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Renal artery reconstruction

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https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#1
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28051019/hemodynamics-in-transplant-renal-artery-stenosis-and-its-alteration-after-stent-implantation-based-on-a-patient-specific-computational-fluid-dynamics-model
#2
Hong-Yang Wang, Long-Shan Liu, Hai-Ming Cao, Jun Li, Rong-Hai Deng, Qian Fu, Huan-Xi Zhang, Ji-Guang Fei, Chang-Xi Wang
BACKGROUND: Accumulating studies on computational fluid dynamics (CFD) support the involvement of hemodynamic factors in artery stenosis. Based on a patient-specific CFD model, the present study aimed to investigate the hemodynamic characteristics of transplant renal artery stenosis (TRAS) and its alteration after stent treatment. METHODS: Computed tomography angiography (CTA) data of kidney transplant recipients in a single transplant center from April 2013 to November 2014 were reviewed...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28043466/increasing-complexity-of-heart-transplantation-in-patients-with-congenital-heart-disease
#3
William Y Shi, Pankaj Saxena, Matthew S Yong, Silvana F Marasco, David C McGiffin, Anne Shipp, Robert G Weintraub, Yves d'Udekem, Christian P Brizard, Igor E Konstantinov
Owing to improved surgical results, there is a growing population of patients with repaired congenital heart disease (CHD) requiring heart transplantation. The objective of the study was to review our experience in these patients. A retrospective review of the outcomes of heart transplantation in patients with CHD (n = 77) between 1988 and 2014 was performed. Outcomes of early (1988-1999) and late (2000-2014) eras were compared. In results, the mean age was 18 ± 14 years (range: 16 days-58 years). Seventy (91%) patients underwent a mean of 2...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27988157/successful-microscopic-renal-autotransplantation-for-left-renal-aneurysm-associated-with-segmental-arterial-mediolysis
#4
Takashi Yoshioka, Motoo Araki, Yuichi Ariyoshi, Koichiro Wada, Noriyuki Tanaka, Yasutomo Nasu
Segmental arterial mediolysis (SAM) is an uncommon, nonarteriosclerotic vascular disease. SAM is characterized by lysis of arterial media and can lead to aneurysm formation. The renal arteries are the third most common arteries associated with SAM. We report the case of a 32-year-old man with left renal artery aneurysm associated with SAM. We successfully performed left renal autotransplantation using microscopic vascular reconstruction. SAM is characterized by vascular fragility; therefore, microscopic surgery is favorable for treating aneurysms associated with SAM...
December 14, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27928064/3d-printing-guiding-stent-graft-fenestration-a-novel-technique-for-fenestration-in-endovascular-aneurysm-repair
#5
Jianhua Huang, Gan Li, Wei Wang, Keming Wu, Tianming Le
OBJECTIVE: To describe a novel approach, 3D printing guiding stent graft fenestration, for fenestration during endovascular aneurysm repair for juxtarenal abdominal aortic aneurysm. METHODS: A 69-year-old male with juxtarenal abdominal aortic aneurysm underwent endovascular aneurysm repair with "off the label" fenestrated stent graft. To precisely locate the fenestration position, we reconstructed a 3D digital abdominal aortic aneurysm model and created a skin template covering this abdominal aortic aneurysm model...
December 6, 2016: Vascular
https://www.readbyqxmd.com/read/27888303/dual-energy-ct-workflow-multi-institutional-consensus-on-standardization-of-abdominopelvic-mdct-protocols
#6
Bhavik N Patel, Lauren Alexander, Brian Allen, Lincoln Berland, Amir Borhani, Achille Mileto, Courtney Moreno, Desiree Morgan, Dushyant Sahani, William Shuman, Eric Tamm, Mitchell Tublin, Benjamin Yeh, Daniele Marin
PURPOSE: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS: 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used...
November 25, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27864460/use-of-the-octopus-endograft-technique-to-reconstruct-renovisceral-arteries-arising-from-the-false-lumen-of-a-rapidly-expanding-type-b-aortic-dissection-after-endovascular-repair
#7
Jiang Xiong, Yangyang Ge, Xiaoping Liu, Lijun Wang, Wei Guo
PURPOSE: To describe the use and 6-month outcomes of the octopus endograft technique to reconstruct renovisceral arteries arising from the false lumen (FL) of a type B aortic dissection after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 46-year-old man post TEVAR for type B aortic dissection was admitted with persistent back pain and a rapidly expanding residual dissection. The celiac and left renal arteries arose from the FL and the superior mesenteric artery from both lumens, with the FL as its main supply...
