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https://www.readbyqxmd.com/read/27903474/functional-assessment-and-evaluation-of-outcome-after-endovascular-therapy-with-coverage-of-the-left-subclavian-artery-in-case-of-blunt-thoracic-aortic-injury
#1
A Gombert, D Kotelis, U M Griepenkerl, G Fraedrich, J Klocker, B Glodny, M J Jacobs, A Greiner, J Grommes
OBJECTIVE: Patients suffering blunt thoracic aortic injury (BTAI) can be treated by use of thoracic endovascular aortic repair (TEVAR). In this setting, the coverage of the left subclavian artery (LSA) is frequently necessary. Nevertheless, the functionality of the upper left extremity after TEVAR had been rarely analyzed. Thus this study intends to underline the safety of TEVAR as well as to determine the functionality of the left arm after coverage of the LSA. METHODS: All patients suffering from BTAI treated by endovascular means in three centers (Aachen [Germany], Maastricht [Netherlands] and Innsbruck [Austria]) between 1996 and 2009 were retrospectively analyzed...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27760812/analysis-of-risk-factors-for-early-type-i-endoleaks-after-thoracic-endovascular-aneurysm-repair
#2
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27671454/outcomes-of-left-subclavian-artery-transposition-for-hybrid-aortic-arch-debranching
#3
Ludovic Canaud, Vincent Ziza, Baris Ata Ozdemir, Jean-Philippe Berthet, Charles-Henri Marty-Ané, Pierre Alric
BACKGROUND: The aim of this study was to evaluate outcomes of left subclavian artery (LSA) revascularization for hybrid aortic arch debranching. METHODS: Between 1998 and 2015, 68 patients (41 men, mean age 67+/-16 years) underwent TEVAR with LSA coverage, 19.2% (n = 13) were never revascularized and the remaining patients underwent LSA revascularization (n = 55; 80.8%) . Revascularization was achieved by LSA-carotid transposition via a medial approach in 81.8% (n = 45) and a lateral approach in 18...
September 23, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27225214/meta-analysis-of-left-subclavian-artery-coverage-with-and-without-revascularization-in-thoracic-endovascular-aortic-repair
#4
Shahin Hajibandeh, Shahab Hajibandeh, Stavros A Antoniou, Francesco Torella, George A Antoniou
PURPOSE: To examine the role of left subclavian artery (LSA) revascularization in thoracic endovascular aortic repair (TEVAR) with LSA coverage. METHODS: A systematic search was conducted to identify all studies providing comparative outcomes with or without LSA revascularization for LSA occlusion during TEVAR. The search included MEDLINE, EMBASE, CINAHL, the Cochrane Central Register of Controlled Trials, the World Health Organization International Clinical Trials Registry, ClinicalTrials...
August 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27119426/revascularisation-of-the-left-subclavian-artery-for-thoracic-endovascular-aortic-repair
#5
REVIEW
Shahin Hajibandeh, Shahab Hajibandeh, Stavros A Antoniou, Francesco Torella, George A Antoniou
BACKGROUND: Controversy exists as to whether revascularisation of the left subclavian artery (LSA) confers improved outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Even though preemptive revascularisation of the LSA has theoretical advantages, including a reduced risk of ischaemic damage to vital organs, such as the brain and the spinal cord, it is not without risks. Current practice guidelines recommend routine revascularisation of the LSA in patients undergoing elective TEVAR where achievement of a proximal seal necessitates coverage of the LSA, and in patients who have an anatomy that compromises perfusion to critical organs...
April 27, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26220365/clinical-outcomes-of-left-subclavian-artery-coverage-on-morbidity-and-mortality-during-thoracic-endovascular-aortic-repair-for-distal-arch-aneurysms
#6
Takeshi Baba, Takao Ohki, Yuji Kanaoka, Koji Maeda
BACKGROUND: This single-center study assessed left subclavian artery (LSA) revascularization management and morbidity and mortality of LSA coverage outcomes during elective thoracic endovascular aortic repair (TEVAR) for distal arch aneurysms. METHODS: Between July 2006 and June 2014, 178 patients underwent TEVAR (zone 2 + 3) for distal arch aneurysms. TEVAR with LSA coverage (zone 2) was performed in 121 patients (68.0 %). Multivariate analysis was performed to determine factors associated with perioperative cerebral infarction (CI) and postoperative endoleak (EL)...
