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Hybrid stents

Giulio Illuminati, Giulia Pizzardi, Rocco Pasqua, Francesca Frezzotti, Piergaspare Palumbo, Francesco Macrina, Francesco Calio
BACKGROUND: Tandem stenoses of the internal carotid artery (ICA) and proximal, ipsilateral common carotid artery (CCA) or innominate artery can be treated with a hybrid approach, combining conventional carotid endarterectomy (CEA) and retrograde stenting of the proximal stenosis, through surgical exposure of the carotid bifurcation. The purpose of this study was to evaluate the results of combining eversion CEA with retrograde CCA/innominate artery stenting. MATERIAL AND METHODS: From January 2015 to July 2017, 7 patients, 6 men of a mean age of 72 years (range 59-83 years) underwent simultaneous, retrograde stenting of the proximal CCA/innominate artery and an eversion CEA of the ipsilateral ICA, through surgical exposure of the carotid bifurcation, for severe tandem stenoses...
March 10, 2018: International Journal of Surgery
Takayuki Shijo, Takashi Shirakawa, Masao Yoshitatsu, Keiji Iwata
Stent grafting for complex aortic anatomy remains a challenge. In particular, stent graft collapse (i.e. infolding) is possible when an excessive oversized device is needed. We describe a case of preoperative stent grafting simulation using a three-dimensional (3D) printed model for extensive aortic arch repair in a 69-year-old woman with multiple aneurysms combined with coarctation. The patient was scheduled to undergo staged hybrid repair. A stent graft larger than 28 mm in diameter was needed to deploy into a coarctation of 15 mm in diameter during the 2nd stage of the operation...
March 8, 2018: European Journal of Cardio-thoracic 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
Alberto Repossini, Lorenzo Di Bacco, Fabrizio Rosati, Maurizio Tespili, Antonio Saino, Alfonso Ielasi, Claudio Muneretto
AIMS: Hybrid revascularization (HCR) has been recently proposed as an alternative strategy in multivessel coronary disease, particularly in patients with high SYNTAX scores and risk scores. The objective of this study is to evaluate the outcomes of HCR versus percutaneous coronary intervention (PCI) drug-eluting stenting in left main treatment. METHODS: A series of 198 consecutive patients with left main stenosis have been treated. HCR, was performed in 77 patients (G1) whereas 121 patients (G2) received PCI on left main...
March 6, 2018: Journal of Cardiovascular Medicine
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
Nikolas Tsilimparis, Sebastian E Debus, Max Biehl, Konstantinos Spanos, Axel Larena-Avellaneda, Sabine Wipper, Fiona Rohlffs, Tilo Kölbel
OBJECTIVE: The aim of this study was to assess the immediate postoperative and midterm outcome of complex aortic aneurysm treatment necessitating four-vessel revascularization with either a total endovascular approach (fenestrated-branched stent graft [FBSG]) or a hybrid technique of visceral debranching plus stenting. METHODS: The clinical data of consecutively treated patients presenting with a complex aortic aneurysm that necessitated four-vessel revascularization between 2010 and 2015 were retrospectively analyzed...
March 1, 2018: Journal of Vascular Surgery
Jong Young Lee, Jong-Hwa Park, Hong Jun Jeon, Dae Young Yoon, Seoung Woo Park, Byung Moon Cho
PURPOSE: A complicated course of the femoral route for neurointervention can prevent approaching the target. Thus, we determined whether transcervical access in the hybrid angiosuite is applicable and beneficial in real practice. METHODS: From January 2014 to March 2017, this approach was used in 17 of 453 (3.75%) cases: 11 cerebral aneurysms (4 ruptured, 7 unruptured), 4 acute occlusions of the large cerebral artery, 1 proximal internal carotid artery (ICA) stenosis, and 1 direct carotid cavernous fistula (CCF)...
