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endovascular aortic procedures

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https://www.readbyqxmd.com/read/28633225/patient-specific-simulation-of-endovascular-thoracic-aortic-repair-initial-experience
#1
Liesbeth M Desender, Isabelle Van Herzeele, Zoran Rancic, Colin Bicknell, Ignatios Zairis, Frank E Vermassen, John H Rundback
PURPOSE: Endovascular thoracic aortic repair (TEVAR) has become the treatment modality of diverse aortic pathology. We report the use of patient-specific simulation using a dedicated PROcedure Rehearsal Studio (PRS) platform (Simbionix USA Corp, Cleveland, OH) before TEVAR and evaluate the feasibility and realism of this technology. DESCRIPTION: Virtual three-dimensional models of the patient's relevant anatomy were reconstructed from computed tomography data. PRS was used in 2 patients before TEVAR...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28631201/seven-esophageal-perforation-cases-after-aortic-replacement-stenting-for-thoracic-aortic-dissection-or-aneurysm
#2
Yoshihisa Yaguchi, Yoshimasa Kumata, Masahiro Horikawa, Takashi Kiyokawa, Tsuyoshi Inaba, Ryoji Fukushima
BACKGROUND: Esophageal perforation after aortic replacement/stenting for aortic dissection or aneurysm is a rare but severe complication. However, its cause, standard treatment, and prognosis are unclear. We analyzed the treatment and outcome retrospectively from seven cases experienced at our hospital. CASE PRESENTATION: The median age of the patients was 70 years (range, 41-86), and six of the seven cases were male. As the first treatment, aortic replacement techniques were performed in five, and thoracic endovascular aortic repair (TEVAR) procedure was performed in two...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28628603/field-and-en-route-resuscitative-endovascular-occlusion-of-the-aorta-a-feasible-military-reality
#3
Viktor A Reva, Tal M Hörer, Andrey I Makhnovskiy, Mikhail V Sokhranov, Igor M Samokhvalov, Joseph J DuBose
BACKGROUND: Severe noncompressible torso hemorrhage remains a leading cause of potentially preventable death in modern military conflicts. Resuscitative endovascular occlusion of the aorta (REBOA) has demonstrated potential as an effective adjunct to the treatment of noncompressible torso hemorrhage in the civilian early hospital and even prehospital settings-but the application of this technology for military prehospital use has not been well described. We aimed to assess the feasibility of both field and en route prehospital REBOA in the military exercise setting, simulating a modern armed conflict...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28619356/operative-and-one-year-outcomes-of-the-custom-made-fenestrated-anaconda%C3%A2-aortic-stent-graft-a-uk-multicentre-study
#4
Frances E Colgan, Peter M Bungay, Nicholas Burfitt, Andrew Hatrick, Michael J Clarke, Alun H Davies, Michael Jenkins, David Gerrard, John W Quarmby, Robin Williams
OBJECTIVES: Early and one year outcomes are presented for fenestrated endovascular aneurysm repair (FEVAR) of complex aortic aneurysmal disease with the custom-made Anaconda fenestrated stent graft in 101 patients. METHODS: Retrospective site-reported data from the first 101 elective cases (2010 to 2014) from four UK centres was studied to evaluate patient demographics, aneurysm morphology, clinical success and one year outcomes in patients undergoing fenestrated aneurysm repair with the custom-made Anaconda device...
