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aortic aneurysm repair

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https://www.readbyqxmd.com/read/29165630/an-eight-branched-aortic-graft-for-reconstruction-of-visceral-and-intercostal-arteries-during-extent-ii-thoraco-abdominal-aortic-surgery
#1
Sung Jun Park, Joon Bum Kim
Reconstruction of the visceral and intercostal arteries is the most challenging part in the open repair of thoraco-abdominal aortic aneurysm. For efficient and expeditious reconstruction of these branching vessels, a technique of using a pre-handsewn 8-branch aortic graft (octopod technique) has been adopted. The octopod graft was manually constructed using commercially available two 4-branch aortic grafts that were spatially oriented based on the preoperative computed tomographic images and connected each other prior to surgery...
November 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29162027/nonenhanced-mri-planning-for-endovascular-repair-of-abdominal-aortic-aneurysms-comparison-with-contrast-enhanced-ct-angiography
#2
Filippo Piacentino, Federico Fontana, Camilla Micieli, Maria G Angeretti, Larissa Nocchi Cardim, Andrea Coppola, Valeria Molinelli, Gabriele Piffaretti, Raffaele Novario, Carlo Fugazzola
BACKGROUND: To assess whether noncontrast-enhanced magnetic resonance imaging (NC-MRI) is an alternative to contrast-enhanced computed tomography angiography (CTA) for aortoiliac measurements before endovascular abdominal aortic aneurysm repair (EVAR). METHODS: This study encompasses 30 patients admitted for elective EVAR (27 men and 3 women). Two expert readers (vascular radiologist and vascular surgeon) reviewed CTA images in consensus and chose the proper endograft for each patient...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29162025/atypical-endoleak-associated-with-inadvertent-cannulation-of-the-ipsilateral-gate-in-an-ovation-trimodular-stent-graft
#3
Geert Maleux, Sabrina Houthoofd, Lien Poorteman, Inge Fourneau
We report on a 54-year-old man who presented with an atypical, proximal, intraoperative endoleak after endovascular aortic repair with an Ovation endograft for a 65-mm-diameter abdominal aortic aneurysm. The endografting was complicated by inadvertent bilateral iliac limb insertion into the right gate without cannulation of the left gate. The endoleak was treated by brachial approach: Through the open left gate, the outflow inferior mesenteric artery was coil embolized and the inflow left gate was closed with an Amplatzer plug...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29162024/modern-fixed-imaging-systems-reduce-radiation-exposure-to-patients-and-providers
#4
Lars Stangenberg, Fahad Shuja, I Martijn J van der Bom, Martine H G van Alfen, Allen D Hamdan, Mark C Wyers, Raul J Guzman, Marc L Schermerhorn
High-definition fluoroscopic imaging is required to perform endovascular procedures safely and precisely, especially in complex cases, resulting in longer procedures and increased radiation exposure. This is of importance for training institutions as trainees, even with sound instruction in as low as reasonably achievable (ALARA) principles, tend to have high radiation exposures. Recently, there was an upgrade in the imaging system allowing for comparison of radiation exposure to patients and providers. We performed an analysis of consecutive endovascular aneurysm repair (EVAR) and superficial femoral artery (SFA) interventions in the years 2013 to 2014...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29161449/endovascular-repair-for-three-channelled-aortic-dissection
#5
Tomokuni Furukawa, Naomichi Uchida, Yoshitaka Yamane
Surgical repair of extensive thoracic aortic disease induced by repeated aortic dissection is challenging due to its invasive nature in some cases. We report a rare case of successful endovascular repair of a dissected 3-channelled thoracic aortic aneurysm using the PETTICOAT (provisional extension to induce complete attachment) technique and false-lumen embolization (the candy-plug technique). The PETTICOAT technique improved visceral flow, and the false lumen of the aneurysm was completely thrombosed by the candy-plug technique...
November 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29161397/abdominal-aortic-aneurysm-repair-in-the-united-kingdom-an-exemplar-for-the-role-of-anaesthetists-in-perioperative-medicine
#6
S J Howell
The past two decades have seen an increasing recognition that the delivery of safe surgery with low complication rates and good long-term outcomes is a team endeavour embracing the whole patient care pathway. The key role of the anaesthetist in managing the patient through the surgical process is widely understood and has driven the emergence of perioperative medicine. In parallel with these developments there has been a sea change in the organisation of the care of patients presenting for elective abdominal aortic aneurysm (AAA) repair...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159573/low-baseline-and-subsequent-higher-aortic-abdominal-aneurysm-fdg-uptake-are-associated-with-poor-sac-shrinkage-post-endovascular-repair
#7
Pierre-Yves Marie, Didier Plissonnier, Stéphanie Bravetti, Raphael Coscas, Martin Rouer, Stéphan Haulon, Damien Mandry, Jean-Marc Alsac, Sergueï Malikov, Nicla Settembre, Yann Gouëffic, Olivier Morel, Véronique Roch, Emilien Micard, Zohra Lamiral, Jean-Baptiste Michel, Patrick Rossignol
PURPOSE: The growth phases of medically treated abdominal aortic aneurysms (AAA) are frequently associated with an (18)F-fluorodesoxyglucose positron emission tomography (FDG-PET) pattern involving low baseline and subsequent higher FDG uptake. However, the FDG-PET patterns associated with the endovascular aneurysm repair (EVAR) of larger AAA are presently unknown. This study aimed to investigate the relationship between serial AAA FDG uptake measurements, obtained before EVAR and 1 and 6 months post-intervention and subsequent sac shrinkage at 6 months, a well-recognized indicator of successful repair...
