Sep 28, 2015. MAJESTIC Trial Data Support Strong Safety Profile with Low Target Lesion Revascularization Rate. New 12-month clinical trial outcomes assessing the safety and performance of the Boston Scientific (NYSE: BSX) Eluvia™ Drug-Eluting Vascular Stent System reflect a primary patency rate1 of more than 96 percent. These results represent the highest 12-month primary patency reported for an interventional treatment of femoropopliteal artery lesions among comparable trials. The Eluvia Stent System is an advanced treatment option for patients with narrowing or blockages in the superficial femoral artery (SFA) or proximal popliteal artery (PPA), a result of peripheral artery disease (PAD).. Results from the MAJESTIC trial, which were presented at the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) annual meeting in Lisbon, Portugal, also included a low 12-month target lesion revascularization (TLR) rate of 3.8 percent, with no observed stent fractures and no ...
The Particulars: Previous research has not established the success rate for stenting of the superficial femoral artery (SFA).. Data Breakdown: An investigation conducted in Germany was performed, involving 517 patients who received 827 SFA stents in 543 limbs. More than three-quarters of patients (78%) were treated for claudication, and the remainder were treated for critical limb ischemia (CLI). At 1, 3, and 5 years, primary patency rates were 86%, 75%, and 61%, respectively. Secondary patency rates at the same time points were 95%, 90%, and 76%. At an average of 93.4 months follow up, 18.8% of patients died.. Take Home Pearl: More than half of patients treated with SFA stents for claudication or CLI appear to retain primary patency with their stents when assessed at 5 years. ...
Miromatrix will present its latest transplantable liver milestone at The Liver Meeting® hosted by the American Association for the Study of Liver Diseases (AASLD) on October 20-24 in Washington, D.C. Building on the companys successful liver re-endothelialization efforts, Miromatrix has advanced its ability to demonstrate functional liver vasculature by maintaining long-term vascular patency of its engineered liver grafts in a porcine model. A poster describing these advancements entitled "Towards Long-Term Vascular Patency of Tissue Engineered Liver Grafts: a Large Animal Study" will be presented at the conference on October 20th (Poster #712). Twenty-seven porcine liver grafts were seeded with endothelial cells cultured in bioreactors, 20 of which were evaluated in vitro to determine important factors that predict in vivo vascular patency. Grafts with higher glucose consumption rate (GCR) had evidence of better endothelial coverage (p=0.012) and correlated significantly with graft flow ...
Aim. Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect on patency nor on limb salvage after bypass to below-knee arteries. However, the Scandinavian patients were a decade older and predominately female compared to the British patients. Can this explain the conflicting result? less thanbrgreater than less thanbrgreater thanMethods: Primary patency with respect to sex, age and the use of vein collar were re-analysed in 345 patients from SCAMICOS with Kaplan-Meier life-table technique, log-rank test and Cox proportional hazards regression to evaluate any interaction between sex or age and the effect of a vein collar on the primary patency rate. less thanbrgreater than less thanbrgreater thanResults. Females had better patency than males (log-rank test, ...
Besides the main result (similar patency of the beating-heart grafts and classic on-pump grafts), the most surprising finding in this study was the low saphenous graft patency in both study groups. This can be explained by the fact that this study was meticulously prepared not to allow cardiac surgeon to influence patient selection for the study. Thus, this study reflects the real-life everyday practice of cardiac surgery at the beginning of the 21st century. This means that almost all patients with good-quality vessels (ie, vessels ,2 mm, without heavy diffuse calcifications, without chronic total occlusions) are treated by percutaneous coronary interventions. Thus, the current cardiac surgery patient population consists of patients not suitable for angioplasty-the most advanced coronary artery disease cases. Most of the older trials investigating angiographic bypass graft patency after classic on-pump surgery were done 10 to 20 years ago, well before the modern stent era. Thus, they enrolled ...
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Parent vessel patency and incidence of different flow patterns over the course of two weeks after mini port implantation in mice.
Remi Bloston is the new hot product on the European market. It is very likely that it will be the best-selling supplement that treats cardiovascular issues this year!
