0000000000005703
AUTHOR
Marco Midulla
Endovascular management of the deep venous thrombosis: A new challenging role for the endovascular specialist in 2020
Over the last years, the endovascular approach to the management of the acute and chronic deep vein thrombosis (DVT) has gained more and more attention from the scientific community. DVT is the third most common cardiovascular disease after coronary heart disease and stroke, with classic treatment based on anticoagulation. Recent evidences have highlighted the risk of postthrombotic syndrome as high as 30%-50% in proximal ilio-femoral lesions, with irreversible clinical symptoms and impact on the quality of life of the population. Since 2000s, the new concept of thrombus removal in the acute phase has been supported by the introduction of different techniques based on the endovascular ablat…
Impact of Thoracic Endografting on the Hemodynamics of the Native Aorta: Pre- and Postoperative Assessments of Wall Shear Stress and Vorticity Using Computational Fluid Dynamics.
Purpose To quantify the hemodynamic consequences of thoracic endovascular aortic repair (TEVAR) by comparing the preoperative and postoperative wall shear stress (WSS) and vorticity profiles on computational fluid dynamics (CFD) simulations. Materials and Methods The pre- and postoperative computed tomography (CT) scans from 20 consecutive patients (median age 69 years, range 20–87) treated for different thoracic aortic pathologies (11 aneurysms, 5 false aneurysms, 3 penetrating ulcers, and 1 traumatic aortic rupture) were segmented to construct patient-specific CFD models using a meshless code. The simulations were run over the cardiac cycle, and the WSS and vorticity values measured at th…
Embolization with ethylene vinyl alcohol copolymer (Onyx®) for peripheral hemostatic and non-hemostatic applications: a feasibility and safety study
International audience; Background: Onyx® is a liquid embolic agent, which is approved for the treatment of cerebral vascular lesions but still rarely used in peripheral interventional radiology. The goal of this study is to report the feasibility and safety of embolization with Onyx® for peripheral hemostatic and non-hemostatic endovascular procedures.Methods: Retrospective study of all consecutive patients who underwent visceral or peripheral embolization with Onyx® for hemostatic or non-hemostatic purpose in our department between May 2014 and November 2016. Demographic data, clinical presentation, underlying etiology, culprit vessel, endovascular procedure, pain during embolization, out…
Transgraft sac Embolization Combined with Graft Reinforcement for Refractory Mixed-Type Endoleak.
International audience; An 80-year-old female underwent EVAR 4 years ago. She presented type II endoleak with sac expansion from 68 to 80 mm during 3-year follow-up after EVAR. Although she underwent translumbar percutaneous sac embolization, the AAA sac continued to enlarge, suggesting mixed-type endoleak including type I, II, and III. Transgraft direct sac angiography revealed endoleak cavity without demonstrable feeding vessel. Transgraft sac embolization using n-butyl cyanoacrylate and graft reinforcement was performed concurrently, without complications. The graft reinforcement consisted of graft extension for eliminating occult type I endoleak, and relining for eliminating occult type…
Commentary: Be Innovative, Stay Clinical! Time for a Patient-Specific SFA Treatment Algorithm?
International audience
Image-Guided Mini-Invasive Treatments for Vascular and Oncologic Diseases: Embolization Therapy
Transcatheter Embolization, also called Embolotherapy, is a mini-invasive, non-surgical therapeutic solution used in Interventional Radiology to close blood vessels deliberately. A wide range of embolic agents is available in clinical practice, including metal coils and liquid agents. More recent advances in biomaterials such as shape-memory foam and in-situ gelling solutions have led to the development of new pre-clinical embolic agents. This review offers a brief overview of current and emerging technologies in the field of endovascular embolization. The focus is on devices, materials and techniques.