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https://www.readbyqxmd.com/read/29143168/limited-influence-of-blunt-aortic-injuries-on-the-outcome-of-polytraumatized-patients-a-matched-pair-analysis
#1
A Omar, C Macke, M Winkelmann, E Beckmann, P Mommsen, C Schröter, C Krettek, Christian Zeckey
INTRODUCTION: Traumatic lesions of great vessels such as the aorta are life-threatening injuries. There is limited evidence about the influence of traumatic aortic injuries in multiple trauma patients in particular with regard to posttraumatic complications. The aim of this study was to evaluate the influence of blunt thoracic aortic injuries in multiple trauma patients compared to a multiple trauma cohort without this specific injury. In addition, the safety of Thoracic Endovascular Aortic Repair (TEVAR) in multiple trauma patients was analyzed...
November 15, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29142582/pseudoaneurysm-of-left-proximal-common-carotid-artery-following-penetrating-trauma
#2
Rehana Shaikh, Saba Sohail, Parvez Ahmed Shaikh, Qamar-Un-Nisa Nisa
A 33-year male with history of penetrating trauma to left upper chest in 2006, presented through Medical unit to Radiology Department with complain of hemoptysis. Chest X-ray showed a soft tissue lesion in left upper lobe with a linear metallic foreign body. Contrast enhanced CT scan of chest and later CTA was performed which showed a saccular aneurysm arising from mediastinal part of left common aortic artery surrounded by thrombosis with a cylindrical linear metallic foreign body. He was planned for endovascular repair with stenting which he could not afford due to financial constraints...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29142494/endovascular-treatment-of-abdominal-aortic-aneurysm-with-complete-iliac-occlusion-case-series-and-literature-review
#3
Randall W Franz, M Taha Ibrahim, Christopher F Tanga, David A Epstein
In patients with abdominal aortic aneurysms (AAA) and complete iliac occlusion, endovascular aortic aneurysm repair (EVAR) using a bifurcated stent graft has clear advantages over aortouniiliac stent grafts. Bifurcated stent grafts had improved hemodynamic flow and increased primary and secondary patency rates compared with aortouniiliac stent grafts. The use of aortouniiliac stent grafts with femorofemoral crossover bypass is associated with complications including infection of the prosthesis, steal phenomenon, and the associated difficulties for further endovascular access at the site of the femoral anastomosis...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29138183/endovascular-or-open-repair-for-ruptured-abdominal-aortic-aneurysm
#4
EDITORIAL
Martin Björck
No abstract text is available yet for this article.
November 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29138135/comparative-clinical-effectiveness-and-cost-effectiveness-of-endovascular-strategy-v-open-repair-for-ruptured-abdominal-aortic-aneurysm-three-year-results-of-the-improve-randomised-trial
#5
(no author information available yet)
Objective To assess the three year clinical outcomes and cost effectiveness of a strategy of endovascular repair (if aortic morphology is suitable, open repair if not) versus open repair for patients with suspected ruptured abdominal aortic aneurysm.Design Randomised controlled trial.Setting 30 vascular centres (29 in UK, one in Canada), 2009-16.Participants 613 eligible patients (480 men) with a clinical diagnosis of ruptured aneurysm, of whom 502 underwent emergency repair for rupture.Interventions 316 patients were randomised to an endovascular strategy (275 with confirmed rupture) and 297 to open repair (261 with confirmed rupture)...
November 14, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29137728/a-computational-model-for-false-lumen-thrombosis-in-type-b-aortic-dissection-following-thoracic-endovascular-repair
#6
Claudia Menichini, Zhuo Cheng, Richard G J Gibbs, Xiao Yun Xu
Thoracic endovascular repair (TEVAR) has recently been established as the preferred treatment option for complicated type B dissection. This procedure involves covering the primary entry tear to stimulate aortic remodelling and promote false lumen thrombosis thereby restoring true lumen flow. However, complications associated with incomplete false lumen thrombosis, such as aortic dilatation and stent graft induced new entry tears, can arise after TEVAR. This study presents the application and validation of a recently developed mathematical model for patient-specific prediction of thrombus formation and growth under physiologically realistic flow conditions...
November 11, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29136140/inaccurate-aortic-stent-graft-deployment-in-the-distal-landing-zone-incidence-reasons-and-consequences
#7
Mikolaj Berezowski, Julia Morlock, Friedhelm Beyersdorf, Marek Jasinski, Tomasz Plonek, Matthias Siepe, Martin Czerny, Bartosz Rylski
OBJECTIVES: The aim of this study was to investigate the accuracy of stent graft deployment in the distal landing zone (LZ) during thoracic endovascular aortic repair (TEVAR). Currently, TEVAR focuses on accurate stent graft deployment in the proximal LZ. Data on landing in the distal LZ are lacking. METHODS: Of 195 TEVAR patients (2005-16) with a non-dissected aortic pathology, 59 [median age 73 years (first quartile 68; third quartile 77), 20 women] patients had a distal LZ shorter than 40 mm...