A method for implanting an end portion of a graft within the body of a patient during a bypass grafting procedure includes the steps of (1) making an arteriotomy in a sidewall of a blood vessel at a f
CINAR BAYER , GOKSEL ONUR S. , YEKELER IBRAHIM THE TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 207(3), 233-238, 2005-11-01 医中誌Web 参考文献15件 被引用文献1件 ...
Aortocoronary bypass graft failure is common and is associated with high morbidity and mortality. Failure of saphenous vein grafts is more common than failure of internal mammary artery grafts. Whether early graft angiography can reduce bypass graft failure remains unknown. The Cardiac CAtheterization for Bypass Graft Patency Rate Optimization (CABG-PRO) randomized-controlled pilot study is a phase III, double-blind, randomized-controlled pilot trial that will randomize 170 patients undergoing coronary artery bypass graft surgery to early (before dismissal) graft angiography vs. no early graft angiography. Coronary angiography will be performed at 12 months, to determine whether compared to no early graft angiography, early graft angiography will result in:. ...
Aortocoronary bypass graft failure is common and is associated with high morbidity and mortality. Failure of saphenous vein grafts is more common than failure of internal mammary artery grafts. Whether early graft angiography can reduce bypass graft failure remains unknown. The Cardiac CAtheterization for Bypass Graft Patency Rate Optimization (CABG-PRO) randomized-controlled pilot study is a phase III, double-blind, randomized-controlled pilot trial that will randomize 170 patients undergoing coronary artery bypass graft surgery to early (before dismissal) graft angiography vs. no early graft angiography. Coronary angiography will be performed at 12 months, to determine whether compared to no early graft angiography, early graft angiography will result in:. ...
Licht et al reported a series of 39 patients undergoing coronary artery bypass grafting(CABG) who had a cephalic vein. 18 had angiographic follow up (mean 31 months). 52% of grafts were patent, 39% of all veins had intraluminal disease, and 19% were dilated. Wijnberg et al compared a group of 28 patients who received a cephalic vein graft with a matched group who received saphenous vein grafts. At mean 4.6 year follow up, cephalic vein patency was 47% compared to 77%. Stoney et al assessed the patency of 56 cephalic or basilic vein grafts from 28 patients. 32/56(57%) grafts were patent at mean 25 months while 7(12.5%) of the patent grafts had localised stenoses. Jarvinen et al reported the patency of 16 cephalic veins in 15 patients. At a mean follow up of 1.4 years (1-42 months), 87% (27/31 distal anastomoses) were patent angiographically although 3 veins also had aneurysmal dilatation. Prieto et al examined ten patients at different intervals. The early patency of arm vein grafts in six ...
HypothesisPercutaneous angioplasty would provide a durable alternative to surgical revision in the treatment of infrainguinal vein graft stenosis.DesignOutcome
Cryopreserved allografts have demonstrated resistance to infection similar to that of autogenous tissue when used for the treatment of prosthetic arterial bypass graft infections. As the number of hemodialysis access procedures increases, prosthetic hemodialysis graft infection has become a significant problem. We have used the cryopreserved femoral vein as an alternative conduit in the treatment of prosthetic arteriovenous (AV) hemodialysis graft infections. Forty-eight cryopreserved femoral vein AV graft procedures were performed. The 1-year primary graft patency rate was 49%, while the secondary graft patency rate was 75%. No subsequent cryopreserved allograft infections occurred. The cryopreserved femoral vein graft is a safe, durable, and infection resistant conduit for the treatment of prosthetic AV hemodialysis graft infections.
Autologous saphenous vein continues to be one of the most widely used conduits for myocardial revascularization7 despite its disappointing long-term patency rate, with ≤50% of vein grafts occluded by 10 years after surgery.8 9 Late occlusion appears to result from both medial and neointimal thickening, caused by migration and proliferation of smooth muscle cells, and the late appearance of mature lipid-laden atherosclerotic plaques. These changes can compromise flow directly or promote thrombotic occlusion.1 10 Neither antiplatelet therapy nor avoidance of surgical preparative injury has been shown conclusively to eliminate medial and neointimal thickening in either experimental models or human vein grafts.1 2 8 Vessel wall thickening may be regarded as an intrinsic adaptation of the vein to arterial pressure,1 10 and grafting per se was recently shown to stimulate the production of endogenous growth factors from pig saphenous vein, which may account for the platelet independence of graft wall ...
