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https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#1
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28428528/-challenge-of-treating-thoracoabdominal-aortic-aneurysms-with-hybrid-thoracic-endovascular-aortic-repair
#2
Takashi Shuto, Shinji Miyamoto
The treatment of thoracoabdominal aortic aneurysms in great vessels is still challenging, as the early results of the operation are not very promising compared with other aortic operations, and the incidence of spinal cord ischemia is relatively high. In Japan, which is becoming a super-aging society, the method of performing minimally invasive operations remains a major issue. At our facility, we have been performing abdominal debranching thoracic endovascular aortic repair (TEVAR) to resolve these issues...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428527/-treatment-strategy-for-complicated-acute-type-b-aortic-dissection-in-the-thoracic-endovascular-aortic-repair-era
#3
Norihisa Karube, Keiji Uchida, Shinichi Suzuki, Munetaka Masuda
Our treatment strategy for acute type B aortic dissection (ABAD) included complicated type is as follows. Indications of thoracic endovascular aortic repair (TEVAR) for ABAD are rupture and organ ischemia, and TEVAR has been the 1st line central repair therapy since January 2009 in our institution. At the time of TEVAR for ruptured communicating type ABAD, we usually seal the proximal entry tear and cover the existing range of hematoma at descending aorta. Procedures for ABAD with malperfusion should be changed according to the patient's condition such as branch vessel obstructions either dynamic type or static type...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428526/-strategy-of-thoracic-endovascular-aortic-repair-for-uncomplicated-type-b-aortic-dissection-in-subacute-and-chronic-phase-interval-from-onset-and-maximum-diameter
#4
Masatoshi Sunada, Kyohei Ueno, Rie Kageyama, Satoru Maeba, Hirofumi Midorikawa, Megumu Kanno
We classified 59 patients who underwent thoracic endovascular aortic repair for uncomplicated type B aortic dissection from April 2008 to April 2016 into 3 groups based on time from onset and maximum aortic diameter:SA (2weeks to 1 year since onset;n=29), C (>1 year since onset;n=17), and D(maximum aneurysm size≥60 mm;n=13). We used the Kaplan-Meier method tso analyze survival, major adverse cardiovascular event and the need for additional treatment. There was no significant difference in outcomes between the SA and C groups (p=0...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428523/-efficacy-of-total-debranching-thoracic-endovascular-aortic-repair-for-the-re-operation-of-aortic-arch-aneurysm
#5
Kyohei Ueno, Megumu Kanno, Hirofumi Midorikawa, Gaku Takinami, Rie Kageyama
Thoracic endovascular aortic repair (TEVAR) combined with all-neck-branch reconstruction (total debranching TEVAR)[td TEVAR] is applied to aortic arch aneurysms as a minimally invasive procedure to improve treatment results. We report the initial and long-term results of td TEVAR for the reoperation of aortic arch aneurysm. By September 2016, td TEVAR for reoperation had been applied in 5 cases. The reasons for the reoperation were dilation of the arch aneurysm after ascending aorta replacement in 4 cases and localized dissection of the proximal landing zone after zone 2 TEVAR in 1 case...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428522/-surgeon-modified-fenestrated-thoracic-endovascular-aortic-repair-for-the-treatment-of-aortic-aneurysm
#6
Kenichi Hashizume, Hideyuki Shimizu
Thoracic endovascular aortic repair( TEVAR) for thoracic aortic aneurysm has been established as a 1st-line therapy, especially in high-risk cases, with device improvements and the appearance of various procedures, but there are still cases of anatomical adaptation. On the other hand, several countermeasures have been developed, but there are no commercially available devices for fenestrated or branched stent grafts in Japan. Moreover, complications such as cerebral infarction, organ ischemia and bypass occlusion and infection are pointed out in popular debranch TEVAR...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28428519/-current-status-of-thoracic-endovascular-aortic-repair-in-our-institution
#7
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/28427320/the-role-of-inelastic-deformations-in-the-mechanical-response-of-endovascular-shape-memory-alloy-devices
#8
Lorenza Petrini, Alessandro Bertini, Francesca Berti, Giancarlo Pennati, Francesco Migliavacca
Nickel-titanium alloys are commonly adopted for producing cardiovascular minimally invasive devices such as self-expandable stents, aortic valves and stent-grafts. These devices are subjected to cyclic loads (due to blood pulsatility, leg or heart movements), that can induce fatigue fracture, and may also be subjected to very large deformations (due to crimping procedure, a tortuous physiological path or overloads), that can induce material yield. Recently, the authors developed a new constitutive model that considers inelastic strains due to not-completed reverse phase transformation (not all the stress-induced martensite turns back to austenite) or/and plasticity and their accumulation during cyclic loads...