November 9, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29136132/aortic-events-and-reoperations-after-elective-arch-surgery-incidence-surgical-strategies-and-outcomes
#8
Maximilian Luehr, Sven Peterss, Andreas Zierer, Davide Pacini, Christian D Etz, Malakh Lal Shrestha, Konstantinos Tsagakis, Bartosz Rylski, Giampiero Esposito, Klaus Kallenbach, Ruggero De Paulis, Paul P Urbanski
OBJECTIVES: The true incidence of aortic events (AEs) and reoperations (REDO) following elective total aortic arch replacement remains unknown. The aim of this study was to review the incidence of AEs and surgical REDO, and its respective outcomes after 1232 elective arch repairs at 11 European aortic centres. METHODS: Retrospective chart review (in the absence of prospective data collection) was performed for statistical analysis. Follow-up was conducted during routine clinical examination or in a telephone interview with patients and/or their respective physicians...
November 9, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29136130/distal-re-entry-closure-with-neobranching-technique-after-thoracic-endovascular-aortic-repair-of-type-b-aortic-dissection
#9
Masaki Yamamoto, Takashi Fukutomi, Tatsuya Noguchi, Kazumasa Orihashi
Retrograde false-lumen flow after thoracic endovascular aortic repair of Type B aortic dissection occurs occasionally and may have a negative impact on aortic remodelling and even prevent the decompression of the false lumen. A 67-year-old man with a Type B aortic dissection underwent thoracic endovascular aortic repair for severe compression of the true lumen and visceral malperfusion 7 weeks after the onset. Intraoperative angiography revealed proximal entry tear closure, but the false-lumen flow increased because of retrograde flow through the re-entry tear...
November 9, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29130855/management-of-chronic-massive-traumatic-popliteal-artery-pseudoaneurysm-a-case-series-with-different-treatment-strategies
#10
Ali Khalifeh, Rami Kantar, J Devin B Watson, Samantha Cox, Rajabrata Sarkar, Shahab Toursvadakohi
Giant traumatic popliteal artery (PA) pseudoaneurysms (PSA) are rare but limb threatening if untreated. Management can be challenging, as no standardized approach exists. This report evaluates our experience with 3 cases treated differently. Treatment is individualized based on patient disease and comorbidities. Endovascular and local patch arterial repair are safe alternatives to graft bypass when feasible.
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29130399/recent-trends-in-publications-of-us-vascular-surgery-program-directors
#11
Afsha Aurshina, Anil Hingorani, Amrit Hingorani, Ayisha Zainab, Natalie Marks, Sheila Blumberg, Enrico Ascher
Objective In order to examine the academic productivity of US vascular surgery program directors, the number of vascular publications listed in PubMed from 2001 to 2015 for US vascular surgery program directors was reviewed. We suggest that this can be used as a benchmark for academic productivity. Methods The names of the program directors were taken from the Accreditation Council for Graduate Medical Education (ACGME) website at two time points: December 2009 (Independent Programs) and December 2015 (Independent + Integrated)...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29129854/update-on-the-therapeutic-strategy-of-type-b-aortic-dissection
#12
Shuichiro Kaji
Stanford type B aortic dissection (TBAD) is a life-threatening disease. Current therapeutic guidelines recommend medical therapy with aggressive blood pressure lowering for patients with acute TBAD unless they have fatal complications. Although patients with uncomplicated TBAD have relatively low early mortality, aorta-related adverse events during the chronic phase worsen the long-term clinical outcome. Recent advances in thoracic endovascular aortic repair (TEVAR) can improve clinical outcomes in patients with both complicated and uncomplicated TBAD...
November 10, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#13
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29124037/chylothorax-after-blunt-chest-trauma-a-case-report
#14
Pawit Sriprasit, Osaree Akaraborworn
Traumatic chylothorax after blunt chest trauma alone is considered rare. Our patient was a 27-year-old female who was in a motorcycle accident and sustained blunt thoracic and traumatic thoracic aortic injuries with T1-T2 vertebral subluxation. She underwent thoracic endovascular aortic repair from T4 to T9 without any thoracic or spinal surgery. On postoperative day 7, the drainage from her left chest turned into a milky-white fluid indicative of chyle leakage. The patient was treated conservatively for 2 weeks and then the chest drain was safely removed...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29123844/primary-aortoduodenal-fistula-with-a-history-of-distal-gastrectomy
#15
Kentaro Inoue, Ryota Fukunaga, Yutaka Matsubara, Yukihiko Aoyagi, Daisuke Matsuda, Ryoichi Kyuragi, Koichi Morisaki, Takuya Matsumoto, Eiji Oki, Yoshihiko Maehara
Case: A 69-year-old man was transferred to our hospital because of an aortoduodenal fistula with hematemesis and pre-shock vital signs. He had a history of alcoholism, malnutrition, and distal gastrectomy and Billroth I reconstruction. Endovascular aneurysm repair was successfully carried out; however, the presence of comorbidities affected further radical treatment. Outcome: The patient survived for 2 months postoperatively. Conclusion: Endovascular aneurysm repair is a useful first-line treatment for high-risk aortoduodenal fistula patients; however, it requires improvement for long-term outcomes in complicated high-risk cases...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123447/endovascular-stent-graft-repair-of-localized-acute-aortic-intramural-hematoma-a-case-report-and-literature-review
#16
Ugur Kaya, Abdurrahim Colak, Necip Becit, Munacettin Ceviz, Hikmet Kocak
Aortic intramural hematoma (IMH) is a variant of acute aortic syndrome, which can be life-threatening. Ascending aorta IMHs, particularly accompanied by penetrating aortic ulcer (PAU), can cause dissection, rupture, and cardiac tamponade. Therefore, early surgical treatment is recommended for IMHs of the ascending aorta. Herein, we present the case of a 60-year-old male patient who was on warfarin sodium treatment and in whom an IMH localized to the arcus aorta was detected incidentally via computed tomography, with the suspicion of pulmonary embolism, and an endovascular stent graft was inserted into the arcus aorta...
