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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/28433350/open-repair-of-chronic-thoracic-and-thoracoabdominal-aortic-dissection-using-deep-hypothermia-and-circulatory-arrest
#1
Joel Corvera, Hannah Copeland, David Blitzer, Adam Hicks, Joshua Manghelli, Philip Hess, John Fehrenbacher
BACKGROUND: Chronic dissection of the thoracic and thoracoabdominal aorta as sequela of a prior type A or B dissection is a challenging problem that requires close radiographic surveillance and prompt operative intervention in the presence of symptoms or aneurysm formation. Open repair of chronic thoracic and thoracoabdominal aortic dissection using deep hypothermia has been our preferred method to treat this complex pathology. The advantages of this technique include organ and spinal cord protection, the flexibility to extend the repair proximally into the arch, and the ability to limit ischemia to all vascular beds...
March 18, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28433218/cardiac-arrhythmia-after-open-thoracoabdominal-aortic-aneurysm-repair
#2
Ahmet Dolapoglu, Irina V Volguina, Matt D Price, Susan Y Green, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Cardiac arrhythmias commonly arise after cardiac surgery and are associated with poor prognosis. In thoracoabdominal aortic aneurysm (TAAA) repair, these complications are poorly understood. We assessed characteristics, incidence, outcomes, and potential predictors of postoperative arrhythmia (PA) after open TAAA repair. METHODS: From 2010 to 2014, 403 consecutive open TAAA replacement operations were performed in patients without preoperative cardiac rhythm abnormalities at a single tertiary center...
April 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28431720/hybrid-endovascular-repair%C3%A2-of%C3%A2-a-right-sided-thoracoabdominal-aortic%C3%A2-aneurysm
#3
Mamoru Hamuro, Tomoyuki Yamada, Kenji Yamamoto, Sakae Enomoto, Masahide Kawatou
A right-sided thoracoabdominal aortic aneurysm involving a right-sided aortic arch is extremely rare. Surgical treatment for a right-sided thoracoabdominal aortic aneurysm is challenging due to the anatomical complexity. We report a case of a right-sided thoracoabdominal aortic aneurysm with a right-sided aortic arch successfully treated by hybrid visceral debranching and endovascular repair.
May 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28428528/-challenge-of-treating-thoracoabdominal-aortic-aneurysms-with-hybrid-thoracic-endovascular-aortic-repair
#4
Takashi Shuto, Shinji Miyamoto
The treatment of thoracoabdominal aortic aneurysms in great vessels is still challenging, as the early results of the operation are not very promising compared with other aortic operations, and the incidence of spinal cord ischemia is relatively high. In Japan, which is becoming a super-aging society, the method of performing minimally invasive operations remains a major issue. At our facility, we have been performing abdominal debranching thoracic endovascular aortic repair (TEVAR) to resolve these issues...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428520/-prevention-of-spinal-cord-ischemia-during-thoracic-endovascular-aortic-repair
#5
Shinya Takahashi, Taijiro Sueda
Spinal cord ischemia(SCI) has been devastating complication of endovascular thoracic and thoracoabdominal aortic repair. Spinal cord blood supply arises from not only segmental artery, subclavian artery, hypogastric artery and these branches, but also perivertebral vasculature and paravertebral muscle and small arterial network, and risk factors of SCI were multifactorial. There are several adjuncts/strategies which are utilized to minimize the incidence of SCI: cerebrospinal fluid drainage, perioperative management of high mean arterial pressure, intraoperative evoked potential monitoring, and staged thoracoabdominal aortic repair...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28423131/thoracoabdominal-aortic-aneurysm-in-a-hiv-positive-patient
#6
Márcio Luís Lucas, Ívia Binotto, Paulo Behar, Nilon Erling, Eduardo Lichtenfels, Newton Aerts
Advent of antiretroviral therapy has increased survival of patients with human immunodeficiency virus (HIV) infections, with the result that some of these patients now develop degenerative diseases, such as atherosclerotic aneurysms. Degenerative thoracoabdominal aortic aneurysm is rare in HIV patients. In this report, a 63-year-old male patient with HIV submitted to open repair of thoracoabdominal aortic aneurysm. The patient did not suffer any type of complication in the perioperative period and remained well in a 28-month follow-up period...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#7