June 12, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28616351/hybrid-aortic-repair-with-antegrade-supra-aortic-and-renovisceral-debranching-from-ascending-aorta
#5
José Antonio Del Castro-Madrazo, Margarita Rivas-Domínguez, Carlota Fernández-Prendes, Amer Zanabili Al-Sibbai, José Manuel Llaneza-Coto, Manuel Alonso-Pérez
Aortic dissection is a life threatening condition. Hybrid repair has been described for the treatment of complex aortic pathology such as thoracoabdominal aortic aneurysms (TAAA) and type A and B dissections, although open and total endovascular repair are also possible. Open surgery is still associated with substantial perioperative morbi-mortality rates, thus less invasive techniques such as endovascular repair and hybrid procedures can achieve good results in centers with experience. We present the case of a patient with a chronic type B dissection and TAAA degeneration that was treated in a single stage hybrid procedure with antegrade supra-aortic and renovisceral debranching from the ascending aorta and TEVAR...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616343/debranching-aortic-surgery
#6
REVIEW
Manuel Alonso Pérez, José Manuel Llaneza Coto, José Antonio Del Castro Madrazo, Carlota Fernández Prendes, Mario González Gay, Amer Zanabili Al-Sibbai
Conventional open surgery still remains as the gold standard of care for aortic arch and thoracoabdominal pathology. In centers of excellence, open repair of the arch has been performed with 5% immediate mortality and a low rate of complications; however overall mortality rates are around 15%, being up to 40% of all patients rejected for treatment due to their age or comorbidities. For thoracoabdominal aortic pathology, data reported from centers of excellence show immediate mortality rates from 5% to 19%, spinal cord ischemia from 2...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616205/appearance-and-rapid-evolution-of-thoraco-abdominal-intramural-hematoma-after-tevar
#7
Edoardo Cervi, Franco Nodari, Emanuele Botteri, Girolomina Mazzeo, Bonardelli Stefano
Some studies consider the different physical properties of the stent graft when compared with the blood vessel on the basis of vascular lesions that may require further intervention. We present a case in which a patient developed an intramural hematoma at the distal landing of previous thoracic endovascular aortic repair (TEVAR) that required the relining with a flared prosthesis. During follow-up, we observed the appearance of more caudal hematoma. We decided to observe this lesion with close radiological controls...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28615114/experimental-assessment-of-physician-modified-proximal-scalloped-stent-graft-to-extend-proximal-landing-zone-in-the-aortic-arch
#8
E M Faure, I Khantalin, P A Peyron, L Canaud, C Marty-Ané, P Alric
OBJECTIVE/BACKGROUND: The aim of the study was to assess a model of physician modified scalloped stent graft (PMSG) on currently available thoracic aortic devices to extend the proximal landing zone in either zone 2, 1 or 0 of the aortic arch while preserving flow in the supra-aortic vessels on human cadaveric aorta. METHODS: Fresh human aortas were harvested at autopsy from adult subjects. A proximal scallop was made on the stent grafts based on direct measurements on the aortas to extend the proximal landing zone in zone 0 (n = 5), zone 1 (n = 5), and zone 2 (n = 5)...
June 11, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28612909/implantation-of-stents-for-postsurgical-recoarctation-of-the-aorta-in-adolescents-and-adults
#9
Sylwia Sulik-Gajda, Roland Fiszer, Jacek Białkowski, Beata Chodór, Szymon Pawlak, Małgorzata Szkutnik
BACKGROUND: Results of stent implantation (SI) of postsurgical recoarctation of the aorta (ReCoA) are not frequently published. AIM: This study sought to retrospectively evaluate results of SI in ReCoA in older children and adults. METHODS: Twenty-eight SI were performed on 26 ReCoA patients with a median age of 23(10-65) years. Dependent upon availability, the following stents were applied -Palmaz, Cheatham Platinum (CP), Andrastents XL/XXL(AS), Covered CP (CVCP) stents and selfexpanding stents (Smart)...
June 14, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28602901/endovascular-treatment-of-aorto-iliac-femoral-anastomotic-pseudoaneurysms-a-multicentric-study
#10
D Laganà, G Guzzardi, M Petullà, M Martelli, A M Ierardi, B Del Sette, G Carrafiello
PURPOSE: Purpose of this study is to assess the effectiveness of anastomotic pseudoaneurysms (APAs) endovascular treatment following aorto-iliac-femoral surgical reconstruction. BASIC PROCEDURES: We retrospectively evaluated 54 patients that underwent aorto-iliac-femoral by-pass (72 APAs). Follow up was performed with Eco-color-Doppler and/or CTA at 1, 3, 6 months after the procedure and than yearly.We compared clinical success in terms of mortality between aortic APAs and non-aortic APAs (iliac-femoral-popliteal)...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28602492/open-versus-endovascular-aneurysm-repair-trial-review
#11
Craig Weinkauf, Elizabeth George, Wei Zhou
The Open versus Endovascular Aneurysm Repair trial is the only randomized controlled trial that is funded by the federal government to evaluate the treatment outcomes of infrarenal abdominal aortic aneurysms. Since the initial publication, multiple post-hoc analyses have become available. This review summarizes these data, focusing on the primary outcome measures (ie, overall survival) and several key secondary outcomes including aneurysm-related death, age consideration, secondary procedures, and endoleaks...
