (Vascutek Terumo, Inchinnan, Scotland, UK) in patients undergoing thoracoabdominal (TA) aortic replacement. METHODS: Within a 24-month period, 39 patients underwent TA replacement at our center. Of these, 6 patients had undergone previous TEVAR with large stent-grafts (42 to 48 mm diameter)...
December 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29197608/use-of-double-barrel-gore-excluder-bifurcated-endografts-for-renal-artery-incorporation-in-an-urgent-endovascular-repair-of-a-thoracoabdominal-aortic-aneurysm
#4
Cali E Johnson, Sung W Ham, Kenneth Ziegler, Fred A Weaver, Vincent L Rowe, Sukgu M Han
Total endovascular repair of a thoracoabdominal aortic aneurysm (TAAA) in an urgent setting requires an advanced endovascular skill set and an innovative approach. We describe a novel technique of treating a symptomatic Crawford extent 4 TAAA with a combination of multi-layered parallel endografting and double-barrel Gore Excluder bifurcated endografts to achieve complete aneurysm exclusion with visceral and bilateral renal artery incorporation. A 75-year-old male presented with a symptomatic 10cm Crawford extent 4 TAAA...
November 29, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29181602/long-parallel-stent-grafts-for-the-treatment-of-complex-aortic-aneurysms
#5
Daniel Silverberg, Uri Rimon, Daniel Raskin, Moshe Halak
PURPOSE: To describe our experience with the chimney technique in endovascular aneurysm repair (ch-EVAR) using long parallel grafts (PGs) of 100 mm or more for the treatment of complex aortic aneurysms. MATERIALS AND METHODS: From 2009 to 2016, data were prospectively collected for patients who underwent ch-EVAR using long PGs. Data included patient demographics and aortic anatomy, technical success, patency and reintervention rate. RESULTS: A total of 29 long PGs were placed in 18 patients (males 16, average age 71 years)...
November 27, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29157740/unplanned-readmissions-after-open-thoracoabdominal-aortic-aneurysm-repair
#6
Darrell Wu, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Sandra J Woodside, Adam Tullos, Qianzi Zhang, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Although reducing the incidence of unplanned readmission after thoracoabdominal aortic aneurysm (TAAA) repair represents an important opportunity to improve outcomes, predictors of readmissions are not known. We sought to characterize and identify factors associated with unplanned readmission after discharge in survivors of open TAAA repair. METHODS: Through prospective phone contact and retrospective record review, we determined the frequency and characteristics of unplanned readmissions within 30 days of discharge in 363 patients who were discharged after open TAAA repair...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29153441/complex-endovascular-repair-of-postdissection-arch-and-thoracoabdominal-aneurysms
#7
Rafaëlle Spear, Adrien Hertault, Katrien Van Calster, Nicla Settembre, Matthieu Delloye, Richard Azzaoui, Jonathan Sobocinski, Dominique Fabre, Mark Tyrrell, Stéphan Haulon
OBJECTIVE: We report our experience of the treatment of postdissection arch aneurysms and thoracoabdominal aortic aneurysms (TAAAs) by endovascular repair using fenestrated and branched endografts. METHODS: This study includes all patients presenting with chronic postdissection aneurysms >55 mm in diameter deemed unfit for open surgery and treated by complex endografting between October 2011 and April 2017. Where appropriate, staged management strategies including left subclavian artery revascularization, thoracic endografting, dissection flap fenestration, and tear enlargement were performed before the complex endovascular repair...
November 15, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29152514/open-thoracoabdominal-aortic-aneurysm-repair-in-expert-hands-all-roads-lead-to-rome
#8
EDITORIAL
Giacomo Murana, Jacopo Alfonsi, Luca Di Marco, Davide Pacini
No abstract text is available yet for this article.
October 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29122422/comparison-of-open-surgical-techniques-for-repair-of-types-iii-and-iv-thoracoabdominal-aortic-aneurysms
#9
Muhammad A Rana, Peter Gloviczki, Audra A Duncan, Manju Kalra, Kevin L Greason, Gustavo S Oderich, Stephen S Cha, Thomas C Bower
OBJECTIVE: The objective of this study was to compare outcomes after repair of type III and type IV thoracoabdominal aortic aneurysms (TAAAs) by three different open surgical techniques at a tertiary care institution. METHODS: Consecutive patients who underwent elective repair of type III and type IV TAAAs at our institution between 1999 and 2011 were retrospectively reviewed. Patients were divided into three groups according to surgical technique: clamp and sew (CS), left-sided heart bypass (LHB), and visceral branching (VB) followed by aortic reconstruction...
