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endovascular aortic procedures

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https://www.readbyqxmd.com/read/28342523/early-experience-with-a-modified-preloaded-system-for-fenestrated-endovascular-aortic-repair
#1
Blandine Maurel, Tim Resch, Rafaelle Spear, Blayne Roeder, Umberto M Bracale, Stephan Haulon, Tara M Mastracci
OBJECTIVE: Preloaded endovascular delivery systems expand the anatomic eligibility for complex aortic repair by requiring only one iliac access vessel and providing a stable platform for guiding sheaths into challenging target vessels. This article reports the lessons learned and early clinical outcomes using a modified preloaded delivery system for fenestrated endovascular aneurysm repair (FEVAR) in three aortic centers in Europe. METHODS: From October 2015 to March 2016, consecutive patients presenting with extensive aortic aneurysm treated with a modified preloaded FEVAR were prospectively enrolled from three high volume European aortic centers...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28335059/retrospective-evaluation-of-percutaneous-access-for-tevar-and-evar-time-to-make-it-the-standard-approach
#2
Rohit Philip Thomas, Tobias Kowald, Bernhard Schmuck, Osama Eldergash, Andreas Klausen, Valentin Dikov, Jerry Easo, Ajay Chavan
Introduction To evaluate the safety of percutaneous endovascular aortic repair and the relationship of access site characteristics to complications Materials and Methods All patients undergoing percutaneous TEVAR, EVAR and FEVAR procedures from January 2010 to May 2016 were retrospectively analysed for incidence of complications and their relationship to various access site characteristics like access artery size, degree of vessel calcification, skin to artery distance and sheath to artery ratio. Hemostasis occurring within 15 min after suture closure with or without manual compression was defined as primary hemostasis...
April 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28331160/kilt-technique-as-an-angle-modification-method-for-endovascular-repair-of-abdominal-aortic-aneurysm-with-severe-neck-angle
#3
Tae-Hoon Kim, Ho-Jun Jang, Young Jin Choi, Chang Keun Lee, Sung Woo Kwon, Won-Heum Shim
PURPOSE: Kilt technique can be useful for overcoming the severe angle in endovascular abdominal aortic repair. Thus, we investigate the utility of the Kilt technique as an angle modification method. METHODS: This study included 16 patients with abdominal aortic aneurysm having severe neck angle (over 60°). Of these, eight were treated using Kilt technique, whereas the remaining eight were by the conventional endovascular method. We investigated the pre- and post-procedural differences in neck angle between the two groups using aortic computed tomography (CT) angiography...
March 23, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28320577/pre-operative-functional-cardiovascular-reserve-is-associated-with-acute-kidney-injury-after-intervention
#4
A Saratzis, J Shakespeare, O Jones, M J Bown, A Mahmood, C H E Imray
BACKGROUND: Acute kidney injury (AKI) is a common complication after endovascular intervention, associated with poor short and long-term outcomes. However, the mechanisms underlying AKI development remain poorly understood. The impact of pre-existing cardiovascular disease and low cardiovascular reserve (CVR) in AKI is unclear; it remains unknown whether AKI is primarily related to pre-existing comorbidity or to procedural parameters. The association between CVR and AKI after EVAR was therefore assessed...
