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Endovascular repair

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https://www.readbyqxmd.com/read/29351610/orthotopic-branched-endovascular-aortic-arch-repair-in-patients-who-cannot-undergo-classical-surgery
#1
Martin Czerny, Bartosz Rylski, Julia Morlock, Holger Schröfel, Friedhelm Beyersdorf, Bertrand Saint Lebes, Olivier Meyrignac, Fatima Mokrane, Mario Lescan, Christian Schlensak, Constatijn Hazenberg, Trijntje Bloemert-Tuin, Sue Braithwaite, Joost van Herwaarden, Herve Rousseau
OBJECTIVES: Our goal was to assess the results after orthotopic branched endovascular aortic arch repair using a new double-branch endoprosthesis in patients with thoracic aortic disease affecting the aortic arch who cannot undergo classical surgery. METHODS: Within a 4-year period, 15 patients with thoracic aortic disease affecting the aortic arch were treated with the Bolton Relay plus double-branch endoprosthesis (Bolton Medical, Sunrise, FL, USA). We assessed clinical outcome, occurrence of endoleaks and the need for secondary interventions...
January 16, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29349440/preservation-of-internal-iliac-arteries-during-endovascular-aneurysm-repair-using-eye-of-the-tiger-technique
#2
Tariq Almerey, W Andrew Oldenburg
Parallel endografts were introduced as a way to expand endovascular repair of aneurysms involving branch vessels. However, endoleaks as a result of the gutters between the parallel endografts made this technique less favorable. The "eye of the tiger" technique was introduced to reduce the gutters between the parallel endografts proximally in the aorta. We report endovascular repair of infrarenal abdominal aortic aneurysm using eye of the tiger technique distally to preserve the internal iliac arteries.
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349437/staged-endovascular-repair-of-an-abdominal-aortic-aneurysm-adjacent-to-a-chronic-high-flow-iliocaval-traumatic-arteriovenous-fistula
#3
S Keisin Wang, Ashley R Gutwein, Tom Casciani, Michael P Murphy, Gary W Lemmon
Large-vessel chronic traumatic arteriovenous fistulas are a rare complication after trauma. Delayed presentation can consist of one or more features of high-output cardiac failure, pulsatile abdominal mass, bruit, limb ischemia, and venous congestion. We describe a patient with a complex iliocaval fistula secondary to a remote gunshot wound associated with a large 8.5-cm aortic aneurysm. Informed consent of the patient was obtained for publication of the case.
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349432/aortic-arch-banding-procedure-for-proximal-type-i-endoleak-after-thoracic-endovascular-aneurysm-repair-with-the-chimney-technique
#4
Genta Chikazawa, Arudo Hiraoka, Koichi Inoue, Kentaro Tamura, Taichi Sakaguchi, Hidenori Yoshitaka
An aortic arch banding procedure was performed on an 82-year-old man for treatment of proximal type I endoleaks 2 days after he had undergone emergency thoracic endovascular aortic repair with the chimney technique for a ruptured aortic arch aneurysm. Contrast-enhanced computed tomography after the second procedure demonstrated significant shrinkage of the aneurysmal sac as well as a complete disappearance of the endoleaks. The basic concept of this technique is to treat the type IA endoleak, including possible gutter endoleaks, by creating a new proximal seal zone distal to the chimney graft using a banding technique...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349431/complete-robotic-repair-of-a-renal-artery-aneurysm
#5
Kira Long, Jonathan Silberstein, Raju Thomas, Ashlie White, Jack Hua, Albert D Sam
Although the majority of renal artery aneurysms require only observation, those that require treatment have been addressed primarily surgically or endovascularly. We report a case of surgical resection of a large, symptomatic renal artery aneurysm from an entirely robotic approach.
