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Renal artery reconstruction

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https://www.readbyqxmd.com/read/28914135/hemodynamic-and-anatomic-predictors-of-renovisceral-stent-graft-occlusion-following-chimney-endovascular-repair-of-juxtarenal-aortic-aneurysms
#1
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/28893708/ex-vivo-reconstruction-and-autotransplantation-for-hilar-renal-artery-aneurysms-in-patients-with-congenital-anomalies
#2
Jaiyeola Adeyemi, Jacob Johnson, Yevgeniy Rits, A George Akingba, Jeffrey Rubin
Renal artery aneurysms (RAAs) are an uncommon finding but are more often associated with other congenital disorders. The complex (hilar) RAAs constitute a subset of RAAs that present a therapeutic dilemma for the vascular surgeon; because of their anatomic location. This dilemma worsens when hilar RAAs occur with a solitary kidney where organ preservation is vital. Ex-vivo reconstruction with autotransplantation is especially suitable for hilar RAAs, even when they are associated with a solitary kidney. We report two of such cases of RAA's with a solitary kidney in patients with pertinent congenital anomalies...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28888094/low-dose-scanning-technology-combined-with-low-concentration-contrast-material-in-renal-computed-tomography-angiography-cta-a-preliminary-study
#3
Sulan Liu, Wei Li, Hao Shi, Huaqiang Sheng, Jingli Fan, Jingzhen He, Hongjun Sun
BACKGROUND This study is to investigate the feasibility of low iodine concentration contrast material (CM) combined with low tube voltage and adaptive statistical iterative reconstruction (ASIR) in renal computed tomography angiography (CTA). MATERIAL AND METHODS A total of 136 patients were enrolled in this prospective trial, and randomly divided into two groups: group A (n=68) and group B (n=68). Group A received 120-kVp and iopromide (370 mg/mL) with filtered back projection (FBP) reconstruction, and group B received 100-kVp and iodixanol (270 mg/mL) with ASIR 40% (ASIR40)...
September 9, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28814170/a-novel-reverse-branch-technique-for-reconstruction-of-a-renal-artery-perfused-by-the-false-lumen-after-thoracic-endovascular-aortic-repair
#4
Jie Jin, Jun Bai, Yongfa Wu, Kangkang Zhi, Xiaomin Wang, Xingzhu Wen, Jianjin Wu, Lefeng Qu
PURPOSE: To describe an innovative endovascular technique that successfully reconstructs a renal artery completely perfused by the false lumen after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 65-year-old patient diagnosed with acute Stanford type B aortic dissection underwent successful TEVAR 4 years ago. Regular follow-up found that the thoracic aorta was well repaired, but the false lumen in the abdominal aorta had enlarged year by year. The left renal artery was supplied entirely by the false lumen, which caused kidney hypoperfusion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28761593/case-series-transplantation-of-kidneys-from-donors-with-renal-artery-aneurysm
#5
Mahmoud Alameddine, Zhobin Moghadamyeghaneh, Giselle Guerra, Mahmoud Morsi, Mohammed Osman, V J Chia, George W Burke, Linda Chen, Rodrigo Vianna, Ian Zheng, Javier González, Gaetano Ciancio
INTRODUCTION: With the present disparity between organ availability and recipient demands, we reported our experience in transplanting kidneys with renal artery aneurysm after back-table reconstruction. METHODS: Four patients were identified. The repair consisted of excision of the aneurysm with ostial closure, and for one of the cases, an ovarian vein patch was used. We reviewed the safety and outcomes of this procedure. All donors were asymptomatic before surgery and were diagnosed incidentally during living donor evaluation...
July 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28723230/retrograde-endourological-management-of-upper-urinary-tract-abnormalities-in-patients-with-ileal-conduit-urinary-diversion-a-dual-center-experience
#6
Louise Olson, Hywel Satherley, Paul Cleaveland, Bachar Zelhof, Max Mokete, Donald Neilson, Shalom Srirangam
INTRODUCTION: Patients with ileal conduit urinary diversions are at an increased risk of long-term upper urinary tract (UUT) complications, including anastomotic strictures, infections, and urolithiasis. The reconstructed urinary system poses challenges for endoscopic manipulation. We present and describe our dual-center experience in performing retrograde ureteroscopy to treat or diagnose UUT abnormalities in patients with ileal conduit incontinent diversion. PATIENT AND METHODS: We performed a retrospective analysis of medical records for all patients with previous urinary diversion who underwent retrograde ureteroscopic procedures via the ileal loop in our institutions over a 9 year period (between June 2007 and August 2016)...
