Luehr M, Etz CD, Mohr FW, Borger MA: Surgical management after stent-graft failure during the frozen elephant trunk technique for acute type A aortic dissection. J Thorac Cardiovasc Surg 2012;144:e106-e108. Czerny M, Bachet J, Bavaria J, Bonser RS, Borger MA, De Paulis R, DiBartolomeo R, Grabenwoeger M, Lonn L, Loubani M, Mestres CA, Schepens MA, Weigang E, Carrel TP: The future of aortic surgery in Europe. Eur J Cardiothorac Surg 2013;43:226-30.
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Does anyone know if this code is a replacement code for 93544? We never did the aortic root injection but do the aortography? I cant see where there
Looking for online definition of translumbar aortography in the Medical Dictionary? translumbar aortography explanation free. What is translumbar aortography? Meaning of translumbar aortography medical term. What does translumbar aortography mean?
TY - JOUR. T1 - Patologia estesa dellaorta toracica. T2 - Trattamento ibrido con la tecnica del frozen elephant trunk. AU - Di Eusanio, Marco. AU - Armaro, Alessandro. AU - Di Marco, Luca. AU - Pacini, Davide. AU - Pantaleo, Antonio. AU - Di Bartolomeo, Roberto. PY - 2011/6. Y1 - 2011/6. N2 - Background. Aneurysms of the aortic arch extending beyond the origin of the left subclavian artery represent a challenging pathology in aortic surgery and, most commonly, are treated with different surgical, endovascular or hybrid two-staged procedures. In 2006, we initiated an intense surgical program with the frozen elephant trunk procedure that, combining together conventional surgery with endovascular techniques, allows single-stage treatment of patients with extended disease of the thoracic aorta. We here describe our surgical technique and the results with the single-stage frozen elephant trunk procedure. Methods. Between January 2007 and August 2010, 87 patients were treated with the frozen elephant ...
This paper contains a brief review of the cases, published earlier, of aneurysms of the sinuses of Valsalva, and a case is reported in which the diagnosis was made before rupture of the aneurysm by means of thoracic aortography. No reports are to be found in the literature of the diagnosis of unruptured aortic sinus aneurysms and of the associated clinical findings. Roentgenograms, aortograms and catheterization findings are included.. ...
Diagnostic Abdominal Aortography and Renal Angiography-Local Coverage Determination,1. The indications for renal arteriography adapted from the American College of Radiology (1999) include the following:
Angiographies of the supra-aortic vessels by magnetic imaging have become common recently. So it was the purpose of this study to evaluate the imaging potential of different contrast agents.. Three contrast agents for magnetic resonance imaging are compared in angiographies of the supra-aortic arteries in a intraindividual study of 10 patients.. All applications of these contrast agents are performed with a flow of 2 ml/s. One contrast medium is applicated a second time with a reduced flow of 1 ml/s.. The angiographies of the supra-aortic vessels are evaluated by two experienced readers in a consensus reading. The signal/noise- and contrast/noise-ratio of anatomic vessel segments of the carotic and vertebral arteries are measured and compared to each other. ...
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Looking for online definition of Amplatz aortography catheter in the Medical Dictionary? Amplatz aortography catheter explanation free. What is Amplatz aortography catheter? Meaning of Amplatz aortography catheter medical term. What does Amplatz aortography catheter mean?
I. The Electrocardiogram … A. Admissibility in Evidence of Electrocardiogram … B. Physician Cannot Testify as to Electrocardiogram without Producing It … C. Electrocardiographic Recordings and Interpreting … D. Physician Who Testifies as to Electrocardiogram Does Not Have to Have Made It … E. Value of Electrocardiogram Lies in Plurality for Purpose of Comparison … F. Clinical Correlation II. The Myelogram … A. Attending Physician May Testify as to Pathology Revealed by Myelogram … B. No Introduction in Evidence of Myelogram after Hearing or Trial … C. May Employee be Compelled to Undergo Myelogram? III. The Aortogram … A. Dangers in Aortography … B. Cause of Paraplegia following Aortogram … C. Who Performs Aortography … D. Injuries following Attempted Aortogram … E. Physicians Negligent Acts in Attempting Aortography IV. The Electroencephalogram … A. Admissibility of Electroencephalograms in Evidence … B. Retroactive Admissibility … C. Foundations Must Be Laid … D.