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349430/surgical-repair-of-a-celiac-artery-aneurysm-using-a-sutureless-proximal-anastomosis-device
#6
Tetsuro Uchida, Azumi Hamasaki, Yoshinori Kuroda, Atsushi Yamashita, Jun Hayashi, Mitsuaki Sadahiro
Some celiac artery aneurysms are not suitable for endovascular therapy. We describe the case of a 63-year-old man with a celiac trunk aneurysm extending to the hepatosplenic bifurcation. The aneurysm was resected and oversewn at the origin from the abdominal aorta. A saphenous vein bypass from the supraceliac aorta to the celiac artery bifurcation was performed using a sutureless anastomotic device (PAS-Port system; Cardica, Redwood City, Calif) to create the proximal anastomosis, eliminating the need for aortic clamping...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349428/hybrid-repair-of-a-large-pseudoaneurysm-of-the-proximal-right-subclavian-artery-in-a-marfan-patient
#7
Emma van der Weijde, Jan Albert Vos, Robin H Heijmen
A pseudoaneurysm of the proximal right subclavian artery is rare and most commonly caused by penetrating or blunt trauma. We report a case of a Marfan patient with a large iatrogenic pseudoaneurysm of the right subclavian artery, induced by a puncture lesion during central venous catheter placement for an elective endovascular thoracic aortic procedure. The patient was successfully treated with a hybrid approach, which consisted of endovascular coiling and balloon occlusion of the adjacent vessels, followed by open surgical exploration and uneventful closure of the puncture hole with the use of bovine pericardium-reinforced sutures...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349422/hybrid-management-of-a-ruptured-right-subclavian-artery-aneurysm-dissection
#8
David Drullinsky, Heather Gill, Jason P Bayne, Jean-Francois Morin, Daniel Obrand
Aberrant right subclavian artery is the most common congenital malformation of the aortic arch (0.4%-2.0%). Aneurysms of aberrant subclavian arteries are extremely rare. This results in little experience with their treatment. We describe a case of a patient who presented to the emergency department with a dissection of an aberrant right subclavian artery that later progressed to rupture. Besides hemodynamic instability, this caused an acute superior vena cava syndrome, making airway control difficult. In the operating room, we obtained proximal control through thoracic endovascular aortic repair; median sternotomy was performed for distal control and evacuation of massive hemomediastinum...
December 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349419/covered-endovascular-repair-of-the-paravisceral-aorta
#9
Markus Plimon, Jürgen Falkensammer, Fadi Taher, Afshin Assadian
Open aortic repair is considered the "gold standard" treatment for aortic occlusive disease. We present the case of an 83-year-old patient with refractory hypertension caused by paravisceral aortic stenosis including both renal arteries and the superior mesenteric artery. We planned an endovascular approach and treated the patient with parallel stent grafts in the paravisceral aorta. At 1.5 years after the operation, the patient was free of hypertensive episodes. Covered endovascular repair of the paravisceral aorta may be a valuable alternative to open aortic repair in patients unfit for open surgery...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349417/emergent-endovascular-repair-of-a-ruptured-giant-internal-iliac-artery-aneurysm-using-an-inverted-iliac-limb-endograft
#10
Bruce L Tjaden, Rana O Afifi, Hazim J Safi
No abstract text is available yet for this article.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349409/salvage-of-bilateral-renal-artery-occlusion-after-endovascular-aneurysm-repair-with-open-splenorenal-bypass
#11
Samuel Jessula, Christine R Herman, Min Lee, Christopher B Lightfoot, Patrick Casey
We report renal salvage maneuvers after accidental bilateral renal artery coverage during endovascular aneurysm repair of an infrarenal abdominal aortic aneurysm. A 79-year-old man with an infrarenal abdominal aortic aneurysm was treated with endovascular aneurysm repair. Completion angiography demonstrated coverage of the renal arteries. Several revascularization techniques were attempted, including endograft repositioning and endovascular stenting through the femoral and brachial approach. The patient eventually underwent open splenorenal bypass with a Y Gore-Tex graft (W...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349408/infolding-of-fenestrated-endovascular-stent-graft
#12
Jason G E Zelt, Prasad Jetty, Adnan Hadziomerovic, Sudhir Nagpal
We report a case of infolding of a fenestrated stent graft involving the visceral vessel segment after a juxtarenal abdominal aorta aneurysm repair. The patient remains free of any significant endoleak, and the aortic sac has shown regression. The patient remains asymptomatic, with no abdominal pain, with normal renal function, and without ischemic limb complications. We hypothesize that significant graft oversizing (20%-30%) with asymmetric engineering of the diameter-reducing ties may have contributed to the infolding...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349407/endovascular-recanalization-of-occluded-superior-mesenteric-artery-using-retrograde-access-through-the-inferior-mesenteric-artery
#13
Eduardo Keller Saadi, Gustavo Oderich, Eduardo Medronha, Rodrigo Petersen Saadi, Marina Petersen Saadi, Cristiano Jaegger
Symptomatic occlusion of the superior mesenteric artery can be treated by open repair, hybrid procedure, or endovascular revascularization. In most cases, endovascular procedures are done by the antegrade approach. We report a case of a 67-year-old woman who presented with acute-on-chronic mesenteric ischemia successfully treated by retrograde endovascular recanalization of an occluded common hepatomesenteric trunk through the inferior mesenteric artery and arc of Riolan.