November 17, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27862938/combined-percutaneous-transrenal-and-transfemoral-endovascular-recanalization-and-angioplastic-reconstruction-of-a-disrupted-transplant-renal-artery-stent-a-novel-salvage-technique
#8
D J Carpenter, S Mohan, L E Ratner, P Schlossberg
Renal artery stenosis is the most common vascular complication following renal transplantation. Percutaneous endovascular transluminal angioplasty with stenting is the treatment of choice for clinically significant renal artery stenosis. The authors present a case describing a novel combined transrenal parenchyma and transfemoral approach to repairing a disrupted transplant renal artery stent. The patient's allograft renal artery stenosis was initially managed via the standard percutaneous approach, but during follow-up the stent became disrupted and crushed, causing partial occlusion of the renal artery...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27861397/application-of-physician-modified-fenestrated-stent-graft-in-urgent-endovascular-repair-of-abdominal-aortic-aneurysm-with-hostile-neck-anatomy-case-report
#9
Rong Zeng, Wei Ye, Changwei Liu, Xuan Wang, Xiaojun Song, Leng Ni, Bao Liu, Yongjun Li, Yuehong Zheng
BACKGROUND: This study aimed to evaluate the feasibility and effectiveness of the Gore Excluder aortic stent graft (WL Gore & Associates, Inc., Flagstaff, AZ) using the C3 Delivery System after physician modification of fenestration for the urgent treatment of patients with abdominal aortic aneurysm showing hostile neck anatomy. CASE SUMMARY: Three urgent cases of abdominal aortic aneurysm with hostile neck anatomy symptom with abdominal pain were reported. The same fenestration method was applied to align the target superior mesenteric artery and bilateral renal arteries with 1 scallop and 2 fenestrations, followed by the reconstruction of the target artery using a bare-metal stent or stent graft...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27827846/age-related-renal-microvascular-changes-evaluation-by-three-dimensional-digital-imaging-of-the-human-renal-microcirculation-using-virtual-microscopy
#10
Noriko Uesugi, Yoshihito Shimazu, Kazunori Kikuchi, Michio Nagata
The renal microvasculature is targeted during aging, sometimes producing chronic kidney disease (CKD). Overdiagnosis of CKD in older persons is concerning. To prevent it, a new concept of "healthy aging" is arising from a healthy renal donor study. We investigated the renal microcirculatory changes of three older persons and compared them with that of one patient with nephrosclerosis using a three-dimensional (3D) reconstruction technique that we previously developed. This method uses a virtual slide system and paraffin-embedded serial sections of surgical material that was double-immunostained by anti-CD34 and anti-α smooth muscle actin (SMA) antibodies for detecting endothelial cells and medial smooth muscle cells, respectively...
November 2, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27803955/open-repair-of-aaa-in-a-high-volume-center
#11
Lazar B Davidovic, Milanko Maksic, Igor Koncar, Nikola Ilic, Marko Dragas, Nikola Fatic, Miroslav Markovic, Igor Banzic, Perica Mutavdzic
OBJECTIVE: To assess results of open repair (OR) of AAA in a single high volume center. METHODS: We analyzed prospectively collected data of 450 patients who underwent elective OR of AAA at the Clinic for Vascular and Endovascular Surgery of the Serbian Clinical Centre in the period between January 2013 and September 2014. RESULTS: Postoperative death occurred in seven patients (1. 55%) during the first 30 postoperative days. The mortality was caused by: uncontrolled bleeding-1, acute myocardial infarction-1, ischemic colitis-2, MOFS-2, sepsis due to infection and dehiscence of laparotomy wound-1...
November 1, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27782315/minimally-circulatory-assisted-on-pump-beating-coronary-artery-bypass-grafting-for-patients-with-complex-conditions-for-off-pump-surgery
#12
Tomohiro Mizuno, Koso Egi, Kenji Sakai, Keiji Oi, Tsuyoshi Hachimaru, Tohru Makita, Kiyotoshi Oishi, Hirokuni Arai
Off-pump coronary artery bypass grafting (OPCAB) in patients with acute myocardial infarction (AMI) is difficult because of circulatory deterioration during displacement of the heart. At our institution, we performed minimally circulatory-assisted on-pump beating coronary artery bypass grafting (MICAB) in these patients. During MICAB, support flow was controlled at a minimal level to maintain a systemic blood pressure of approximately 100 mm Hg and a pulmonary arterial systolic pressure of <30 mm Hg, providing optimal pulsatile circulation for end-organ perfusion and prevention of heart congestion...
October 26, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27759632/preoperative-evaluation-of-renal-artery-in-patients-with-renal-tumor-using-noncontrast-enhanced-magnetic-resonance-angiography
#13
Liangsong Zhu, Guangyu Wu, Jianfeng Wang, Jiwei Huang, Wen Kong, Yonghui Chen, Wei Xue, Yiran Huang, Jin Zhang
To investigate the feasibility of the noncontrast-enhanced magnetic resonance angiography (NCE-MRA) to evaluate renal arteries before partial nephrectomy (PN).Retrospective analyzed 479 patients who underwent renal surgery between January 2013 and December 2015 with NCE-MRA or computed tomographic angiography (CTA) renal artery image reconstruction preoperative in our department. The renal artery reconstruction score (RARS) was based on the level of artery visualization in a 4-class criterion, and the R.E.N...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27754474/zero-ischaemia-partial-nephrectomy-a-call-for-standardized-nomenclature-and-functional-outcomes
#14
Ahmad Alenezi, Giacomo Novara, Alexander Mottrie, Salah Al-Buheissi, Omer Karim
Nephron-sparing surgery for the removal of small renal masses delivers equivalent oncological outcomes and better functional outcomes compared with those associated with radical nephrectomy. All contemporary partial nephrectomy techniques including open, laparoscopic and robotic approaches involve the use of hilar clamping in order to facilitate haemostasis, and to enable accurate tumour excision and parenchymal reconstruction. Zero ischaemia was subsequently introduced as a technique to eliminate the renal ischaemia induced by hilar clamping...