March 17, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28318632/endovascular-aneurysm-repair-evar-and-transcatheter-aortic-valve-replacement-tavr-associated-acute-kidney-injury
#5
REVIEW
Kenar D Jhaveri, Athanasios N Saratzis, Rimda J Wanchoo, Pantelis A Sarafidis
Acute kidney injury (AKI) after surgery or intervention is an important complication that may impact mortality, morbidity, and health care costs. Endovascular procedures are now performed routinely for a variety of pathologies that were traditionally treated with open surgery because randomized trials comparing endovascular and open surgery have shown at least equally good results and reduced complication and hospitalization rates with endovascular techniques. However, endovascular procedures have been associated with an increased risk for postoperative AKI, predominantly owing to contrast nephrotoxicity...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28315573/mortality-length-of-stay-and-cost-implications-of-procedural-bleeding-after-percutaneous-interventions-using-large-bore-catheters
#6
Björn Redfors, Brendan M Watson, Thomas McAndrew, Emilie Palisaitis, Dominic P Francese, Mehdi Razavi, Jordan Safirstein, Roxana Mehran, Ajay J Kirtane, Philippe Généreux
Importance: Bleeding complications after percutaneous transcatheter interventions that used large-bore catheters are frequent and associated with high mortality and morbidity. Objective: To describe the incidence of bleeding complications among patients undergoing contemporary endovascular interventions involving large-bore catheters and its association with in-hospital mortality, length of stay, and health care cost. Design, Setting, and Participants: This retrospective cohort study analyzed all 17 672 patients from the Healthcare Cost and Utilization Project's National Inpatient Sample database who were recorded as having undergone a transcatheter aortic valve replacement (n = 3223), an endovascular aneurysm repair (n = 12 633), or a percutaneous left ventricular assist device implant (n = 1816) between January 1, 2012, and December 31, 2013...
March 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28302475/safety-and-effectiveness-of-a-percutaneous-first-approach-to-endovascular-aortic-aneurysm-repair
#7
Christopher Agrusa, Andrew Meltzer, Darren Schneider, Peter Connolly
BACKGROUND: Percutaneous endovascular aneurysm repair (PEVAR) has been increasingly employed in the endovascular treatment of abdominal aortic aneurysms. Furthermore, the percutaneous approach can be used with minimal sedation and local anesthesia in the majority of cases. The purpose of this study is to assess the safety and effectiveness of a "percutaneous first" approach to femoral access for EVAR. METHOD: From 2012 to 2014, PEVAR has been the preferred approach to femoral access for EVAR at our institution...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28302474/outcomes-of-endovascular-therapy-for-infrarenal-aortic-occlusion-of-tasc-ii-d-classification
#8
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
PURPOSE: This study aimed to investigate the treatment outcomes of endovascular therapy (EVT) in patients with infrarenal aortic occlusive disease. METHODS: Between January 2012 and December 2015, 11 patients with infrarenal aortic occlusion of Trans-Atlantic Inter-Society Consensus II D classification were treated. Procedural results, complications, and midterm results were analyzed retrospectively. RESULTS: The technical success was 81.8%...
March 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28294669/-visceral-complications-of-the-aortic-dissections-indications-and-technique-of-the-thoracoabdominal-refenestration
#9
Csaba Dzsinich, Jenő Szolnoky, Gábor Vallus, Gábor Darabos, Gabriella Nyiri, Dániel Teknős
Aortic dissection is a life threatening cardiovascular catastrophy. Its incidence estimated to 5-6 cases per 100,000 patients/year. The intimal tear happens at the ascending aorta in Type A, meanwhile at the aortic isthmus in Type B, but entry point may develop anywhere alongside the entire aorta. All types may affect a short aortic segment resulting in a localized false aneurysm, others separate the intimal layer at longer extension down to the visceral segment and far beyond to the femoral arteries. Dissection of orifices of side branches may lead to cerebral, upper extremity, spinal, visceral, renal and lower extremity malperfusion...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28294662/-endovascular-treatment-of-blunt-thoracic-aortic-injuries
#10