November 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29121844/patient-and-aneurysm-characteristics-predicting-prolonged-length-of-stay-after-elective-open-aaa-repair-in-the-endovascular-era
#10
Sergio Casillas-Berumen, Florencia A Rojas-Miguez, Alik Farber, Sevan Komshian, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
INTRODUCTION: Open aortic aneurysm repair (AAA) repair can be resource intensive and associated with a prolonged length of stay (LOS). We sought to examine patient and aneurysm predictors of prolonged LOS to better identify those at risk in the preoperative setting. METHODS: Patient data were obtained from the targeted AAA American College of Surgery National Surgical Quality Improvement Program database from 2012 to 2014 of patients undergoing open AAA repair. Multivariable logistic regression was used to determine predictors of prolonged postoperative LOS defined as greater than 10 days (75th percentile)...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29119033/the-utility-of-mri-in-the-diagnosis-of-takayasu-arteritis
#11
Marian Gaballah, Rachelle Goldfisher, John B Amodio
Takayasu Arteritis (TA) is an inflammatory disorder involving the thoracoabdominal aorta and its branches and the pulmonary arteries, with eventual vascular stenosis, occlusion, or aneurysm formation. Conventional angiography has been the reference imaging standard for diagnosis of TA. The purpose of this case report is to demonstrate the utility of MR imaging and MR angiography in the diagnosis of Takayasu Arteritis in a pediatric patient. The patient is a 15-year-old female patient presenting with anemia, hypertension, and acute kidney injury...
2017: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/29100806/comparison-of-sacrificed-healthy-aorta-during-thoracoabdominal-aortic-aneurysm-repair-using-off-the-shelf-endovascular-branched-devices-and-open-surgery
#12
Luca Bertoglio, Tommaso Cambiaghi, Ciro Ferrer, Domenico Baccellieri, Fabio Verzini, Germano Melissano, Roberto Chiesa, Yamume Tshomba
BACKGROUND: Off-the-shelf devices for branched endovascular aortic repair of thoracoabdominal aortic aneurysm (TAAA) have been developed to overcome the manufacturing- and logistics-related delays characteristic of device customization. Nonetheless, the structural requirements of branched endovascular aortic repair, together with the need for additional thoracic components to suit different anatomies, might lead to a large sacrifice of healthy aorta. METHODS: We enrolled 18 consecutive TAAA patients treated between 2010 and 2016 in two centers employing the off-the-shelf t-Branch (Cook Medical, Bloomington, Ind) device (TB group)...
October 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29098123/point-of-care-ultrasound-diagnosis-of-a-massive-thoracoabdominal-aortic-aneurysm
#13
Allison M Yee, Cyrus V Etebari, Srikar Adhikari, Richard Amini
This report highlights an atypical presentation of extensive thoracoabdominal aortic aneurysm with intramural hematoma and transient paralysis of the lower extremities. Clinical suspicion for aortic pathology prompted a point of care ultrasound of the heart and aorta, which demonstrated a thoracic and abdominal aortic aneurysm with intraluminal pathology. Consultation and transfer to a tertiary care facility was based solely on the emergency physician's ultrasound. Subsequent computed tomography (CT) imaging confirmed the ultrasound findings and discovered a left common iliac artery thrombosis consistent with the patient's presentation...
August 26, 2017: Curēus
https://www.readbyqxmd.com/read/29097044/standard-off-the-shelf-multibranched-thoracoabdominal-endograft-in-urgent-and-elective-patients-with-single-and-staged-procedures-in-a-multicenter-experience
#14
Roberto Silingardi, Stefano Gennai, Nicola Leone, Mauro Gargiulo, Gianluca Faggioli, Piergiorgio Cao, Fabio Verzini, Arnaldo Ippoliti, Nicola Tusini, Carmelo Ricci, Michele Antonello, Roberto Chiesa, Enrico Maria Marone, Nicola Mangialardi, Francesco Speziale, Gian Franco Veraldi, Stefano Bonardelli, Luigi Marcheselli
OBJECTIVE: The objective of this study was to assess immediate and midterm outcomes for urgent/emergent and elective patients with thoracoabdominal aortic aneurysms (TAAAs) treated with the first commercially available "off-the-shelf" multibranched endograft for endovascular aneurysm repair, with a single-step or a staged surgical approach. METHODS: A multicenter, nonrandomized, retrospective study was conducted of TAAA patients grouped by urgent/emergent and elective treatment with multibranched endograft for endovascular aneurysm repair at 13 Italian centers from November 2012 to August 2016...