October 18, 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/27742898/initial-experience-with-covered-endovascular-reconstruction-of-the-aortic-bifurcation-in-conjunction-with-chimney-grafts
#15
Martijn L Dijkstra, Peter C J M Goverde, Andrew Holden, Clark J Zeebregts, Michel M P J Reijnen
PURPOSE: To show feasibility of the covered endovascular repair of the aortic bifurcation (CERAB) technique in conjunction with chimney grafts in aortic side branches for complex aortoiliac occlusive disease. METHODS: Two European centers and one facility located in New Zealand participated in a retrospective observational study that enrolled 14 consecutive patients (mean age 61.2±8.9 years; 11 men) treated with CERAB in conjunction with chimney graft(s) between December 2012 and May 2015...
October 14, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27687328/reconstruction-for-renal-artery-aneurysms-using-the-tailoring-technique
#16
Mansur Duran, Daniel Ferdinand Hausmann, Klaus Grabitz, Hubert Schelzig, Florian Simon, Tolga Atilla Sagban
OBJECTIVE: Renal artery (RA) aneurysm (RAA) is a rare and complex disease. Treatment options for a RAA include endovascular surgery and open surgery with ex vivo repair or in situ reconstruction. This study evaluated the long-term outcome after vascular reconstruction of RAAs using the tailoring technique. Tailoring or aneurysmorrhaphy means a partial resection of the aneurysm with direct suture of the remaining arterial wall. METHODS: A single-center retrospective study was conducted between January 1990 and December 2015...
September 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27684548/levosimendan-administration-in-limb-ischemia-multicomponent-signaling-serving-kidney-protection
#17
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
https://www.readbyqxmd.com/read/27673541/a-new-approach-for-reconstruction-of-diabetic-foot-wounds-using-the-angiosome-and-supermicrosurgery-concept
#18
Hyun Suk Suh, Tae Suk Oh, Ho Seung Lee, Seung Hwan Lee, Yong Pil Cho, Joong Ryul Park, Joon Pio Hong
BACKGROUND: Major vessels in the diabetic foot are often calcified and inadequate for use as recipient vessels. Thus, a supermicrosurgery technique using small branches or perforators from other collateral vessels with an adequate pulse may be an alternative method. This study evaluated outcome using the supermicrosurgery concept and the risk factors involved. METHODS: Ninety-five cases of diabetic foot reconstruction were reviewed; the average patient age was 57 years; average follow-up was 43...
October 2016: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27671450/repair-of-chronic-aneurysmal-aortic-dissection-using-a-stent-graft-and-an-amplatzer%C3%A2-vascular-plug-a-case-study
#19
Yuji Kanaoka, Takao Ohki, Hirotsugu Ozawa
We report a case in which a stent graft and an Amplatzer® vascular plug (AVP) were effective for the treatment of chronic aneurysmal aortic dissection. The patient was a 52-year-old man. At 45 years of age, he developed acute aortic dissection, for which he underwent surgery four times with prosthetic graft replacement in the abdominal aorta, descending thoracic, ascending aorta (without neck branch reconstruction), and thoracoabdominal aorta with the reconstruction of the celiac, superior mesenteric and bilateral renal arteries...
September 23, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27577511/adrenal-and-nephrogenic-hypertension-an-image-quality-study-of-low-tube-voltage-low-concentration-contrast-media-combined-with-adaptive-statistical-iterative-reconstruction
#20
Zhen Li, Qiong Li, Yaqi Shen, Anqin Li, Haojie Li, Lili Liang, Yao Hu, Xuemei Hu, Daoyu Hu
PURPOSE: The aim of this study was to investigate the effect of using low tube voltage, low-concentration contrast media and adaptive statistical iterative reconstruction (ASIR) for reducing the radiation and iodine contrast doses in adrenal and nephrogenic hypertension patients. METHODS AND MATERIALS: A total of 148 hypertension patients who were suspected for adrenal lesions or renal artery stenoses were assigned to two groups and. Group A (n=74) underwent a low tube voltage, low molecular weight dextran enhanced multi-detector row spiral CT (MDCT) (80 kVp, 270 mg I/mL contrast agent), and the raw data were reconstructed with standard filtered back projection (FBP) and ASIR at four different levels of blending (20%, 40%, 60% and 80%, respectively)...
September 2016: International Journal of Clinical Practice
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