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endovascular aortic procedures

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https://www.readbyqxmd.com/read/27909276/-closure-of-ascending-aortic-entry-by-debranching-endovascular-management-in-an-elderly-patient-with-acute-stanford-type-a-dissection
#1
Munehiro Saiki, Keiji Yunoki, Naoya Sakoda, Shigeru Hattori, Gaku Uchino, Takuya Kawabata, Yasufumi Fujita, Kunikazu Hisamochi, Hideo Yoshida
An 85-year-old woman was hospitalized by emergency for an acute Stanford type A aortic dissection. Computed tomography showed a primary entry on the ascending aorta and pericardial effusion. Although her hemodynamics was unstable due to cardiac shock, her family wished no open surgery considering her age and frailty. A couple of days later, her condition became stabilized with antihypertensive therapy. Since the dissection was limited within the ascending aorta, closure of the entry with the stentgraft was considered appropriate and much less invasive as compared with an open surgery...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27908815/regional-variation-in-postoperative-myocardial-infarction-in-patients-undergoing-vascular-surgery-in-the-united-states
#2
Andrea M Steely, Peter W Callas, Daniel Neal, Salvatore T Scali, Philip P Goodney, Andres Schanzer, Jack L Cronenwett, Daniel J Bertges
OBJECTIVE: To assess for regional variation in the incidence of postoperative myocardial infarction (POMI) following non-emergent vascular surgery across the United States in order to identify potential areas for quality improvement initiatives. METHODS: We evaluated POMI rates across 17 regional Vascular Quality Initiative (VQI) groups comprised of 243 centers with 1,343 surgeons who performed 75,057 vascular operations from 2010-2014. Four procedures were included in the analysis: carotid endarterectomy (CEA, n=39,118), endovascular abdominal aortic aneurysm (AAA) repair (EVAR, n=15,106), infra-inguinal bypass (INFRA, n=17,176), and open infra-renal AAA repair (OAAA, n=3,657)...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908811/decreased-serum-levels-of-high-mobility-group-box-1-hmgb-1-after-graft-replacement-or-stenting-of-abdominal-aortic-aneurysm
#3
Daiki Ousaka, Yasuhiro Fujii, Susumu Oozawa, Masahiro Nishibori, Yosuke Kuroko, Zenichi Masuda, Shunji Sano
OBJECTIVES: High-mobility group box 1 (HMGB-1) is a key substance mediating inflammation and development of atherosclerotic lesions (AL), including abdominal aortic aneurysms (AAA). Serum levels of HMGB-1 are increased in patients with AAA than in normal controls because the ALs in AAAs secrete HMGB-1. We therefore postulate that the serum HMGB-1 level should decrease after endovascular aortic repair (EVAR) or open aortic repair (OAR). However, there is no evidence of this in the literature...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27908807/incomplete-expansion-of-chimney-stent-graft-during-chimney-thoracic-endovascular-aneurysm-repair-ch-tevar
#4
Athanasios Katsargyris, Domenico Spinelli, Kyriakos Oikonomou, Hozan Mufty, Eric Lg Verhoeven
PURPOSE: To report a technical complication during a chimney-thoracic endovascular aneurysm repair (Ch-TEVAR) procedure. CASE REPORT: A 77 year-old female patient underwent Ch-TEVAR for a symptomatic thoracic aortic aneurysm (TAA) with a short and angulated proximal neck. Deployment of the aortic stent-graft over the left subclavian artery (LSA) was followed by placement of a balloon expandable covered stent as a chimney for the LSA. Chimney deployment failed due to balloon perforation...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27905691/is-volume-important-in-aneurysm-treatment-outcome
#5
Athanasios Katsargyris, Chris Klonaris, Eric L Verhoeven
Several studies have suggested that surgical procedures performed at high-volume centers may result in superior outcome. Technically more demanding procedures such as aortic aneurysm repair appear to demonstrate a stronger relationship with volume. The present chapter reviewed the literature using the MEDLINE database to identify studies investigating the effect of volume in aortic aneurysm repair outcomes. The great majority of studies identified shows an advantage for high-volume hospitals with regard to perioperative mortality of abdominal (AAA), thoracic (TAA) and thoracoabdominal (TAAA) aortic aneurysm repair...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27905690/learning-curve-in-fenestrated-and-branched-grafting
#6
Teresa Martin-Gonzalez, Tara M Mastracci
In surgical practice new technologies and techniques require a period of adjustment before the main operator becomes familiar with the new procedure, improving the results and the performances. This period, called learning curve, could be applied into the endovascular aortic treatment. The CUSUM technique had been used to define the learning curve in new procedures and through the literature some studies applied it to demonstrate the improving outcomes in complex endovascular aneurysm repair during increasing experience time...