October 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29097041/comparable-perioperative-mortality-outcomes-in-younger-patients-undergoing-elective-open-and-endovascular-abdominal-aortic-aneurysm-repair
#15
Nathan L Liang, Katherine M Reitz, Michel S Makaroun, Mahmoud B Malas, Edith Tzeng
BACKGROUND: Evidence for benefit of endovascular aneurysm repair (EVAR) over open surgical repair for de novo infrarenal abdominal aortic aneurysms (AAAs) in younger patients remains conflicting because of heterogeneous study populations and small sample sizes. The objective of this study was to compare perioperative and short-term outcomes for EVAR and open surgery in younger patients using a large national disease and procedure-specific data set. METHODS: We identified patients 65 years of age or younger undergoing first-time elective EVAR or open AAA repair from the Vascular Quality Initiative (2003-2014)...
October 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29080918/ultra-high-resolution-ct-angiography-of-the-artery-of-adamkiewicz-a-feasibility-study
#16
Kunihiro Yoshioka, Ryoichi Tanaka, Hidenobu Takagi, Yuta Ueyama, Kei Kikuchi, Takuya Chiba, Kazumasa Arakita, Joanne D Schuijf, Yasuo Saito
PURPOSE: Preoperative identification of the artery of Adamkiewicz can help prevent postoperative spinal cord injury following thoracic and thoracoabdominal aortic repair. Several studies have demonstrated the feasibility of evaluating the artery of Adamkiewicz using multi-detector row computed tomography (CT), but precise visualization remains a challenge. The present study was conducted to evaluate the usefulness of ultra-high-resolution CT for visualizing the artery of Adamkiewicz with a slice thickness of 0...
October 28, 2017: Neuroradiology
https://www.readbyqxmd.com/read/29078246/-surgeon-modified-stent-grafts-in-emergency-cases-as-addition-to-off-the-shelf-stent-grafts-for-complex-abdominal-and-thoracoabdominal-aortic-pathologies
#17
Franziska Heidemann, Tilo Kölbel, Sebastian Debus, Christian-Alexander Behrendt, Holger Diener, Fiona Rohlffs, Nikolaos Tsilimparis
Background Endovascular techniques have revolutionised the therapy of abdominal and thoracoabdominal aortic disease. For infrarenal abdominal aortic aneurysm, the endovascular aortic repair has become a standard for elective and emergent cases. In complex abdominal or thoracoabdominal aortic pathologies, involving reno-visceral vessels, there are technical challenges for open and endovascular surgery. Due to high mortality and morbidity of open surgery of complex aortic lesions, especially in emergent cases, endovascular techniques have developed as well...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29058970/cerebrospinal-fluid-drainage-and-thoracic-endovascular-aneurysm-repair
#18
Gilles Godet, Michèle Bertrand, Marie-Hélène Fléron, Jean-Pierre Goarin, Pascal Colson, Alain Cardon, Fabien Koskas, Jean-Philippe Verhoye, Edouard Kieffer
Spinal cord complications including paraplegia and partial neurologic deficits remain a frequent problem during repair of descending thoracic or thoracoabdominal aortic aneurysms. Effective prevention of this dreaded complication is of paramount importance. Among the many adjuncts that have been proposed to prevent spinal cord complications, spinal fluid drainage is one that has been used by numerous teams. The aim of this review is to answer the following question: does spinal fluid drainage afford spinal cord protection during both open and endovascular repair of thoracic or thoracoabdominal aortic aneurysms?...
January 1, 2017: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29056350/late-patency-of-reconstructed-visceral-arteries-after-open-repair-of-thoracoabdominal-aortic-aneurysm
#19
Andrea Kahlberg, Angela M R Ferrante, Riccardo Miloro, Daniele Mascia, Luca Bertoglio, Domenico Baccellieri, Germano Melissano, Roberto Chiesa
BACKGROUND: In the era of rising endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs), the analysis of visceral vessel (VV) patency after open surgical repair is crucial to provide a future benchmark between these different approaches. This study reports the late outcomes of a single-center experience with open TAAA repair, focusing on the results of different techniques adopted for renal and splanchnic revascularization. METHODS: Data were analyzed for 382 consecutive open TAAA repairs performed between January 2009 and July 2015 (284 men; mean age, 66 ± 10 years)...
October 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29054233/managing-a-mycotic-thoracoabdominal-aneurysm-the-importance-of-molecular-diagnostics
#20
Christopher D Bayliss, Karen L Booth, Robin Williams, John H Dark, Kate F Gould
Pneumococcal mycotic aneurysms are rare and associated with significant mortality and morbidity. Early intravenous antibiotic therapy and surgical intervention is the mainstay of treatment. Pneumococci frequently autolyze in blood cultures, making microbiological diagnosis challenging. We present the case of a man in his mid 70s with multiple thoracoabdominal mycotic aneurysms. Surgery was performed to a threatening saccular aortic arch aneurysm. Samples were sent for microbiological analysis and all were culture negative...
November 2017: Annals of Thoracic Surgery
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