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https://www.readbyqxmd.com/read/28902661/giant-thoracoabdominal-aortic-aneurysm
#1
Luca Di Marco, Domenico Attinà, Davide Pacini
: Aneurysms of the descending thoracic and thoracoabdominal aorta are life-threatening conditions. All aneurysms which have not yet had an indication for the treatment need regular follow-up to prevent rupture or dissection. We present a case of a patient with a giant aneurysm of the thoracoabdominal aorta who was denied both surgery and endovascular treatment.
September 11, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28898794/surgical-management-of-late-bullet-embolization-from-the-abdomen-to-the-right-ventricle-case-report
#2
Ramos Mayo Alan Elison, Diaz Elizondo Jose Antonio, Segura Marin Hector, Lopez Garnica Dolores, Treviño Garza Francisco Xavier
INTRODUCTION: Secondary embolus from gun projectile is a rare entity, it represents a clinical and therapeutic dilemma because the potential complications involving central and peripheral circulation. Each case reported in the literature represents a challenge because their unique and different clinical scenarios. PRESENTATION OF CASE: We present the management of a 33-year-old man with past history of a gunshot wound on left flank with no evidence of any exit wounds, treated with exploratory laparotomy without removing the gunshot bullet from the abdomen...
September 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28898729/evaluation-of-the-multi-slice-computed-tomography-outcomes-in-diaphragmatic-injuries-related-to-penetrating-and-blunt-trauma
#3
REVIEW
Mehmet Turmak, Muhammed Akif Deniz, Cihan Akgül Özmen, Aydın Aslan
PURPOSE: Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region. MATERIAL AND METHODS: 56 patients who underwent surgical procedure due to blunt or penetrating trauma were included to the study. RESULTS: There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was "the direct monitoring of defect" (54,3%)...
September 6, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28898129/trans-atlantic-comparison-of-ct-radiation-doses-in-the-era-of-radiation-dose-tracking-software
#4
Anushri Parakh, Andre Euler, Zsolt Szucs-Farkas, Sebastian T Schindera
OBJECTIVE: The purpose of this study is to compare diagnostic reference levels from a local European CT dose registry, using radiation-tracking software from a large patient sample, with preexisting European and North American diagnostic reference levels. MATERIALS AND METHODS: Data (n = 43,761 CT scans obtained over the course of 2 years) for the European local CT dose registry were obtained from eight CT scanners at six institutions. Means, medians, and interquartile ranges of volumetric CT dose index (CTDIvol), dose-length product (DLP), size-specific dose estimate, and effective dose values for CT examinations of the head, paranasal sinuses, thorax, pulmonary angiogram, abdomen-pelvis, renal-colic, thorax-abdomen-pelvis, and thoracoabdominal angiogram were obtained using radiation-tracking software...
September 12, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28892971/a-case-report-of-largest-documented-multilocular-cystic-nephroma-removed-by-thoracoabdominal-approach
#5
Ajit S Sawant, Abhishek Jaysukh Savalia, Prakash Pawar, Saylee Narwade, Radheshyam Chaudhari
Large renal tumours are not uncommon in developing countries. Enhancing renal tumours are considered to be malignant unless proved otherwise and radical surgical resection remains the mainstay of treatment of such tumours. A giant renal tumour, especially on right side, poses a big challenge for the operating team and requires a thoracoabdominal approach for successful excision. We report successful removal of the largest documented Multilocular Cystic Nephroma (MLCN, 5.5 kg) from a 28-year-old female who presented with right abdomen lump since two years...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28888759/impact-of-iliac-artery-anatomy-on-the-outcome-of-fenestrated-and-branched-endovascular-aortic-repair
#6
Enrico Gallitto, Mauro Gargiulo, Gianluca Faggioli, Rodolfo Pini, Chiara Mascoli, Antonio Freyrie, Stefano Ancetti, Andrea Stella
OBJECTIVE: Fenestrated and branched endovascular aneurysm repair (FB-EVAR) is a valid option to treat juxtarenal and pararenal abdominal aortic aneurysms and thoracoabdominal aortic aneurysms. Because successful deployment depends on complex maneuvers, hostile iliac artery anatomy (HIA) can prejudice the FB-EVAR outcome. The aim of the study was to evaluate the impact of HIA on FB-EVAR outcome. METHODS: Between 2010 and 2015, all patients undergoing FB-EVAR were prospectively categorized according to iliac anatomy (friendly iliac artery anatomy [FIA] or HIA)...