In this issue of the Journal, Gaudino et al. (1) report on an interesting and fairly unique study describing the 20-year patency and outcomes in their initial series of 100 patients who received a radial artery (RA) graft, and who were prospectively followed. Previous long-term follow-up series of the RA as a coronary artery bypass graft (CABG) included those from Achouh et al. (2), Shi et al. (3), and the investigators of the Gaudino paper themselves (4). The main strength of the present study is the pre-specified systematic assessment of graft patency and RA harvest-related arm complications at specific time points, with a long period of follow-up.. All studies that deal primarily with long-term graft patency have inherent weaknesses. Because it is virtually impossible to have all patients return for long-term invasive coronary anatomy and graft assessment, various methodological approaches may be used to estimate true conduit patency. Some authors choose to ignore, that is "censor," patients ...
PURPOSE: To evaluate the influence of serum lipid subfraction concentrations on arterial patency after percutaneous transluminal angioplasty (PTA) in patients with infrainguinal peripheral artery occlusive disease (PAOD). METHODS: From January 2007 t
This study shows that in patients randomly treated with either an RGEA or an SVG for a stenosis of the RCA, the proportion of grafts found occluded on systematic 6-month angiographic control is low and independent of the type of graft conduit; however, the flow pattern is significantly more affected by the angiographic characteristics of the grafted RCA for RGEA than for SVG. Consequently, most SVG but only a minority of RGEA remained functional when the MLD of the RCA was larger than a threshold value close to 1.0 mm.. Previous angiographic follow-up studies of RGEA have suggested that the graft patency might be affected by the stenosis of the recipient RCA, most likely as a result of competitive flow (3,15,16). The evaluation of stenosis severity was based on visual interpretation of post-operative coronary angiogram at the time of angiographic follow-up. In the present study, the evaluation of RCA stenosis severity was done on pre-operative angiogram to eliminate the possible influence of ...
According to his study-"Stent graft vs. balloon angioplasty for failing dialysis-access grafts"- published in the New England Journal of Medicine, anatomic success with the stent graft compared to percutaneous transluminal angioplasty was 94% and 73% respectively. At six months, Haskal explained, binary restenosis was 27.63% for the stent graft and 77.61% for angioplasty.. He also noted that the 12-month reintervention rate to maintain patency was 1.9% for the stent graft and 2.4% for angioplasty. The 12-month index of patency function was 5.3% for the stent graft and 4.4% for angioplasty, for access circuit primary patency it was 24.1% and 10.3%, and for treatment area primary patency it was 4.7% and 24.8% respectively. The latter was statistically significant (p,0.001).. "Results of the study exceeded our expectations, and that is a boon for dialysis patients," said Haskal. "Dialysis is very demanding, and anything that prevents access sites from failing and reduces the need for invasive ...
November 23, 2016-Biotronik announced that interim data from the BIOFLEX PEACE all-comers trial, which confirm the efficacy of the companys Pulsar-18 bare-metal, self-expanding stent (BMS SE) in the treatment of superficial femoral artery (SFA) disease, were presented at the 43rd annual VEITHsymposium, which was held November 15-19, 2016, in New York, New York. Jos C. van den Berg, MD, from Ospedale Regionale di Lugano, Switzerland, presented the results for Pulsar-18 during the symposiums main program on behalf of the trials lead investigator, Michael Lichtenberg, MD, of the Vascular Center, Arnsberg, Germany.. BIOFLEX PEACE is a prospective, multicenter registry examining 151 patients in an all-comers enrollment. The studys primary endpoint is primary patency at 12 months.. According to the company, the available 12-month interim results demonstrate that the Pulsar-18 BMS SE is an effective treatment option in the SFA. The primary patency rate of 75% and freedom from target lesion ...
Over a million coronary bypass procedures using human saphenous vein (HSV) are performed yearly worldwide. Nearly half of these grafts fail over a period of 12...
Two-year findings from the VIRTUS trial of the VICI venous stent (Boston Scientific) showed a primary patency rate of 79.4%. As has been seen in other trials, primary patency was higher in non-thrombotic lesions (94.6%) as compared to post-thrombotic lesions (73.4%).