July 19, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28691001/hand-assisted-laparoscopic-nephrectomy-and-auto-transplantation-for-a-hilar-renal-artery-aneurysm-a-case-report
#7
Min Jung Kim, Kyo Won Lee, Jae Berm Park, Sung Joo Kim
A 52-year-old man was admitted with an incidentally detected right renal artery aneurysm (RAA). Computed tomographic angiography with three-dimensional reconstruction revealed that the aneurysm was 2.2 cm in diameter and located at the renal hilum. We performed hand-assisted laparoscopic nephrectomy with ex vivo repair of the RAA and auto-transplantation with minimal elongation of Gibson incision. The operation and postoperative course were uneventful. At last follow-up, the patient was alive with a well-functioning auto-transplant...
June 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28689482/a-semiautomated-method-for-measuring-the-3-dimensional-fabric-to-renal-artery-distances-to-determine-endograft-position-after-endovascular-aneurysm-repair
#8
Richte C L Schuurmann, Simon P Overeem, Kenneth Ouriel, Cornelis H Slump, William D Jordan, Bart E Muhs, Jean-Paul P M de Vries
PURPOSE: To report a methodology for 3-dimensional (3D) assessment of the stent-graft deployment accuracy after endovascular aneurysm repair (EVAR). METHODS: A methodology was developed and validated to calculate the 3D distances between the endograft fabric and the renal arteries over the curve of the aorta. The shortest distance between one of the renal arteries and the fabric (SFD) and the distance from the contralateral renal artery to the fabric (CFD) were determined on the first postoperative computed tomography (CT) scan of 81 elective EVAR patients...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28673448/renovascular-ct-comparison-between-adaptive-statistical-iterative-reconstruction-and-model-based-iterative-reconstruction
#9
COMPARATIVE STUDY
Y Noda, S Goshima, H Koyasu, S Shigeyama, T Miyoshi, H Kawada, N Kawai, M Matsuo
AIM: To compare contrast enhancement and image quality between renovascular computed tomography (CT) images with adaptive statistical iterative reconstruction (ASiR) and that with model-based iterative reconstruction (MBIR). MATERIAL AND METHODS: This retrospective study was approved by the institutional review board and written informed consent was waived. Twenty-five consecutive patients who underwent renovascular CT were enrolled in this study. The same raw projection data were reconstructed using ASiR 40%, 100%, and MBIR...
October 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28654057/murine-aortic-crush-injury-an-efficient-in-vivo-model-of-smooth-muscle-cell-proliferation-and-endothelial-function
#10
Dan Yu, George Makkar, Rajabrata Sarkar, Dudley K Strickland, Thomas S Monahan
Arterial reconstruction, whether angioplasty or bypass surgery, involves iatrogenic trauma causing endothelial disruption and vascular smooth muscle cell (VSMC) proliferation. Common murine models study small vessels such as the carotid and femoral arteries. Herein we describe an in vivo system in which both VSMC proliferation and endothelial barrier function can be simultaneously assessed in a large vessel. We studied the infrarenal aortic response to injury in C57BL/6 mice. The aorta was injured from the left renal vein to the aortic bifurcation by 30 transmural crushes of 5-seconds duration with a cotton-tipped applicator...
June 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28648481/outcomes-of-concomitant-renal-reconstruction-during-open-paravisceral-aortic-aneurysm-repair
#11
Mathew Wooster, Martin Back, Shivangi Patel, Adam Tanious, Paul Armstrong, Murray Shames
OBJECTIVE: The objective of this study was to review the outcomes of renal artery revascularizations during open aortic aneurysm repair. METHODS: Open abdominal aneurysm repairs performed from 2010 to 2015 at a single institution were reviewed, including type IV thoracoabdominal, suprarenal, and juxtarenal aneurysms. Direct renal reconstruction techniques included eversion endarterectomy, bypass, and vessel reimplantation based on the patient's anatomy. Renal loss was defined by artery occlusion...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648480/a-10-year-institutional-experience-with-open-branched-graft-reconstruction-of-aortic-aneurysms-in-connective-tissue-disorders-versus-degenerative-disease
#12
Caitlin W Hicks, Jennifer Lue, Natalia O Glebova, Bryan A Ehlert, James H Black
OBJECTIVE: Aortic reconstruction for complex thoracoabdominal aortic aneurysms (TAAAs) can be challenging, especially in patients with connective tissue disorders (CTDs) in whom tissue fragility is a major concern. Branched graft reconstruction is a more complex operation compared with inclusion patch repair of the aorta but is frequently necessary in patients with CTDs or other pathologies because of anatomic reasons. We describe our institutional experience with open branched graft reconstruction of aortic aneurysms and compare outcomes for patients with CTDs vs degenerative pathologies...