November 21, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29158067/psoas-muscle-area-as-a-prognostic-factor-for-survival-in-patients-with-an-asymptomatic-infrarenal-abdominal-aortic-aneurysm-a-retrospective-cohort-study
#8
Reza Indrakusuma, Jendé L Zijlmans, Hamid Jalalzadeh, R Nils Planken, Ron Balm, Mark J W Koelemay
OBJECTIVES: Loss of muscle mass has been associated with poor survival in several surgical patient populations, including those with an abdominal aortic aneurysm (AAA). We wanted to replicate these findings and assesse the association between psoas muscle area (PMA) and survival in patients with an asymptomatic AAA. METHODS: Patients with an asymptomatic infrarenal AAA who underwent computed tomography (CT) scanning between January 1, 2007, and December 31, 2013, were included in this single-centre retrospective cohort study...
November 17, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29157740/unplanned-readmissions-after-open-thoracoabdominal-aortic-aneurysm-repair
#9
Darrell Wu, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Sandra J Woodside, Adam Tullos, Qianzi Zhang, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Although reducing the incidence of unplanned readmission after thoracoabdominal aortic aneurysm (TAAA) repair represents an important opportunity to improve outcomes, predictors of readmissions are not known. We sought to characterize and identify factors associated with unplanned readmission after discharge in survivors of open TAAA repair. METHODS: Through prospective phone contact and retrospective record review, we determined the frequency and characteristics of unplanned readmissions within 30 days of discharge in 363 patients who were discharged after open TAAA repair...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29157682/outcomes-of-thoracic-endovascular-aortic-repair-for-chronic-aortic-dissections
#10
Allan M Conway, Khalil Qato, Laurie R Mondry, Guillaume J Stoffels, Gary Giangola, Alfio Carroccio
BACKGROUND: Open surgical repair remains the "gold standard" treatment for chronic type B aortic dissection (cTBD) with aneurysm. Thoracic endovascular aortic repair (TEVAR) has gained popularity in recent years for the treatment of thoracic aortic diseases, including cTBD. We assessed the effectiveness of TEVAR in the treatment of cTBD using the Vascular Quality Initiative (VQI) database. METHODS: The VQI registry identified 4713 patients treated with TEVAR from July 2010 to November 2015, including 125 repairs for cTBD...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29156021/type-1a-endoleak-following-zone-1-and-zone-2-thoracic-endovascular-aortic-repair-effect-of-bird-beak-configuration
#11
Tomoaki Kudo, Toru Kuratani, Kazuo Shimamura, Tomohiko Sakamoto, Keiwa Kin, Kenta Masada, Takayuki Shijo, Kei Torikai, Koichi Maeda, Yoshiki Sawa
OBJECTIVES: Type 1a endoleak is one of the most severe complications after thoracic endovascular aortic repair (TEVAR), because it carries the risk of aortic rupture. The association between bird-beak configuration and Type 1a endoleak remains unclear. The purpose of this study was to analyse the predictors of Type 1a endoleak following Zone 1 and Zone 2 TEVAR, with a particular focus on the effect of bird-beak configuration. METHODS: From April 2008 to July 2015, 105 patients (mean age 68...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155940/stented-balloon-fenestration-before-entry-repair-using-the-frozen-elephant-trunk-technique-for-chronic-aortic-dissection
#12
Naomichi Uchida, Yoshitaka Yamane, Tomokuni Furukawa
Endovascular fenestration on the abdominal aorta is effective for preventing visceral malperfusion in aortic dissection. We report a case of stented balloon fenestration before residual entry repair using the frozen elephant trunk technique for chronic aneurysmal dissection after ascending aortic replacement for DeBakey I aortic dissection. We recognized poor communication between the true lumen and false lumen in the abdominal aorta, and visceral perfusion depended almost entirely on the proximal large entry...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155935/early-and-late-outcomes-of-open-repair-for-dissecting-aneurysms-of-the-descending-or-thoraco-abdominal-aorta
#13
Atsushi Omura, Kenji Minatoya, Jiro Matsuo, Yosuke Inoue, Yoshimasa Seike, Kyokun Uehara, Hiroaki Sasaki, Hitoshi Matsuda, Junjiro Kobayashi
OBJECTIVES: Although open repair is the standard surgical option for dissecting descending thoracic aneurysms (DTAs) and thoraco-abdominal aorta aneurysms (TAAAs), it remains a significant challenge with considerable perioperative morbidity and mortality. We retrospectively analysed early and late outcomes of open repair for these aortic aneurysms. METHODS: Early and late outcomes were investigated for 223 consecutive patients who underwent open repair for dissecting DTA or TAAA between January 2003 and December 2014 (mean age 55 ± 16 years)...