Methods and apparatus for determining the occurrence of an apnea, patency and/or partial obstruction of the airway are disclosed. Respiratory air flow from a patient is measured to give an air flow si
A Stanford neuroscientist is presenting evidence of how chronic stress physically damages a region of the brain that processes learning and memory.
WASHINGTON -- Claudication patients given an investigational self-expanding stent were significantly more likely to maintain vessel patency at 12 months than those treated with percutaneous translumin
Artegraft has been in continuous clinical use since 1970. The first vascular graft approved by the FDA, it has clinically proven higher primary and assisted patency rates over ePTFE grafts.
Envigo has developed an effective method for anchoring the PinPort and has achieved impressive patency information for catheterized animals using the PinPort exteriorization method.
Cells with solid polymer electrolytes have not reached full commercialization and are still a topic of research.[citation needed] Prototype cells of this type could be considered to be between a traditional lithium-ion battery (with liquid electrolyte) and a completely plastic, solid-state lithium-ion battery.[19] The simplest approach is to use a polymer matrix, such as polyvinylidene fluoride (PVdF) or poly(acrylonitrile) (PAN), gelled with conventional salts and solvents, such as LiPF6 in EC/DMC/DEC. Nishi mentions that Sony started research on lithium-ion cells with gelled polymer electrolytes (GPE) in 1988, before the commercialisation of the liquid-electrolyte lithium-ion cell in 1991.[20] At that time polymer batteries were promising and it seemed polymer electrolytes would become indispensable.[21] Eventually, this type of cell went into the market in 1998.[20] However, Scrosati argues that, in the strictest sense, gelled membranes cannot be classified as "true" polymer electrolytes, but ...
TY - JOUR. T1 - Use of a harvested radial artery graft with preservation of the vena comitantes to reduce spasm risk and improve graft patency for extracranial to intracranial bypass. T2 - Technical note. AU - El Tecle, Najib E.. AU - Zammar, Samer G.. AU - Hamade, Youssef J.. AU - El Ahmadieh, Tarek Y.. AU - Aoun, Rami James N. AU - Nanney, Allan D.. AU - Batjer, Hunt H.. AU - Dumanian, Gregory A.. AU - Bendok, Bernard. PY - 2016/3/1. Y1 - 2016/3/1. N2 - Background and significance: The vessels of choice for cerebrovascular high-flow direct bypass procedures are the radial artery and the saphenous vein. Radial artery grafts have become favored over saphenous vein grafts because of higher patency rates and better size matching to appropriate recipient vessels. Radial grafts are prone to spasm however, and this may be seen in 4-10% of cases and can be associated with ischemic sequelae. The standard technique for radial artery harvest calls for complete separation of the artery from its ...
Objectives: Critical limb ischaemia (CLI) requiring infra-inguinal bypass is a common presentation to the vascular surgery service. A significant number of CLI patients also present with anaemia as a comorbidity, the impact of which is unknown. We reviewed the impact of anaemia on mortality and amputation in patients who underwent infra-inguinal bypass surgery. Methods: Demographic data from all patients who underwent infra-inguinal bypass surgery for CLI at the Flinders Medical Centre & Repatriation General Hospital, South Australia between January 2005 and January 2010 were recorded. Haemoglobin (Hb) level, serum creatinine (SCr) level, mortality and amputation events were also recorded for retrospective analysis. Results: 190 patients (141M, 49F) who underwent infra-inguinal bypass surgery over a 5 year period were analyzed. 100 (53%) of these patients had mild anaemia (mean Hb 113 g/L, mean for females 103 g/L, mean for males 116 g/L). Those who presented with anaemia were more likely to have
The final 3-year outcomes of the SUPERB trial showed that use of an interwoven nitinol stent design achieved high primary patency and maintained clinical durability outcomes in patients with lower-limb arterial obstructive disease. “Peripheral artery disease is a growing worldwide epidemic,” Lawrence A. Garcia, MD, from the division of cardiology and vascular medicine at St.
