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aortic aneurysm repair

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https://www.readbyqxmd.com/read/28928956/a-primer-on-infrarenal-abdominal-aortic-aneurysms
#1
REVIEW
Norman R Hertzer
Ruptured abdominal aortic aneurysms have an alarmingly high mortality rate that often exceeds 50%, even when patients survive long enough to be transported to hospitals. Historical data have shown that ruptures are especially likely to occur with aneurysms measuring ≥6 cm in diameter, but there are so many exceptions to this that several randomized clinical trials have been done in an attempt to determine whether smaller aneurysms should be repaired electively as soon as they are discovered. More recently, further trials have been conducted in order to compare the relative benefits and disadvantages of modern endovascular aneurysm repair to those of traditional open surgery...
2017: F1000Research
https://www.readbyqxmd.com/read/28927932/chitosan-doxycycline-hydrogel-an-mmp-inhibitor-sclerosing-embolizing-agent-as-a-new-approach-to-endoleak-prevention-and-treatment-after-endovascular-aneurysm-repair
#2
Fatemeh Zehtabi, Pompilia Ispas-Szabo, Djahida Djerir, Lojan Sivakumaran, Borhane Annabi, Gilles Soulez, Mircea Alexandru Mateescu, Sophie Lerouge
The success of endovascular repair of abdominal aortic aneurysms remains limited due to the development of endoleaks. Sac embolization has been proposed to manage endoleaks, but current embolizing materials are associated with frequent recurrence. An injectable agent that combines vascular occlusion and sclerosing properties has demonstrated promise for the treatment of endoleaks. Moreover, the inhibition of aneurysmal wall degradation via matrix metalloproteinases (MMPs) may further prevent aneurysm progression...
September 16, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28925817/using-multiple-classifiers-for-predicting-the-risk-of-endovascular-aortic-aneurysm-repair-re-intervention-through-hybrid-feature-selection
#3
Omneya Attallah, Alan Karthikesalingam, Peter Je Holt, Matthew M Thompson, Rob Sayers, Matthew J Bown, Eddie C Choke, Xianghong Ma
Feature selection is essential in medical area; however, its process becomes complicated with the presence of censoring which is the unique character of survival analysis. Most survival feature selection methods are based on Cox's proportional hazard model, though machine learning classifiers are preferred. They are less employed in survival analysis due to censoring which prevents them from directly being used to survival data. Among the few work that employed machine learning classifiers, partial logistic artificial neural network with auto-relevance determination is a well-known method that deals with censoring and perform feature selection for survival data...
September 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28922688/medium-term-outcomes-of-fenestrated-endovascular-repair-of-juxtarenal-abdominal-aortic-aneurysms
#4
Timothy P Shiraev, Trevor M Y Kwok, Steven R Dubenec
BACKGROUND: Abdominal aortic aneurysms pose a substantial clinical burden, and a significant proportion are not anatomically suitable for open repair or standard endovascular aneurysm repair (EVAR), instead requiring fenestrated EVAR (fEVAR). We sought to compare clinical outcomes and trends over time in patients undergoing fEVAR in Australia. METHODS: We conducted a retrospective analysis of all patients undergoing fEVAR at a tertiary referral centre between 2010 and 2015, including outcomes and complications, both as inpatients and after discharge...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28921013/spinal-cord-injury-as-a-complication-of-thoracic-endovascular-aneurysm-repair
#5
REVIEW
Taijiro Sueda, Shinya Takahashi
OBJECTIVE: Spinal cord ischemia (SCI) is a devastating complication of thoracic aortic aneurysm repair in the era of thoracic endovascular aneurysm repair (TEVAR). This review aims to clarify the causes of SCI during TEVAR and to propose ways that it may be prevented. METHODS AND RESULTS: We performed an extensive literature search of SCI during TEVAR. Based on the existing literature, we examined the anatomy of the anterior spinal cord artery, which supplies blood to the anterior aspect of the spinal cord, and discuss reported effective ways to prevent SCI during TEVAR, including augmentation of arterial blood pressure and drainage of cerebrospinal fluid...