October 9, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29155740/creation-of-a-rodent-model-of-abdominal-aortic-aneurysm-by-blocking-adventitial-vasa-vasorum-perfusion
#14
Hiroki Tanaka, Naoki Unno, Tatsuro Yata, Hirona Kugo, Nobuhiro Zaima, Takeshi Sasaki, Tetsumei Urano
The adventitial vasa vasorum (VV) provides oxygen and nourishment to the aortic wall. Hypoxia in the aortic wall can cause enlarged abdominal aortic aneurysms (AAAs). This article introduces and describes a standard protocol used to induce AAAs through adventitial VV hypoperfusion created with a combination of polyurethane catheter insertion into the aortic lumen and suture ligation of the infrarenal abdominal aorta. The protocol involves the use of male rats weighing 300-400 g, which are provided food and water ad libitum...
November 8, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29153807/thoracic-endovascular-aortic-repair-using-vascular-plug-for-chronic-type-iiib-aortic-dissection
#15
Up Huh, Seunghwan Song, Eunji Kim, Chang Won Kim
A 72-year-old man previously treated for an abdominal aortic aneurysm (AAA) was diagnosed with the 70-mm-sized type IIIb aortic dissection. Endovascular repair was considered, but there was no stent graft passing through the 8-mm iliac graft that was used for open repair of the AAA. We sealed the 5-mm-sized intimal tear site, using an Amplatzer Vascular Plug, which successfully repaired. The patient was discharged and had no complications. Serial follow-up computerized tomography scans showed that the vascular plug was positioned without migration, and the size of the aorta decreased...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29153534/configuration-affects-parallel-stent-grafting-results
#16
Adam Tanious, Mathew Wooster, Paul A Armstrong, Bruce Zwiebel, Shane Grundy, Martin R Back, Murray L Shames
OBJECTIVE: A number of adjunctive "off-the-shelf" procedures have been described to treat complex aortic diseases. Our goal was to evaluate parallel stent graft configurations and to determine an optimal formula for these procedures. METHODS: This is a retrospective review of all patients at a single medical center treated with parallel stent grafts from January 2010 to September 2015. Outcomes were evaluated on the basis of parallel graft orientation, type, and main body device...
November 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29153441/complex-endovascular-repair-of-postdissection-arch-and-thoracoabdominal-aneurysms
#17
Rafaëlle Spear, Adrien Hertault, Katrien Van Calster, Nicla Settembre, Matthieu Delloye, Richard Azzaoui, Jonathan Sobocinski, Dominique Fabre, Mark Tyrrell, Stéphan Haulon
OBJECTIVE: We report our experience of the treatment of postdissection arch aneurysms and thoracoabdominal aortic aneurysms (TAAAs) by endovascular repair using fenestrated and branched endografts. METHODS: This study includes all patients presenting with chronic postdissection aneurysms >55 mm in diameter deemed unfit for open surgery and treated by complex endografting between October 2011 and April 2017. Where appropriate, staged management strategies including left subclavian artery revascularization, thoracic endografting, dissection flap fenestration, and tear enlargement were performed before the complex endovascular repair...
November 15, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29152514/open-thoracoabdominal-aortic-aneurysm-repair-in-expert-hands-all-roads-lead-to-rome
#18
EDITORIAL
Giacomo Murana, Jacopo Alfonsi, Luca Di Marco, Davide Pacini
No abstract text is available yet for this article.
October 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29149960/real-renal-function-after-renal-autotransplantation-through-the-analysis-of-solitary-kidney-autotransplantation-cases
#19
J G Gwon, Y H Kim, D J Han
INTRODUCTION: Previous studies of the safety of renal autotransplantation (RAT) have been limited by a lack of evidence. Because of the influence of the opposite kidney, it is difficult to evaluate actual renal function. This study evaluated the actual results of RAT by collecting only cases involving a solitary kidney. METHODS: Between September 1, 1999, and November 30, 2015, 9 RAT procedures were performed in 9 patients with a solitary kidney. We retrospectively evaluated medical data collected prospectively...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149818/renal-dysfunction-following-elective-endovascular-aortic-aneurysm-repair
#20
Esma Isenovic, Djodje Radak, Mihailo Neskovic, Petar Otasevic
Abdominal aortic aneurysm (AAA) is a degenerative disease of the aortic wall with potentially fatal complications. Open repair (OR) was considered the gold standard, until the emergence of endovascular aneurysm repair (EVAR), which is less invasive and equally (if not more) effective. As the popularity of endovascular procedures grows, related complications become more evident, with kidney damage being one of them. Although acute kidney injury (AKI) following EVAR is relatively common, its true incidence is still uncertain...
November 16, 2017: Current Vascular Pharmacology
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