October 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/29122572/characterization-of-vessel-deformations-during-evar-a-preliminary-retrospective-analysis-to-improve-fidelity-of-endovascular-simulators
#17
Laura Cercenelli, Barbara Bortolani, Guido Tiberi, Chiara Mascoli, Ivan Corazza, Mauro Gargiulo, Emanuela Marcelli
OBJECTIVE: During endovascular aneurysm repair (EVAR), vessel deformations occur due to the insertion of tools and deployment of stent grafts in the arteries. We present a method for the characterization of vessel deformations during EVAR, and its application on patient datasets for a preliminary retrospective analysis that may be used to improve fidelity of endovascular simulators. DESIGN: The method provides the extraction of vessel profiles from intraoperative fluoroscopic images and the calculation of a tortuosity index in the 2D fluoroscopy view (τ2D) used to quantify the vessel deformations (δ%) during EVAR caused by the stiff guidewire insertion (δ%Stiff) and the stent graft deployment (δ%Graft), when compared with the undeformed vessel configuration (no device inserted)...
November 6, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/29122421/evaluating-strategies-for-reducing-scattered-radiation-in-fixed-imaging-hybrid-operating-suites
#18
Claire Miller, Daniel Kendrick, Andrew Shevitz, Ann Kim, Henry Baele, David Jordan, Vikram S Kashyap
OBJECTIVE: High-resolution fixed C-arm fluoroscopic systems allow high-quality endovascular imaging but come at a cost of greater scatter radiation generation and increased occupational exposure for surgeons. The purpose of this study was to evaluate the efficacy of two methods in reducing scattered radiation exposure. METHODS: There were 164 endovascular cases analyzed in three phases. In phase 1 (P1), baseline radiation exposure was calculated. In phase 2 (P2), staff used real-time radiation dose monitoring (dosimetry badges [RaySafe; Unfors, Hopkinton, Mass])...
November 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29121846/retrograde-ascending-dissection-after-thoracic-endovascular-aortic-repair-combined-with-the-chimney-technique-and-successful-open-repair-using-the-frozen-elephant-trunk-technique
#19
Koji Hirano, Toshiya Tokui, Bun Nakamura, Ryosai Inoue, Masahiro Inagaki, Yasumi Maze, Noriyuki Kato
The chimney technique can be combined with thoracic endovascular aortic repair (TEVAR) to both obtain an appropriate landing zone and maintain blood flow of the arch vessels. However, surgical repair becomes more complicated if retrograde type A aortic dissection occurs after TEVAR with the chimney technique. We herein report a case involving a 73-year-old woman who developed a retrograde ascending dissection 3 months after TEVAR for acute type B aortic dissection. To ensure an adequate proximal sealing distance, the proximal edge of the stent graft was located at the zone 2 level and an additional bare stent was placed at the left subclavian artery (the chimney technique) at the time of TEVAR...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29121844/patient-and-aneurysm-characteristics-predicting-prolonged-length-of-stay-after-elective-open-aaa-repair-in-the-endovascular-era
#20
Sergio Casillas-Berumen, Florencia A Rojas-Miguez, Alik Farber, Sevan Komshian, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
INTRODUCTION: Open aortic aneurysm repair (AAA) repair can be resource intensive and associated with a prolonged length of stay (LOS). We sought to examine patient and aneurysm predictors of prolonged LOS to better identify those at risk in the preoperative setting. METHODS: Patient data were obtained from the targeted AAA American College of Surgery National Surgical Quality Improvement Program database from 2012 to 2014 of patients undergoing open AAA repair. Multivariable logistic regression was used to determine predictors of prolonged postoperative LOS defined as greater than 10 days (75th percentile)...
January 1, 2017: Vascular and Endovascular Surgery
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