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https://www.readbyqxmd.com/read/29775657/stabilization-of-the-abdominal-aorta-during-the-cardiac-cycle-with-the-sac-anchoring-nellix-device
#1
Nathan K Itoga, Ga-Young Suh, Christopher P Cheng
The Nellix device utilizes polymer filled endobags to stabilize the abdominal aortic aneurysm (AAA) sac described as endovascular aneurysm sealing (EVAS). We analyzed cardiac gated CTA scans of repaired AAA with EVAS in four patients to evaluate geometry and cardiac pulsatility-induced deformation. Graft translation and aortic curvature changes were found to be minimal during the cardiac cycle. The mean±SD changes in renal-aorta angles (1.0±0.9°) were less than the changes in the SMA-aorta angle (4.0±2...
May 15, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#2
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#3
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29772329/impact-of-stent-graft-oversizing-on-gutter-areas-after-chimney-graft-repair-for-complex-abdominal-aortic-aneurysms
#4
Romain de Blic, Frédéric Cochennec, Faris Alomran, Hicham Kobeiter, Eric Allaire, Pascal Desgranges, Jean-Pierre Becquemin
PURPOSE: The aim of this retrospective study was to examine the impact of graft oversizing on gutter area and stent compression in chimney graft (CG) for complex abdominal aortic aneurysms (CAAA) repair. The influence of stent graft oversizing on type Ia endoleaks and bridging stent occlusion rates were also examined. METHODS: Preoperative and postoperative computed tomographic angiography (CTA) scans of patients requiring chimney grafts for CAAA between June 2009 and April 2013 in our institution were analysed...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772328/current-evidence-on-management-of-aortic-stent-graft-infection-a-systematic-review-and-meta-analysis
#5
REVIEW
Hai Lei Li, Yiu Che Chan, Stephen W Cheng
OBJECTIVE: Aortic stent-graft infection is rare, but remains one of the most challenging and threatening complications. This systematic review aimed to identify the clinical features, treatment and outcomes of endograft infection after abdominal endovascular aortic repair (EVAR) and thoracic endovascular aortic repair (TEVAR). METHODS: A systematic literature review of all published literature from January 1991 to September 2016 on stent-graft infection was performed under the instruction of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772324/morphology-related-limitations-of-evar-applicability-in-the-treatment-of-aaa-in-west-central-poland
#6
Łukasz Dzieciuchowicz, Jolanta Tomczak, Ewa Strauss, Grzegorz Oszkinis
BACKGROUND: To analyze the current applicability of endovascular aneurysm repair (EVAR) in patients with an infrarenal abdominal aortic aneurysm (AAAs) with indication for elective treatment in West-Central Poland. METHODS: Computed tomography angiograms of 100 consecutive patients with infrarenal AAA deemed to require treatment were analyzed with an OsiriX DICOM viewer in 3D-MPR mode. Proximal neck diameter, length, angulation, shape, the presence of thrombus and calcification, distal neck diameter, and morphology of the iliac arteries were determined...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772314/urgent-use-of-gore-excluder-iliac-branch-endoprosthesis-ibe-with-left-transaxillary-approach-for-preservation-of-the-residual-hypogastric-artery-a-case-series
#7
D'Oria Mario, Chiarandini Stefano, Pipitone Marco, Calvagna Cristiano, Riccitelli Francesco, Rotelli Alice, Zamolo Francesca, Griselli Filippo
Preservation of the residual hypogastric artery (HGA) in patients with previous endovascular aortic aneurysm repair (EVAR) may require complex operative strategies. We report an alternative technique to preserve the residual HGA with the Gore Excluder Iliac Branch endoprosthesis (IBE) in urgent situations. MethodsWe report the case of two high-risk patients (unfit for open surgery), with previous EVAR and exclusion of one HGA, treated in emergency setting. Both patients met the anatomical requirements for Gore IBE use...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772312/early-and-late-outcomes-of-endovascular-aortic-aneurysm-repair-versus-open-surgical-repair-of-an-abdominal-aortic-aneurysm-a-single-center-study
#8
Kyunghak Choi, Youngjin Han, Gi-Young Ko, Yong-Pil Cho, Tae-Won Kwon
OBJECTIVE: To compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center. METHODS: Patients treated for an AAA at a single center between January 2007 and December 2012 were retrospectively identified and classified based on the treatment that they received (EVAR or OSR). Patient demographics, and in hospital costs were recorded. Long-term survival was calculated using the Kaplan-Meier method...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772311/mid-term-outcomes-of-endovascular-aortic-aneurysm-repair-with-carbon-dioxide-guided-angiography
#9
Yuriko Takeuchi, Noriyasu Morikage, Yutaro Matsuno, Tamami Nakamura, Makoto Samura, Koshiro Ueda, Takasuke Harada, Yoshitaka Ikeda, Kotaro Suehiro, Hiroshi Ito, Kensuke Sakata, Kimikazu Hamano