November 2015: World Journal of Surgery
https://www.readbyqxmd.com/read/25872688/outcomes-of-thoracic-endovascular-aortic-repair-and-subclavian-revascularization-techniques
#7
Kimberly C Zamor, Mark K Eskandari, Heron E Rodriguez, Karen J Ho, Mark D Morasch, Andrew W Hoel
BACKGROUND: Practice guidelines for management of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR) are based on low-quality evidence, and there is limited literature that addresses optimal revascularization techniques. The purpose of this study was to compare outcomes of LSA coverage during TEVAR and revascularization techniques. STUDY DESIGN: We performed a single-center retrospective cohort study from 2001 to 2013. Patients were categorized by LSA revascularization and by revascularization technique, carotid-subclavian bypass (CSB), or subclavian-carotid transposition (SCT)...
July 2015: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/25702140/aortic-morphometry-at-endograft-position-as-assessed-by-3d-image-analysis-affects-risk-of-type-i-endoleak-formation-after-tevar
#8
Drosos Kotelis, Carolin Brenke, Stefan Wörz, Fabian Rengier, Karl Rohr, Hans-Ulrich Kauczor, Dittmar Böckler, Hendrik von Tengg-Kobligk
PURPOSE: The purpose of this study was to identify morphologic factors affecting type I endoleak formation and bird-beak configuration after thoracic endovascular aortic repair (TEVAR). METHODS: Computed tomography (CT) data of 57 patients (40 males; median age, 66 years) undergoing TEVAR for thoracic aortic aneurysm (34 TAA, 19 TAAA) or penetrating aortic ulcer (n = 4) between 2001 and 2010 were retrospectively reviewed. In 28 patients, the Gore TAG® stent-graft was used, followed by the Medtronic Valiant® in 16 cases, the Medtronic Talent® in 8, and the Cook Zenith® in 5 cases...
May 2015: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/25630782/development-of-stroke-induced-quadriplegia-after-endovascular-repair-of-blunt-aortic-injury-pseudoaneurysm
#9
Abdullah S Amoudi, Anas A Merdad, Ahmed Q Makhdoom, Reda A Jamjoom
Endovascular repair of blunt aortic injury is now a first-line approach in management. This can warrant coverage of the left subclavian artery (LSA), which could lead to posterior strokes. In this case report, we present a severe complication of endovascular repair of a traumatic aortic aneurysm. A 53-year-old man presented with blunt aortic injury, endovascular repair was carried out where the left subclavian artery was covered. The intervention had a 100% technical success. Twelve hours later, he was discovered to have quadriplegia, a CT scan showed a large left cerebellar infarction extending to the medulla oblongata and proximal spinal cord...
January 2015: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/25454103/management-of-the-left-subclavian-artery-and-neurologic-complications-after-thoracic-endovascular-aortic-repair
#10
Benjamin O Patterson, Peter J Holt, Christoph Nienaber, Ronald M Fairman, Robin H Heijmen, Matt M Thompson
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) of various pathologies has been associated with peri-interventional neurologic complication rates of up to 15%. The objective of this study was to determine the influence of the management of the left subclavian artery (LSA) on neurologic complications and to define subgroups that might benefit from LSA revascularization. METHODS: The Medtronic Thoracic Endovascular Registry (MOTHER; Medtronic, Santa Rosa, Calif), consists of data from five sponsored trials and one institutional series incorporating 1010 patients undergoing TEVAR from 2002 to 2010...
December 2014: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/25304906/aortic-arch-and-descending-thoracic-aortic-saccular-aneurysms-treatment-with-fenestrated-endograft-and-chimney-technique-for-aortic-branch-rescue
#11
Holta Kasemi, Mario Marino, Costantino Luca Di Angelo, Gian Franco Fadda, Francesco Speziale
We report the case of a 76-year-old man presented with three saccular aneurysms at the aortic arch and descending thoracic aorta. A two-staged hybrid approach was performed. A left common carotid-to-left subclavian artery bypass and a custom-made fenestrated endograft were used for the two proximal aneurysms. The endograft deployment was complicated by the unadverted coverage of the left common carotid artery ostium, promptly corrected with the chimney technique. The endovascular treatment was completed with the third endovascular aneurysm exclusion 5 months after the first procedure to reduce the risk of spinal cord ischemia...