March 1, 2018: Neuroradiology
N Rudarakanchana, M P Jenkins
BACKGROUND: Recent advances in endovascular technology have enabled minimally invasive repair of the aortic arch, with specifically designed stent-grafts. This article reviews hybrid and total endovascular repair in the management of aortic arch pathology. METHODS: Studies relating to aortic arch management were identified using MEDLINE and Embase, focusing on endovascular repair. RESULTS: Hybrid arch repair is associated with an early mortality rate of some 12 per cent, and carries significant risk of stroke (up to 15 per cent), paraplegia (up to 6 per cent), retrograde dissection (up to 6·5 per cent) and proximal endoleak (6 per cent)...
March 2018: British Journal of Surgery
Eva Kapravelou, David Anderson, Gareth J Morgan
The use of hybrid techniques to avoid neonatal cardiopulmonary bypass in high-risk individuals is well reported in the setting of hypoplastic left heart syndrome. We describe the use of that technique as a bridging procedure in high-risk neonates with an interrupted aortic arch. We report three cases where hybrid branch pulmonary artery banding and ductal stent implantation has been successfully used to defer complete repair, allowing recovery, maturity, and weight gain. This strategy may be considered for patients deemed at high risk for primary neonatal repair...
March 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Juliet J Ray, Sarah A Eidelson, Charles A Karcutskie, Jonathan P Meizoso, Hilene DeAmorim, Lee J Goldstein, John Karwowski, Arash Bornak
INTRODUCTION: This study examines the outcome of hybrid revascularization combining iliofemoral endartectomy and iliac artery stenting using covered stents in TASC C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS: A retrospective review was conducted of patients with TASC C and D AIOD involving the CFA and undergoing hybrid revascularization. Covered stents were used primarily. Demographics, indications for surgery, lesion classification, hospital length-of-stay (LOS), 30-day morbidity/mortality, hemodynamic and clinical success, as well as patency were assessed...
February 23, 2018: Annals of Vascular Surgery
Fan Qiao, Cunhua Su, Qingqi Han, Mengwei Tan, Jun Wang, Yang Liu, Fanglin Lu, Lin Han, Zhiyun Xu
PURPOSE: To report the results of a hybrid approach to aortic arch repair using an innovative unibody double-branched stent graft in a canine model. MATERIALS AND METHODS: The stent-graft system consists of two parts: the main body and two branches for reconstruction of the supra-arch branches. There is a 2-cm-long suturing portion at the proximal end of the main body. Twenty adult German sheep dogs underwent a hybrid surgical treatment to place the stent-grafts into the proximal descending aorta and the supra-arch branches...
February 22, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
R N Komarov, I A Vinokurov, P A Karavaykin, I M Abdulmutalibov, Yu V Belov
AIM: To generalize our experience of step-by-step hybrid thoracoabdominal aortic replacement. MATERIAL AND METHODS: Twenty-three patients were enrolled who underwent staged hybrid treatment of thoracoabdominal aortic aneurysm. There were 5 (21.7%) women and 18 (78.3%) men aged 61.4±8.3 years (37-74 years). The first stage was proximal debranching, the second - distal (abdominal) procedure and the third - stenting of the thoracoabdominal aorta. RESULTS: There were no any complications after proximal debranching and aortic stenting...
2018: Khirurgiia
Damien Kenny, Terence Prendiville, Kevin P Walsh, Jonathan McGuinness
Repair of tetralogy of Fallot with atrioventricular septal defect may be associated with hemodynamic challenges in the postoperative period particularly as left atrial hypertension secondary to left atrioventricular valve dysfunction may exacerbate pulmonary regurgitation and augment low cardiac output. We present a case describing hybrid strategies to treat severe left atrioventricular and pulmonary valve regurgitation with modified balloon expandable stent valves to counter low cardiac output secondary to valve dysfunction...
March 2018: Annals of Thoracic Surgery
Duarte Rego, Paulo Almeida, Paulo Soares, Rui Almeida
INTRODUCTION: Celiac artery (CA) occlusions/stenosis are infrequently associated with liver ischemia due to its unique vascularization where portal vein provides about 75% of liver's perfusion. Collateral flow from gastroduodenal artery also provides, in most cases, enough blood supply to prevent ischemic hepatitis. In cases where these collateral pathways are compromised severe liver ischemia can occur. METHODS: We present a case of acute mesenteric ischemia following gastric surgery that was treated with a hybrid retrograde CA stenting...
