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https://www.readbyqxmd.com/read/28721336/post-endovascular-aneurysm-repair-evar-testicular-ischemia-a-rare-complication
#1
Eric Thomas, Brett L Parra, Shonak Patel
Endovascular aneurysm repair (EVAR) is a common modality of treating abdominal aortic aneurysms (AAA). Common complications include endoleak, bleeding, infection, contrast related injuries, and ischemia. We present the case of a patient who experienced a testicular infarction following repair of an infrarenal AAA. We also discuss the implications for this complication and review the available literature for similar cases and treatment options.
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28720724/aortic-wall-inflammation-predicts-abdominal-aortic-aneurysm-expansion-rupture-and-need-for-surgical-repair
#2
The Ma Rs Study Investigators
Background -Ultrasmall superparamagnetic particles of iron oxide (USPIO) detect cellular inflammation on magnetic resonance imaging (MRI). In patients with abdominal aortic aneurysm, we assessed whether USPIO-enhanced MRI can predict aneurysm growth rates and clinical outcomes. Methods -In a prospective multicentre open-label cohort study, 342 patients with abdominal aortic aneurysm (diameter ≥40 mm) were classified by the presence of USPIO enhancement and were monitored with serial ultrasound and clinical follow-up for at least 2 years...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28720226/a-comparative-review-of-open-and-endovascular-abdominal-aortic-aneurysm-repairs-in-the-national-operative-quality-improvement-database
#3
Kanika Kalra, Shipra Arya
Repair of abdominal aortic aneurysms with endovascular techniques has emerged as the first line of therapy, due to procedural ease and excellent patient outcomes. Open aneurysm repair is increasingly used as a secondary option for lesions with anatomic complexity that involve arterial branches. Understanding the impact of endovascular abdominal aortic aneurysms repair on the shift in vascular operation practice for abdominal aortic aneurysms repair, requires a comprehensive and risk-adjusted review of operative outcomes between the 2 repair types...
July 15, 2017: Surgery
https://www.readbyqxmd.com/read/28715511/endovascular-treatment-of-genetically-linked-aortic-diseases
#4
D Böckler, K Meisenbacher, A S Peters, C Grond-Ginsbach, M S Bischoff
BACKGROUND: The most important structural proteins of the vascular wall are collagen and elastin. Genetically linked connective tissue diseases lead to degeneration, aneurysm formation and spontaneous dissection or rupture of arteries. The most well-known are Marfan syndrome, vascular Ehlers-Danlos syndrome (type IV), Loeys-Dietz syndrome and familial aortic aneurysms and dissections. OBJECTIVE: This review article addresses the current status of endovascular treatment options for important connective tissue diseases...
2017: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
https://www.readbyqxmd.com/read/28714856/use-of-human-aortic-extracellular-matrix-as-a-scaffold-for-construction-of-patient-specific-tissue-engineered-vascular-patch
#5
Liping Gao, Mingjun Du, Jingjing Lv, Sebastian Schmull, Ritai Huang, Jun Li
Abstract Synthetic or biologic materials are usually used to repair vascular malformation in congenital heart defects; however, non-autologous materials show both mismatch compliance and antigenicity, as well as a lack of recellularization on its surface. Here, we constructed a tissue-engineered vascular patch (TEVP) using decellularized extracellular matrix (ECM) scaffold obtained from excised human aorta during surgery, which was seeded with patient-derived bone marrow CD34-positive (CD34+) progenitor cells...
July 17, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28714620/-management-of-aortic-aneurysms-in-the-endovascular-era
#6
Gino Gemayel, Michel Montessuit, Jorge Sierra, Nadia Lahlaidi Sierra, Marek Bednarkiewicz
Abdominal aortic aneurysm is a disease seen in the elderly. Without intervention, an aneurysm can rupture which leads to death in most cases. Surgical resection was the gold standard treatment for many years but since two decades, endovascular repair has surged drastically. Less invasive and morbid than open repair, this technique has significantly evolved in the recent years. Nowadays the whole aorta can be treated with endovascular techniques in expert hands. This article presents an overview of different endovascular solutions and innovations in the management of aortic aneurysms...