Traumatic aortic injury (TAI) is most often caused by blunt trauma (refered to as BTAI) and is best described in terms of injury location, type and and severity: abdominal aortic injury aortic pseudoaneurysm thoracic aortic injury minimal aor...
Patients involved in high-energy blunt trauma involving rapid deceleration are at significant risk for blunt aortic injury. The majority of blunt aortic injuries are due to motor vehicle collision. In the United States, blunt aortic injury is the sec
The CX Aortic Edited Cases session yesterday provided the unique opportunity for the audience to interact with experts and ask questions about the cases being presented. The first session focused on thoracic aortic cases and the remainder were abdominal aortic cases.. Michael Dake (Stanford, USA) presented a case with the TAG thoracic branch endoprosthesis (Gore) which is part of a US feasibility multicentre trial that has evaluated 22 patients (mean age 74.1±10.5 years, 54.5% male) undergoing branched thoracic endovascular aortic repair (B-TEVAR) in Ishimaru zone 2.. According to Dake, the endograft features a single side branch designed to facilitate aortic coverage proximal to the left subclavian artery, while maintaining branch vessel patency. Pathology treated included fusiform (n=10) or saccular (n=12) aneurysm, with a mean aortic diameter of 5.7±1.1cm.. Reporting on the progress of the trial, he said that the primary endpoints of device delivery and branch vessel patency was achieved in ...
An improved stent design and stent delivery catheter assembly for repairing a main vessel and a side branch vessel forming a bifurcation. The stent includes rings aligned along a common longitudinal axis and connected by links, where the stent has one or more portals for aligning with and partially expanding into the opening to the side branch vessel. The stent is implanted at a bifurcation so that the main stent section is in the main vessel, and the portal section covers at least a portion of the opening to the side branch vessel. A second stent can be implanted in the side branch vessel and abut the expanded central section to provide full coverage of the bifurcated area in the main vessel and the side branch vessel. Radiopaque markers on the stent and on the tip of the delivery catheter assist in aligning the portal section with the opening to the side branch vessel.
The catheter assembly includes an expandable member mounted to the distal end of a placement catheter, for delivery of a therapeutic device in one of the branch vessels of a bifurcated vessel. The catheter assembly includes lumens for a tracking guide wire and a positioning guide member for placement of the therapeutic device. The therapeutic device is mounted on the expandable member, the tracking guide wire is placed into the target branch vessel, and the placement catheter is then introduced over the tracking guide wire. A positioning guide member is introduced through the catheter, extended through an exit port in the catheter proximal to the expandable member, and then placed in another branch vessel of the bifurcation. The placement catheter then is advanced until the positioning guide member engages the vessel carina between the branch vessels, and the therapeutic device then may be placed accurately in the target branch vessel. In another form of the catheter assembly, a secondary catheter
The only disclosure restriction on the PI is that the sponsor can review results communications prior to public release and can embargo communications regarding trial results for a period that is more than 60 days but less than or equal to 180 days. The sponsor cannot require changes to the communication and cannot extend the embargo ...
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TY - JOUR. T1 - Outcome of medical and surgical treatment in patients with acute type B aortic dissection. AU - Hsu, Ron Bin. AU - Ho, Yi Lwun. AU - Chen, Robert J.. AU - Wang, Shoei Shen. AU - Lin, Fang Yue. AU - Chu, Shu Hsun. PY - 2005/1/1. Y1 - 2005/1/1. N2 - Background. Optimal treatment of acute type B aortic dissection remain unclear. The aim of this study was to assess the clinical outcome of acute type B aortic dissection. Methods. In the last 8 years, 107 patients were admitted for acute type B aortic dissection. We medically treated patients at the time of onset with antihypertensives. Surgery was considered if there is intractable pain, uncontrolled hypertension, severe aortic branch malperfusion, or aneurysm expansion. Results. Twenty-nine patients had pleural effusion (27%), 9 patients had leg ischemia (8%), 5 patients had impending rupture, and 2 patients had aneurysm enlargement exceeding 60 mm on repeated imaging studies. A total of 16 patients (15%) underwent surgical ...