The US Food and Drug Administration has approved the Vici stent for use in treating iliofemoral venous obstructive disease, Boston Scientific announced today. This is the second approval this year for a dedicated venous stent for a disease that has typically been managed in the past with off-label device use. The Vici approval was supported by data from the 170-patient VIRTUS study. As reported by TCTMD earlier this year at ISET 2019, VIRTUS demonstrated a 12-month primary patency rate of 84%, exceeding the performance goal of 72.1% (P , 0.001). Additionally, the Venous Clinical Severity Score (VCSS) declined from 10 at baseline to 5.6 at 12 months, with only 27.3% of patients having a score of 8 or higher.. Vici joins the Venovo (Becton Dickinson) device, which received FDA approval for a similar indication less than 2 months ago based on favorable results from the VERNACULAR trial. As reported by TCTMD at VIVA 2018, VERNACULAR demonstrated a high rate of primary patency at 12 months (88.3%) ...
DISCUSSION. CABG has become the gold standard for the treatment of coronary artery disease involving multiple vessels, and it consists of on-pump CABG and off-pump CABG. In the early 1980s, two surgeons published their extensive series of off-pump CABG in patients who received grafts in the LAD and the main RCA, but with more limited and difficult grafting of coronary arteries on the posterior and lateral walls[15,16]. On-pump CABG provides a motionless operative field, but it can be associated with a number of complications, such as myocardial ischemic injury, strokes, coagulation, and inflammatory responses[17,18]. To the present, it has been reported that the advantage of sequential coronary artery bypass technology is that it can save grafts, reduce proximal anastomosis, shorten the operation time, provide a more complete vascularization, and have a satisfactory long-term patency rate[19,20]. It is more accurate to determine the direction and length of the bridge between anastomoses. There ...
OBJECTIVE--To determine whether concomitant treatment with intravenous heparin affects coronary patency and outcome in patients treated with alteplase thrombolysis for acute myocardial infarction. DESIGN--Double blind randomised trial. TREATMENT REGIMENS--Alteplase 100 mg (not weight adjusted) plus aspirin (250 mg intravenously followed by 75-125 mg on alternate days) plus heparin (5000 units intravenously followed by 1000 units hourly without dose adjustment) was compared with alteplase plus aspirin plus placebo for heparin. SETTING--19 cardiac centres in six European countries. SUBJECTS--652 patients aged 21-70 years with clinical and electrocardiographic features of infarcting myocardium in whom thrombolytic therapy could be started within six hours of the onset of major symptoms. MAIN OUTCOME MEASURE--Angiographic coronary patency 48-120 hours after randomisation. RESULTS--Coronary patency (TIMI grades 2 or 3) was 83.4% in the heparin group and 74.7% in the group given placebo for heparin. ...
An improved technique of free internal mammary artery (IMA) to ascending aorta anastomosis for coronary bypass is described. A small patch vein with a suitable side branch or branches is interposed, connecting the proximal end of a detached IMA to the ascending aorta. A single or double free IMA alone or in combination with an additional saphenous vein graft was performed in 77 patients. A total of 125 free IMA grafts were done. The hospital mortality was 2-7% and late mortality 1-4%. Seventy-one of the 74 surviving patients had no angina and returned to a normal life. Postoperative coronary arteriography in 65 patients showed a patency rate of 96%. On years experience with this technique is very encouraging. However, prolonged follow-up is necessary to determine if free IMA, as used by us, will increase the long-term patency rate.. ...
Objective: Physiological reaction to competitive flow is considered as the primary mechanism of arterial graft occlusion. Reopening of graft lumen had been also reported, but details remain unknown. We sought to delineate the effect of management of the moderately stenotic targets on the occurrence of competitive flow and clinical results. Methods: Clinical records and angiograms of 3263 bypass grafts in 852 patients, who underwent off-pump coronary revascularization using the internal thoracic artery (ITA) and radial artery without aortic manipulation since 2000, were examined. Dominant flow direction was graded as antegrade, competitive, and no flow (occlusion). Late angiography was performed in 157 patients with 561 bypass grafts for clinical reasons. The follow-up period was 55.5 ± 31.1 months. Results: The early graft patency rate was 98.0% (3197/3263). The rate of antegrade flow was 91.5% (2986/3263), while competitive flow was detected in 6.5% (211/3263). The actuarial patency rates of ...