September 18, 2017: Surgery Today
https://www.readbyqxmd.com/read/28920634/outcomes-analysis-of-stent-graft-repair-for-thoracic-aorta-emergencies
#6
Mourad Boufi, Florent Vernet, Bianca Dona, Olivier Hartung, Anderson D Loundou, Martine Haccoun, Marc Leone, Yves S Alimi
BACKGROUND: This study aimed to identify patient, pathology and procedure-related factors affecting perioperative and mid-term mortality of thoracic aorta emergencies. METHODS: Between 2007 and 2014, patients treated emergently with thoracic stent-graft were retrospectively reviewed. Variables analyzed were: age, renal insufficiency, shock, cardiac arrest, transfer status, pathology, debranching procedures, operation duration, vascular access and European System for Cardiac Operative Risk Evaluation (EuroSCORE)...
December 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28919708/alginate-oligosaccharide-indirectly-affects-toll-like-receptor-signaling-via-the-inhibition-of-microrna-29b-in-aneurysm-patients-after-endovascular-aortic-repair
#7
Yong Yang, Zhenhuan Ma, Guokai Yang, Jia Wan, Guojian Li, Lingjuan Du, Ping Lu
Endovascular aortic repair (EVAR) is often followed by aneurysm recurrence. Alginate oligosaccharide (AOS) has potential antitumor properties as a natural product while the related mechanisms remain unclear. Toll-like receptor (TLR) signaling is associated with inflammatory activity of aneurysm and may be affected by miR-29b. Thus, inhibitory function of AOS on aneurysms was explored by measuring the important molecules in TLR4 signaling. After EVAR, a total of 248 aortic aneurysm patients were recruited and randomly assigned into two groups: AOS group (AG, oral administration 10-mg AOS daily) and control group (CG, placebo daily)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28919522/the-incidence-of-ischemic-colitis-after-repair-of-ruptured-abdominal-aortic-aneurysms-is-decreasing-in-the-endovascular-era
#8
S K Desikan, N Singh, S R Steele, N Tran, E Quiroga, P Danaher, B T Garland, B W Starnes
OBJECTIVE: Ischemic colitis (IC) is a well-described complication of ruptured abdominal aortic aneurysms (rAAA). The purpose of this study was to compare the incidence of IC in patients with rAAA undergoing open (OR) vs. endovascular aneurysm repair (EVAR) at a single institution. In addition, we analyzed the incidence of ischemic colitis pre- and post- implementation of a formal rupture AAA protocol (rEVAR protocol). METHODS: A retrospective analysis of prospectively collected data on all patients presenting with rAAA to our institution between Jan 2002 and Oct 2013 was performed...
September 14, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28914135/hemodynamic-and-anatomic-predictors-of-renovisceral-stent-graft-occlusion-following-chimney-endovascular-repair-of-juxtarenal-aortic-aneurysms
#9
Rosamaria Tricarico, Yong He, Liza Laquian, Salvatore T Scali, Roger Tran-Son-Tay, Adam W Beck, Scott A Berceli
PURPOSE: To identify anatomic and hemodynamic changes associated with impending visceral chimney stent-graft occlusion after endovascular aneurysm repair (EVAR) with the chimney technique (chEVAR). METHODS: A retrospective evaluation was performed of computed tomography scans from 41 patients who underwent juxtarenal chEVAR from 2008 to 2012 to identify stent-grafts demonstrating conformational changes following initial placement. Six subjects (mean age 74 years; 3 men) were selected for detailed reconstruction and computational hemodynamic analysis; 4 had at least 1 occluded chimney stent-graft...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28913787/mortality-rates-and-risk-factors-for-emergent-open-repair-of-abdominal-aortic-aneurysms-in-the-endovascular-era
#10
Felice Pecoraro, Steffen Gloekler, Caecilia E Mader, Malgorzata Roos, Lyubov Chaykovska, Frank J Veith, Neal S Cayne, Nicola Mangialardi, Thomas Neff, Mario Lachat
The background of this paper is to report the mortality at 30 and 90 days and at mean follow-up after open abdominal aortic aneurysms (AAA) emergent repair and to identify predictive risk factors for 30- and 90-day mortality. Between 1997 and 2002, 104 patients underwent emergent AAA open surgery. Symptomatic and ruptured AAAs were observed, respectively, in 21 and 79% of cases. Mean patient age was 70 (SD 9.2) years. Mean aneurysm maximal diameter was 7.4 (SD 1.6) cm. Primary endpoints were 30- and 90-day mortality...
