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Thoracoabdominal aortic aneurysm

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https://www.readbyqxmd.com/read/29665666/-early-results-of-fenestrated-endovascular-aortic-repair-for-the-treatment-of-patients-with-thoracoabdominal-pathologies
#1
J C Zhu, X C Dai, Y D Luo, H L Fan, Z Feng, Y W Zhang, F G Hu
Objective: To evaluate the early results of fenestrated endovascular aortic repair (FEVAR) using physician-modified stent grafts (PMSGs) for the treatment of patients with thoracoabdominal pathologies. Methods: Nineteen consecutive patients who underwent FEVAR using PMSGs between April 2012 and September 2017 were retrospectively reviewed. The modality of FEVAR technique was assessed, perioperative clinical data was recorded and the early results were evaluated. Results: Indications were thoracoabdominal aortic pathologies, including juxtarenal abdominal aortic aneurysm (JAAA) ( n =12), chronic thoracoabdominal aortic dissection with aneurysmal dilatation ( n =3), thoracoabdominal aortic aneurysm (TAAA) ( n =1), infrarenal AAA with an accessory renal artery in the segment of the aneurysmal neck ( n =2) and type Ⅰ endoleak after EVAR for AAA( n =1)...
March 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29619775/current-strategies-of-spinal-cord-protection-during-thoracoabdominal-aortic-surgery
#2
REVIEW
Akiko Tanaka, Hazim J Safi, Anthony L Estrera
Despite improved survival rates after thoracoabdominal aortic aneurysm repairs, paraplegia remains a devastating complication with high incidence, ranging from 3 to 10%. Ischemic insults to the spinal cord are unavoidable during thoracoabdominal aortic aneurysm repairs. There is no single measure that can prevent paraplegia alone. A multimodality approach is required to minimize the ischemic insults during thoracoabdominal aortic aneurysm repairs and postoperative second hit to the spinal cord. Distal aortic perfusion is important to maintain the collateral network perfusion pressure, while cerebrospinal drainage allows to directly maintain the spinal cord perfusion...
April 4, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29615357/use-of-extracorporeal-bypass-is-associated-with-improved-outcomes-in-open-thoracic-and-thoracoabdominal-aortic-aneurysm-repair
#3
Jahan Mohebali, Stephanie Carvalho, R Todd Lancaster, Emel A Ergul, Mark F Conrad, W Darrin Clouse, Richard P Cambria, Virendra I Patel
OBJECTIVE: There is no consensus on the use or benefit of extracorporeal circulation (EC) during aneurysm repair of the descending thoracic aorta (DTA) or thoracoabdominal aorta (TAA). We evaluated the role of EC during DTA or TAA aneurysm repair using U.S. Medicare data. METHODS: Medicare (2004-2007) patients undergoing open repair of nonruptured DTA or TAA aneurysm were identified by International Classification of Diseases, Ninth Revision code. Specific exclusions included ascending aortic or arch repairs, concomitant cardiac procedures, and procedures employing deep hypothermic circulatory arrest...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29611032/thoracoabdominal-aortic-replacement-in-patients-aged-50-and-younger
#4
REVIEW
Kenji Minatoya, Yosuke Inoue, Yoshimasa Seike, Atsushi Omura, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVE: Open repair of a thoracoabdominal aortic aneurysm (TAAA) has been regarded as one of the most invasive procedures in cardiovascular surgery. Conversely, endovascular technology currently enables the repair of the thoracoabdominal aorta, and this approach is less invasive. However, the long-term durability of this method of endovascular repair remains unknown. This investigation retrospectively analyzed the long-term durability of thoracoabdominal aorta repair in patients aged 50 and younger...
April 2, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29606567/open-repair-of-descending-and-thoracoabdominal-aortic-aneurysms-in-octogenarians
#5
Leonard N Girardi, Christopher Lau, Lucas B Ohmes, Benjamin C Degner, Jeremy R Leonard, Ahmed Abouarab, Antonino Di Franco, Erin M Iannacone, Monica Munjal, Mario Gaudino
OBJECTIVE: Despite improved outcomes for open repair of descending thoracic aneurysm (DTA) and thoracoabdominal aortic aneurysm (TAAA), these operations remain challenging in octogenarians. Patients unsuitable for thoracic endovascular aortic repair require open surgery to avoid catastrophic rupture. We analyzed our results for DTA/TAAA repair in these elderly patients. METHODS: Our institutional aortic database was queried to identify those ≥80 years old and those <80 years old undergoing open DTA/TAAA repair...
