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https://www.readbyqxmd.com/read/28432073/in-situ-laser-fenestration-is-a-feasible-method-for-revascularization-of-aortic-arch-during-thoracic-endovascular-aortic-repair
#1
Jinbao Qin, Zhen Zhao, Ruihua Wang, Kaichuang Ye, Weimin Li, Xiaobing Liu, Guang Liu, Chaoyi Cui, Huihua Shi, Zhiyou Peng, Fukang Yuan, Xinrui Yang, Min Lu, Xintian Huang, Mier Jiang, Xin Wang, Minyi Yin, Xinwu Lu
BACKGROUND: Reconstruction of the aortic major branches during thoracic endovascular aortic repair is complicated because of the complex anatomic configuration and variation of the aortic arch. In situ laser fenestration has shown great potential for the revascularization of aortic branches. This study aims to evaluate the feasibility, effectiveness, and safety of in situ laser fenestration on the three branches of the aortic arch during thoracic endovascular aortic repair. METHODS AND RESULTS: Before clinical application, the polytetrafluoroethylene and Dacron grafts were fenestrated by an 810-nm laser system ex vivo, which did not damage the bare metal portion of the endografts and created a clean fenestration while maintaining the integrity of the endografts...
April 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28431107/double-fixation-for-abdominal-aortic-aneurysm-repair-using-afx-body-and-endurant-proximal-aortic-cuff-mid-term-results
#2
Miltiadis I Matsagkas, George Kouvelos, Konstantinos Spanos, Athanasios Athanasoulas, Athanasios Giannoukas
Our goal was to evaluate the use of an AFX main body combined with an Endurant proximal aortic cuff to treat selected patients with an abdominal aortic aneurysm (AAA) associated with anatomical challenges, such as a small distal aortic diameter and a hostile aortic neck. A retrospective analysis of prospectively collected data from 2 vascular institutions identified 14 elective patients with an AAA (all men, 73.5 ± 5.1 years) treated with the AFX main body combined with an Endurant proximal aortic cuff...
April 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28428519/-current-status-of-thoracic-endovascular-aortic-repair-in-our-institution
#3
Daisuke Fukui, Kenji Okada
Within 8-year period between 2009 and 2016, we treated 215 patient with a strategy of primary thoracic endovascular aortic repair( TEVAR). In-hospital mortality was 4.4%( 8 cases). Thirty-two emergency cases was included and we treated 23 cases of zone 0 debranching TEVAR with chimney techinique in this period. In recent 2-year period between 2015 and 2016, we treated 44 cases of TEVAR without type I a endoleaks with 0% mortality(most of the them was zone 2~3 TEVAR in this period) on the one hand, and the number of open surgery for thoracic aorta was 80 on the other...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28422344/use-of-blood-pool-agents-with-steady-state-mri-to-assess-the-vascular-system
#4
Avnesh S Thakor, John Chung, Premal Patel, Anthony Chan, Amdad Ahmed, Graeme McNeil, David M Liu, Bruce Forster, Darren Klass
Over the past two decades there have been significant advances in the use of magnetic resonance imaging (MRI) to assess the vascular system. New imaging sequences and improvements in magnet design have enabled the creation of higher spatial resolution images. MRI is now a viable alternative imaging modality when compared to both invasive angiography and computed tomographic angiography. The use of blood pool agents has further facilitated the use of MR angiography (MRA); their high molecular weight allows for lower doses of contrast medium administration while their prolonged presence in the blood stream allows for repeated high-quality volumetric imaging of both the arterial and venous circulation...
April 19, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#5
Jeremy L Irvan, James R Elmore, Sarah L Flora, Evan J Ryer
BACKGROUND: Emergency treatment of complex aortic pathology is challenging in the setting of a right-sided aortic arch. We report the successful treatment of a ruptured thoracic aortic aneurysm (TAA) in the setting of a Stanford type B aortic dissection (TBAD) and right-sided aortic arch. PRESENTATION OF CASE: The patient is a 66-year-old male with chronic kidney disease (CKD) admitted with right sided chest pain and hypotension. Computed tomography angiography (CTA) revealed a 5cm ruptured TAA in the setting of a TBAD and right-sided aortic arch...
