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https://www.readbyqxmd.com/read/28814172/novel-endovascular-management-of-proximal-type-a-debakey-ii-aortic-dissection-with-a-patent-foramen-ovale-occluder
#1
Xun Yuan, Andreas Mitsis, David Mozalbat, Christoph A Nienaber
PURPOSE: To present a novel endovascular management option that avoids open surgery in selected patients with subacute type A aortic dissection (DeBakey II). CASE REPORT: A 75-year-old woman with previous infrarenal abdominal aortic aneurysm repaired in 2006 and multiple comorbidities (EURO score II 20.5%) was admitted with chest pain; computed tomography angiography (CTA) showed a new dissection in the ascending aorta just above the right coronary ostium. As the patient was considered unfit to undergo surgery, an endovascular solution was suggested after multidisciplinary team discussion...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28807407/infrarenal-aorta-as-the-donor-site-for-bypasses-to-the-superior-mesenteric-artery-for-chronic-mesenteric-ischemia-a-prospective-clinical-series-of-24-patients
#2
Giulio Illuminati, Giulia Pizzardi, Francesco G Calio', Rocco Pasqua, Federica Masci, Francesco Vietri
BACKGROUND: Treatment of symptomatic, chronic mesenteric ischemia is indicated to relieve symptoms and prevent acute ischemia and death. Current therapeutic options include endovascular and open surgery. The purpose of this prospective study was to evaluate the results of bypasses to the superior mesenteric artery arising from the infrarenal aorta or infrarenal aortic grafts. METHODS: From January 1999 to December 2016, 24 consecutive patients with a mean age of 61 years underwent a prosthetic bypass to the superior mesenteric artery...
August 11, 2017: Surgery
https://www.readbyqxmd.com/read/28805140/a-rat-model-for-the-in-vivo-assessment-of-biological-and-tissue-engineered-valvular-and-vascular-grafts
#3
Yukiharu Sugimura, Anna Kathrin Schmidt, Artur Lichtenberg, Alexander Assmann, Payam Akhyari
The demand for an improvement of the biocompatibility and durability of vascular and valvular implants requires translational animal models to study the in vivo fate of cardiovascular grafts. In the present article, a review on the development and application of a microsurgical rat model of infrarenal implantation of aortic grafts and aortic valved conduits is provided. By refinement of surgical techniques and inclusion of hemodynamic considerations, a functional model has been created, which provides a modular platform for the in vivo assessment of biological and tissue-engineered grafts...
August 12, 2017: Tissue Engineering. Part C, Methods
https://www.readbyqxmd.com/read/28795036/delayed-type-iii-endoleak-caused-by-fabric-erosion-after-endovascular-repair-of-an-abdominal-aortic-aneurysm
#4
Jae Hang Lee, Eung-Joong Kim, Jin-Ho Choi
A 74-year-old patient presented with recurrent aneurysms in the infrarenal abdominal aorta and right common iliac artery 6 years after endovascular aortic repair using endografts in the same location. The patient underwent an aorto-bi-iliac replacement with removal of the stent graft. Two holes measuring 2 mm each were found in the removed graft, and they appeared to have been caused by wear from continuous friction between the endograft and the aortic wall.