SCVS 2020 Abstracts: Single-stage Hybrid Repair Of A Thoracoabdominal Aortic Aneurysm Complicated By Chronic Type B Aortic Dissection And Kommerells Diverticulum Via Simultaneous Median Sternotomy And Laparotomy
Thoracic endovascular aneurysm repair (TEVAR) is a safe and effective procedure for the treatment of thoracic aortic aneurysms (TAAs).
Current management and outcome of chronic type B aortic dissection: results with open and endovascular repair since the advent of thoracic endografting
Current management and outcome of chronic type B aortic dissection: results with open and endovascular repair since the advent of thoracic endografting
Aortic dissection, though rare, is an often fatal event.1 A recent population-based study from Oxford showed that women have higher mortality from aortic dissection and are more likely to die before hospital assessment,2 which was also shown by the worlds largest registry of aortic dissection.3 Importantly, most individuals with aortic dissection had inadequately controlled hypertension, suggesting that modifiable risk factors may play a role in prevention.2 Moreover, women have worse outcomes following surgery for aortic dissection,3 and the surgical risk is even higher during pregnancy.4 ,5 The majority of aortic dissections in women of childbearing age occur during pregnancy and have adverse consequences for the mother and the fetus.6 Data from the Swedish National Birth Registry in women ,40 years of age have shown that pregnancy is associated with a 25-fold increased risk of aortic dissection.6 The scientific literature regarding aortic dissection and pregnancy is largely made up of case ...
Sternotomy for AVR surgery. Bilateral hilar prominence; pulmonary arteries dilatation? On the lateral view, possibility of an enormous aortic pseudoaneurysm vs enormous pulmonary trunk. Those findings werent present in previous chest x-rays, before the surgery. ...
Greenhalgh spoke to the audience about innovations and challenges to innovation in collecting data. He presented insights from the European Vascular and Endovascular Monitor, a consumption-based monitor covering 200 centres from Western Europe. He said that the advantage of a monitor approach was that it was enduring and effective in rapidly-shifting markets.. From the thoracic market, data showed that thoracic endovascular aneurysm repair remains the "gold standard" and that the current issues in the thoracic field were the size of the aneurysm, and the perceived need for a screening programme. For carotid procedures, Greenhalgh said the data indicated open surgery as the gold standard and that endovascular procedures were focused in the German and Italian markets.. "Endovascular procedures continue to grow at the expense of open surgery," Greenhalgh commented on aortic-iliac procedures and femoropopliteal, with the use of drug-eluting balloons on the increase in the latter. Hefsyv identified ...
... : Current Techniques with Fenestrated, Branched and Parallel Stent-Grafts by Gustavo S. Oderich English | 9 Apr. 2017 | ISBN: 3319151
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Pena, Constantino, "Aortoiliac Aneurysms with No Distal Landing Zone: Strategies for Management of the Hypogastric Artery and External Iliac Extensions" (2014). All Publications. 281 ...
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An endograft delivery device assembly is disclosed. The assembly comprises: a tip; a guide wire cannula, the guide wire cannula; a pusher disposed around the guide wire cannula, the pusher having a sheath assembly receiving portion at a proximal end thereof and a main portion extending distally from the sheath assembly receiving portion to a distal end, the sheath assembly receiving portion having at least one longitudinally extending groove; and a sheath assembly slidably mounted to the sheath assembly receiving portion of the pusher. The sheath assembly has a sheath portion, mountable over a endograft, and slide connecter portion. The slide connector portion has at least one inwardly projecting key, the key keying with the groove. The sheath assembly is slidably movable from an extended position over the endograft to a retracted position in which the endograft is uncovered.