December 1, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27903931/comparison-of-perioperative-outcomes-in-endovascular-versus-open-repair-for-juxtarenal-and-pararenal-aortic-aneurysms-a-propensity-matched-analysis
#7
Nathan T Orr, Daniel L Davenport, David J Minion, Eleftherios S Xenos
OBJECTIVE: Endoluminal aortic aneurysm repair is suitable within certain anatomic specifications. This study aims to compare 30-day outcomes of endovascular versus open repairs for juxtarenal and pararenal aortic aneurysms (JAA/PAAs). METHODS: The ACS-NSQIP database was queried from 2012 to 2015 for JAA/PAA repairs. Procedures characterized as emergent were included in the study; however, failed prior repairs and ruptured aneurysms were excluded. The preoperative and perioperative patient characteristics, operative techniques, and outcome variables were compared between the open aortic repair and the endovascular aortic repair groups...
November 30, 2016: Vascular
https://www.readbyqxmd.com/read/27903485/endovascular-repair-of-thoraco-abdominal-aortic-aneurysm-in-high-surgical-risk-patients-fenestrated-and-branched-endografts
#8
E Gallitto, M Gargiulo, A Freyrie, C Bianchini Massoni, R Pini, C Mascoli, G L Faggioli, S Ancetti, A Stella
AIM: To report early and mid-term results of endovascular repair of thoraco-abdominal aneurysms (TAAA) by using of Cook-Zenith fenestrated/branched endografts (FB-EVAR) in high-surgical risk patients unfit for open repair (OR). METHODS: Between January 2012 and April 2015, all the patients with TAAA, considered at high-surgical risk for OR and treated by Cook-Zenith FB-EVAR, were prospectively enrolled. Patients were studied using a thoraco-abdominal computer tomography angiography (CTA) and dedicated software for advanced vessels analysis...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903477/simultaneous-endovascular-repair-for-thoracic-and-abdominal-aortic-pathologies-early-and-mid-term-results
#9
Yuanyuan Guo, Hongbo Cai, Bin Yang, Hui Jin
OBJECTIVES: To analyse information from a single clinical centre, evaluating early and mid-term results of simultaneous thoracic endovascular aortic repair (TEVAR) and endovascular aneurysm repair (EVAR) for co-existing thoracic and abdominal aortic pathologies. METHODS: From January 2005 to December 2014, 13 patients (8 men, 5 women; mean age, 75.3 years, range, 69-82 years) with concomitant thoracic and abdominal aortic disease (aneurysms, type B dissection, penetrating aortic ulcers) were treated with simultaneous TEVAR and EVAR...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903476/rapid-aneurysmal-sac-expansion-following-endovascular-repair-of-a-dissecting-thoracoabdominal-aneurysm
#10
Pau Bargay-Juan, Teresa Martin-Gonzalez, Rachel Clough, Rafaëlle Spear, Jonathan Sobocinski, Stephan Haulon
Endovascular repair of dissecting thoracoabdominal aneurysms (TAAA) is challenging and often requires multiple procedures. A 61-year-old man with a dissecting type-II TAAA treated first by placement of a thoracic endograft, and subsequently implantation of a fenestrated endograft. Six months postoperatively, a 10mm increase of the aorta was observed. A re-entry tear in left external iliac artery(EIA) was perfusing the false lumen in a retrograde fashion connecting with the endoleak caused by the inferior mesenteric artery and lumbar arteries...
November 26, 2016: Annals of Vascular Surgery
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
#11
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/27903469/determinants-of-follow-up-failure-in-patients-undergoing-vascular-surgery-procedures
#12
Dejah R Judelson, Jessica P Simons, Julie M Flahive, Virendra I Patel, Christopher T Healey, Brian W Nolan, Daniel J Bertges, Andres Schanzer
OBJECTIVE: The Vascular Study Group of New England (VSGNE) requires documentation of follow-up for >80% of patients at least 9 months post-procedure. However, many participating groups fall short of this goal. We sought to identify factors independently associated with loss to long-term follow-up (LTF). METHODS: The VSGNE was queried from 2008-2012, for all carotid endarterectomy (CEA), endovascular aneurysm repair (EVAR), open abdominal aortic aneurysm repair (OPEN), infrainguinal bypass (INFRA), and suprainguinal bypass (SUPRA) procedures in patients who survived greater than 9 months post-procedure...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27891504/thoracic-aorta-aneurysm-repair-in-a-patient-with-a-solitary-kidney-hybrid-surgery-as-a-bailout-procedure
#13
Chris Bakoyiannis, Demetrios Moris, George Karaolanis, Nikolaos Patelis, Dimitrios Schizas, Sotirios Georgopoulos, Theodoros Liakakos
Thoracic endovascular aortic repair (TEVAR) is an emerging treatment option for thoracic aorta aneurysms (TAA). Endovascular access is a challenge. We present a novel TEVAR technique in a patient with single kidney and a 6.4 cm TAA. Attempting to place a sheath through iliac arteries was unsuccessful. The decision to proceed to hybrid TEVAR was made. The protection of the solitary kidney was achieved through axillo-femoral bypass, followed by an end-to-side anastomosis between the aorta and a bifurcated graft...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27890849/hybrid-treatment-of-a-suprarenal-aortic-aneurysm-with-an-infrarenal-aorto-bifemoral-surgical-graft-and-a-fenestrated-stent-graft