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#8
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389292/laparoscopic-transarterial-embolization-of-type-ii-endoleak-after-branched-fenestrated-thoracoabdominal-aortic-aneurysm-endovascular-repair
#9
Gian Franco Fadda, Holta Kasemi, Costantino Luca Di Angelo, Carlo De Nisco, Francesco Balestra, Antonio Cruccu, Mario Marino
Type II endoleak is the most frequent procedure-related complication during endovascular aneurysm exclusion. Actually there is little controversy in the management of type I and III endoleak, while type II endoleak still generates conflicting reports about their timing and type of treatment. Currently, the intervention is needed only in case of sac enlargement, but not in case of persistent endoleak alone. We report the case of a 77 year-old man treated with a custom-made branched/fenestrated endograft for a type III thoracoabdominal aortic aneurysm...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389286/decision-to-interrupt-second-stage-side-branch-completion-in-thoracoabdominal-branched-aortic-stent-grafting-to-prevent-spinal-cord-ischemia
#10
Joseph Touma, Bachir Benamara, Hicham Kobeiter, Pascal Desgranges
PURPOSE: To describe voluntary interruption of side-branch completion in staged branched endovascular aneurysm treatment due to uncertainty regarding spinal cord ischemia (SCI) possible onset, based on intraoperative angiography findings. CASE REPORT: We report a case of a staged endovascular treatment of thoracoabdominal aortic aneurysm in a 64 year-old patient using a branched endograft with an additional side branch that allows temporary sac perfusion (TASP) to prevent spinal cord ischemia...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28366305/off-the-shelf-multibranched-endograft-for-urgent-endovascular-repair-of-thoracoabdominal-aortic-aneurysms
#11
Enrico Gallitto, Mauro Gargiulo, Antonio Freyrie, Rodolfo Pini, Chiara Mascoli, Stefano Ancetti, Gianluca Faggioli, Andrea Stella
OBJECTIVE: The aim of this paper was to report early and midterm results of endovascular repair of urgent thoracoabdominal aortic aneurysms (TAAAs) by the off-the-shelf multibranched Zenith t-Branch endograft (Cook Medical, Bloomington, Ind). METHODS: Between January 2014 and April 2016, all patients with urgent TAAAs (asymptomatic with diameter >8 cm, symptomatic, or ruptured TAAAs) and aortoiliac anatomic feasibility underwent endovascular repair by t-Branch and were prospectively enrolled...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28359794/multilayered-parallel-endografting-for-urgent-endovascular-repair-of-a-severely-angulated-thoracoabdominal-aortic-aneurysm
#12
Sukgu M Han, Sarah Wartman, Sung W Ham, Eric C Kuo, Vincent L Rowe, Fred A Weaver
Total endovascular repair of TAAA using branched, fenestrated stent-grafts have been performed with promising midterm results. However, severe angulation of the aorta as well as close proximity of the visceral and renal artery ostia pose a significant technical challenge in designing and implanting branched, fenestrated stent-grafts. Parallel grafting offers an alternative technique, allowing an urgent, or emergent total endovascular repair of symptomatic, or ruptured TAAA. We describe a technique of 4-vessel incorporation in a total endovascular repair of TAAA, using multi-layered parallel endografting via bilateral femoral and unilateral brachial access...
March 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28359793/preoperative-hypoalbuminemia-is-a-risk-factor-for-early-and-late-mortality-in-patients-undergoing-endovascular-juxtarenal-and-thoracoabdominal-aortic-aneurysm-repair
#13
M Wohlauer, C Brier, Y Kuramochi, M Eagleton
INTRODUCTION: Advances in endovascular aneurysm repair now allow surgeons to treat high risk patients with complex aortic aneurysms. Stringent selection criteria for repair exists from an anatomic and technical perspective, however there is a paucity of literature examining frailty in patients being evaluated for fenestrated and branched endovascular aortic repair (FEVAR). As a marker of frailty well supported in the literature, we hypothesized that preoperative hypoalbuminemia would increase risk for short-term mortality following endovascular juxtarenal and thoracoabdominal aortic aneurysm repair...