August 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28782417/improving-patient-compliance-with-post-evar-surveillance-may-prevent-late-rupture
#5
Alicia L Skervin, Chung S Lim, Kaji Sritharan
Endovascular aneurysm repair (EVAR) has gained increasing popularity in the treatment of infrarenal abdominal aortic aneurysm. Despite its favorable early outcomes, the long-term efficacy of EVAR remains a concern. Late rupture is the ultimate treatment failure and continues to complicate EVAR. Univariate and multivariate analyses have identified factors predictive of late rupture. The importance of EVAR surveillance to prevent late complications is equally widely acknowledged. This article aims to present our current understanding of the precipitating factors of late rupture after EVAR and explores whether the key to its prevention lies within improving patient factors, particularly compliance to follow-up appointments or whether physicians hold the solution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28782415/no-difference-in-neck-enlargement-for-patients-treated-with-double-proximal-self-expandable-suprarenal-fixation-endografting
#6
Andrés Reyes Valdivia, Georgios Pitoulias, África Duque Santos, Martín Fabregate Fuente, Apostolos G Pitoulias, Julia Ocaña Guaita, Claudio Gandarias
INTRODUCTION: Neck enlargement is well described in patients treated with self-expandable endografts for abdominal aortic aneurysms. Double endografting (ie, overlapping of stent grafts) occurs in patients with proximal cuffs or bifurcated to monoiliacal configuration conversions. When the aortic neck of patients receives 2 suprarenal fixation endografts, it may behave differently in terms of radial force and interaction of additional suprarenal stents extending to the visceral aorta...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28782109/low-vs-high-haemoglobin-trigger-for-transfusion-in-vascular-surgery-protocol-for-a-randomised-trial
#7
A Møller, H B Nielsen, J Wetterslev, O B Pedersen, D Hellemann, S Shahidi
BACKGROUND: In patients with cardiovascular disease, guidelines for administration of red blood cells (RBC) are mainly based on studies outside the vascular surgical setting with the recommendation to use a haemoglobin (hb) trigger-level lower than by guidelines from The European Society for Vascular Surgery. Restricting RBC transfusion may affect blood O2 transport with a risk for development of tissue ischaemia and postoperative complications. METHODS: In a single-centre, open-label, assessor blinded trial, 58 vascular surgical patients (> 40 years of age) awaiting open surgery of the infrarenal aorta or infrainguinal arterial bypass surgery undergo a web-based randomisation to one of two groups: perioperative RBC transfusion triggered by hb < 8 g/dl or hb < 9...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28779856/renal-complications-after-evar-with-suprarenal-versus-infrarenal-fixation-among-all-users-and-routine-users
#8
S L Zettervall, S E Deery, P A Soden, K Shean, J J Siracuse, M Alef, V I Patel, M L Schermerhorn
BACKGROUND: Previous studies comparing endografts with suprarenal and infrarenal fixation for endovascular abdominal aortic aneurysm repair (EVAR) have found conflicting results and did not account for differences in patient selection. This study aims to evaluate the differences in outcomes among surgeons who routinely use either suprarenal or infrarenal fixation, as well as all surgeons in the Vascular Study Group of New England (VSGNE). METHODS: All patients undergoing EVAR in the VSGNE from 2003 to 2014 were identified...
August 2, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28765014/follow-up-on-small-abdominal-aortic-aneurysms-using-three-dimensional-ultrasound-volume-versus-diameter
#9
Q M Ghulam, K K Bredahl, L Lönn, L Rouet, H H Sillesen, J P Eiberg
OBJECTIVES: Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. DESIGN: This was a prospective cohort study with repeated diameter and volume measurements by 3D-US...
July 29, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#10
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28758762/-leiomyoma-of-external-iliac-vein
#11
V Sihotský, P Berek, I Kopolovets, M Kubíková, M Frankovičová
Authors present a case report of a patient who was diagnosed with a tumour of external iliac vein. Excision of venous wall with tumour and reconstruction of external iliac vein with venous patch was performed. Postoperative course was without complication. The patient is without complications and also without signs of recurrence in one year follow up. Tumours of venous wall are rare. They originate from vena cava inferior, less often from extremity veins. The most frequent primary tumours of vein wall are leiomyosarcomas...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28756046/a-preoperative-risk-score-for-transfusion-in-infrarenal-endovascular-aneurysm-repair-to-avoid-type-and-cross
#12
Thomas F X O'Donnell, Katie E Shean, Sarah E Deery, Thomas C F Bodewes, Mark C Wyers, Kerry L O'Brien, Robina Matyal, Marc L Schermerhorn
OBJECTIVE: Preoperative type and cross are often routinely ordered before elective endovascular aneurysm repair (EVAR), but the cost of this practice is high, and transfusion is rare. We therefore aimed to stratify patients by their risk of transfusion to identify a cohort in whom a type and screen would be sufficient. METHODS: We queried the targeted vascular module of the National Surgical Quality Improvement Program (NSQIP) for all elective EVARs from 2011 to 2015...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28751118/description-of-a-reproducible-anatomically-based-surgical-algorithm-for-detection-of-pelvic-sentinel-lymph-nodes-in-endometrial-cancer
#13
Jan Persson, Barbara Geppert, Céline Lönnerfors, Michele Bollino, Anna Måsbäck
OBJECTIVE: To describe and evaluate a reproducible, anatomically based surgical algorithm, including reinjection of tracer to enhance technical success rate, for detection of pelvic sentinel lymph nodes (SLNs) in endometrial cancer (EC). METHODS: A prospective study of 102 consecutive women with high risk EC scheduled for robotic surgery was conducted. Following cervical injection of a fluorescent dye, an algorithm for trans- and retroperitoneal identification of tracer display in the lower and upper paracervical pathways was strictly adhered to...
