Search results for " dissection."
showing 10 items of 218 documents
The role of sentinel node tumor burden in modeling the prognosis of melanoma patients with positive sentinel node biopsy: an Italian melanoma intergr…
2022
Abstract Background: The management of melanoma patients with metastatic sentinel nodes (SN) is evolving based on the results of trials questioning the impact of completion lymph node dissection (CLND) and demonstrating the efficacy of new adjuvant treatments. In this landscape, new prognostic tools for fine risk stratification are eagerly sought to optimize the therapeutic path of these patients. Methods: A retrospective cohort of 2,086 patients treated with CLND after a positive SN biopsy in thirteen Italian Melanoma Centers was reviewed. Overall survival (OS) was the outcome of interest; included independent variables were the following: age, gender, primary melanoma site, Breslow thickn…
Chirurgische Strategien bei Schilddrüsenerkrankungen im Kindes- und Jugendalter
1990
In the Department of Paediatric Surgery of the University Hospital of Mainz and the Department of Paediatric Surgery of the University Hospital of Frankfurt/M 90 children with thyroid gland lesions were operated on between 1970 and 1988. 78 patients had benign findings and 12 had malignant tumours. The most frequent operative indication for benign lesions was the euthyroid goitre (57 patients). We found nodular goitre in 45 patients, cystic goitre in 11 patients, and diffuse goitre in only 1 patient. 20 children were suffering from hyperthyroidism (11 with Basedow's disease, 9 with autonomy) and 1 from Hashimoto's thyroiditis. Among the malignant tumours, papillary carcinomas were the most …
Dual guidewire balloon antegrade fenestration and re‐entrytechnique for coronary chronic total occlusions percutaneouscoronary interventions
2022
Objectives:To describe the experience of coronary chronic total occlusions (CTOs)percutaneous coronary interventions (PCI) using antegrade fenestration and re‐entry(AFR) technique with a dedicated dual guidewire balloon (DGB).Background:Antegrade dissection and re‐entry (ADR) techniques has beenemphasized in recent worldwide CTO consensus documents. We investigated thefeasibility and safety of DGB as a dedicated device to perform guidewire‐based AFR.Methods and Results:Fourteen consecutive patients with complex CTO (J‐CTOscore: 3.1 ± 0.9) underwent DGB‐AFR in the years 2020–2021. DGB‐AFR consists inadvancing the DGB over a guidewire that reached the vessel distal to the CTO in anextra plaqu…
Hochfrequenz-Rotationsatherektomie bei koronarer Herzkrankheit
2008
Percutaneous high frequency coronary rotational ablation (PTCR) was used in 10 patients with significant coronary artery disease. PTCR removes arteriosclerotic material from the vessel wall. A diamond-coated (60-80 micron) brass burr-drill, fastened to a flexible drive shaft rotating and tracking along a central coaxial guide wire, was used. The turbine rotates the drive shaft in excess of 150,000-190,000 revolutions per minute. PTCR was successful in all patients, but in three additional percutaneous transluminal coronary angioplasty (PTCA) was then successfully performed. Coronary dissection occurred only once, requiring surgery which was successful. No vessel perforation was observed. Al…
Penetrating aortic ulcer post migration of thoracic aortic endoprosthesis: Case report
2021
Introduction Thoracic endovascular aortic repair (TEVAR) is the first treatment option for many thoracic aortic pathologies. Especially after aortic dissections, it is possible to have progression during follow-up with appearance of new lesions on arterial wall. Herein, we report a case of Penetrating Aortic Ulcer (PAU) post release of Thoracic endoprosthesis. Presentation of case A 67-years-old male with hypertension and diabetes mellitus was followed at our hospital after an emergency procedure for Type B aortic dissection (TBAD) complicated by symptomatic large infrarenal AAA and treated with a proximal TEVAR plus chimney for left subclavian artery and PETTICOAT with EVAR for abdominal a…
Contribution of molecular analyses in diagnosing Marfan syndrome and type I fibrillinopathies: an international study of 1009 probands.
2008
International audience; BACKGROUND: The diagnosis of Marfan syndrome (MFS) is usually initially based on clinical criteria according to the number of major and minor systems affected following international nosology. The number of FBN1 mutation carriers, at risk of aortic complications who would not be properly diagnosed based only on clinical grounds, is of growing importance owing to the increased availability of molecular screening. The aim of the study was to identify patients who should be considered for FBN1 mutation screening. METHODS: Our international series included 1009 probands with a known FBN1 mutation. Patients were classified as either fulfilling or not fulfilling "clinical"…
Internal carotid artery dissection in a patient with hemophilia A: a case report and literature review
2023
Spontaneous cervical artery dissection (sCeAD) is the most common cause of ischemic stroke at a young age, but its pathogenetic mechanism and risk factors are not fully elucidated. It is reasonable to think that bleeding propensity, vascular risk factors such as hypertension and head or neck trauma, and constitutional weakness of the arterial wall together play a role in the pathogenesis of sCeAD. Hemophilia A is known to be an X-linked condition that leads to spontaneous bleeding in various tissues and organs. To date, a few cases of acute arterial dissection in patients with hemophilia have been reported, but the relationship between these two diseases has not been studied so far. In addi…
Computational fluid dynamics of the ascending aorta before the onset of type A aortic dissection.
2016
We performed a pre-dissection computational fluid analysis of an ascending aortic aneurysm associated with unicuspid aortic valve. The analysis showed an abnormal helical flow pattern inside the aneurysm and an increased wall stress on the right postero-lateral wall of the ascending aorta. These values were largely higher than the theoretical cut-off for aortic wall dissection, their topographic distribution followed the intimal tear site as subsequently diagnosed by computed tomography scan and confirmed during the operation for dissection repair.
Diagnosis of aortic dissection: the value of transesophageal echocardiography.
1987
Using the transesophageal approach the descending part of the aorta can be imaged by two-dimensional enchocardiography in cross sections comparable to computer tomograms. The value of combined transesophageal and transthoracic echocardiography was evaluated in 53 patients who were studied consecutively from 1983 to 1986 with symptoms of aortic dissection and compared with computed tomography, angiography, surgery and/or autopsy. In all patients the transthoracic aorta could be visualized and the dissection could be classified according to DeBakey: in 9 of 29 patients (34%) type I dissection, in 4 (14%) type II dissection and in 16 (55%) type III dissection was found. Operation was carried o…