January 2015: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/25298833/endovascular-surgery-for-traumatic-thoracic-aortic-injury-our-experience-with-five-cases-two-of-whom-were-young-patients
#12
Yoshiyuki Yamashita, Takashi Matsumoto, Sho Matsuyama, Fumio Fukumura, Hiromi Ando, Jiro Tanaka, Takayuki Uchida
OBJECTIVES: We present our experience of endovascular surgery for traumatic aortic injury and the results of our procedures. MATERIALS AND METHODS: From January 2009 to December 2013, we performed endovascular repairs of traumatic thoracic aortic injury on 5 male patients 16-75 years old (mean, 50.8), two of whom were young. Three of the patients had multiple organ injuries. The mean interval time to the operation is 22.0 hours (range, 10-36). All patients underwent endovascular repair with heparinization...
2014: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/25287611/on-the-selection-of-ordinary-differential-equation-models-with-application-to-predator-prey-dynamical-models
#13
COMPARATIVE STUDY
Xinyu Zhang, Jiguo Cao, Raymond J Carroll
We consider model selection and estimation in a context where there are competing ordinary differential equation (ODE) models, and all the models are special cases of a "full" model. We propose a computationally inexpensive approach that employs statistical estimation of the full model, followed by a combination of a least squares approximation (LSA) and the adaptive Lasso. We show the resulting method, here called the LSA method, to be an (asymptotically) oracle model selection method. The finite sample performance of the proposed LSA method is investigated with Monte Carlo simulations, in which we examine the percentage of selecting true ODE models, the efficiency of the parameter estimation compared to simply using the full and true models, and coverage probabilities of the estimated confidence intervals for ODE parameters, all of which have satisfactory performances...
March 2015: Biometrics
https://www.readbyqxmd.com/read/25080884/intentional-left-subclavian-artery-coverage-during-thoracic-endovascular-aortic-repair-for-traumatic-aortic-injury
#14
Cameron L McBride, Joseph J Dubose, Charles C Miller, Alexa P Perlick, Kristofer M Charlton-Ouw, Anthony L Estrera, Hazim J Safi, Ali Azizzadeh
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) is widely used for treatment of traumatic aortic injury (TAI). Stent graft coverage of the left subclavian artery (LSA) may be required in up to 40% of patients. We evaluated the long-term effects of intentional LSA coverage (LSAC) on symptoms and return to normal activity in TAI patients compared with a similarly treated group whose LSA was uncovered (LSAU). METHODS: Patients were identified from a prospective institutional trauma registry between September 2005 and July 2012...
January 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/24934686/mid-term-results-of-endovascular-treatment-with-the-gore-tag-device-for-degenerative-descending-thoracic-aortic-aneurysms
#15
Junji Yunoki, Toru Kuratani, Yukitoshi Shirakawa, Kei Torikai, Kazuo Shimamura, Keiwa Kin, Yoshiki Sawa
PURPOSE: To confirm the validity of using Gore TAG for degenerative descending thoracic aneurysm repair, we evaluated the mid-term clinical outcomes in our single-center experience. METHODS: From May 2008 to April 2011, elective thoracic endovascular aortic repair (TEVAR) with Gore TAG without left subclavian artery (LSA) coverage for a degenerative descending thoracic aneurysm was performed in 36 consecutive cases. RESULTS: The procedural success rate was 100%, and no patient died within 30 days of the operation...
