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Endovascular grafts

Up Huh, Chung Won Lee, Seon Hee Kim, Chan Ik Park, Sung Woon Chung, Seunghwan Song, Chang Won Kim
Blunt abdominal aortic injury (BAAI) is extremely rare. Three known treatments of BAAI exist: medical treatment, conventional surgical treatment, and endovascular treatment. Outcomes of medical and conventional surgical treatments, such as bypass graft, thrombectomy, and intimal suture, were not satisfactory. A 47-year-old man presented with multiple injuries after a high-speed vehicular accident. He was diagnosed with the traumatic aortic injury to be an intra-mural hematoma in the bifurcation of the terminal aorta...
March 15, 2018: Cardiovascular and Interventional Radiology
Athanasios Katsargyris, Pablo Marques de Marino, Hozan Mufty, Luis Mendes Pedro, Ruy Fernandes, Eric L G Verhoeven
OBJECTIVES: Visceral arteries in fenestrated and branched endovascular repair (F/BEVAR) have been addressed by fenestrations or directional side branches. Inner branches, as used in the arch branched device, could provide an extra option for visceral arteries "unsuitable" for fenestrations or directional side branches. Early experience with the use of inner branches for visceral arteries in F/BEVAR is described. METHODS: All consecutive patients treated by F/BEVAR for complex abdominal aortic aneurysm (AAA) or thoraco-abdominal aneurysm (TAAA) using stent grafts with inner branches were included...
March 12, 2018: European Journal of Vascular and Endovascular Surgery
Simon P Overeem, Esmé J Donselaar, Jorrit T Boersen, Erik Groot Jebbink, Cornelis H Slump, Jean-Paul P M de Vries, Michel M P J Reijnen
PURPOSE: To assess the dynamic behavior of chimney grafts during the cardiac cycle. METHODS: Three chimney endovascular aneurysm repair (EVAR) stent-graft configurations (Endurant and Advanta V12, Endurant and Viabahn, and Endurant and BeGraft) were placed in silicone aneurysm models and subjected to physiologic flow. Electrocardiography (ECG)-gated contrast-enhanced computed tomography was used to visualize geometric changes during the cardiac cycle. Endograft and chimney graft surface, gutter volume, chimney graft angulation over the center lumen line, and the D-ratio (the ratio between the lengths of the major and minor axes) were independently assessed by 2 observers at 10 time points in the cardiac cycle...
March 1, 2018: Journal of Endovascular Therapy
Jared T Feyko, Peter Zmijewski, Cara Lyle, Allison Wilson, Luke Marone
We describe a 36-year-old woman who presented to our facility after sustaining a gunshot wound to the epigastric region. The gunshot resulted in injury to the left lobe of the liver and the twelfth thoracic vertebral body as well as in a through-and-through injury to the abdominal aorta at the level of the celiac axis. The vascular injury was managed successfully by placement of a thoracic stent graft with coverage of the celiac axis. This case demonstrates the feasibility of managing this uncommon injury with endovascular techniques...
March 2018: Journal of Vascular Surgery Cases and Innovative Techniques
Andrea Agostinelli, Davide Carino, Bruno Borrello, Francesco Nicolini
The 2-stage elephant trunk procedure is widely used to treat extensive disease of the aortic arch and descending thoracic aorta. The 2nd stage of the procedure can be accomplished with both a standard surgical procedure and a retrograde transfemoral endovascular approach using the dangling graft as proximal landing zone. However, in some patients, severe disease of iliofemoral vessels can prevent standard retrograde thoracic endovascular aortic repair (TEVAR). In such cases, an alternative route to gain endovascular access must be used...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
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
Hyun-Chel Joo, Seung-Hyun Lee, Byung-Chul Chang, Sak Lee, Kyung-Jong Yoo, Young-Nam Youn
BACKGROUND: With the increasing use of endovascular aortic repair, secondary interventions after aortic stent grafting remain a concern. We retrospectively reviewed open conversion cases with complications following endovascular abdominal aortic repair (EVAR). METHODS: EVAR due to infra-renal abdominal aortic aneurysm (AAA) was performed in 566 patients between January 1994 and May 2015. A retrospective review of EVAR requiring late open conversion (>1 month after implant) was conducted...
March 12, 2018: Journal of Cardiovascular Surgery
Eugenio Pompeo, Ahmed Elkhouly, Andrea Ascoli Marchetti, Arnaldo Ippoliti
No abstract text is available yet for this article.
February 17, 2018: Journal of Thoracic and Cardiovascular Surgery
Yong Kook Hong, Kyung Hoon Kang, Tae Hwan Kim, Hee Chul Yang
INTRODUCTION: We report a case of vein rupture by Arrow-Trerotola percutaneous thrombolytic device (Trerotola PTD) during a treatment of thrombosed arteriovenous graft (AVG). CASE DESCRIPTION: A 77-year-old woman with a problem of thrombosed AVG underwent an endovascular treatment including a procedure of angioplasty of axillary vein. After angioplasty of axillary vein, we found a newly developed thrombus in axillary vein and performed thrombolysis using an over-the-wire 7F Trerotola PTD...
March 1, 2018: Journal of Vascular Access
Jan Raupach, Jan Vales, Jan Vojacek, Petr Hoffmann, Miroslav Lojik, Katerina Kamaradova, Pavla Cabelkova, Vendelin Chovanec, Ondrej Renc, Antonin Krajina, Radovan Maly
An aggressive periaortic lymphoma could very rarely invade the aortic wall. We present a unique case of a patient with symptomatic thoracic aneurysm and imminent rupture due to the periaortic lymphoma, in which endovascular treatment using stent graft was applied. After stabilization of the aorta and histological confirmation of aggressive B-cell lymphoma by computed tomography-guided biopsy, the antilymphoma therapy was initiated. Despite the full treatment, the patient died 12 months later.