#14
Sebastian Nagel, Athanasios Katsargyris, Kyriakos Oikonomou, Eric L G Verhoeven
PURPOSE: To report a hybrid technique for the treatment of a suprarenal aortic aneurysm (SAA) in a patient with iliac occlusive disease. Initially an infrarenal aorto-bifemoral surgical graft was implanted, followed by deployment of a fenestrated bifurcated stent-graft at the suprarenal part of the aorta. CASE REPORT: A 69-year old man presented with a 51-mm saccular SAA and iliac occlusive disease with intermittent claudication. Both common iliac arteries had been previously treated with kissing stents...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27887905/a-systematic-review-on-the-safety-of-prostar-xl-versus-proglide-after-tavr-and-evar
#15
REVIEW
Christos Maniotis, Constantinos Andreou, Ioannis Karalis, Giasemi Koutouzi, Maria Agelaki, Michael Koutouzis
BACKGROUND: Endovascular aortic aneurysm repair (EVAR) and transfemoral transcatheter aortic valve replacement (TAVR) are widely spreading minimally invasive procedures performed mainly through the femoral artery. Prostar XL and ProGlide vascular closure devices are used in clinical practice for the hemostasis in these procedures and they have been shown to be safe and effective. PURPOSE: The aim of our systematic review is to compare the safety of these two devices for percutaneous closure of large arteriotomies in patients undergoing TAVR and EVAR...
November 9, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27884710/predisposing-factors-for-re-interventions-with-additional-iliac-stent-grafts-after-endovascular-aortic-repair
#16
H Roos, C Sandström, G Koutouzi, A Jeppsson, M Falkenberg
BACKGROUND: Endoleaks of type Ib and III are relatively common causes of re-intervention after EVAR. The aim was to determine underlying causes and identify anatomical factors associated with these re-interventions. METHODS: A total of 444 patients with standard bifurcated stent grafts were included in a retrospective observational study. Patients requiring additional iliac stent grafts (n = 24) were compared to those who did not (n = 420). Pre- and post-operative CT examinations were reviewed in patients with additional iliac stents...
November 21, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27881689/acute-type-a-aortic-dissection-treated-using-a-tubular-stent-graft-in-the-ascending-aorta-and-a-multibranched-stent-graft-in-the-aortic-arch
#17
Tilo Kölbel, Christian Detter, Sebastian W Carpenter, Fiona Rohlffs, Yskert von Kodolitsch, Sabine Wipper, Herrmann Reichenspurner, E Sebastian Debus, Nikolaos Tsilimparis
PURPOSE: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. TECHNIQUE: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients...
November 23, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27876371/approaches-for-treatment-of-aortic-arch-aneurysm-a-numerical-study
#18
Asaph Nardi, Idit Avrahami
Aortic arch aneurysm is a complex pathology which requires coverage of one or more aortic arch vessels. In this study we explore the hemodynamic behavior of the aortic arch in aneurysmatic and treated cases with three currently available treatment approaches: Surgery Graft, hybrid Stent-Graft and chimney Stent Graft. The analysis included four models of the time-dependent fluid domains of aneurysmatic arch and of the surgery, hybrid and chimney endovascular techniques. Dimensions of the models are based on typical anatomy, and boundary conditions are based on typical physiological flow...
November 12, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27871211/registry-and-health-insurance-claims-data-in-vascular-research-and-quality-improvement
#19
Christian-Alexander Behrendt, Franziska Heidemann, Henrik Christian Rieß, Konstanze Stoberock, Sebastian Eike Debus
The expansion of procedures in multidisciplinary vascular medicine has sparked a controversy regarding measures of quality improvement. In addition to primary registries, the use of health insurance claims data is becoming of increasing importance. However, due to the fact that health insurance claims data are not collected for scientific evaluation but rather for reimbursement purposes, meticulous validation is necessary before and during usage in research and quality improvement matters. This review highlights the advantages and disadvantages of such data sources...
November 22, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27866141/transapical-aortic-stenting-an-initial-case-series
#20
Tamer G Ghazy, Ahmed S Ouda, Ahmed M Mashhour, Manuel Wilbring, Klaus Matschke, Utz W Kappert
AIMS: The standard approach for thoracic endovascular aortic repair (TEVAR) is transfemoral; however, calcifications and tortuosity of the access vessels might be so extensive as to increase the operative risk markedly or preclude the procedure. This study evaluates the transapical approach as an alternative route for TEVAR in such patients. METHODS AND RESULTS: From June 2011 to July 2013, the institution's interdisciplinary board for aortic diseases initially denied TEVAR for eight patients with thoracic aortic pathology due to extensive calcification and tortuosity of the distal vessels...
November 20, 2016: EuroIntervention
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