March 29, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602471/early-and-midterm-outcome-of-multilayer-flow-modulator-stent-for-complex-aortic-aneurysm-treatment-in-germany
#6
Walid Ibrahim, Konstantinos Spanos, Andreas Gussmann, Christoph A Nienaber, Joerg Tessarek, Heinrich Walter, Jörg Thalwitzer, Sebastian E Debus, Nikolaos Tsilimparis, Tilo Kölbel
OBJECTIVE: The objective of this study was to assess the early and midterm outcomes of endovascular repair of complex aortic aneurysm cases using the Multilayer Flow Modulator (MFM; Cardiatis, Isnes, Belgium) endograft in Germany. METHODS: A retrospective study including patients presenting with abdominal aortic aneurysm (AAA), thoracic aortic aneurysm, or thoracoabdominal aortic aneurysm treated with the MFM was conducted in Germany. Mortality and morbidity (in terms of spinal cord ischemia, visceral ischemia, and stroke) at 30 days postoperatively were evaluated...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29576405/a-propensity-matched-comparison-of-fenestrated-endovascular-aneurysm-repair-and-open-surgical-repair-of-pararenal-and-paravisceral-aortic-aneurysms
#7
Giovanni Tinelli, Maria Antonietta Crea, Chiara de Waure, Gian Luca Di Tanna, Jean-Pierre Becquemin, Jonathan Sobocinski, Francesco Snider, Stéphan Haulon
OBJECTIVE: This study investigated the outcomes of a current series of patients treated with fenestrated and branched endovascular aneurysm repair (F-BEVAR) or open surgical repair (OSR) for pararenal abdominal aortic aneurysms (pr-AAAs), including juxtarenal, suprarenal, and type IV thoracoabdominal aneurysms. This study compares the outcomes of these procedures from two high-volume centers without the bias induced by a learning curve. METHODS: All patients with pr-AAAs undergoing repair at two centers between January 2010 and June 2016 were included in a prospective database...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29567025/endovascular-thoracic-aortic-repair-in-confirmed-or-suspected-genetically-triggered-thoracic-aortic-dissection
#8
Sherene Shalhub, Kim A Eagle, Federico M Asch, Scott A LeMaire, Dianna M Milewicz
OBJECTIVE: Endovascular repair in patients with connective tissues disorders is not recommended because of concern for repair failure. The aim of this study was to investigate thoracic endovascular aortic repair (TEVAR) outcomes in patients with confirmed or suspected syndromic and nonsyndromic genetically triggered thoracic aortic dissection. METHODS: We analyzed data for patients with descending thoracic aorta (DTA) dissection treated with TEVAR from the National Registry of Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC)...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29554863/laser-fenestration-for-treatment-of-a-complicated-chronic-type-b-aortic-dissection
#9
Tara Talaie, Christopher Werter, Charles Drucker, Brittany O Aicher, Robert Crawford, Shahab Toursavadkohi
We report a case of a complex chronic type B aortic dissection treated by thoracic endovascular aortic repair and laser fenestration of the false septum to preserve flow to branch vessels originating from both the true and false lumen. Dissections complicated by thoracoabdominal aneurysmal degeneration with critical organs being perfused by branches arising from both true and false lumens are rare and leave limited options for repair. Despite advancements in endovascular techniques, fenestration remains one of the only means of preserving flow to both the true and false lumens and thus was necessary in the management of our patient...
April 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29552983/octopus-endograft-technique-to-treat-a-ruptured-thoracoabdominal-aortic-aneurysm
#10
Zilun Li, Henghui Yin, Mian Wang, Ridong Wu, Chenshu Liu, Chen Yao, Guangqi Chang
PURPOSE: To report the use of the octopus endograft technique to treat a patient with a ruptured thoracoabdominal aortic aneurysm (TAAA). CASE REPORT: A 46-year-old man was diagnosed with a contained rupture of a 9-cm type V TAAA. The presence of an occluded superior mesenteric artery (SMA), a stenotic celiac trunk, an enlarged inferior mesenteric artery (IMA), and rich collaterals with the SMA and celiac trunk made endovascular repair with the octopus endograft technique appear feasible...
April 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29552513/state-of-the-art-review-on-the-renal-and-visceral-protection-during-open-thoracoabdominal-aortic-aneurysm-repair
#11
REVIEW
Karl Waked, Marc Schepens
During open thoracoabdominal aortic aneurysm repair (OTAAAR), there is an inevitable organ ischemic period that occurs when the abdominal arteries are being reattached to the aortic graft. Despite various protective techniques, the incidence of renal and visceral complications remains substantial. This state-of-the-art review gives an overview of the current and most evidence-based organ protection methods during OTAAAR, based on the most recent publications and personal experience. An electronic search was performed in four medical databases, using the following MeSH terms: thoracoabdominal aneurysm, TAAAR, visceral protection, renal protection, kidney, perfusion, and intestines...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29536780/treatment-for-thoracoabdominal-aortic-aneurysm-by-fenestrated-endovascular-aortic-repair-with-physician-modified-stent-graft
#12
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
https://www.readbyqxmd.com/read/29523439/the-impact-of-prior-aortic-surgery-on-outcomes-after-multibranched-endovascular-aortic-aneurysm-repair
#13
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
https://www.readbyqxmd.com/read/29511868/technical-note-dissection-flap-perforation-with-use-of-a-tips-needle-during-fenestrated-endografting-for-post-dissection-thoracoabdominal-aneurysms
#14
Hozan Mufty, Athanasios Katsargyris, Sabrina Houthoofd, Inge Fourneau, Eric Verhoeven, Geert Maleux
INTRODUCTION: Fenestrated/branched thoracic endovascular aneurysm repair (F/Br-TEVAR) is a new minimal invasive treatment option for patients with post-dissection thoracoabdominal aortic aneurysms. This specific pathology is challenging to F/Br-TEVAR, especially when target vessels originate from the false lumen. Crossing from the true lumen into the false lumen to catheterize such target vessels may prove cumbersome in the usually thickened dissection flap. TECHNIQUE: We describe a bailout technique when standard catheterization techniques fail, by using a transjugular intrahepatic portosystemic shunt (TIPS)-needle to perforate the dissection flap...