September 6, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28887256/remote-ischemic-preconditioning-decreases-the-magnitude-of-hepatic-ischemia-reperfusion-injury-on-a-swine-model-of-supraceliac-aortic-cross-clamping
#7
G Martikos, A Kapelouzou, M Peroulis, A Paspala, D Athanasiadis, A Maheras, T D Liakakos, K Moulakakis, S Vasdekis, A M Lazaris
BACKGROUND: Temporary hepatic ischemia is inevitable during open aortic surgery when supraceliac clamping is necessary, as in thoracoabdominal or pararenal aneurysms. Remote ischemic preconditioning (RIPC) has been described as a potential protective means against ischemia - reperfusion injury (IRI) in various tissues including the liver. The aim of this experimental study was to detect the effect of RIPC on liver IRI in a model of supraceliac aortic cross-clamping. METHODS: An animal study was performed...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28882080/use-of-the-nellix-endovascular-aneurysm-sealing-system-in-combination-with-parallel-grafts-for-the-treatment-of-a-symptomatic-type-v-thoracoabdominal-aortic-aneurysm
#8
Chris Klonaris, Athanasios Katsargyris, Dimitris Athanasiadis, Theodor Liakakos
PURPOSE: To report endovascular treatment of a symptomatic type V thoracoabdominal aortic aneurysm (TAAA) using the combined techniques of endovascular aneurysm sealing and parallel stent-grafts. CASE REPORT: A 70-year-old man was referred with a symptomatic type V TAAA. The Nellix EndoVascular Aneurysm Sealing (EVAS) System was used in combination with 2 chimney grafts for the celiac artery (CA) and the superior mesenteric artery (SMA); one periscope graft perfused the right renal artery...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28881905/perforated-esophageal-intervention-focus-perf-study-a-multi-center-examination-of-contemporary-treatment
#9
J T Ali, R D Rice, E A David, J D Spicer, J J Dubose, L Bonavina, S Siboni, T A O'Callaghan, X Luo-Owen, S Harrison, C G Ball, J Bini, G A Vercruysse, D Skarupa, C C Miller Iii, A L Estrera, K G Khalil
The treatment of esophageal perforation (EP) remains a significant clinical challenge. While a number of investigators have previously documented efficient approaches, these were mostly single-center experiences reported prior to the introduction of newer technologies: specifically endoluminal stents. This study was designed to document contemporary practice in the diagnosis and management of EP at multiple institutions around the world and includes early clinical outcomes. A five-year (2009-2013) multicenter retrospective review of management and outcomes for patients with thoracic or abdominal esophageal perforation was conducted...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28876672/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#10
V M Meijering, A T Hattam, P H Navsaria, A J Nicol, S Edu
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#11
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876661/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#12
M Z Koto, F Mosai, O Y Matsevych
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practised, but in Africa the use of laparoscopy is still in its infancy stage. METHOD: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done. All patients offered laparoscopic exploration and repair from January 2012 to December 2015 at Dr George Mukhari Academic Hospital were analysed...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876604/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#13
F Mosai
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practiced, but in Africa the use of laparoscopy is still in its infancy stage. We reviewed a single centre experience in using laparoscopy in Africa for management of patients with penetrating diaphragmatic injuries with or without associated intra-abdominal injuries. METHOD: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875285/current-status-of-cardiovascular-surgery-in-japan-2013-and-2014-a-report-based-on-the-japan-cardiovascular-surgery-database-5-thoracic-aortic-surgery
#14
REVIEW
Hideyuki Shimizu, Norimichi Hirahara, Noboru Motomura, Hiroaki Miyata, Shinichi Takamoto
BACKGROUND: Although open aortic repair (OAR) is still considered to be a standard treatment for thoracic aortic diseases, the indications for thoracic endovascular treatment (TEVAR)/hybrid aortic repair (HAR) have expanded in recent years. The purpose of this study was to review the current status of treatment of thoracic aortic diseases in Japan. METHODS: Data for 2013 and 2014 concerning surgery for diseases of the thoracic/thoracoabdominal aorta were extracted from the Japan Cardiovascular Surgery Database (JCVSD)...