January 1, 2018: Vascular and Endovascular Surgery
Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
March 8, 2018: La Presse Médicale
Miriam Elisabeth Uhlmann, Corinna Walter, Fadi Taher, Markus Plimon, Jürgen Falkensammer, Afshin Assadian
OBJECTIVE: Because of its minimally invasive nature, percutaneous femoral access for endovascular aneurysm repair (pEVAR) is currently undergoing rapid popularization. Compared with surgical cutdown for femoral access (cEVAR), it offers the advantage of faster recovery after surgery as well as a reduction in wound complications. Despite proposed advantages, the method is largely considered uneconomical because of its reliance on costly closure devices. METHODS: There were 50 patients undergoing EVAR who were enrolled in this randomized prospective single-center trial...
March 8, 2018: Journal of Vascular Surgery
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
OBJECTIVE: Tibial interventions for critical limb ischemia are now commonplace. Restenosis and occlusion remain barriers to durability after intervention. The aim of this study was to examine the patient-centered outcomes of open and endovascular reintervention for symptomatic recurrent disease after a primary isolated tibial endovascular intervention. METHODS: A database of patients undergoing isolated primary lower extremity tibial endovascular interventions between 2006 and 2016 was retrospectively queried...
March 8, 2018: Journal of Vascular Surgery
Konstantinos Tigkiropoulos, Fragiska Sigala, Diamantis I Tsilimigras, Demetrios Moris, Konstantinos Filis, Nikolaos Melas, Dimitrios Karamanos, Christos Kontogiannis, Ioannis Lazaridis, Nikolaos Saratzis
BACKGROUND: Blunt thoracic aortic injury (BTAI) is the second most common cause of death in trauma patients. Nowadays, thoracic endovascular aortic repair (TEVAR) has become the treatment of choice due to lower rates of mortality, paraplegia and stroke. However, concerns have been raised whether graft implantation is related to the development of hypertension in the postoperative period. OBJECTIVES: To report short- and long-term outcomes of patients undergoing TEVAR for BTAIs at a tertiary hospital as well as investigate post-implant hypertension...
March 7, 2018: Annals of Vascular Surgery
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
Gianfranco Varetto, Alessandra Trevisan, Giovanni Barile, Lorenzo Gibello, Flavia Spalla, Edoardo Frola, Daniele Pennica, Pietro Rispoli PhD
BACKGROUND: Pseudoaneurysm (PA) after carotid endarterectomy (CEA) is a rare and potentially life-threatening complication, with an incidence lower than 1%. Most of the cases described report PAs after carotid patch angioplasty and are associated with infection, often caused by Staphylococci. The management of PAs can be surgical, endovascular, or hybrid. METHODS: We herein present the case of an infected carotid PA 27 days after an eversion CEA. We performed a common to internal carotid bypass with the interposition of great saphenous vein (GSV) associated with specific polyantibiotic therapy for 4 weeks...
January 1, 2018: Vascular and Endovascular Surgery
Neil P Reddy, Sung Wan Ham, Fred A Weaver, Vincent L Rowe, Kenneth R Ziegler, Sukgu M Han
Endovascular aneurysm repair has become the first-line treatment modality for infrarenal aortic aneurysms. However, obtaining successful long-term results frequently require re-interventions. Particularly, delayed type 1a endoleaks pose a challenging problem, as they are often associated with proximal extension of the aneurysmal process to juxta or para-renal aortic segments. We describe two remedial techniques to repair delayed type 1a endoleak by extending the seal zone to the suprarenal aorta, while incorporating the renal arteries...
March 5, 2018: Annals of Vascular Surgery
G Simonte, G Isernia, B Fiorucci, E Paciaroni, E Cieri, A Rebonato, M Lenti
During implantation of an Ovation endograft for abdominal aortic aneurysm correction a patient experienced anaphylactic reaction following polymer leakage outside the device circuit. Procedure was completed after hemodynamic stabilization. Since postoperative day ll, patient complained for loss of legs strength. Medullar injury was excluded by electromyography test and the clinical signs attributed to muscular necrosis and peripheral nerve involvement following arterial embolization. Furthermore, immediately after surgery, a wide erythematous area appeared in the lumbar region...
March 5, 2018: Annals of Vascular Surgery
Georgios Karaolanis, Dimitrios Moris, C Cameron McCoy, Diamantis I Tsilimigras, Sotirios Georgopoulos, Chris Bakoyiannis
The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary...
2018: Frontiers in Surgery
Shunichiro Fujioka, Shigeru Hosaka, Hayato Morimura, Ken Chen, Zhi Chao Wang, Koji Toguchi, Shoji Fukuda, Koki Takizawa, Hiroshi Osawa
Objective : Patients of aorto-iliac aneurysms who undergo endovascular aortic repair (EVAR) require internal iliac artery (IIA) occlusion with coil embolization and its coverage with the stent graft to prevent type II endoleak after extending the endograft into the external iliac artery. However, it has become well recognized that IIA occlusion cause buttock claudication and other various sequelae due to pelvic ischemia. We retrospectively analyzed IIA occlusion outcomes. Methods : From October 2008 to February 2015, 71 patients with aorto-iliac aneurysms underwent IIA occlusion prior to EVAR...
December 25, 2017: Annals of Vascular Diseases
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