Background: Bypass graft thrombosis remains a significant mode of failure in prosthetic graft revascularization. The purpose of this investigation was to evaluate the long-term thromboresistant effect of heparin-bonded expanded polytetrafluoroethylene (ePTFE) graft using Carmeda BioActive Surface technology in a canine model. Methods: Bilateral femorofemoral artery bypass grafts with ePTFE grafts were performed in 25 adult grayhound dogs. In each animal, a heparin-bonded ePTFE graft (Propaten, WL Gore) was placed on one side, whereas a control nonheparin graft was placed on the contralateral side. The graft patency was assessed at 1, 6, 12, 18, and 24 months (n = 5 per group) following the bypass. Heparin bioactivity of the graft material was analyzed. The effect of intimal hyperplasia was also assessed. Results: All bypass grafts were patent at 1 month. Significantly greater patency rates were noted in the Propaten group compared to the control group at 12, 18, and 24 months, which were 84%, ...
This thesis investigates the principal factors responsible for early failure of femorodistal vein grafts. Chapter 1 provides an overview of severe lower limb ischaemia which is their principal indication. Chapter 2 outlines the role of surgery in the management of the severely ischaemic limb, concentrating on the development of distal bypass using autogenous vein. Chapter 3 considers the multiple causes of vein graft failure, concentrating on the early period and includes an account of currently employed methods designed to reduce the problem. Chapter 4 is a retrospective review of the results of 130 in situ vein grafts performed at Leicester Royal Infirmary in the 8 year period prior to the commencement of this study. The primary early failure rate was 30%, with two thirds of patients undergoing amputation. Chapter 5 outlines the methods used in a series of 42 patients undergoing distal vein bypass. Preoperative assessment included arteriography and 3 methods using Doppler ultrasound. Doppler ...
small study in which 40 patients underwent nitinol stent placement in the SFA and then had a follow-up angiography, stent fracture occurred in 28% (11/40) after a mean follow-up of 13.6 months, more in patients who walked more in the time after the procedure. A retrospective analysis of 239 patients who underwent femoro-popliteal nitinol stent placement for claudication and critical limb ischemia reported a 4 year stent fracture rate of 17% and primary patency rate of 65%, similar to patients in whom there was no fracture. Clinical outcomes were not reported. A retrospective analysis of 742 limbs in 585 consecutive patients who underwent de novo SFA nitinol stent placement reported a primary and secondary patency rate of 67% and 86% at 6 years, respectively. Stent fracture, observed in 14% of limbs, was associated with early restenosis (P=0.0004). The association between stent fracture and clinical outcomes has been described in one small study of 53 patients who were followed for a median of 16 ...
Results There were 39 occlusions (30 total, 9 partial) in 27 patients; occlusion rate 0.1 per 1000 CVC days. 25 patients had CVC, 2 patients ports. Patency was restored in 38 (97%) episodes. The 1 unsuccessful episode was a total occlusion in a port resistant to all methods. The 30 total occlusions occurred in 19 patients; 17 patients CVC, 2 patients port. Patency restored on 29 (97%) occasions. Hub clearout used in 5 (17%) episodes, in 2(7%) this was the only method used. POP technique used for 28 (93%) episodes, 3(10%) following hub clearout. Urokinase used in 4 (13%) episodes. In 2 cases patency was restored by the POP technique but with some residual resistance. Urokinase was instilled using the POP technique on 1 occasion. Alcohol was only used once and was unsuccessful. Of the 9 partial occlusions, patency was restored in all. Hub clearout alone was used in 7(78%) occasions. POP technique used in 2(22%) episodes and once with Urokinase (11%). There were no catheter ruptures, "ballooning" ...
A number of clinical and anatomic factors influence the decision between infrainguinal bypass surgeries and endovascular procedures used to treat lower extremity vascular disease, according to a new database and early outcomes study.
RESULTS: Two of 14 heparinized PTFE grafts and nine of 14 grafts in the control PTFE-group were occluded at explantation (P=0.006). Six-month patency rates for heparinized PTFE grafts and for standard PTFE grafts were 86% and 36%, respectively. Mean graft anastomotic IH thickness in open grafts were 0.074 mm for heparinized PTFE grafts and 0.259 mm for PTFE-grafts (P=0.006 ...