June 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#13
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28573100/vascular-augmentation-in-renal-transplantation-supercharging-and-turbocharging
#14
Euicheol C Jeong, Seung Hwan Hwang, Su Rak Eo
The most common anatomic variant seen in donor kidneys for renal transplantation is the presence of multiple renal arteries, which can cause an increased risk of complications. Accessory renal arteries should be anastomosed to the proper source arteries to improve renal perfusion via the appropriate vascular reconstruction techniques. In microsurgery, 2 kinds of vascular augmentation methods, known as 'supercharging' and 'turbocharging,' have been introduced to ensure vascular perfusion in the transferred flap...
May 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28507439/infrainguinal-open-reconstruction-a-review-of-surgical-considerations-and-expected-outcomes
#15
REVIEW
Sevan R Komshian, Kimberly Lu, Steven L Pike, Jeffrey J Siracuse
Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0-5...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28457423/mycotic-pseudoaneurysm-after-kidney-transplantation-two-case-reports
#16
A Ministro, T Ferreira, L Batista, A Santana, N Alves, J Guerra, J Fernandes E Fernandes
BACKGROUND: Vascular complications after kidney transplantation may cause allograft loss. Here, we describe 2 patients with extrarenal mycotic pseudoaneurysm after kidney transplantation. PATIENTS: Patient 1 was a 54-year-old man who developed pseudoaneurysm 60 days after transplantation, and patient 2 was a 48-year-old woman who was diagnosed with a pseudoaneurysm 5 months after transplantation. RESULTS: Patient 1 had a deceased-donor kidney transplant with end-to-side external iliac arterial anastomosis that was reconstructed 8 days after transplantation owing to rupture and major bleeding...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28341512/change-in-aortic-neck-diameter-after-endovascular-aortic-aneurysm-repair
#17
Marcus R Kret, Kenneth Tran, Jason T Lee
BACKGROUND: Implications of aortic neck dilatation following endovascular aneurysm repair (EVAR) are unclear. Previous studies are limited to comparisons of individual, early generation devices. We compared aortic neck dilatation among contemporary stent grafts. METHODS: We reviewed preoperative and postoperative computed tomographic angiograms for EVARs performed from 2008-2014. Images were analyzed using 3-dimensional centerline reconstructions. Aortic neck diameter was measured in orthogonal planes at and 10 mm below the lowest renal artery...
August 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28332957/three-dimensional-computed-tomography-reconstruction-in-transplant-renal-artery-stenosis
#18
Xufeng Zhang, Hongwei Wang, Shuangde Liu, Jieke Yan, Xiaoli Liu, Dongsheng Xu, Chuan Tian
OBJECTIVES: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. MATERIALS AND METHODS: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomography reconstruction and were treated with endovascular approaches or medically managed...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28238921/geometric-alteration-of-renal-arteries-after-fenestrated-grafting-and-the-impact-on-renal-function
#20
Jiale Ou, Yiu-Che Chan, Crystal Yin-Tung Chan, Stephen W K Cheng
BACKGROUND: This study aims to investigate the degree of geometric change on renal arteries and its impact on renal function after fenestrated endovascular aortic repair (fEVAR). METHODS: Twenty-five patients with fEVAR were included. There were 47 renal arteries target vessels, and 43 of these (22 left and 21 right vessels) stented successfully. Their preoperative and first postoperative follow-up computed tomography (CT) images were reconstructed using the Aquarius workstation (TeraRecon, San Mateo, CA, USA)...
May 2017: Annals of Vascular Surgery
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