May 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28423129/totally-percutaneous-access-using-perclose-proglide-for-endovascular-treatment-of-aortic-diseases
#9
Eduardo Keller Saadi, Marina Saadi, Rodrigo Saadi, Ana Paula Tagliari, Bernardo Mastella
Objective: To evaluate our experience following the introduction of a percutaneous program for endovascular treatment of aortic diseases using Perclose Proglide® assessing efficacy, complications and identification of potential risk factors that could predict failure or major access site complications. Methods: A retrospective cohort study during a two-year period was performed. All the patients submitted to totally percutaneous endovascular repair (PEVAR) of aortic diseases and transcatheter aortic valve implantation since we started the total percutaneous approach with the preclosure technique from November 2013 to December 2015 were included in the study...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28416191/assessment-of-international-outcomes-of-intact-abdominal-aortic-aneurysm-repair-over-9-years
#10
J Budtz-Lilly, M Venermo, S Debus, C-A Behrendt, M Altreuther, B Beiles, Z Szeberin, N Eldrup, G Danielsson, I Thomson, P Wigger, M Björck, I Loftus, K Mani
BACKGROUND: Case mix and outcomes of complex surgical procedures vary over time and between regions. This study analyses peri-operative mortality after intact abdominal aortic aneurysm (AAA) repair in 11 countries over 9 years. METHODS: Data on primary AAA repair from vascular surgery registries in 11 countries for the years 2005-2009 and 2010-2013 were analysed. Multivariate adjusted logistic regression analyses were carried out to adjust for variations in case mix...
April 13, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28411526/endovascular-repair-of-a-ruptured-thoracic-aortic-dissection-with-a-right-sided-aortic-arch-a-case-report
#11
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
#12
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/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#13
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28398399/-acute-aortic-dissection-during-ineffective-attempt-of-transcatheter-implant-of-a-fully-resheathable-respositionable-and-retrievable-aortic-valve
#14
Annamaria Dachille, Fortunato Iacovelli, Francesco Giardinelli, Emanuela De Cillis, Nicola Signore, Marco Matteo Ciccone, Stefano Favale, Gaetano Contegiacomo, Alessandro Santo Bortone
Aortic injury is a rare but severe complication that may occur during transcatheter aortic valve implantation (TAVI). Few patients with type A dissection are treated surgically because of the high rate of postoperative mortality and neurological complications in this high-risk population; thoracic endovascular aortic repair is rare too, and technically challenging because of the anatomical variations of spiral type A aortic dissection. Sometimes a watchful waiting strategy could be the best solution. We report the case of an acute, extended aortic type A dissection occurred during a TAVI procedure, probably due to the rupture of the dedicated sheath, and conservatively managed...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28393672/radiation-awareness-for-endovascular-abdominal-aortic-aneurysm-repair-in-the-hybrid-operating-room-an-instant-patient-risk-chart-for-daily-practice
#15
Quirina M de Ruiter, Crystel M Gijsberts, Constantijn E Hazenberg, Frans L Moll, Joost A van Herwaarden
PURPOSE: To determine which patient and C-arm characteristics are the strongest predictors of intraoperative patient radiation dose rates (DRs) during endovascular aneurysm repair (EVAR) procedures and create a patient risk chart. METHODS: A retrospective analysis was performed of 74 EVAR procedures, including 16,889 X-ray runs using fixed C-arm imaging equipment. Four multivariate log-linear mixed models (with patient as a random effect) were constructed. Mean air kerma DR (DRAK, mGy/s) and the mean dose area product DR (DRDAP, mGycm(2)/s) were the outcome variables utilized for fluoroscopy as differentiated from digital subtraction angiography (DSA)...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28390918/dynamic-geometric-analysis-of-the-renal-arteries-and-aorta-following-complex-endovascular-aneurysm-repair
#16
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
#17
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/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#18
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390772/outcomes-of-thoracic-endovascular-repair-for-type-b-aortic-dissection-with-multichanneled-morphology
#19
Baolei Guo, Kai Hou, Daqiao Guo, Xin Xu, Zhenyu Shi, Yan Shan, Peng Lv, Weiguo Fu
OBJECTIVE: Clinical outcomes after thoracic endovascular aortic repair (TEVAR) for patients with multichanneled aortic dissection (MCAD) are poorly understood but seem substantially different from those for patients with double-channeled aortic dissection (AD). This study compared the anatomic and clinical factors for patients with MCAD who underwent TEVAR with or without full true lumen (TL) collapse. METHODS: From January 2012 to March 2016, 54 of 644 consecutive type B AD patients (8...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390767/management-and-outcomes-of-carotid-artery-extension-of-aortic-dissections
#20
Adriana Laser, Charles B Drucker, Donald G Harris, Tanya Flohr, Shahab Toursavadkohi, Rajabrata Sarkar, Bradley Taylor, Robert S Crawford
BACKGROUND: Aortic dissection (AD) is the most common aortic catastrophe. Carotid artery dissection due to extension of AD (CAEAD) is one severe complication of this condition. Despite years of refinement in the techniques for repair of AD, the optimal management strategy for CAEAD remains yet to be described. We hypothesized that CAEAD eventually resolves on antiplatelet therapy with a low but not insignificant risk of cerebrovascular accident (CVA). METHODS: This was a single-institution retrospective review of patients admitted with nontraumatic coincident aortic and carotid dissection between 2001 and 2013...
April 5, 2017: Journal of Vascular Surgery
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