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[117 Pages Report] Check for Discount on Global Aortic Repair Devices Sales Market Report 2017 report by QYResearch Group. In this report, the global Aortic Repair Devices market is...
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Aortic dissection is a condition in which the inner layer of the aortic wall splits open. The main situations in which an aortic...
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A system and method for endoluminal grafting of a main anatomical conduit (e.g., the aorta) and various branch conduits (e.g., side branch vessels such as the carotid, innominate, subclavian, intercos
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Conformability Matters With TEVAR In Or Near The Aortic Arch: Modifications Of The C-TAG Device To Deal With Radial Fit Issues Of The Proximal Endograft: Redeployability And The Ability To Modify Proximal Graft Angles Are Also ...
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A series of studies of f-electron systems based on density functional theory methods have been performed. The focus of the studies has been on magnetic and structural properties, as well as investigating ways to handle strong electron correlation in these systems.. A version of the self-interaction correction (SIC) method has been developed for a full-potential linear muffin-tin orbital method. The method is demonstrated to have the strong capabilities of previous SIC implementations, to study energetics and phase stabilities of d- and f-electron systems with localisation-delocalisation transitions, but with no geometrical constraints from the underlying band structure method. The method is applied to the high-TC superconductor CeOFeAs, in which the f-shell of the Ce atoms is argued to undergo a Mott transition to a delocalised state under pressure.. The non-collinear magnetic structures of two rare earth compounds, TbNi5 and CeRhIn5 have been studied, and in both cases the complex magnetic ...
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In this study, we provide a contemporary overview of clinical outcomes in patients with known MFS without prior aortic dissection. This represents one of the largest MFS studies to date using 3-dimensional imaging techniques. We found a type B aortic dissection rate of 9% during a median follow-up period of 6 years. Type B aortic dissections generally occurred in mildly dilated proximal descending aortas, especially in patients with prior prophylactic aortic surgery. From our data, we were able to develop a risk score to predict type B aortic dissection in patients with MFS, on the basis of history of prophylactic aortic root surgery and proximal descending aortic diameter.. The occurrence of type A aortic dissection has become a rare event in patients with known MFS in the era of aggressive prophylactic surgery. Although AoRR has improved life expectancy considerably, distal aortic disease may develop later in patients with MFS (14,15). Replacement of the aortic root or ascending aorta with a ...
In this study, we provide a contemporary overview of clinical outcomes in patients with known MFS without prior aortic dissection. This represents one of the largest MFS studies to date using 3-dimensional imaging techniques. We found a type B aortic dissection rate of 9% during a median follow-up period of 6 years. Type B aortic dissections generally occurred in mildly dilated proximal descending aortas, especially in patients with prior prophylactic aortic surgery. From our data, we were able to develop a risk score to predict type B aortic dissection in patients with MFS, on the basis of history of prophylactic aortic root surgery and proximal descending aortic diameter.. The occurrence of type A aortic dissection has become a rare event in patients with known MFS in the era of aggressive prophylactic surgery. Although AoRR has improved life expectancy considerably, distal aortic disease may develop later in patients with MFS (14,15). Replacement of the aortic root or ascending aorta with a ...
TY - JOUR. T1 - Endovascular aortic aneurysm repair with carbon dioxide-guided angiography in patients with renal insufficiency. AU - Criado, Enrique. AU - Upchurch, Gilbert R.. AU - Young, Kate. AU - Rectenwald, John E.. AU - Coleman, Dawn M.. AU - Eliason, Jonathon L.. AU - Escobar, Guillermo A.. PY - 2012/6/1. Y1 - 2012/6/1. N2 - Objective: Renal dysfunction following endovascular abdominal aortic aneurysm repair (EVAR) remains a significant source of morbidity and mortality. We studied the use of carbon dioxide (CO 2) as a non-nephrotoxic contrast agent for EVAR. Methods: Recorded data from 114 consecutive patients who underwent EVAR with CO 2 as the contrast agent over 44 months were retrospectively analyzed. CO 2 was used exclusively in 72 patients and in an additional 42 patients iodinated contrast (IC) was given (mean, 37 mL). Renal and hypogastric artery localization and completion angiography were done with CO 2 in all patients, including additional arterial embolization in 16 cases. ...