March 1, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28713813/incidental-finding-of-an-aorto-right-atrial-fistula-in-a-patient-undergoing-repair-of-a-sinus-of-valsalva-aneurysm
#7
Byron R Rosero-Britton, Anthony Nguyen, Ibrahim Warsame, Muhammad Shabsigh, Luke Dong, James Wolfe, Bryan Whitson, Michael Essandoh
A sinus of Valsalva aneurysm is a rare malformation of the aortic root that can fistulize to another cardiac structure such as the right atrium. Although transthoracic echocardiography and computed tomography angiography have demonstrated utility for the diagnosis of a sinus of Valsalva-to-right atrial fistula, there are few cases where a misdiagnosis may occur. Intraoperative transesophageal echocardiography may be an essential imaging tool for the diagnosis and management of incidental findings such as a sinus of Valsalva-to-right atrial fistula during cardiac surgery and should be used routinely...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28712962/fenestrated-endograft-as-a-new-perspective-for-the-treatment-of-infra-renal-abdominal-aortic-aneurysm-with-a-congenital-pelvic-kidney-a-case-report-and-review-of-literature
#8
Barun Majumder, Anisha H Parera, Neil Browning, Mark MacGregor, Alex Chapman
The coexistence of Abdominal Aortic Aneurysm (AAA) and Congenital Pelvic Kidney (CPK) is infrequent. Various treatment modalities have been reported in literature for treatment of the above condition. We report a complete endovascular modality for the treatment of this association, especially for high-risk patients. Only one such treatment has been reported before. Compared to this previously reported case, we would like to share our experience with additional prototype testing, prior to surgery which provided us with more detailed information about the planning and deployment of the branched endograft...
July 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28712812/peroxynitrite-footprint-in-circulating-neutrophils-of-abdominal-aortic-aneurysm-patients-is-lower-in-statin-than-in-non-statin-users
#9
M E Groeneveld, J J van der Reijden, G J Tangelder, L C Westin, L Renwarin, R J P Musters, W Wisselink, K K Yeung
OBJECTIVES: Extensive reactive oxygen and nitrogen species (also reactive species) production is a mechanism involved in abdominal aortic aneurysm (AAA) development. White blood cells (WBCs) are a known source of reactive species. Their production may be decreased by statins, thereby reducing the AAA growth rate. Reactive species production in circulating WBCs of AAA patients and the effect of statins on their production was investigated. METHODS: This observational study investigated reactive species production in vivo and ex vivo in circulating WBCs of AAA patients, using venous blood from patients prior to elective AAA repair (n = 34; 18 statin users) and from healthy volunteers (n = 10)...
July 14, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28712695/endoleaks-after-endovascular-aortic-aneurysm-repair-improved-detection-with-noise-optimized-virtual-monoenergetic-dual-energy-ct
#10
Simon S Martin, Julian L Wichmann, Hendrik Weyer, Jan-Erik Scholtz, Doris Leithner, Adam Spandorfer, Boris Bodelle, Volkmar Jacobi, Thomas J Vogl, Moritz H Albrecht
PURPOSE: To assess image quality and diagnostic performance of a noise-optimized algorithm to reconstruct virtual monoenergetic images (VMI+) for the detection of endoleaks after endovascular abdominal aortic aneurysm repair (EVAR) using dual-energy CT angiography (DE-CTA). MATERIALS AND METHODS: Seventy-five patients (42 men; 66.2±11.7years) underwent DE-CTA following EVAR. Arterial phase images were acquired in dual-energy mode for the reconstruction of standard linearly-blended M_0...
June 27, 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28711966/modified-single-patch-technique-versus-two-patch-technique-for-the-repair-of-complete-atrioventricular-septal-defect-a-meta-analysis
#11
Dongxu Li, Qiang Fan, Tomoyuki Iwase, Yasutaka Hirata, Qi An
Technical selection for surgical repair of complete atrioventricular septal defect (CAVSD) still remains controversial. This meta-analysis aimed to compare the modified single-patch (MP) technique with the two-patch (TP) technique for patients with CAVSD. Relevant studies comparing the MP technique with the TP technique were identified through a literature search using MEDLINE, EMBASE, Google Scholar, Cochrane Library, and the China National Knowledge Infrastructure databases. The variables were ventricular septal defect (VSD) size, cardiopulmonary bypass (CBP) time, aortic cross-clamp (ACC) time, intensive care unit stay, hospital stay, and other outcomes involving mortality, left ventricular outflow tract obstruction, atrioventricular valve regurgitation, residual septal shunt, atrioventricular block, and reoperation...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28711965/efficacy-of-an-extracellular-matrix-in-systemic-loading-conditions-in-congenital-heart-surgery
#12
Adeel Ashfaq, Amit Iyengar, Oh Jin Kwon, Mohammad S Soroya, Son Nguyen, Ryan Ou, Brian Reemtsen
Extracellular matrices (ECM) are commonly used to repair congenital heart defects; however, there is a lack of literature pertaining to outcomes with ECM use in high-pressure conditions. Between 2011 and 2014, a total of 202 patients underwent congenital heart disease repair using the ECM placed in a systemic pressure condition. The operative sites included: defects in the ventricular septum, mitral valve, aortic valve, ascending aorta, and aortic arch. Patients were followed and evaluated for mortality and reoperations due to loss of ECM integrity...