Zsuzsanna Mihály, Péter Banga, Lilla Szatai, Árpád Simonffy, Daniele Mariastefano Fontanini, Judit Bélteki, Bianka Forgó, Zoltán Szeberin
INTRODUCTION: A new era has begun in the last two decades with the advent of endovascular methods in the therapy of blunt thoracic aorta injuries. Our experiences with the endovascular interventions of blunt aortic trauma in the Cardiovascular Center of Semmelweis University are summarised here. METHODS: We included those patients who underwent endovascular intervention due to blunt aortic trauma in a university hospital between 1998 and 2014. The statistical analysis was performed with the use of Excel...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28294661/-nellix-new-possibilities-in-the-treatment-of-the-aorto-iliac-aneurysm-our-initial-experiences
#11
László Hidi, Csaba Csobay-Novák, Attila Nemes, Balázs Nemes, Zoltán Oláh, Dániel Pál, Péter Sótonyi
INTRODUCTION: The Endologix developed an aortoiliac stent graft system that is different than the conventional implantation technique (Nellix, EVAS-endovascular aneurysm sealing system). The first implantation in Hungary has been performed in the beginning of 2016 at Heart and Vascular Center. METHODS: Nellix: two endobags surrounding ballon-expandable covered stent (10 mm) with optional length, biocompatible polymer which is able to be injected into the endobags and a procedure-coordinating console...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28291303/thoracic-endovascular-aortic-repair-for-traumatic-type-b-aortic-dissection-a-five-year-experience-from-a-single-center
#12
Shuang Li, Wenwu Cai, Xin Li, Jian Qiu, Quanming Li, Chang Shu
BACKGROUND: to share our experience and demonstrate the feasibility, safety and efficacy of Thoracic endovascular aortic repair (TEVAR) for traumatic Type B Aortic Dissection (TTBAD). METHODS: Between October 2010 and October 2015, 36 patients, who have been diagnosed as TTBAD, were included. A computed tomography angiography (CTA) scan was performed to confirm the diagnosis and to localize the aortic entry. The clinical data and outcomes of these patients were retrospectively reviewed and collected for further analysis...
March 14, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28288889/cardiac-stress-testing-during-workup-for-abdominal-aortic-aneurysm-repair-is-not-associated-with-improved-patient-outcomes
#13
Benjamin S Brooke, Mark R Sarfati, Yingying Zhang, Yue Zhang, Angela P Presson, Tom H Greene, Larry W Kraiss
BACKGROUND: Cardiac stress testing (CST) is commonly used to help determine whether patients with abdominal aortic aneurysms (AAA) are better candidates for open vs. endovascular repair, although it is unknown whether use of CST achieves its goal of optimizing patient selection and postoperative outcomes. METHODS: We retrospectively identified 3,635 patients in the Vascular Quality Initiative (VQI) database (2010- 2012) with an AAA ≥ 5.0cm who were candidates for either open or endovascular AAA repair...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28286187/hybrid-evar-preservation-of-pelvic-perfusion-with-external-to-internal-iliac-artery-bypass
#14
Neel A Mansukhani, George E Havelka, Irene B Helenowski, Heron E Rodriguez, Andrew W Hoel, Mark K Eskandari
INTRODUCTION: Diminished pelvic arterial flow as a result of intentional coverage/embolization of internal iliac arteries (IIA) during isolated endovascular common iliac artery aneurysm (CIAA) repair or endovascular repair of abdominal aortic aneurysms (EVAR) may result in symptomatic pelvic ischemia. While generally well tolerated, in severe cases pelvic ischemia may manifest as recalcitrant buttock claudication, vasculogenic impotence, or perineal, vesicle, rectal, and/or spinal cord ischemia...
March 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28279526/applicability-and-midterm-results-of-branch-cuff-closure-with-vascular-plug-in-branched-endovascular-repair-for-thoracoabdominal-aortic-aneurysms
#15
Kiattisak Hongku, Timothy Resch, Björn Sonesson, Thorarinn Kristmundsson, Nuno V Dias
OBJECTIVE: This study assessed the applicability and outcomes of the closure of unused cuffs in branched endovascular aneurysm repair (b-EVAR) of thoracoabdominal aortic aneurysm. METHODS: We reviewed b-EVAR procedures at a tertiary referral center to identify patients who underwent incomplete branching and needed closure of the unused branch cuffs. An electronic database and intraoperative and follow-up imaging studies were reviewed to assess technical applicability and outcomes...