March 27, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28342523/early-experience-with-a-modified-preloaded-system-for-fenestrated-endovascular-aortic-repair
#14
Blandine Maurel, Tim Resch, Rafaelle Spear, Blayne Roeder, Umberto M Bracale, Stephan Haulon, Tara M Mastracci
OBJECTIVE: Preloaded endovascular delivery systems expand the anatomic eligibility for complex aortic repair by requiring only one iliac access vessel and providing a stable platform for guiding sheaths into challenging target vessels. This article reports the lessons learned and early clinical outcomes using a modified preloaded delivery system for fenestrated endovascular aneurysm repair (FEVAR) in three aortic centers in Europe. METHODS: From October 2015 to March 2016, consecutive patients presenting with extensive aortic aneurysm treated with a modified preloaded FEVAR were prospectively enrolled from three high volume European aortic centers...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28342519/evidence-of-use-of-multilayer-flow-modulator-stents-in-treatment-of-thoracoabdominal-aortic-aneurysms-and-dissections
#15
EDITORIAL
Gustavo S Oderich
No abstract text is available yet for this article.
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28341507/endovascular-aortic-repair-for-progressive-chronic-thoracoabdominal-aortic-dissections
#16
Vito Mantese, Shameem Kunhammed
BACKGROUND: Ascending and thoracic aortic dissections progress into thoracoabdominal aneurysms 20-40% of the time, due to the initial aortic injury with associated weakness of the aortic wall. The increased firmness of the intimal flap usually results in a collapsed true lumen that does not spontaneously re-expand even with progressive dilatation of the aorta. In an effort to identify a safe and effective treatment path for this complex disease process, we present 4 cases illustrating successful sequential thoracic endovascular aortic repair (TEVAR) and fenestrated endovascular aortic repair (FEVAR)...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#17
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28279526/applicability-and-midterm-results-of-branch-cuff-closure-with-vascular-plug-in-branched-endovascular-repair-for-thoracoabdominal-aortic-aneurysms
#18
Kiattisak Hongku, Timothy Resch, Björn Sonesson, Thorarinn Kristmundsson, Nuno V Dias
OBJECTIVE: This study assessed the applicability and outcomes of the closure of unused cuffs in branched endovascular aneurysm repair (b-EVAR) of thoracoabdominal aortic aneurysm. METHODS: We reviewed b-EVAR procedures at a tertiary referral center to identify patients who underwent incomplete branching and needed closure of the unused branch cuffs. An electronic database and intraoperative and follow-up imaging studies were reviewed to assess technical applicability and outcomes...
March 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28268106/right-brachial-access-is-safe-for-branched-endovascular-aneurysm-repair-in-complex-aortic-disease
#19
Beatrice Fiorucci, Tilo Kölbel, Fiona Rohlffs, Franziska Heidemann, Sebastian Eike Debus, Nikolaos Tsilimparis
BACKGROUND: The risk of perioperative cerebrovascular events in endovascular repair of thoracic and thoracoabdominal aneurysms is reported from 2% to 15%. The unavoidable use of an upper extremity access during branched endovascular aneurysm repair (b-EVAR) may play a role in embolic brain injuries. For this reason, some advocate the use of a left-sided upper access to avoid crossing the origin of supra-aortic vessels. However, the assumption that right brachial access has a higher risk for stroke during b-EVAR has not been confirmed in the literature...
March 4, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259577/outcomes-of-fenestrated-and-branched-endovascular-repair-of-complex-abdominal-and-thoracoabdominal-aortic-aneurysms
#20
Andres Schanzer, Jessica P Simons, Julie Flahive, Jonathan Durgin, Francesco A Aiello, Danielle Doucet, Robert Steppacher, Louis M Messina
BACKGROUND: More than 80% of infrarenal aortic aneurysms are treated by endovascular repair. However, adoption of fenestrated and branched endovascular repair for complex aortic aneurysms has been limited, despite high morbidity and mortality associated with open repair. There are few published reports of consecutive outcomes, inclusive of all fenestrated and branched endovascular repairs, starting from the inception of a complex aortic aneurysm program. Therefore, we examined a single center's consecutive experience of fenestrated and branched endovascular repair of complex aortic aneurysms...
March 1, 2017: Journal of Vascular Surgery
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