September 14, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28912007/adventitial-adipogenic-degeneration-is-an-unidentified-contributor-to-aortic-wall-weakening-in-the-abdominal-aortic-aneurysm
#11
Stefan A Doderer, Gabor Gäbel, Vivianne B C Kokje, Bernd H Northoff, Lesca M Holdt, Jaap F Hamming, Jan H N Lindeman
OBJECTIVE: The processes driving human abdominal aortic aneurysm (AAA) progression are not fully understood. Although antiinflammatory and proteolytic strategies effectively quench aneurysm progression in preclinical models, so far all clinical interventions failed. These observations hint at an incomplete understanding of the processes involved in AAA progression and rupture. Interestingly, strong clinical and molecular associations exist between popliteal artery aneurysms (PAAs) and AAAs; however, PAAs have an extremely low propensity to rupture...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28912006/predictors-of-late-aortic-intervention-in-patients-with-medically-treated-type-b-aortic-dissection
#12
Samuel I Schwartz, Christopher Durham, W Darrin Clouse, Virendra I Patel, R Todd Lancaster, Richard P Cambria, Mark F Conrad
BACKGROUND: Patients with medically managed type B aortic dissection (TBAD) have a high incidence of aorta-related complications over time. Whereas early thoracic endovascular aortic repair (TEVAR) to seal the entry tear can promote aortic remodeling and prevent late aneurysm formation, there are sparse data as to which patients will benefit from such therapy. The goal of this study was to identify clinical and anatomic factors that are associated with the need for subsequent aortic intervention in patients who present with uncomplicated TBAD...
September 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28905268/fluid-and-biomechanical-analysis-of-ascending-thoracic-aorta-aneurysm-with-concomitant-aortic-insufficiency
#13
F Condemi, S Campisi, M Viallon, T Troalen, G Xuexin, A J Barker, M Markl, P Croisille, O Trabelsi, C Cavinato, A Duprey, S Avril
We present a comprehensive and original framework for the biomechanical analysis of patients affected by ascending thoracic aorta aneurysm and aortic insufficiency. Our aim is to obtain crucial indications about the role played by deranged hemodynamics on the ATAAs risk of rupture. Computational fluid dynamics analysis was performed using patient-specific geometries and boundary conditions derived from 4D MRI. Blood flow helicity and wall shear stress descriptors were assessed. A bulge inflation test was carried out in vitro on the 4 ATAAs after surgical repair...
September 13, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28902826/-treatment-of-type-ib-endoleak-after-endoprosthetic-repair-of-infrarenal-aneurysm
#14
A A Karpenko, P V Ignatenko, I V Popova
The article deals with a case report regarding successful surgical management of late type IB endoleak caused by dislocation of the leg of the stent graft, occurring three years after endoprosthetic repair of an aneurysm of the aortic infrarenal portion with the COOK stent graft, aneurysmectomy with prosthetic repair of the right common femoral artery using the linear vascular graft Intergard 8Ч20. The patient underwent surgical treatment: endoprosthetic repair of the iliac branch ZSLE-24-90-90 ZT of the Zenith Spiral AAA stent graft...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28899569/on-the-influence-of-wall-calcification-and-intraluminal-thrombus-on-prediction-of-abdominal-aortic-aneurysm-rupture
#15
Hilary E Barrett, Eoghan M Cunnane, Hena Hidayat, Julie M O'Brien, Michael A Moloney, Eamon G Kavanagh, Michael T Walsh
OBJECTIVE: Parameters other than maximum diameter that predict rupture of abdominal aortic aneurysms (AAAs) may be helpful for risk-benefit analysis in individual patients. The aim of this study was to characterize the biomechanical-structural characteristics associated with AAA walls to better identify the related mechanistic variables required for an accurate prediction of rupture risk. METHODS: Anterior AAA wall (n = 40) and intraluminal thrombus (ILT; n = 114) samples were acquired from 18 patients undergoing open surgical repair...