March 28, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28410923/infrarenal-endograft-clamping-in-late-open-conversions-after-endovascular-abdominal-aneurysm-repair
#6
Paolo Perini, Alessandro de Troia, Tiziano Tecchio, Matteo Azzarone, Claudio Bianchini Massoni, Pierfranco Salcuni, Antonio Freyrie
OBJECTIVE: The aim of this study was to report the technical aspects and outcomes of late open conversion (LOC) after endovascular aneurysm repair (EVAR) in a single center by using exclusively infrarenal clamping of the endograft as an alternative to suprarenal or supraceliac aortic clamping. METHODS: A retrospective analysis of EVAR requiring late explantation (>30 days) from January 1996 to October 2016 was performed. Patients' demographics, type of endograft, duration of implantation, reason for removal, extent of stent graft removal, type of reconstruction, 30-day mortality, postoperative complications, and long-term survival were obtained for analysis...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28401533/long-term-follow-up-of-fenestrated-endovascular-repair-for-juxtarenal-aortic-aneurysm
#7
I N Roy, A M Millen, S M Jones, S R Vallabhaneni, J R H Scurr, R G McWilliams, J A Brennan, R K Fisher
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) is increasingly being used for juxtarenal aortic aneurysms. The aim of this study was to review long-term results and assess the importance of changing stent-graft design on outcomes. METHODS: This was a retrospective review of all patients who underwent FEVAR within a single unit over 12 years (February 2003 to December 2015). Kaplan-Meier analysis of survival, and freedom from target vessel loss, aneurysm expansion, graft-related endoleak and secondary intervention was performed...
April 12, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28399700/reply-to-another-pattern-of-chimney-evar-related-type-i-endoleak
#8
Konstantinos P Donas, Frank J Criado, Giovanni Torsello, Frank J Veith, David J Minion
No abstract text is available yet for this article.
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28395872/outcomes-of-antegrade-stent-graft-deployment-during-hybrid-aortic-arch-repair
#9
Seyed Hossein Aalaei-Andabili, Salvatore Scali, Charles Klodell, Teng Lee, Philip Hess, Tomas Martin, Adam Beck, Robert Feezor, Mahmoud Alhussaini, George Arnaoutakis, Thomas Beaver
BACKGROUND: Complex aortic arch disease can be a formidable challenge and is often treated with a two-stage elephant trunk technique. We examined our experience with hybrid arch repair with combined zone 0 stent graft deployment. METHODS: A retrospective review was conducted of all patients who underwent type 2 hybrid arch replacement and zone 0 antegrade endovascular stent graft deployments at a single university center from June 2010 to August 2015. RESULTS: The review included 48 patients, 25 (52%) elective and 23 (48%) nonelective, with a mean ± SD age of 64 ± 11 years...
April 7, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28395595/preoperative-risk-factors-for-aneurysm-sac-expansion-caused-by-type-2-endoleak-after-endovascular-aneurysm-repair
#10
Koichi Morisaki, Terutoshi Yamaoka, Kazuom Iwasa, Takahiro Ohmine, Atsushi Guntani
Purpose The objective of this study was to investigate the preoperatively definable risk factors which predict the aneurysm sac expansion caused by persistent type 2 endoleak after endovascular aneurysm repair. Methods Between 2008 and 2014, retrospective analysis was performed to examine the predictive risk factors for aneurysm sac enlargement caused by persistent type 2 endoleak, which was defined as a continuous endoleak present for more than six months. Aneurysm sac expansion was diagnosed if the maximum transverse diameter increased by 5 mm or more compared with the preoperative measurement...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28392056/open-conversion-after-endovascular-abdominal-aneurysm-repair-an-8-year-single-centre-experience
#11
I Ben Abdallah, S El Batti, M Abou-Rjeili, J-N Fabiani, P Julia, J-M Alsac
OBJECTIVE: To report experience with open conversion (OC) after previous failed EVAR and to compare outcomes of patients undergoing elective OC with those operated on in an urgent setting. METHODS: Patients undergoing OC after EVAR between August 2008 and September 2016 were included in this retrospective and observational single institution study. Indications, demographic, anatomical, intra-operative and post-operative data were collected prospectively. Primary endpoints were 30 day and in hospital mortality...