January 2015: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/24785650/treatment-decisions-for-descending-thoracic-aneurysm-preferences-for-thoracic-endovascular-aneurysm-repair-or-surveillance-in-a-discrete-choice-experiment
#16
N Rudarakanchana, B C Reeves, C D Bicknell, F M Heatley, N J Cheshire, J T Powell
OBJECTIVE: To investigate and rank factors that influence endovascular treatment decisions by specialists for patients with descending thoracic aortic aneurysm (dTAA). METHODS: Specialists completed a diagrammatic survey describing uncertainty about the benefit of thoracic endovascular aneurysm repair (TEVAR) for dTAA with respect to age, sex, and aneurysm diameter. Subsequently, a detailed discrete choice experiment was designed. Specialists were recruited and asked to indicate treatment their preference (TEVAR or surveillance) in 25 hypothetical cases of dTAA, with variable patient attributes: age, sex, American Society of Anesthesiologists (ASA) grade, aneurysm diameter, adequate landing zone distal to left subclavian artery (LSA), and length of aortic coverage...
July 2014: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/24770837/thoracic-endovascular-aortic-repair-with-left-subclavian-artery-coverage-without-prophylactic-revascularisation-early-and-midterm-results
#17
COMPARATIVE STUDY
J Wojciechowski, L Znaniecki, K Bury, J Rogowski
BACKGROUND: The management of the left subclavian artery when coverage is necessary during thoracic aorta endografting remains a matter of debate. MATERIALS AND METHODS: A retrospective analysis of a single-centre experience with thoracic endovascular aorta repair (TEVAR) was performed. Between April 2004 and October 2012, 125 cases of TEVAR were performed. The analysis focused on patients who required coverage of the left subclavian artery (LSA). We analysed mortality and morbidity with special attention to the rates of cerebrovascular accidents (CVAs) and spinal cord ischaemia (SCI) in the early and midterm...
June 2014: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/24657299/ischemia-and-functional-status-of-the-left-arm-and-quality-of-life-after-left-subclavian-artery-coverage-during-stent-grafting-of-thoracic-aortic-diseases
#18
Josef Klocker, Anna Koell, Maximilian Erlmeier, Georg Goebel, Werner Jaschke, Gustav Fraedrich
BACKGROUND: The objective of this study was to report on the incidence of left arm ischemia, left arm function, and quality of life after thoracic endovascular aortic repair (TEVAR) by stent grafting with and without coverage of the left subclavian artery (LSA). METHODS: All patients who underwent TEVAR since 1996 in our institution were included. Basic demographic parameters, underlying disease, details of TEVAR, long-term left arm function (Disabilities of the Arm, Shoulder, and Hand [DASH] questionnaire), and quality of life (12-Item Short Form Health Survey) were analyzed...
July 2014: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/24003009/routine-revascularization-is-unnecessary-in-the-majority-of-patients-requiring-zone-ii-coverage-during-thoracic-endovascular-aortic-repair-a-longitudinal-outcomes-study-using-united-states-medicare-population-data
#19
Jonathan E Wilson, Edgar L Galiñanes, Parker Hu, Viktor Y Dombrovskiy, Todd R Vogel
OBJECTIVE: We aimed to evaluate outcomes of thoracic endovascular aortic repair (TEVAR) with left subclavian artery (LSA) coverage without bypass (TEVAR + SUB) to TEVAR with coverage of the LSA with a bypass at the time of the initial procedure or later at a separate procedure (TEVAR + SUB + BYPASS). METHODS: The Centers for Medicare & Medicaid Services inpatient claims for 2006-2007 were queried using Current Procedural Terminology codes for TEVAR, TEVAR + SUB, TEVAR + SUB + BYPASS or later as a separate procedure...
August 2014: Vascular
https://www.readbyqxmd.com/read/23443593/intentional-left-subclavian-artery-coverage-without-revascularization-during-tevar
#20
REVIEW
A Greiner, J Kalder, H Jalaie, M J Jacobs
At present, endovascular therapy is a well-established treatment for different types of thoracic aortic pathologies. There is growing evidence, that thoracic endovascular aortic repair (TEVAR) has advantages over open repair with regard to perioperative morbidity and mortality in the treatment of thoracic aortic aneurysms. However, in up to 50% of TEVAR procedures the proximal end of the stent-graft will (partly) cover the origin of the left subclavian artery (LSA) in order to achieve a save sealing zone. Intracranial stroke and paraplegia are feared complications and might be associated with LSA exclusion from the circulation...
February 2013: Journal of Cardiovascular Surgery
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