September 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28899568/long-term-survival-after-acute-kidney-injury-following-ruptured-abdominal-aortic-aneurysm-repair
#16
Hamid Jalalzadeh, Reza Indrakusuma, Liffert Vogt, Sytse C van Beek, Anco C Vahl, Willem Wisselink, Mark J W Koelemay, Ron Balm
OBJECTIVE: Acute kidney injury (AKI) is a major complication of ruptured abdominal aortic aneurysm (RAAA). Severe AKI is associated with high morbidity and mortality in the short term. The objective of this study was to determine the association between AKI after RAAA repair and long-term survival. METHODS: We conducted a retrospective cohort study of all patients undergoing RAAA repair in three hospitals between 2004 and 2011. Outcomes were long-term survival after RAAA repair, incidence of postoperative AKI, and chronic dialysis rates...
September 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28895448/anatomical-applicability-of-endovascular-aneurysm-sealing-techniques-in-a-consecutive-cohort-of-fenestrated-endovascular-aneurysm-repairs
#17
Iain N Roy, Menatalla Gharib, Sebastian Zerwes, Rudolf Jakob, Francesco Torella, Richard G McWilliams, Robert K Fisher
PURPOSE: To determine how many endovascular aneurysm sealing (EVAS) procedures with/without off-label use of chimneys (ChEVAS) could have been performed in a cohort of patients who had undergone fenestrated endovascular aneurysm repair (FEVAR). METHODS: Sixty patients (median age 76.3 years; 54 men) who underwent FEVAR in our institution between 2013 and 2015 were selected for the study. The median aneurysm diameter was 62.0 mm (interquartile range 59.3, 69.0). Preoperative computed tomography angiograms (CTA) were anonymized and sent to 2 physicians with experience of more than 40 ChEVAS interventions...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28895367/is-management-of-complex-abdominal-aortic-aneurysms-consistent-across-the-uk-a-questionnaire-based-survey
#18
Eleanor Atkins, Ranjeet Narlawar, Francesco Torella, George A Antoniou
BACKGROUND: Our objective was to quantify variability across the UK in the management of a complex abdominal aortic aneurysm (AAA). METHODS: An online survey was emailed to all members of the Vascular Society for Great Britain and Ireland. The survey presented a vignette of a 63-year-old woman with significant respiratory co-morbidity whose computed tomographic (CT) angiogram demonstrated a 54 mm AAA with a short (7 mm) proximal neck but no other adverse morphological features for a standard or complex endovascular aneurysm repair (EVAR)...
September 11, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28894058/-ruptured-aneurysm-of-the-sinus-of-valsalva-accompanied-with-a-bicuspid-aortic-valve-in-an-elderly-man-report-of-a-case
#19
Toshifumi Murase, Susumu Tamura, Yasuhiro Ohzeki, Kunio Ebine
The combination of ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve is very rare in an elderly person. A 71-year-old man with ruptured aneurysm of the sinus of Valsalva and a bicuspid aortic valve had undergone an operation. He was admitted to his other hospital because of heart failure. He was transferred to our hospital to undergo treatment for ruptured aneurysm of sinus of Valsalva. At our hospital, echocardiography findings showed ruptured aneurysm of the sinus of Valsalva, a ventricular septal defect (VSD), and severe aortic regurgitation with moderate stenosis of the bicuspid aortic valve...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28893704/late-complication-after-thoracic-endovascular-aortic-repair-what-is-a-role-of-an-open-surgical-conversion
#20
Lazar Davidovic, Milos Sladojevic, Igor Koncar, Miroslav Markovic, Tulga Ulus, Nikola Ilic, Marko Dragas, Vladimir Cvetic, Zoran Rancic
BACKGROUND: We would like to evaluate causes of Thoracic Endovascular Aortic Repair (TEVAR) failure and conversion to open surgery (COS) in high volume vascular center for open surgery, with low volume TEVAR procedures. METHODS: A total of 8 patients (6 males, mean aged 55.14 years) underwent COS after TEVAR. The indications for conversion to open surgery, intraoperative strategy, as well as early postoperative and mid follow-up results were analyzed. RESULTS: The indications for COS were persistent proximal type I endoleak with progressive aneurysm enlargement in two patients, endoleak type III in one patient, progressive aneurysm enlargement with no endoleak in one patient, stent graft migration in two patients, secondary aorto-esophageal fistula in one patient, secondary aorto-esophageal and aorto-bronchial fistula in one patient, as well as distal progression of the aneurysmal disease in 2 patient...
September 8, 2017: Annals of Vascular Surgery
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