April 5, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28390918/dynamic-geometric-analysis-of-the-renal-arteries-and-aorta-following-complex-endovascular-aneurysm-repair
#12
Brant W Ullery, Ga-Young Suh, John J Kim, Jason T Lee, Ronald L Dalman, Christopher P Cheng
INTRODUCTION: Aneurysm regression and target vessel patency during early and mid-term follow-up may be related to the effect of stent graft configuration on the anatomy. We quantified geometry and remodeling of the renal arteries and aneurysm following fenestrated (F-) or snorkel/chimney (Sn-) endovascular aneurysm repair (EVAR). METHODS: 29 patients (mean age, 76.8±7.8 years) treated with F- or Sn-EVAR underwent computed tomography angiography at pre-op, post-op, and follow-up...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390913/could-preoperative-neck-anatomy-influence-follow-up-of-evar
#13
A Giménez-Gaibar, E González-Cañas, T Solanich-Valldaura, C Herranz-Pinilla, S Rioja-Artal, E Ferraz-Huguet
OBJECTIVE: Assess the clinical utility of strict CT-scan surveillance at 1, 6, 12 and 24 months after endovascular abdominal aneurysm repair (EVAR). Consider whether the anatomy of abdominal aortic aneurysm (AAA) neck (favourable/hostile) requires more imaging control. METHODS: Retrospective study 2006-2013. AAA patients who underwent EVAR with aortobiiliac endoprostheses. EXCLUSION CRITERIA: Other types of devices, hybrid techniques, open surgery...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389292/laparoscopic-transarterial-embolization-of-type-ii-endoleak-after-branched-fenestrated-thoracoabdominal-aortic-aneurysm-endovascular-repair
#14
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/28389291/a-word-of-caution-for-extra-large-self-expandable-nitinol-stents
#15
Andrés Reyes Valdivia, Africa Duque Santos, Francisco Alvarez Marcos, Asunción Romero Lozano, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
PURPOSE: To report an unsuccessful use of large nitinol stent to prevent proximal endoleak in endograft treatment for juxtarenal aortic aneurysm. CASE REPORT: Male of 82 years old, with coronary disease and severe chronic obstructive pulmonary disease (COPD) requiring oxygen support. A large 80 mm. juxtarenal aneurysm was found on routine urological examination. Neck features were as follows: 7mm and high anterior-posterior angulation. ASA IV was given. Patient wanted to be treated...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#16
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28387611/thoracic-endovascular-aortic-repair-with-single-double-chimney-technique-for-aortic-arch-pathologies
#17
Tun Wang, Chang Shu, Ming Li, Quan-Ming Li, Xin Li, Jian Qiu, Kun Fang, Alan Dardik, Chen-Zi Yang
PURPOSE: To summarize a single-center experience using the single/double chimney technique in association with thoracic endovascular aortic repairs (TEVAR) for aortic arch pathologies. METHODS: From November 2007 to March 2016, 122 patients (mean age 50.4±12.7 years, range 29-80; 92 men) with aortic arch pathologies underwent TEVAR combined with single (n=101) or double (n=21) chimney grafts to reconstruct the supra-aortic branches: 21 innominate arteries, 114 left common carotid arteries, and 8 left subclavian arteries (LSA)...
March 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28386812/a-novel-technique-of-total-debranching-tevar-with-inflow-from-the-descending-aorta
#18
Saiki Munehiro, Yunoki Keiji, Sakoda Naoya, Hattori Shigeru, Uchino Gaku, Kawabata Takuya, Fujita Yasufumi, Hisamochi Kunikazu, Yoshida Hideo
An 82-year-old male with TAA was considered high risk for conventional surgery because of previous CABG. Therefore, a hybrid repair was performed. First, the arch vessels were debranched extra-anatomical bypass. Second, left thoracotomy was performed. The proximal side of a bifurcated graft was anastomosed to the descending aorta. To arch vessels' debranch graft, two bifurcated graft distal limbs were anastomosed with a 10-mm distance. Two stentgrafts were deployed from the ascending to descending aorta. Postoperative CT did not reveal any endoleak, and all debranch grafts were patent...
April 6, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28386748/open-and-endovascular-elective-treatment-of-abdominal-aortic-aneurysms-a-real-world-experience
#19
Daniela Mazzaccaro, Giovanni Nano, Alberto M Settembrini, Michele Carmo, Raffaello Dallatana, Simone Salvati, Giovanni Malacrida, Piergiorgio G Settembrini
PURPOSE: To present a real-world experience of the elective treatment of abdominal aortic aneurysms (AAAs) using both open repair (OR) and endovascular repair (EVAR). METHODS: Data from patients treated consecutively between January 1, 2000 and December 31, 2014 were collected retrospectively and reviewed. The primary outcomes were 30-day mortality and complication rates, freedom from reintervention, and survival in the long-term. RESULTS: We analyzed data on 1112 patients (660 EVAR, 452 OR)...
April 6, 2017: Surgery Today
https://www.readbyqxmd.com/read/28382077/safety-and-efficacy-of-an-aortic-arch-stent-graft-with-window-shaped-fenestration-for-supra-aortic-arch-vessels-an-experimental-study-in-swine
#20
Jong Ha Park, Han Cheol Lee, Jeong Cheon Choe, Sang-Pil Kim, Tae Sik Park, Jinhee Ahn, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Kwang Soo Cha
BACKGROUND AND OBJECTIVES: Thoracic endovascular aortic repair exhibits limitations in cases where the aortic pathology involves the aortic arch. We had already developed a fenestrated aortic stent graft (FASG) with a preloaded catheter for aortic pathology involving the aortic arch. FASG was suitable for elective cases. MATERIALS AND METHODS: An aortic arch stent graft with a window-shaped fenestration (FASG-W) for supra-aortic arch vessels is suitable for emergent cases...
March 2017: Korean Circulation Journal
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