Sixty-eight patients presented with AMI and 54 underwent PMAS, of which four were unsuccessful and followed by ROMS. Eleven patients were directly treated with ROMS, making a total of 15 patients (10 women and five men; median age, 66 years [interquartile range, 54-73 years]). In all patients, only the superior mesenteric artery was revascularized. In nine of the 15 patients, all three mesenteric arteries were severely stenotic or occluded. Technical success was achieved in 14 patients. At ROMS in two patients, the small bowel was severely ischemic. One of these patients needed a partial bowel resection because of irreversible transmural ischemia. At 30 days, the mortality rate was 20% and the primary patency was 92%. Ten patients underwent unplanned relaparotomy, of whom one needed resection of a large part of the small bowel. At 12 months, the mortality rate was still 20%. The primary patency was 83%. Primary assisted patency was 91%, and secondary patency was 100%. Clinical success at 30 ...
There was a predominance of male gender (65%), and the group mean age was 68.1 ± 8.3 years. The mean follow-up period was 29.6 ± 26.3 months. The operative mortality (30 days) rate was 7.5%. The main alternative conduit was non-spliced cephalic vein (37.5%). Composite grafts included GSV + AVC (45.2%), AVC + AVC (43.3%) and small saphenous vein + AVC (11.5%). The 5-year primary and secondary patency (SP) rates were 45.2 ± 5.6% and 56.5 ± 5.0%, respectively. The 5-year SP rate was greatest when using non-spliced cephalic vein (65.8 ± 7.6%), but there was no difference in cumulative patency between spliced and non-spliced veins (49.5 ± 8.0% vs. 61.2 ± 6.4%; p = 0.501). The 5-year limb salvage and survival rates were 70.6 ± 5.9% and 59.6 ± 5.8%, respectively ...
RESULTS: During this study period, a total of 54 patients underwent TEVAR for thoracic or thoracoabdominal aneurysm with the use of EndoAnchors at our institution. Twenty-seven cases were performed as the index operation. Twenty-seven cases were considered redo operations. EndoAnchors were deployed for therapeutic and prophylactic indications. Mean follow-up was 9.6±8.8 months. EndoAnchors were used for therapeutic indications in 31.5% of patients and for prophylactic indications in 68.5%. The technical success of EndoAnchor deployment was 99.8%. The overall initial technical success of the operation was 98.1%. There were no instances of graft migration. The overall endoleak rate was 5.4% with prophylactic EndoAnchor use and 11.8% with therapeutic use. Aortic-related reintervention was required in 13.5% of patients who received prophylactic EndoAnchor placement and 23.5% of patients who received therapeutic EndoAnchor placement. Only one reintervention was performed for EndoAnchor failure. A p ...
Results showed dual therapy with aspirin and ticagrelor resulted in improved patency of saphenous vein grafts vs either agent alone, but the data are unlikely to change practice yet, observers say.
The outcome of 185 consecutive autogenous vein bypass grafts for femoro-popliteal occlusions carried out between January 1962 and June 1968 has been reviewed. One patient died at operation and 21 late deaths have occurred since. The overall five-year patency was 61·5%, but was much lower when the popliteal-tibial runoff arteries were diseased. Distal anastomosis of the graft to the popliteal artery below the level of the knee joint also impaired the results, and if this was performed with a graft of minimal diameter less than 5 mm. sustained patency was obtained in only a quarter of the limbs. Nevertheless, where major amputation was imminent owing to advanced ischaemia three out of four limbs were salvaged.. ...
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Cardiovascular disease is the leading cause of death worldwide, accounting for 29% of all global deaths and is set to rise to 23 million deaths a year by 2030 (World Health Organisation, 2012). Arterial bypassing, both peripheral and coronary, is usually performed with autologously harvested vessels. However, the quantity available is often very limited as well as the vessels of elderly patients often suffering from thrombus, aneurysm formation or arthrosclerosis in high pressure arterial sites. The shortcomings of autografts has led to a substantial amount of research being directed towards tissue engineered vascular grafts (TEVGs) (Kakisis et al., 2005). Currently available artificial grafts for small diameter vasculature (mm) suffer from poor patency rates due to thrombosis, aneurysm formation, and a compliance mismatch, which often stems from the inherent properties of synthetic polymers. The primary goal of the research presented in this thesis was to develop a small diameter tissue engineered