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Endovascular surgery

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https://www.readbyqxmd.com/read/28737565/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-a-multidisciplinary-approach
#1
Carolina Nilsson, Linda Bilos, Tal Hörer, Artai Pirouzram
The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach...
July 21, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28736346/shifting-treatment-paradigms-for-ruptured-aneurysms-from-open-surgery-to-endovascular-therapy-over-25-years
#2
M T Bender, H Wendt, T Monarch, L M Lin, B Jiang, J Huang, A L Coon, R J Tamargo, G P Colby
BACKGROUND: Since the introduction of GDCs in the early 1990s, major clinical studies have supported an increasing role for coil embolization of ruptured aneurysms. We assessed aneurysm location and treatment modality in aneurysmal subarachnoid hemorrhage (aSAH) over the past 25 years. METHODS: A prospective, IRB-approved aneurysm database was screened for patients presenting with aSAH from 1991-2016. Microsurgical and endovascular capabilities were present throughout...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28735955/current-status-of-carbon-dioxide-angiography
#3
REVIEW
Mel J Sharafuddin, Anna E Marjan
OBJECTIVE: Unfamiliarity of endovascular surgeons with carbon dioxide (CO2) angiography is one of the main reasons for its limited use. This review is intended to familiarize the reader with the principles and applications of that modality. METHODS: We conducted a comprehensive review of contemporary literature related to CO2 angiography and its use in the field of vascular and endovascular surgery, including technical details and diagnostic and interventional applications...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28735438/adenosine-assisted-neurovascular-surgery-initial-case-series-and-review-of-literature
#4
REVIEW
Alaa Al-Mousa, Gahan Bose, Katharine Hunt, Ahmed K Toma
Cerebral aneurysms in complex anatomical locations and intraoperative rupture of aneurysms are challenging for neurosurgeons and anaesthetists alike. Mechanical and non-mechanical methods to reduce blood flow into aneurysms are well-recognised techniques to facilitate aneurysm exclusion from the circulation. Mechanical methods like temporary clipping of parent arteries, carotid artery ligation and endovascular balloon occlusion are commonly used in clinical practice. However, non-mechanical techniques such as rapid ventricular pacing and adenosine-induced cardiac standstill with hypotension are still emerging strategies...
July 22, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28734705/a-proficiency-based-stepwise-endovascular-curricular-training-prospect-program-enhances-operative-performance-in-real-life-a-randomised-controlled-trial
#5
H Maertens, R Aggarwal, N Moreels, F Vermassen, I Van Herzeele
OBJECTIVES: Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. DESIGN: A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions...
July 19, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28733225/microneurosurgical-clip-ligation-of-acutely-ruptured-cerebral-aneurysm-immediately-preceded-by-intentional-subtotal-endovascular-coil-embolization-under-a-single-anesthesia-observations-using-a-deliberate-combined-sequential-treatment-strategy-in-13-cases
#6
Jeffrey E Thomas, Jack C Rose
BACKGROUND: Endovascular coil embolization and craniotomy with clip ligation are the two most commonly used treatments for ruptured cerebral aneurysm. While coiling maintains the advantages of brevity and complete avoidance of brain retraction and manipulation, clipping offers the benefits of decompression of the injured brain and lower aneurysm recurrence rates. A combined, immediately sequential treatment strategy for acutely ruptured cerebral aneurysm that simultaneously maximizes the advantages of both techniques, while minimizing their respective disadvantages, may be a useful paradigm...
July 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28732458/use-of-a-complete-autologous-blood-recovery-system-the-sorin-xtra%C3%A2-autotransfusion-system-during-mechanical-thrombectomy-of-extensive-cerebral-venous-sinus-thrombosis
#7
C Castaño, C Cubells, S Remollo, M R García-Sort, M Terceño
Background The endovascular therapy for cerebral venous sinus thrombosis (CVST) is currently accepted as a second-line treatment for patients who have failed or those in whom systemic anticoagulation is contraindicated or in a subgroup of patients presenting with rapid neurologic deterioration. A number of different mechanical and pharmacologic endovascular strategies have been reported, either as separate or combined approaches. These new catheters and aspiration systems have a high power and vacuum capacity, which carries a risk of anemization of the patient and hypovolemic shock, being necessitating the transfusion of the patient...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28727356/-management-of-carotid-artery-stenosis
#8
Francesco Puccinelli, Marco Roffi, Nicolas Murith, Roman Sztajzel
Carotid artery atherosclerosis remains one of the major causes of stroke. The efficacy of carotid artery recanalization has already been established and is considered significant for symptomatic stenosis >70% and moderate for stenosis between 50-69 %. Regarding asymptomatic stenosis, carotid artery recanalization should be reserved for carefully selected patients with a stenosis between 70-90 % and an estimated procedural risk at less than 3 %. Two therapeutic options are currently available : angioplasty with stent placement and endarterectomy...