Treatment of endoleaks after thoracic endovascular repair remains challenging, particularly when the proximal landing zone is small and partly includes the origin of the neck vessels. We report a Type Ia endoleak, occurring after thoracic endovascula
Boomington, Ind. ─ Cook Medical has received premarket approval from the U.S. Food and Drug Administration (FDA) for its lower-profile Zenith Alpha™ Thoracic Endovascular Graft. Zenith Alpha Thoracic is indicated for the endovascular treatment of patients with isolated lesions of the descending thoracic aorta (not including dissections) having vascular anatomy suitable for endovascular repair1. The approval of Zenith Alpha Thoracic was based on two pivotal clinical trials that studied the safety and effectiveness of the device in patients with aortic aneurysm/ulcer or blunt traumatic aortic injury.. Zenith Alpha Thoracic will allow physicians to treat more patients with TEVAR (thoracic endovascular aortic repair) because of its lower-profile introduction system and broad range of sizes. With a 16-20 French delivery system, Zenith Alpha Thoracic was developed to address vascular access issues associated with larger-profile devices and to increase conformability in tortuous anatomy.. The ...
FLAGSTAFF, Ariz. - July 13, 2017 - W. L. Gore & Associates, Inc. (Gore) today announced the first patient implant of the GORE® TAG® Conformable Thoracic Stent Graft with ACTIVE CONTROL System after receiving CE Mark last month. The first implant was performed by Prof. Dr. med. Giovanni Torsello and Dr. med. Martin Austermann at St. Franziskus Hospital, Munster, Germany.. The thoracic endovascular aortic repair (TEVAR) device is the first to feature a new delivery system that provides the physician with controlled, staged deployment. The system optimizes accuracy, angulation, and apposition to treat etiologies of the descending thoracic aorta including aneurysms, transections, and acute and chronic Type B dissections. The new device will be formally launched in European regions later this year.. The GORE® ACTIVE CONTROL System enhances the exceptional conformability of the stent graft; facilitating the optimized wall apposition that the Conformable GORE® TAG® Device is renowned for even in ...
Introduction: Endovascular aneurysm repair (EVAR) has been an established treatment for abdominal aortic aneurysm (AAA). Although statin use has been shown associated with better long-term survival following open AAA surgery, its impact on EVAR has not been systematically explored.. Methods: We retrospectively analyzed a multicenter database of 368 consecutive patients (age, 76 ± 8 years; 84% male) undergoing EVAR for AAA between November 2006 and December 2013. The outcome measure was overall survival following EVAR. Independent predictor associated with the outcome was assessed by Cox proportional hazard regression model. Furthermore, the association between the statin use and the outcome was assessed.. Results: During the follow-up of 30 ± 20 months, 38 patients died from cardiovascular disease (33%), cancer (23%) or infection (23%). Survival rate was 96% and 81% at 1 and 5 years, respectively. In Cox regression analysis, statin use (in 213 AAA patients, 58%) was negatively associated with ...
BACKGROUND: Aortic dissection is a separation of the aortic wall, caused by blood flowing through a tear in the inner layer of the aorta. Aortic dissection is an infrequent but life-threatening condition. The incidence of aortic dissection is 3 to 6 per 10,000 per year in the Western population, and can be up to 43 per 10,000 per year in the Eastern population. Over 20% of people with an aortic dissection do not reach a hospital alive. After admission, the mortality rates for people with an aortic dissection are between 10% and 20% for those who received endovascular treatment, and between 20% and 30% for those who had open surgery. Thoracic endovascular aortic repair (TEVAR) is the standard endovascular method to treat complicated type B aortic dissection (aortic dissections without involvement of the ascending aorta). Although TEVAR is less invasive than open surgery and has a better long-term aortic remodeling effect than conservative medical treatment, favourable aortic remodelling is ...