BACKGROUND: Although iodinated contrast (IC) agents are commonly used in endovascular aneurysm repair (EVAR), perioperative use in patients with renal dysfunction or IC allergies is avoided. Carbon dioxide (CO2 )-guided angiography is a promising alternative. We aimed to evaluate short-term and mid-term outcomes of EVAR using CO2 -guided angiography. METHODS: Three hundred and eighty-one patients who underwent EVAR from January 2012 to September 2016 were retrospectively reviewed and divided into an IC-EVAR group (n=351) and CO2 -EVAR group (n=30)...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29771724/early-impact-of-medicare-accountable-care-organizations-on-inpatient-surgical-spending
#10
Hari Nathan, Jyothi R Thumma, Andrew M Ryan, Justin B Dimick
OBJECTIVE: To evaluate whether hospital participation in accountable care organizations (ACOs) is associated with reduced Medicare spending for inpatient surgery. BACKGROUND: ACOs have proliferated rapidly and now cover more than 32 million Americans. Medicare Shared Savings Program (MSSP) ACOs have shown modest success in reducing medical spending. Whether they have reduced surgical spending remains unknown. METHODS: We used 100% Medicare claims from 2010 to 2014 for patients aged 65 to 99 years undergoing 6 common elective surgical procedures [abdominal aortic aneurysm (AAA) repair, colectomy, coronary artery bypass grafting (CABG), hip or knee replacement, or lung resection]...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29770795/cytokines-as-biomarkers-of-inflammatory-response-after-open-versus-endovascular-repair-of-abdominal-aortic-aneurysms-a-systematic-review
#11
REVIEW
Diamantis I Tsilimigras, Fragiska Sigala, Georgios Karaolanis, Ioannis Ntanasis-Stathopoulos, Eleftherios Spartalis, Michael Spartalis, Nikolaos Patelis, Alexandros Papalampros, Chandler Long, Demetrios Moris
The repair of an abdominal aortic aneurysm (AAA) is a high-risk surgical procedure related to hormonal and metabolic stress-related response with an ensuing activation of the inflammatory cascade. In contrast to open repair (OR), endovascular aortic aneurysm repair (EVAR) seems to decrease the postoperative stress by offering less extensive incisions, dissection, and tissue manipulation. However, these beneficial effects may be offset by the release of cytokines and arachidonic acid metabolites during intra-luminal manipulation of the thrombus using catheters in endovascular repair, resulting in systemic inflammatory response (SIR), which is clinically called post-implantation syndrome...
May 17, 2018: Acta Pharmacologica Sinica
https://www.readbyqxmd.com/read/29767819/is-there-a-prospect-for-hybrid-aortic-arch-surgery
#12
REVIEW
Mohamad Bashir, Amer Harky, Haris Bilal
The surge of endovascular repair of aortic aneurysm in current modern aortic surgery practice has been the key for surgical management of elective cases of thoracic aortic aneurysms. This has paved way for the combined hybrid approach to be amongst the armamentarium for the management of aortic arch disease. The pivotal understanding of the aortic arch natural history coupled with device technology advancement allowed surgeons insight into delivery of hybrid surgery with acceptable morbidity and mortality results...
May 16, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29766010/single-stage-endovascular-treatment-of-a-penetrating-aortic-ulcer-with-a-concomitant-isolated-iliac-aneurysm
#13
Haidi Hu, Jianming Guo, Hualong Bai, Alan Dardik
Penetrating aortic ulcer (PAU) is an acute aortic syndrome that can proceed to life-threatening aortic dissection or even aortic rupture. Isolated iliac aneurysms are relatively rare and often asymptomatic due to their deep pelvic location but are frequently associated with high mortality with rupture. We report a case of a 68-year-old man with a symptomatic penetrating ulcer in the descending aorta and an asymptomatic right iliac aneurysm involving the common and internal iliac arteries. The patient was successfully treated by endovascular repair in a single-stage manner using stent grafts in the descending aorta and right common iliac artery after coil embolization of the right internal iliac artery...
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29766009/persistent-buttock-claudication-after-endovascular-abdominal-aortic-aneurysm-repair
#14
Alessandro Robaldo, Stefano Pagliari, Filippo Piaggio, Patrizio Colotto
We describe the successful surgical treatment of a 71-year-old man affected by right buttock claudication after a right internal iliac artery (IIA) coil embolization as an adjunct to endovascular iliac artery aneurysm repair. Computed tomography angiography revealed extensive aortoiliac calcifications and thrombus in the vessel walls. Despite patency of the contralateral IIA and preservation of right distal collateral flow through ipsilateral hypogastric branches, the symptom was persistent and disabling. The high-risk patient underwent an "open" repair of the infrarenal abdominal aneurysm with removal of the entire stent-graft and concomitant revascularization of the right IIA...