July 15, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28711400/thirty-day-outcomes-after-fenestrated-endovascular-repair-are-superior-to-open-repair-of-abdominal-aortic-aneurysms-involving-visceral-vessels
#13
Prateek K Gupta, Reshma Brahmbhatt, Kelly Kempe, Shaun M Stickley, Michael J Rohrer
OBJECTIVE: Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs. METHODS: Patients who underwent FEVAR (n = 535) and OS (n = 1207) for elective AAA-Vs were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) 2008 to 2013 database...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711399/restrictive-bare-stent-prevents-distal-stent-graft-induced-new-entry-in-endovascular-repair-of-type-b-aortic-dissection
#14
Yang Zhao, Yitian Chen, Mian Wang, Liang Zheng, Zilun Li, Guangqi Chang, Henghui Yin
OBJECTIVE: Distal stent graft-induced new entry (SINE) can occur after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. This study investigated the mechanism of distal SINE and its prevention using a restrictive bare stent (RBS) technique. METHODS: From January 2013 to December 2014, 68 consecutive type B aortic dissection patients received endovascular repair at our center. The RBS technique was used with distal oversizing (between the diameter of the thoracic stent graft and the descending aorta true lumen diameter at the level of the intended distal edge of the thoracic stent graft) >20%...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#15
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28710563/an-observational-study-examining-the-effects-of-a-surgically-induced-inflammatory-response-on-the-distribution-of-morphine-and-its-metabolites-into-cerebrospinal-fluid
#16
Yan Wang, Kerry B Goralski, Derek J Roberts, Kathryn Landry, Mark E Issa, Lekha Sleno, Lisa C Julien, Jeremy Wood, Richard I Hall
PURPOSE: Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function...
July 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28706584/assessment-of-aortic-valve-disease-a-clinician-oriented-review
#17
REVIEW
Andrei D Mǎrgulescu
Aortic valve disease [aortic stenosis (AS) and aortic regurgitation (AR)] represents an important global health problem; when severe, aortic valve disease carries poor prognosis. For AS, aortic valve replacement, either surgical or interventional, may provide definite treatment in carefully selected patients. For AR, valve surgery (either replacement or - in selected cases - aortic valve repair) remains the gold standard of care. To properly identify those patients who are candidates for surgery, the clinician has to carefully assess the severity of valve disease with an understanding of the potential pitfalls involved in these assessments...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28705593/parallel-placement-of-excluder-legs-for-treatment-of-type-iiib-endoleaks-caused-by-fabric-tear-after-endovascular-aneurysm-repair
#18
Takashi Hashimoto, Noriyuki Kato, Toshiya Tokui, Yoichiro Miyake, Michihiro Nasu, Ken Nakajima, Takatoshi Higashigawa, Shuji Chino
A total of 576 patients underwent endovascular aneurysm repair using main body devices for treatment of abdominal aortic aneurysms or iliac artery aneurysms. During follow-up, type IIIb endoleaks caused by fabric tear occurred in six patients (1.0% [6/576]). The device used was Zenith (Cook Medical, Bloomington, Ind) in five cases and Talent (Medtronic, Santa Rosa, Calif) in one case. All endoleaks were close to the flow divider of the main body devices. The distance between the lower renal artery and the top end of the contralateral leg was 53 ± 14 mm...
July 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28705444/evar-and-open-treatment-of-abdominal-aortic-aneurysm-what-is-the-role-of-mmp-9-in-the-follow-up
#19
A Ascoli Marchetti, G Pratesi, L Di Giulio, M Battistini, R Massoud, A Ippoliti
INTRODUCTION: The aim of our study is to verify the role of metalloproteinases in endovascular repair (EVAR) and OPEN surgery treatment for abdominal aortic aneurysm (AAA). Postoperatively, these enzymes could represent an important biomarker to adapt diagnostic tests and further investigations during follow-up. MATERIAL AND METHOD: From 2004 to 2008, 55 patients were considered with AAA. Of these, 33 patients (mean age: 70.1 years), (mean AAA diameter: 5.4cm) were treated with OPEN surgery (group A) and 22 (mean age: 74...
February 2017: J Med Vasc
https://www.readbyqxmd.com/read/28705339/-surgical-and-endoluminal-management-of-the-inflammatory-aortitis-a-tunisian-center-experience
#20
H Ben Jmaà, R Karray, H Jmal, T Cherif, F Dhouib, I Souissi, A Karoui, Z Bahloul, S Masmoudi, N Elleuch, I Frikha
Non-infectious aortitis is usually due to giant-cell arteritis, Takayasu disease or Behçet disease. The main aortic lesions are stenoses, occlusions and aneurysms in the Takayasu disease and aneurysms in the Behçet disease and giant-cell arteritis. Treatment is based on corticosteroid therapy and surgery. Endoluminal management is now the rule. We report a retrospective descriptive study of 10 patients who underwent surgical or endoluminal management of inflammatory lesions of the aorta between January 2000 and December 2015...
July 2017: J Med Vasc
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