June 8, 2017: Surgery
https://www.readbyqxmd.com/read/28602115/total-endovascular-treatment-of-aortic-arch-disease-using-an-arch-endograft-with-3-inner-branches
#12
Rafaëlle Spear, Rachel E Clough, Dominique Fabre, Blayne Roeder, Adrien Hertault, Teresa Martin Gonzalez, Richard Azzaoui, Jonathan Sobocinski, Stéphan Haulon
PURPOSE: To report early experience with a new endovascular graft developed for aortic arch aneurysm repair in patients unfit for open surgery. CASE REPORT: Three consecutive men (62, 74, and 69 years old) at high risk for open repair were treated for postdissection aortic arch aneurysms using a custom-made 3 inner branched endovascular graft. The 2 proximal branches are antegrade and perfuse the innominate artery and the left common carotid artery; the third branch is retrograde and perfuses the left subclavian artery...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28598924/resuscitative-endovascular-balloon-occlusion-of-the-aorta-principles-initial-clinical-experience-and-considerations-for-the-anesthesiologist
#13
Srikanth Sridhar, Sam D Gumbert, Christopher Stephens, Laura J Moore, Evan G Pivalizza
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an endovascular technique that allows for temporary occlusion of the aorta in patients with severe, life-threatening, trauma-induced noncompressible hemorrhage arising below the diaphragm. REBOA utilizes a transfemoral balloon catheter inserted in a retrograde fashion into the aorta to provide inflow control and support blood pressure until definitive hemostasis can be achieved. Initial retrospective and registry clinical data in the trauma surgical literature demonstrate improvement in systolic blood pressure with balloon inflation and improved survival compared to open aortic cross-clamping via resuscitative thoracotomy...
June 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28591766/elective-frozen-elephant-trunk-procedure-using-the-e-vita-open-plus-prosthesis-in-94-patients-a-multicentre-french-registry
#14
Jean-Philippe Verhoye, Reda Belhaj Soulami, Olivier Fouquet, Vito Giovanni Ruggieri, Adrien Kaladji, Jacques Tomasi, Michel Sellin, Fadi Farhat, Amedeo Anselmi
OBJECTIVES: Our goal was to evaluate the operative outcomes of the frozen elephant trunk technique using the E-Vita Open Plus ® hybrid prosthesis in chronic aortic arch diseases and report clinical and radiological outcomes at the 1-year follow-up. METHODS: As determined from a prospective multicentre registry, 94 patients underwent frozen elephant trunk procedures using the E-Vita Open Plus hybrid device for the treatment of chronic aortic conditions, including 50% chronic aortic dissections, 40% degenerative aneurysms and 10% miscellaneous indications...
June 7, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28587563/how-precise-are-preinterventional-measurements-using-centerline-analysis-applications-objective-ground-truth-evaluation-reveals-software-specific-centerline-characteristics
#15
Philipp Hoegen, Stefan Wörz, Matthias Müller-Eschner, Philipp Geisbüsch, Wei Liao, Karl Rohr, Matthias Schmitt, Fabian Rengier, Hans-Ulrich Kauczor, Hendrik von Tengg-Kobligk
PURPOSE: To evaluate different centerline analysis applications using objective ground truth from realistic aortic aneurysm phantoms with precisely defined geometry and centerlines to overcome the lack of unknown true dimensions in previously published in vivo validation studies. METHODS: Three aortic phantoms were created using computer-aided design (CAD) software and a 3-dimensional (3D) printer. Computed tomography angiograms (CTAs) of phantoms and 3 patients were analyzed with 3 clinically approved and 1 research software application...