April 26, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726649/lipoprotein-associated-phospholipase-a2-as-a-marker-of-vulnerable-atherosclerotic-plaque-in-patients-with-internal-carotid-artery-stenosis
#9
P Štefanič, I Kopolovets, Z Hertelyová, Š Tóth, M Frankovičová
The aim of this study was to compare the concentration of inflammatory vascular markers and morphological structure of atherosclerotic plaque in symptomatic and asymptomatic patients with the stenosis of internal carotid artery (ICA). The research was carried out in 70 patients with hemodynamically significant stenosis of ICA out of which 40 (57%) were asymptomatic patients and 30 (43%) were symptomatic patients, of which 20 patients (66%) have had a stroke, or transient ischemic attack (TIA), 10 patients (33%)...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28725517/preoperative-embolization-for-skull-base-meningiomas
#10
Kensuke Suzuki, Masaya Nagaishi, Yoshiyuki Matsumoto, Yoshiko Fujii, Yuki Inoue, Yoshiki Sugiura, Koji Hirata, Ryotaro Suzuki, Yosuke Kawamura, Ryuta Nakae, Yoshihiro Tanaka, Akio Hyodo
The results of preoperative embolization for skull base meningiomas were retrospectively evaluated to confirm the efficacy of this procedure. Skull base meningiomas that were treated with preoperative embolization were evaluated in 20 patients. The occluded arteries, embolic materials, treatment time, excision rate, neurologic manifestations, and complications were analyzed. The embolic material was 80% liquid, 30% coils, and 15% particles. The surgery was normally completed within 3 to 5 hours. Blood loss was normally approximately 250 mL, excluding four patients having the following conditions: malignant meningioma, a large tumor located on the medial side of the sphenoidal ridge, the petroclival tumor, and infiltrated tumor into the sigmoid sinus...
August 2017: Journal of Neurological Surgery. Part B, Skull Base
https://www.readbyqxmd.com/read/28722300/digital-subtraction-angiography-dynavision-in-pretreatment-planning-for-embolization-of-dural-arterio-venous-fistulas
#11
Alex Botsford, Jai Jai Shiva Shankar
BACKGROUND AND PURPOSE: We have found DSA-Dynavision with multiplanar reconstruction very helpful in understanding the complex anatomy and planning of treatment of carotico-cavernous fistulas. The purpose of our study was to examine whether using DSA-Dynavision in pretreatment planning results in better outcome after endovascular treatment of dural arterio-venous fistulas (dAVFs). METHODS: Patients with dAVF treated with endovascular embolization were retrospectively identified from our interventional neuroradiology database...
July 19, 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/28720744/-preoperative-embolization-for-solid-cerebellar-hemangioblastoma-on-the-day-of-surgery-two-case-reports
#12
Ken Kuwahara, Tomotsugu Ichikawa, Jun Haruma, Tomohito Hishikawa, Masafumi Hiramatsu, Kenji Sugiu, Isao Date
Surgical resection of solid cerebellar hemangioblastomas can be challenging because of the profuse blood supply and tight space. We report two cases of solid cerebellar hemangioblastomas treated via surgical resection with the aid of preoperative endovascular embolization on the day of surgery. Case 1: A 36-year-old woman presented with a two-month history of headache and vomiting. Magnetic resonance imaging(MRI)revealed a right cerebellar solid mass, mild hydrocephalus, and apparent peritumoral edema. Angiogram showed a highly vascularized mass, three feeding arteries from the superior cerebellar artery(SCA), and a dilated vein draining into the confluence...