February 15, 2018: Annals of Vascular Surgery
A H Perera, N Rudarakanchana, L Monzon, C D Bicknell, B Modarai, O Kirmi, T Athanasiou, M Hamady, R G Gibbs
BACKGROUND: Silent cerebral infarction is brain injury detected incidentally on imaging; it can be associated with cognitive decline and future stroke. This study investigated cerebral embolization, silent cerebral infarction and neurocognitive decline following thoracic endovascular aortic repair (TEVAR). METHODS: Patients undergoing elective or emergency TEVAR at Imperial College Healthcare NHS Trust and Guy's and St Thomas' NHS Foundation Trust between January 2012 and April 2015 were recruited...
February 12, 2018: British Journal of Surgery
Christian Uhl, Thomas Betz, Barbara Weiss, Ingolf Töpel, Markus Steinbauer
INTRODUCTION: According to the guidelines aortoiliac TASC D lesions should be treated by bypass. The purpose of this study was to examine the results of hybrid procedures with the use of a self-expanding covered heparin-bonded stent graft (Viabahn) in patients with extensive aorto-iliac lesions who were not considered to be suitable for open aorto-iliac surgery. METHODS: All patients who received a hybrid procedure in combination with a Viabahn stent in our clinic to treat aortoiliac lesions between October 2011 and April 2017 were included in this retrospective analysis...
February 8, 2018: Journal of Cardiovascular Surgery
Uygar Yörüker, Hakan Akintürk
This article reviews our experience using hybrid stage I palliation in the neonatal period and subsequently with comprehensive stage II palliation for hypoplastic left heart syndrome. Between June 1998 and April 2017, 154 patients with the diagnosis of hypoplastic left heart syndrome and variants underwent a hybrid stage I palliation (bilateral pulmonary artery banding and ductal stenting). One hundred thirty-nine patients could be further univentricularly palliated. One hundred twenty-one patients underwent a comprehensive stage II operation with an operative mortality of 6...
March 2018: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Takashi Shuto, Tomoyuki Wada, Shinji Miyamoto, Noritaka Kamei, Norio Hongo, Hiromu Mori
OBJECTIVES: The treatment of thoraco-abdominal aortic aneurysm continues to have a high mortality and paraplegia rate. In superaging societies, the methods of performing less invasive operations remain a major issue. We reviewed our 10-year experience in the treatment of thoraco-abdominal aortic aneurysm using a hybrid procedure of combined visceral reconstruction and thoracic endovascular aortic repair. METHODS: Sixty patients underwent a hybrid repair for the treatment of the thoraco-abdominal aortic aneurysm between 2007 and 2016...
February 2, 2018: Interactive Cardiovascular and Thoracic Surgery
Carlo Zivelonghi, Jan P van Kuijk, Vincent Nijenhuis, Enrico Poletti, Maarten J Suttorp, Jan A S van der Heyden, Frank D Eefting, Benno J Rensing, Jurrien M Ten Berg, Lorenzo Azzalini, Floris S van den Brink, Flavio Ribichini, Antonio Colombo, José P S Henriques, Pierfrancesco Agostoni
BACKGROUND: Coronary chronic total occlusions (CTO) usually coexist with diffusely diseased coronary segments proximal and/or distal to the CTO segment. During percutaneous treatment of CTO, multiple overlapping stents are often needed to treat these long lesions. OBJECTIVES: Aim of this study is to report the first use of long, tapered coronary sirolimus-eluting stents (SES) in this setting. METHODS AND RESULTS: This is a retrospective analysis of 100 consecutive patients undergoing CTO recanalization following the hybrid algorithm...
February 7, 2018: Catheterization and Cardiovascular Interventions
Naoki Misumida, David J Moliterno
The present meta-analysis found no significant difference between hybrid coronary revascularization (HCR) and bypass surgery (CABG) regarding intermediate-term major adverse cardiac and cerebrovascular events. HCR is feasible, historically with higher revascularization rates but less perioperative morbidity With a comparable frequency of repeat revascularization between current-generation drug-eluting stents and CABG, future trials of HCR are considering multi-vessel PCI as the new comparator.
February 1, 2018: Catheterization and Cardiovascular Interventions
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