If you have been diagnosed with thoracic aortic aneurysm, you may be a candidate for endovascular stent grafting. Medtronic stent grafts used to treat over 100,000 patients.
Research Report on Global Endovascular Aneurysm Repair (EVAR) Stent Grafts Sales Market Report 2017. The Report includes market price, demand, trends, size, Share, Growth, Forecast, Analysis & Overview.
OBJECTIVE This study reports the early and midterm to long-term experience of chimney grafts (CGs) in urgent endovascular repair of complex lesions in the thoracic aorta. METHODS Twenty-nine high-risk patients (20 men) who were unfit for open repair were treated using CG technique for ruptured (n = 14) or symptomatic (n = 15) aortic lesions engaging the aortic arch itself (n = 9), the descending aorta (n = 10), or the thoracoabdominal aorta (n = 10). Twenty-two patients (76%) were treated urgently (≤24 hours) and seven were semiurgent (≤3 days). Of 41 chimneys used, 24 were placed in supra-aortic branches and 17 in visceral branches. Median follow-up (interquartile range) for the entire cohort was 2 years (0.6-3.8 years), 2.5 years (1-4 years) for 30-day survivors, and 3.5 years (1.9-6.4 years) for those who were still alive. RESULTS Four patients (14%) died ≤30 days of cerebral infarction (n = 1), visceral ischemia secondary to the initial rupture (n = 1), multiple organ failure (n = 1), or
Prior to endograft deployment, the position of all arch branches was ascertained by arteriography using a pigtail catheter inserted from left femoral arterial access. The endograft was then deployed, but it remained partially constrained because of the DLTs. Partial constraint of the endograft and traction towards the inner aortic curvature (using ETAG) were necessary to leave space for the cannulation of fenestrations from the side of the outer aortic arch curvature. The IA and LCCA fenestrations were cannulated (the LSA had been pre-cannulated) and covered stents positioned within all three and kept ready for deployment: BeGraft 14 × 38 mm (Bentley InnoMed GmbH, Lotzenäcker 25, 72379 Hechingen, Germany) via 12 Fr/45 cm guiding sheath (Flexor Ansel, COOK Medical, Bloomington, IN 47402-4195 USA) in the IA, Advanta 12 × 29 mm (Getinge, 40 Continental Blvd, Merrimack, NH 03054, USA) via 9 Fr/45 cm guiding sheath (Flexor Ansel, COOK Medical) in the LSA and BeGraft 7 × 38 mm via 7 Fr/90 cm ...
Methods In 11 patients with Stanford B aortic dissection, TEE and TTE were used to determine the parameters for pre-surgery diagnosis and selection of a coated stent. During surgery, TEE and TTE provided real-time and dynamic monitoring and guiding for precise implantation of the coated stent to effectively seal the tear of the aortic dissection. After surgery, clinical efficacy and potential side effects of the implantation of the coated stent were evaluated.. ...
Clause 1, describes the global Stent Grafts market introduction, market overview, product image, market opportunities, market summary, market risk, development scope, global Stent Grafts market presence;. Clause 2 and 3 studies the key Stent Grafts market competitors, their sales volume, market profits and price of Stent Grafts in 2016 and 2017;. Clause 4,5 and 6, introduces the global Stent Grafts market by regions, with sales, market revenue, and share of Stent Grafts market for each region from 2017 to 2022;. Clause 7, conducts the region-wise study of the global Stent Grafts market based on the sales ratio in each region and market share from 2012 to 2017;. Clause 8 displays the market by type and application, with sales global Stent Grafts market share and growth rate by application, type, from 2012 to 2017;. Clause 9 and 10 describes the global Stent Grafts market prediction, by regions, application, and type with global Stent Grafts market revenue and sales, from 2017 to 2022.. Clause 11, ...