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349398/unexplained-rupture-after-endovascular-aneurysm-repair
#14
Marie Josee Elizabeth van Rijn, Sander Ten Raa, Joke M Hendriks, Frederico Bastos Goncalves, Hence J M Verhagen
We present a case of a 70-year-old man who was admitted with rupture of an abdominal aneurysm 4 years after endovascular aneurysm repair. He was compliant with yearly follow-up computed tomography angiography. One month earlier, his computed tomography angiogram showed perfect exclusion of the aneurysm and no endoleak. We explanted the stent graft and confirmed effective sealing, and the graft was intact. We found no signs of infection during 2 years of follow-up. This rupture is nonpredictable and unexplained and illustrates that unremarkable imaging does not guarantee prevention of rupture...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349390/durability-of-the-viabahn-stent-graft-after-axillary-artery-pseudoaneurysm-exclusion
#15
Aaron Y Chen, Isaac Laniado, Peter H Lin
Pseudoaneurysm formation caused by iatrogenic arterial injury during a regional anesthetic block is a rare complication. We report a case of a 56-year-old male patient who developed an axillary artery pseudoaneurysm caused by brachial plexus block performed for an upper extremity dialysis access operation. Successful repair of this pseudoaneurysm was achieved with endovascular stent graft exclusion. The repaired axillary artery with the stent graft remained patent after 10 years of follow-up. The successful long-term patency of this treatment and a strategy to potentially avoid this complication are discussed...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349386/successful-use-of-retrograde-branched-extension-limb-assembling-technique-in-endovascular-repair-of-pararenal-abdominal-aortic-aneurysm
#16
Jiang Xiong, Zhongzhou Hu, Hongpeng Zhang, Huanming Xu, Duanduan Chen, Wei Guo
Surgeon-modified retrograde branched extension limb assembling technique and bridged endografts were successfully used to exclude an asymptomatic pararenal abdominal aortic aneurysm and to reconstruct the superior mesenteric artery and bilateral renal arteries in a case with high-grade celiac artery stenosis, nondilated aorta above the superior mesenteric artery, and large lumen below the renal arteries. In patient-specific models for hemodynamics analysis, enhanced flow diversion to visceral arteries up to 6-month follow-up confirmed treatment feasibility; however, endograft configurations could be improved to avoid sharp corners at bifurcations, thereby ensuring smooth flow transport and possibly reducing risk for endograft narrowing or the development of thrombosis...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349377/emergency-thoracic-endovascular-aortic-repair-with-celiac-artery-coverage-in-hereditary-hemorrhagic-telangiectasia
#17
Yuji Kawano, Yuji Kanaoka, Nobuhiko Hiraiwa, Daisuke Nakatsuka, Minoru Tabata
Celiac artery (CA) coverage during thoracic endovascular aortic repair has been demonstrated to be a feasible and effective strategy for selected cases. However, there is a potential risk of ischemic complications due to CA coverage in patients with certain types of hereditary hemorrhagic telangiectasia (HHT). Herein, we report a case of thoracoabdominal aortic rupture in a patient with HHT that was successfully treated with emergency thoracic endovascular aortic repair covering the CA preceded by hepatic artery bypass...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349376/directional-tip-control-technique-for-optimal-stent-graft-alignment-in-angulated-proximal-aortic-landing-zones
#18
Toshio Takayama, Patrick J Phelan, Jon S Matsumura
Angulated anatomy in the aorta, such as tortuous infrarenal aortic necks or steep aortic arches, is a significant challenge for endovascular aortic repair because it often causes inadequate sealing and fixation, which may lead to treatment failure. We have developed a technique using off-the-shelf equipment to precisely control the deployment of stent grafts in challenging landing zones. The key of this technique is to create a through-and-through wire between two access sites and to use a guiding device over the wire...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349373/lower-extremity-compartment-syndrome-after-elective-percutaneous-fenestrated-endovascular-repair-of-an-abdominal-aortic-aneurysm
#19
John F Charitable, Thomas S Maldonado
Ischemic complications after fenestrated endovascular aortic aneurysm repair (FEVAR) can result in significant morbidity and mortality. We present a case of a 65-year-old man who underwent a FEVAR complicated by bilateral lower extremity compartment syndrome requiring four-compartment fasciotomies. This ischemic complication was likely caused by sheath occlusion because the patient had no evidence of arterial injury or distal plaque embolization. This case highlights the importance of careful postoperative monitoring after FEVAR, because the larger sheaths required can be occlusive and result in lower extremity ischemia, even for relatively short cases...
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349372/successful-off-label-use-of-the-gore-excluder-iliac-branch-endoprosthesis-to-preserve-gluteal-perfusion-during-staged-endovascular-repair-of-bilateral-isolated-hypogastric-aneurysms
#20
James W Cornwall, Daniel K Han, Daniel I Fremed, Peter L Faries, Ageliki G Vouyouka
Endovascular repair of iliac artery aneurysms has emerged as an alternative to traditional open surgical repair. Although there is little consensus on indications to preserve hypogastric blood flow during aneurysm repair, it is well understood that complications from bilateral hypogastric occlusion may be significant. The GORE EXCLUDER Iliac Branch Endoprosthesis (W. L. Gore and Associates, Flagstaff, Ariz) received United States Food and Drug Administration approval in March 2016 for treatment of common iliac artery and aortoiliac aneurysms...
March 2017: Journal of Vascular Surgery Cases and Innovative Techniques
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