December 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29764709/influence-of-proximal-aortic-neck-diameter-on-durability-of-aneurysm-sealing-and-overall-survival-in-patients-undergoing-endovascular-aneurysm-repair-real-world-data-from-the-gore-global-registry-for-endovascular-aortic-treatment-great
#15
Dominic P J Howard, Conor D Marron, Ediri Sideso, Phillip J Puckridge, Eric L G Verhoeven, James I Spark
OBJECTIVES: Aortic neck diameter is an independent anatomical feature that is poorly understood, yet potentially linked to proximal seal failure and adverse outcome following standard EVAR. The aim of this study was to assess whether large proximal aortic neck (LAN) diameter is associated with adverse outcome using prospectively collected individual patient data from The Global Registry for Endovascular Aortic Treatment (GREAT). METHODS: A total of 3166 consecutive patients, from 78 global centres, receiving Gore Excluder stent grafts for infrarenal abdominal aortic aneurysm repair between 2011 and 2017 were included...
May 12, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29759039/common-femoral-artery-endarterectomy-in-the-age-of-endovascular-therapy
#16
Mohamed Elsherif, Wael Tawfick, Mohamed Elsharkawi, Ruth Campell, Niamh Hynes, Sherif Sultan
Objectives Common femoral artery endarterectomy (CFE) is the standard treatment for common femoral artery occlusive disease. We aim to assess the medium term outcomes of CFE with or without further concomitant procedures. Design A retrospective observational study. Methods All patients who underwent either isolated CFE (ICFE), CFE with angioplasty for occlusive arterial disease (CFEA) or concomitant CFE with endovascular aortic aneurysm repair (CFEE) were included. Patient demographics follow up, clinical improvement, types of CFE closure, patency rates, and survival-free amputation were noted...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29757367/successful-total-endovascular-repair-of-a-giant-salmonella-infected-painful-thoraco-abdominal-aortic-pseudoaneurysm
#17
Nellie Della Schiava, Matthieu Arsicot, Mathias Montveneur, Antoine Millon
Endovascular approach is now a safe and effective technique for the elective treatment of a thoraco-abdominal aneurysm. This technique has significantly reduced the morbi-mortality for elective surgery. Moreover, it can permit to treat patients with a high surgical risk who are not eligible for open surgery. The permanent availability of endovascular material opens the door for treating a complex emergency thoraco-abdominal aneurysm. Here, we present the case of an 81-year-old man who had a rapidly evolving salmonella-infected aortic thoraco-abdominal Type IV pseudoaneurysm...
May 10, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29755091/-coil-embolization-of-bronchial-artery-aneurysm-report-of-a-case
#18
Kenichi Hagiwara, Hiroshi Moriya, Yoshiyuki Sato
An 82-year-old male was admitted due to mild chest discomfort. Enhanced computed tomography showed a large bronchial artery aneurysm(BAA) of 26×27 mm at the left hilus. To avoid the rupture of BAA, coil embolization alone was performed. There has been no enlargement of BAA for these 4 years. In general, coil embolization only should be indicated in a patient with BAA with a stalk because of thoracic endovascular aortic repair (TEVAR) being off-label and low cost performance. TEVAR would be considered as a last resort only in case of enlarging BAA even after coil embolization...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755088/-hybrid-repair-of-distal-arch-aortic-aneurysm-total-aortic-arch-repair-with-the-lupiae-vascular-graft-and-thoracic-endovascular-aortic-repair-report-of-two-cases
#19
Nobu Yokoyama, Daigo Shinoda, Mitsunori Nakano, Manabu Shiraishi, Satoshi Itoh
Surgical treatment for distal arch aortic aneurysm is generally invasive, and there is no definitive approach for it. We report 2 cases of men who was admitted for the treatment of aortic aneurysm. First case is a 78-year-old man. Two saccular aneurysm were observed on distal aortic arch and descending aorta by contrast-enhanced computed tomography. Two staged-repair was performed with using the Lupiae vascular graft and thoracic endovascular aortic repair(TEVAR). The postoperative course was uneventful, and he was discharged on day 21 after 1st operation...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755086/-total-arch-replacement-with-concomitant-thoracic-endovascular-aortic-repair-via-the-ascending-aorta-for-extended-thoracic-aneurysm-report-of-a-case
#20
Yoshiki Endo, Yoshihito Irie, Kousuke Nishida, Tsuyoshi Fujimiya, Yoshiaki Katada
The patient was a 66 year-old male. Computed tomography (CT) angiography showed a huge aneurysm(120 mm) in the aortic arch and chronic type B aortic dissection(45 mm) in the descending aorta. Echocardiography showed patent ductus arteriosus( PDA). Because of pulmonary hypertension due to PDA, it was considered unacceptable to put him under general anesthesia twice. We performed thoracic endovascular aortic repair (TEVAR) via the ascending aorta and total arch replacement (TAR) simultaneously to prevent paraplegia...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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