different portions of the stent/stent graft 10 are heat set at different diameters. For example, a braided material could be fabricated on a mandrel having a first larger diameter (e.g., 30-35 mm), which is generally the maximum diameter to which the stent/stent graft would be capable of expanding. The braided material may then be pulled down or compressed onto a mandrel having a second smaller diameter (e.g., 20-25 mm) and heat set such that the heat set stent/stent graft is capable of self-expanding to the diameter of the second smaller diameter. However, when the stent/stent graft 10 is axially compressed, the stent/stent graft is capable of expanding to the first larger diameter. Thus, in order to deploy the stent/stent graft 10, the distal end 34 of the stent/stent graft 10 may be positioned distally of the aneurysm 14 and as the delivery catheter 38 is retracted, the distal end of the stent/stent graft engages the lumen 12. As the stent/stent graft is further deployed in the region of an ...
Endovascular aortic aneurysm repair (EVAR) is a surgical operation for patients suffering from aorta inflation known as aorta aneurysm. EVAR carries significantly lower preoperative risk than open repair surgery; therefore, it is preferred by patients and recommended by medical guidelines as the choice for treating abdominal aortic aneurysm AAA [1]. There is an obligatory need for lifelong surveillance after this operation and it is considered to be expensive, varied, and poorly-calibrated [2]. However, the surveillance procedures are extensively various [3] and there is shortage of an indication to select the best timing or modality; Patients may be exposed to radiations and contrast nephropathy as a result of frequent surveillance. However, for some patients, complications required for treatment might be missed between surveillance [4-6]. For that reason, optimizing surveillance is very important [7, 8]. It is considered as an important issue in clinics and affects the long-standing ...
Renal insufficiency is a risk factor for mortality and morbidity during endovascular aneurysm repair. Multiple changes in practice have occurred to mitigate renal injury and renal dysfunction. Transrenal fixation does carry an increased risk of a decline in renal function in the medium term. Renal stenting for athero-occlusive disease during endovascular aneurysm repair needs careful consideration, as indications have changed and there are unexpected consequences with early vessel occlusion. The growing number of renal interventions during complex endovascular aneurysm repair with the advent of chimney snorkel/periscope techniques and the introduction of fenestrated grafts has shown the resilience of the intervention with relatively low renal issues (approximately 10%), but has also illustrated the need for additional device development ...
BACKGROUND: The chimney technique has been successfully used to treat juxtarenal aortic aneurysms. The two main issues with this technique are gutter formation and chimney graft (CG) compression, which induce a risk for type Ia endoleaks and stent thrombosis, respectively. In this benchtop study, the geometry and renal artery flow of chimney endovascular aneurysm repair configurations were compared with chimney configurations with endovascular aneurysm sealing (ch-EVAS). METHODS: Seven flow phantoms were constructed, including one control and six chimney endovascular aneurysm repairs (Endurant [Medtronic Inc, Minneapolis, Minn] and AFX [Endologix Inc, Irvine, Calif]) or ch-EVAS (Nellix, Endologix) configurations, combined with either balloon-expandable or self-expanding CGs with an intended higher positioning of the right CG in comparison to the left CG ...
In recent years, in parallel with the increase of endovascular aortic repair (EVAR) procedures performances, a rise of late open surgical removal of EVAR implants has been observed, due to non-endovascularly correctable graft complications. Among them endograft infection is a rare but devastating occurrence, accounting for an incidence ranging from 0.2% to 0.7% in major series, and almost 1% of all causes of endograft explantations. However, a real estimation of the incidence of the problem respect to the number of EVAR implantations is difficult to obtain. Time to infection is usually defined as the period between EVAR and presentation of symptoms that leads to the infection diagnosis. It can be extremely variable, depending on bacterial virulence and host conditions. The diagnosis of an endograft infection is usually based on a combination of clinical symptoms, imaging studies and microbial cultures whenever possible. If computed tomography (CT) scan is employed in almost 100% of infection ...