March 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28275940/physician-and-patient-radiation-exposure-during-endovascular-procedures
#16
REVIEW
Andrew M Goldsweig, J Dawn Abbott, Herbert D Aronow
Endovascular procedures expose both patients and physicians to fluoroscopic ionizing radiation that carries a dose-dependent risk of acute toxicity and a small, but demonstrable, long-term risk of malignancy due to resultant genetic mutations. Exposure doses vary widely based upon patient-related factors including body size and anatomic complexity, operator technique, procedure type (diagnostic vs. therapeutic), vascular bed imaged, and imaging equipment employed. Effective dosage may vary as much as 200-fold for physicians and 20-fold for patients depending upon the procedure: for example, complex aortic interventions with branched graft devices may convey mean effective doses of more than 0...
February 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28275425/a-clinical-and-ethical-review-on-late-results-and-benefits-after-evar
#17
REVIEW
Carlo Setacci, Pasqualino Sirignano, Vittorio Fineschi, Paola Frati, Giovanna Ricci, Francesco Speziale
INTRODUCTION: The aim of this review is to assess if late mortality after endovascular repair (EVAR) of abdominal aortic aneurysms (AAA) is a real problem, and whether it could be an issue in the case of medical litigation. MATERIAL AND METHODS: A review of all English language literature was performed on PubMed web-site, looking for all papers reporting EVAR long-term mortality rate. EVAR performances were reviewed also from an ethical and medico-legal point of view, based on current Italian laws...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28268549/guide-wire-detecting-using-a-modified-cascade-classifier-in-interventional-radiology
#18
Li Wang, Xiao-Liang Xie, Zhan-Jie Gao, Gui-Bin Bian, Zeng-Guang Hou
Endovascular surgery is becoming a widespread procedure to treat cardiovascular diseases (CVDs) such as abdominal aortic aneurysm and peripheral artery disease. The guide-wire is a crucial surgical instrument inserted into vessels to offer guidance to physicians during the surgery. There are some approaches for tracking the guide-wire, most algorithms consist of two phases, namely, the initialization phase and the tracking phase. In the initialization phase, most algorithms use B-splines for modeling the guide-wire which requires manually annotated data...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268109/the-incidence-and-fate-of-endoleaks-vary-between-ruptured-and-elective-endovascular-abdominal-aortic-aneurysm-repair
#19
Adam A Quinn, Manish Mehta, Mehdi J Teymouri, Megan E Keenan, Philip S K Paty, Yi Zhou, Benjamin B Chang, Paul Feustel
BACKGROUND: The number of ruptured abdominal aortic aneurysm (r-AAA) patients who are treated by endovascular means is increasing as ruptured endovascular aneurysm repair (r-EVAR) enters the mainstream. However, even today, data on the incidence and behavior of endoleaks after r-EVAR are scarce. This study analyzed whether endoleaks behave differently after EVAR for rupture vs elective AAA repair. METHODS: From 2002 to 2013, there were 2052 patients who underwent EVAR for treatment of rupture (n = 166 [8...
March 4, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28268106/right-brachial-access-is-safe-for-branched-endovascular-aneurysm-repair-in-complex-aortic-disease
#20
Beatrice Fiorucci, Tilo Kölbel, Fiona Rohlffs, Franziska Heidemann, Sebastian Eike Debus, Nikolaos Tsilimparis
BACKGROUND: The risk of perioperative cerebrovascular events in endovascular repair of thoracic and thoracoabdominal aneurysms is reported from 2% to 15%. The unavoidable use of an upper extremity access during branched endovascular aneurysm repair (b-EVAR) may play a role in embolic brain injuries. For this reason, some advocate the use of a left-sided upper access to avoid crossing the origin of supra-aortic vessels. However, the assumption that right brachial access has a higher risk for stroke during b-EVAR has not been confirmed in the literature...
March 4, 2017: Journal of Vascular Surgery
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