September 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28874089/outcome-of-surgeon-modified-fenestrated-branched-stent-grafts-for-symptomatic-complex-aortic-pathologies-or-contained-rupture
#15
Nikolaos Tsilimparis, Franziska Heidemann, Fiona Rohlffs, Holger Diener, Sabine Wipper, E Sebastian Debus, Tilo Kölbel
PURPOSE: To analyze the outcome of surgeon-modified fenestrated and branched stent-grafts (sm-FBSG) in high-risk patients with symptomatic complex aortic pathology or contained rupture. METHODS: A single-center retrospective analysis was conducted of 21 consecutive patients (mean age 70 years, range 58-87; 16 men) treated with a sm-FBSG from April 2014 to September 2016. The indications included 11 thoracoabdominal and 10 pararenal aortic pathologies, which presented as symptomatic in 8 and as contained rupture in 13 patients...
September 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28856583/thoracoabdominal-aortic-aneurysm-repair-open-endovascular-or-hybrid
#16
REVIEW
Joshua M Rosenblum, Edward P Chen
Successful repair of complex thoracoabdominal aortic aneurysms requires careful surgical planning based on anatomic and patient considerations. Not only are surgical considerations key, but also post-operative care, regardless of surgical approach, can dramatically impact both short- and long-term outcomes. While open repair has been the gold standard for decades, the technical challenges associated with operative repair, a specialty approach requisite for good outcomes, and the unique challenges in the post-operative care of these patients have given providers pause when considering operative intervention...
August 30, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28853590/pedunculated-well-differentiated-liposarcoma-of-the-oesophagus-mimicking-giant-fibrovascular-polyp
#17
A S Mehdorn, F Schmidt, K Steinestel, E Wardelmann, B Greulich, D Palmes, N Senninger
We present a rare case of a big oesophageal liposarcoma causing dysphagia and weight loss in a 75-year-old patient. Endoscopically, a pedunculated lesion with subtotal obstruction of the oesophageal lumen had been detected and thoracoabdominal oesophageal resection with gastric sleeve reconstruction was performed. Surprisingly, a liposarcoma of the oesophagus was revealed on histopathological analysis, showing MDM2 overexpression. Oncological follow-up has been uneventful and the patient remains in good clinical shape at 15 months after surgery...
September 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28838022/-characteristics-and-treatment-strategies-for-penetrating-injuries-on-the-example-of-gunshot-and-blast-victims-without-ballistic-body-armour-in-afghanistan-2009%C3%A2-%C3%A2-2013
#18
Christoph Güsgen, Arnulf Willms, Ines Richardsen, Dan Bieler, Erwin Kollig, Robert Schwab
Much like other countries, Germany has recently seen terrorist attacks being planned, executed or prevented at the last minute. This highlights the need for expertise in the treatment of penetrating torso traumas by bullets or explosions. Data on the treatment of firearm injuries and, even more so, blast injuries often stems from crises or war regions. However, it is difficult to compare injuries from such regions with injuries from civilian terrorist attacks due to the ballistic body protection (protective vests, body armour) worn by soldiers...
August 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28836901/a-clinical-review-of-early-outcomes-from-contemporary-flow-modulation-versus-open-fenestrated-and-branch-technologies-in-the-management-of-thoracoabdominal-aortic-aneurysm
#19
Sherif Sultan, Edel P Kavanagh, Edward Diethrich, Victor Costache, Mohamed Sultan, Fionnuala Jordan, Niamh Hynes
Traditional therapeutic options for complex thoracoabdominal aneurysm include open repair, hybrid repair or endovascular repair (involving fenestrated or branched endografts). The Streamliner Multilayer Flow Modulator has been available for treatment of thoracoabdominal aneurysms since 2010. Its design permits blood flow to perfuse through the mesh in a modus that preserves collateral branch patency, while modulating turbulent to laminar flow within the device. The flow then stagnates over time within the surrounding aneurysm sac...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28818295/total-endovascular-treatment-for-extent-type-1-and-5-thoracoabdominal-aortic-aneurysms
#20
Gabriele Piffaretti, Federico Fontana, Marco Franchin, Alessandro Bacuzzi, Walter Dorigo, Patrizio Castelli, Matteo Tozzi
OBJECTIVE: The study objective was to describe the results of thoracic endovascular aortic repair with the intentional coverage of the celiac artery and distal supramesenteric landing zone for extent type 1 and type 5 thoracoabdominal aortic aneurysms. METHODS: Inclusion criteria were thoracic endovascular aortic repair with celiac artery coverage to treat elective or urgent extent type 1 and 5 thoracoabdominal aortic aneurysms. Primary end points were in-hospital and follow-up survival, freedom from aortic-related mortality, and freedom from reintervention...
July 22, 2017: Journal of Thoracic and Cardiovascular Surgery
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