Type B aortic dissection (AoD) is a disease connected to high blood load on the aortic wall and to a reduced aortic wall resistance. Nowadays, prognosis on type B AoD results to be particularly difficult with an high incidence of patients treated with medical therapy which manifest complication connected with dissection and which should have been treated with surgical repair immediately. This work aims to study those haemodynamical and morphological proprieties of dissected aorta, which can influence the progression or stability of type B AoD. Computational fluid-dynamic analyses were performed on twenty-five patients with type B AoD, whose nine presented an aneurysm evolution and sixteen presented no further complication connected with dissection. Blood flow features showed that the true lumen flow was laminar and uniform while false lumen flow was less homogeneous with a consequent recirculating path. We found that entry point zone proximal to the aortic arch showed both high blood velocity ...
Objectives At the conclusion of this educational activity, participants should be able to: Define aortic dissection Describe epidemiology of acute aortic dissection State common and uncommon presentations of acute aortic dissection Appreciate that a normal chest radiograph should not be used to rule out acute aortic dissection List three factors leading to a missed diagnosis of aortic dissection List key pitfalls in the management of acute aortic dissection 3
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Guidelines from the Society of Vascular Surgery recommend yearly surveillance imaging with CT scanning or ultrasonography after patients undergo endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA). Still, the frequent use of imaging may not be necessary in some patients, based on results of a study published online in JAMA Surgery on July 8.
Present and future cardiothoracic intensivists will enjoy this talk by Brian Plunkett on thoracic aortic dissection given at Bedside Critical Care Conference 4.. ...
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Welcome to this weeks Gasclass. For the final week of this term we remain in theatre. You have been assigned to the Tuesday vascular list, where a 75 year old man has been listed for an elective Endovascular Aortic Aneurysm Repair (EVAR). Todays task is to list concerns and considertations relevant to anaesthesia for EVAR.…
When the decision to intervene is made, one of the most important factors to consider is the proximal extent of the repair, Modarai noted, and added, "We know from the literature that almost half of all repairs will be in zone 2; dissection patients are younger than those with aneurysmal disease and tend to have less favourable arch morphology; and our data suggest that around 16% of cases will have a retrograde extension into the arch. According to the IRAD data, the latter does not impact adverse outcomes but all of these factors are important considerations for making the decision whether to intervene or not and how safe that intervention is likely to be, particularly in uncomplicated cases.". Unfavourable arch anatomy is associated with increased risk. It demands a longer sealing zone, and tortuosity and high angulation make deployment more challenging. "The characteristics of the graft and the reliability with which we deploy it are of paramount importance. Particular attention should be ...
This video shows the heart beating then stopped inside the pericardium. The surgeon then opens up the aorta, graphically illustrating the blood loss involved i…
I am 60 years old. When I was 54 I had a bypass surgery for coronary triple vessel disease. After 2 years, I had a severe leg pain and underwent an aortography which detected 80% block in the arteries in lower limb and consequently inserted 4 stents in the hip junction and in femoral arteries in both legs. All the treatment was taken at Madras Medical Mission. Since then it was ok for some time regarding arterial blocks in the lower limbs, but of late I am experiencing the pain while walking. I am currently taking simvotin 10mg, ASA 50mg, for artery problems and became a type II diabetic since 1998 and taking amaril 1mg and glycomet 500mg, and lastly asomex AT for high blood pressure for the last 6 months. Off late there is a development of appearing white patches in the foot and wrist. Also the scratch wounds occurred in the hand also not healed but appearing as white patch. |b|What are the reasons for leg pain and the white patches|/b| and what are the remedy for the above?
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Rogers AM, Hermann LK, Booher AM, Nienaber CA, Williams DM, Kazerooni EA, Froehlich JB, OGara PT, Montgomery DG, Cooper JV, Harris KM, Hutchison S, Evangelista A, Isselbacher EM, Eagle KA, IRAD Investigators (2011) Sensitivity of the aortic dissection detection risk score, a novel guideline-based tool for identification of acute aortic dissection at initial presentation: results from the international registry of acute aortic dissection. Circulation 123(20):2213-2218. https://doi.org/10.1161/CIRCULATIONAHA.110.988568 CrossRefPubMedGoogle Scholar ...
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