June 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28584942/combined-ct-fluoroscopic-and-ivus-guidance-for-percutaneous-treatment-of-a-postsurgical-pseudoaneurysm-following-repair-of-ascending-thoracic-aortic-aneurysm
#16
Anastasia Hadjivassiliou, Joel Gagnon, Michael Janusz, Darren Klass
Thoracic aortic pseudoaneurysms are a recognized complication following aortic arch replacement. The established first line treatment is surgical repair; however, this may not be feasible in all patients. Percutaneous treatment of ascending thoracic pseudoaneurysms has been described as an alternative for nonsurgical candidates. Utilization of multimodality imaging can prove invaluable in minimizing the risk of potentially fatal intra-procedural complications. We present a case of successful embolization using computer tomography-guided direct percutaneous puncture of the pseudoaneurysm, with concomitant endovascular treatment under fluoroscopic and intravascular ultrasound guidance in a patient with challenging vascular anatomy...
June 5, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28583735/electromagnetic-tracking-of-flexible-robotic-catheters-enables-assisted-navigation-and-brings-automation-to-endovascular-navigation-in-an-in-vitro-study
#17
Adeline Schwein, Benjamin Kramer, Ponraj Chinnadurai, Neha Virmani, Sean Walker, Marcia O'Malley, Alan B Lumsden, Jean Bismuth
OBJECTIVE: Combining three-dimensional (3D) catheter control with electromagnetic (EM) tracking-based navigation significantly reduced fluoroscopy time and improved robotic catheter movement quality in a previous in vitro pilot study. The aim of this study was to expound on previous results and to expand the value of EM tracking with a novel feature, assistednavigation, allowing automatic catheter orientation and semiautomatic vessel cannulation. METHODS: Eighteen users navigated a robotic catheter in an aortic aneurysm phantom using an EM guidewire and a modified 9F robotic catheter with EM sensors at the tip of both leader and sheath...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28583734/thoracic-endovascular-aortic-repair-with-branched-inoue-stent-graft-for-arch-aortic-aneurysms
#18
Junichi Tazaki, Kanji Inoue, Hirooki Higami, Nobuya Higashitani, Masanao Toma, Naritatsu Saito, Masahide Kawatou, Takeshi Kimura
BACKGROUND: Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is in rapid expansion due to its minimal invasiveness. However, TEVAR for an arch aneurysm with a straight stent graft needs surgical reconstruction for supra-aortic vessels. A branched stent graft pioneered by Inoue (branched Inoue Stent Graft [ISG]) has been expected to resolve this problem, but its utility remains to be established in the real clinical setting. This study evaluated the long-term clinical outcome of branched ISGs for TAAs...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28583728/conical-neck-is-strongly-associated-with-proximal-failure-in-standard-endovascular-aneurysm-repair
#19
Georgios A Pitoulias, Andrés Reyes Valdivia, Suteekhanit Hahtapornsawan, Giovanni Torsello, Apostolos G Pitoulias, Martin Austermann, Claudio Gandarias, Konstantinos P Donas
OBJECTIVE: Hostile proximal aortic neck (HN) challenges the suitability for standard endovascular aneurysm repair (EVAR) of patients at high risk for "open" repair. However, there has been little if any focus placed on the individual role of the "nonlength" HN features in EVAR outcomes. The aim of this study was to evaluate their individual and potentially predictive role in outcomes of EVAR under HN conditions. METHODS: Data of 156 consecutive EVAR patients with short (<15 mm) HN, treated with the Endurant device (Medtronic Cardiovascular, Santa Rosa, Calif) at three European academic vascular centers between 2007 and 2015, were collected and retrospectively analyzed...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28579290/improved-outcomes-and-value-in-staged-hybrid-extent-ii-thoracoabdominal-aortic-aneurysm-repair
#20
Robert B Hawkins, J Hunter Mehaffey, Adishesh K Narahari, Amit Jain, Ravi K Ghanta, Irving L Kron, John A Kern, Gilbert R Upchurch
OBJECTIVE: Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared with traditional open repair over 10 years. METHODS: A prospectively collected database was used to identify all patients with an extent II TAAA undergoing repair at a single institution between 2005 and 2015...
May 31, 2017: Journal of Vascular Surgery
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