July 24, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28745670/-the-administration-of-neurocytoprotectors-in-a-rat-model-of-experimental-spinal-cord-ischemia
#14
G V Ponomarev, A A Shmonin, A G Shumeeva, K T Aliev, T D Vlasov, A A Skoromets
AIM: To study an effect of cortexin on functional recovery and morphology of the spinal cord of rats with spinal cord ischemia. MATERIAL AND METHODS: Spinal cord ischemia was achieved by ligation of the infrarenal abdominal aorta in 16 rats stratified into two equal groups: the ligation of infrarenal aorta was performed in the control group, aorta ligation was performed also in the experimental group with preliminary intraperitoneally administration of cortexin in a dose of 0...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28739468/back-table-surgeon-modification-of-a-t-branch
#15
M Scheerbaum, T Kölbel, F Rohlffs, F Heidemann, E S Debus, N Tsilimparis
PURPOSE: Surgeon-modification of commercially available aortic stent grafts represents a salvage option to treat complex aortic pathologies in high-risk patients. TECHNIQUE: A 68-year old male was referred in our hospital with a contained rupture of the visceral aorta. The patient was previously treated with an infrarenal tube graft 16 years earlier as well as with a Crawford procedure with island patch of the coeliac trunk (TC) and the superior mesenteric artery (SMA) and bypasses to both renal arteries 6 years prior to admission...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739456/acute-type-b-dissection-causing-collapse-of-evar-endograft-and-iliac-limb-occlusion
#16
Nathan K Itoga, Tiffany Wu, Michael D Dake, Ronald L Dalman, Jason T Lee
We describe a rare case of acute type B dissection causing collapse of a previously placed infrarenal stent-graft, resulting in acute limb ischemia due to left iliac limb thrombosis in a 59-year-old male. The patient presented with acute back and abdominal discomfort radiating to his back, bilateral buttock stabbing discomfort, and left> right thigh and calf rest pain. CTA showed a spiral type B dissection with collapse of the proximal portion of the EVAR device and left limb occlusion. Urgent treatment with TEVAR distal to the left subclavian covered the entry tear and redirected the majority of the flow to the true lumen leading to near immediate expansion of the proximal portion of the EVAR device...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739451/rescue-of-a-failing-endovascular-infrarenal-aortic-repair-using-an-off-the-shelf-branched-endograft
#17
Gino Gemayel, Gabriel Verdon, Nicolas Murith, Christoph Huber
INTRODUCTION: Proximal aortic dilation following open and endovascular aortic repair (EVAR) is a well-known phenomenon. If severe enough it may lead to late onset of type Ia endoleak that jeopardise the proximal seal. CASE REPORT: We report the case of a patient previously treated by EVAR for an infrarenal aneurysm who developed a type Ia endoleak after proximal aortic dilation. His aneurysms enlarged to 10 cm mandating a rapid repair without the delay for a custom-made device...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28721336/post-endovascular-aneurysm-repair-evar-testicular-ischemia-a-rare-complication
#18
Eric Thomas, Brett L Parra, Shonak Patel
Endovascular aneurysm repair (EVAR) is a common modality of treating abdominal aortic aneurysms (AAA). Common complications include endoleak, bleeding, infection, contrast related injuries, and ischemia. We present the case of a patient who experienced a testicular infarction following repair of an infrarenal AAA. We also discuss the implications for this complication and review the available literature for similar cases and treatment options.
September 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28721011/effect-of-picroside-ii-on-hind-limb-ischemia-reperfusion-injury-in-rats
#19
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#20
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
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