Search results for " Endovascular"
showing 10 items of 53 documents
How to diagnose and treat abdominal compartment syndrome after endovascular and open repair of ruptured abdominal aortic aneurysms
2014
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are frequently encountered in patients treated for ruptured abdominal aortic aneurysms (rAAA) and carry a high morbidity and mortality risk. Despite these facts, IAH/ACS are still overlooked by many physicians, timely diagnosis is missed and treatment often inadequate. All staff involved in the treatment of rAAA should be aware of the risk factors predicting IAH/ACS, the profound implications and derangements on all organ systems, the clinical presentation, the appropriate measurement of intra-abdominal pressure to detect IAH/ACS and the current treatment options for these detrimental syndromes. This comprehensive r…
Periscopes, chimneys, sandwich and VORTEC to facilitate abdominal and thoracoabdominal aortic aneurysm repair
2012
The VORTEC (VIABAHN open revascularization technique) and the chimney graft technique are tools with which to maintain or restore blood flow to the aortic branches and can be used intentionally or as a bailout procedure in open surgery or endovascular procedures. VORTEC is a stent graft-based vascular connection technique that achieves end-to-end anastomosis configuration; it is especially useful when the traditional suture technique proves (can be) cumbersome. It is also a speedy tool with virtually no blood flow interruption and no anastomotic bleeding, and patency rates compare favorably with sutured anastomosis. The chimney/periscope, as well as the sandwich graft technique (CHIMPES), i…
Biomechanical implications of excessive endograft protrusion into the aortic arch after thoracic endovascular repair
2015
Endografts placed in the aorta for thoracic endovascular aortic repair (TEVAR) may determine malappositioning to the lesser curvature of the aortic wall, thus resulting in a devastating complication known as endograft collapse. This premature device failure commonly occurs in young individuals after TEVAR for traumatic aortic injuries as a result of applications outside the physical conditions for which the endograft was designed. In this study, an experimentally-calibrated fluid-structure interaction (FSI) model was developed to assess the hemodynamic and stress/strain distributions acting on the excessive protrusion extension (PE) of endografts deployed in four young patients underwent TE…
Endovascular treatment of CCSVI in patients with multiple sclerosis: clinical outcome of 462 cases
2013
Although it is still debated whether chronic cerebro-spinal venous insufficiency (CCSVI) plays a role in multiple sclerosis (MS) development, many patients underwent endovascular treatment (ET) of CCSVI. The objective of the study is to evaluate the outcome and safety of ET in Italian MS patients. Italian MS centers that are part of the Italian MS Study Group were all invited to participate to this retrospective study. A structured questionnaire was used to collect detailed clinical data before and after the ET. Data from 462 patients were collected in 33 centers. ET consisted of balloon dilatation (93 % of cases) or stent application. The mean follow-up duration after ET was 31 weeks. Mean…
Multiple periscope and chimney grafts to treat ruptured thoracoabdominal and pararenal aortic aneurysms
2011
Purpose: To report midterm outcomes after urgent endovascular repair of ruptured pararenal or thoracoabdominal aortic aneurysms using multiple periscope and chimney grafts to preserve renovisceral branch perfusion and facilitate aneurysm exclusion. Methods: Nine consecutive men (mean age 72614 years, range 40–88) presenting with ruptured thoracoabdominal (n56), pararenal (n52), or infrarenal (n51) aortic aneurysm underwent urgent endovascular repair with at least 1 periscope graft delivered via a transfemoral access; chimney grafts were installed from an axillary access. In all, 17 periscope and 7 chimney grafts were used to reperfuse 11 renal and 13 visceral arteries in the 9 patients. The…
Chimney and periscope grafts to facilitate endovascular treatment of aortic transection in a patient with aberrant right subclavian artery
2014
Purpose: To report the use of parallel grafts to extend the proximal landing zone for stentgraft repair of aortic transection involving an aberrant right subclavian artery (ARSA). Case Report: A 28-year-old patient was referred for treatment of traumatic aortic transection with contained rupture at the level of an ARSA. Immediate thoracic endovascular aortic repair (TEVAR) was planned because of hemodynamic instability. To achieve rapid sealing and maintain perfusion to both subclavian arteries, a chimney stent to the left subclavian artery (LSA) and a periscope stent-graft to the ARSA were deployed successfully. After surgical repair of all fractures, the patient was discharged 1 month aft…
Total occlusion of aortic arch in a 62-year-old man presenting with acute myocardial infarction
2011
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An In Vitro Phantom Study on the Role of the Bird-Beak Configuration in Endograft Infolding in the Aortic Arch.
2015
Purpose: To assess endograft infolding for excessive bird-beak configurations in the aortic arch in relation to hemodynamic variables by quantifying device displacement and rotation of oversized stent-grafts deployed in a phantom model. Methods: A patient-specific, compliant, phantom pulsatile flow model was reconstructed from a patient who presented with collapse of a Gore TAG thoracic endoprosthesis. Device infolding was measured under different flow and pressure conditions for 3 protrusion extensions (13, 19, and 24 mm) of the bird-beak configuration resulting from 2 TAG endografts with oversizing of 11% and 45%, respectively. Results: The bird-beak configuration with the greatest protr…
The use of Endurant stent-graft for abdominal aortic aneurysm: the story about extension of instruction for use with persistent good results of stent…
2012
The Endurant stent-graft (Medtronic, Inc., Minneapolis, MN, USA) is a latest generation device for the treatment of abdominal aortic aneurysm. The idea behind designing such a graft came from the intention to broad the instruction for use (IFU) and to enable it to treat more challenging anatomy including the 10mm neck lengths, and more severe suprarenal and infrarenal angulations. Endurant stent-graft has active fixation through suprarenal stent with anchoring pins to provide migration resistance, optimized heights of stents and spacing between them for improved flexibility and conformability, low-profile delivery system with hydrophilic coating and controlled simple deployment mechanism. S…