March 6, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29511866/complications-and-reinterventions-after-fenestrated-and-branched-evar-in-patients-with-paravisceral-and-thoracoabdominal-aneurysms
#15
Ivan Kuang Hsin Huang, Seyed Ameli Renani, Robert A Morgan
The application of endovascular strategies to treat aneurysms involving the abdominal and thoracoabdominal aorta has evolved significantly since the inception of endovascular aneurysm repair. Advances in endograft technology and operator experience have enabled the management of a wider spectrum of challenging aortic anatomy. Fenestrated endovascular and branched endovascular aneurysm repair represent two technical innovations, which have expanded endovascular treatment options to include patients with paravisceral and thoracoabdominal aortic aneurysms...
March 6, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29506945/national-trends-in-admissions-repair-and-mortality-for-thoracic-aortic-aneurysm-and-type-b-dissection-in-the-national-inpatient-sample
#16
Grace J Wang, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Philip P Goodney, Rachel R Kelz, Christopher Wirtalla, Ronald M Fairman
OBJECTIVE: The advent of endovascular repair for both thoracic aortic aneurysm and type B dissection has transformed the management of these disease processes. This study was undertaken to better define, compare, and contrast the national trends in hospital admissions, invasive treatments, and inpatient mortality of patients with thoracic aortic aneurysm and type B dissection in the National Inpatient Sample. METHODS: The cohort was derived from International Classification of Diseases, Ninth Revision diagnosis codes for thoracic aortic dissection and thoracic aortic or thoracoabdominal aortic aneurysm...
March 2, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29503006/percutaneous-axillary-artery-access-for-fenestrated-and-branched-thoracoabdominal-endovascular-repair
#17
Luca Bertoglio, Daniele Mascia, Tommaso Cambiaghi, Andrea Kahlberg, Germano Melissano, Roberto Chiesa
OBJECTIVE: The aim of this study was to assess the safety and effectiveness of upper extremity access (UEA) with percutaneous closure of the axillary artery (AxA) during endovascular treatment of thoracoabdominal aortic aneurysms with fenestrated and branched endografts. METHODS: Between January 2014 and 2017, 34 out of 37 patients (92%) required UEA during a staged branched and fenestrated endovascular approach. A percutaneous AxA (pAxA) approach was used in 14 consecutive patients (41%) with the off-label use of two Perclose ProGlide (Abbott Vascular, Santa Clara, Calif) devices...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29478789/-thoracoabdominal-aneurysms
#18
Raphael Soler, Aurelien Vallee, Dominique Fabre, Stéphan Haulon
Endovascular treatment of thoracoabdominal aneurysms: what's new? Thoracoabdominal aneurysms (T-AAA) are aortic aneurysms that involve both the thoracic and abdominal segments of the aorta and its associated visceral branches. Although the first successful open repair was reported over 50 years ago, the risks of treatment remain considerable. As the first generations of devices available for endovascular aneurysm repair (EVAR) were relatively simple tubes or bifurcated grafts, initial attempts to extend the benefits of EVAR to patients with T-AAA lead to "hybrid solution"...
February 22, 2018: La Presse Médicale
https://www.readbyqxmd.com/read/29460875/-staged-approach-for-hybrid-thoracoabdominal-aortic-replacement
#19
R N Komarov, I A Vinokurov, P A Karavaykin, I M Abdulmutalibov, Yu V Belov
AIM: To generalize our experience of step-by-step hybrid thoracoabdominal aortic replacement. MATERIAL AND METHODS: Twenty-three patients were enrolled who underwent staged hybrid treatment of thoracoabdominal aortic aneurysm. There were 5 (21.7%) women and 18 (78.3%) men aged 61.4±8.3 years (37-74 years). The first stage was proximal debranching, the second - distal (abdominal) procedure and the third - stenting of the thoracoabdominal aorta. RESULTS: There were no any complications after proximal debranching and aortic stenting...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29428620/postoperative-chylothorax-after-thoracoabdominal-aortic-aneurysm-repair
#20
Darrell Wu, Arina E Chesnokova, Shahab Akvan, Matt D Price, David J Sugarbaker, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Chylothorax is a potentially deadly complication that can occur after thoracoabdominal aortic aneurysm (TAAA) repair. We describe our contemporary experience (2005-2014) with this complication, our efforts to identify perioperative variables associated with it, and our attempts to assess treatment outcomes. METHODS: We reviewed the records of 1092 consecutive patients who underwent TAAA repair between 2005 and 2014. Standard bivariate analysis was used to test for between-group differences...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
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