July 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#13
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716703/bridge-to-surgery-best-practice-protocol-derived-from-early-clinical-experience-with-the-bridge-occlusion-balloon
#14
Bruce L Wilkoff, Charles Kennergren, Charles J Love, Steven P Kutalek, Laurence M Epstein, Roger Carrillo
A league of physicians at the Eleventh Annual Lead Management Symposium in Miami, Florida developed an expert opinion and federated agreement on a best practice protocol for Bridge™ Occlusion Balloon (Bridge) deployment for patients undergoing transvenous cardiac implantable electronic devices (CIED) lead extraction based on early clinical experience with the balloon. Injury to the superior vena cava (SVC) is a rare, but a serious complication of transvenous lead extraction. Bridge is designed to provide temporary endovascular occlusion of the SVC...
July 14, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28712962/fenestrated-endograft-as-a-new-perspective-for-the-treatment-of-infra-renal-abdominal-aortic-aneurysm-with-a-congenital-pelvic-kidney-a-case-report-and-review-of-literature
#15
Barun Majumder, Anisha H Parera, Neil Browning, Mark MacGregor, Alex Chapman
The coexistence of Abdominal Aortic Aneurysm (AAA) and Congenital Pelvic Kidney (CPK) is infrequent. Various treatment modalities have been reported in literature for treatment of the above condition. We report a complete endovascular modality for the treatment of this association, especially for high-risk patients. Only one such treatment has been reported before. Compared to this previously reported case, we would like to share our experience with additional prototype testing, prior to surgery which provided us with more detailed information about the planning and deployment of the branched endograft...
July 13, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28711529/initial-treatment-strategy-for-intracranial-mycotic-aneurysms-two-case-reports-and-literature-review
#16
Makoto Ohtake, Kensuke Tateishi, Naoki Ikegaya, Junya Iwata, Shoji Yamanaka, Hidetoshi Murata
BACKGROUND: Intracranial mycotic aneurysm (IMA) is a rare neurovascular disease and a well-known complication following infective endocarditis. IMAs potentially carry a high mortality risk due to intracranial hemorrhage. Therefore, initial treatment is crucial for IMA patients, but an optimal treatment strategy remains unknown. Herein, we report two cases of IMA patients treated with the current usual modalities, and we provide a comprehensive literature review to propose an optimal initial treatment strategy for IMAs...
July 12, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28711400/thirty-day-outcomes-after-fenestrated-endovascular-repair-are-superior-to-open-repair-of-abdominal-aortic-aneurysms-involving-visceral-vessels
#17
Prateek K Gupta, Reshma Brahmbhatt, Kelly Kempe, Shaun M Stickley, Michael J Rohrer
OBJECTIVE: Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs. METHODS: Patients who underwent FEVAR (n = 535) and OS (n = 1207) for elective AAA-Vs were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) 2008 to 2013 database...
July 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#18
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
July 12, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28710563/an-observational-study-examining-the-effects-of-a-surgically-induced-inflammatory-response-on-the-distribution-of-morphine-and-its-metabolites-into-cerebrospinal-fluid
#19
Yan Wang, Kerry B Goralski, Derek J Roberts, Kathryn Landry, Mark E Issa, Lekha Sleno, Lisa C Julien, Jeremy Wood, Richard I Hall
PURPOSE: Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function...
July 14, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28707350/midterm-to-long-term-safety-and-efficacy-of-self-expandable-nitinol-stent-implantation-for-coarctation-of-aorta-in-adults
#20
Ali Mohammad Haji Zeinali, Mohammad Sadeghian, Shakeel A Qureshi, Payam Ghazi
PURPOSE: Endovascular treatment of coarctation of aorta (CoA) by self-expandable Nitinol stents is one of the recognized treatment methods and may be an alternative to surgery or balloon-expandable stent implantation for CoA but there is little information about midterm to long term results of self-expandable stents. METHODS: Sixty-two patients with CoA (40 men), with a mean age of 30.7 ± 11 years, (range 17-63 years) underwent stent implantation with Optimed self-expandable Nitinol stents between 2005 and 2014...
July 14, 2017: Catheterization and Cardiovascular Interventions
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