Search results for "endovascular aortic repair"
showing 10 items of 11 documents
Assessment of EVAR Complications using CIRSE Complication Classification System in the UK Tertiary Referral Centre: A ∼6-Year Retrospective Analysis …
2021
Purpose: To retrospectively analyse complications in endovascular aortic repair (EVAR) interventions and evaluate if the CIRSE (Cardiovascular and Interventional Radiological Society of Europe) complication classification system is appropriate as a standardized classification tool for EVAR patients. Materials and Methods: Demographic, procedural and complication data in 719 consecutive patients undergoing EVAR at one institution from January 2014 to October 2019 were retrospectively reviewed. Data (imaging reports, procedural reports, nurse notes, discharge summary reports) were collected consulting the electronic patient record system (EPR) of the hospital and cleaned and stored in a Micro…
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…
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…
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…
Peroperative Intravascular Ultrasound for Endovascular Aneurysm Repair versus Peroperative Angiography: A Pilot Study in Fit Patients with Favorable …
2020
The aim of this study was to compare intravascular ultrasound (IVUS) assistance for endovascular aortic aneurysm repair (EVAR) to standard assistance by angiography.From June 2015 to June 2017, 173 consecutive patients underwent EVAR. In this group, 69 procedures were IVUS-assisted with X-ray exposure limited to completion angiography for safety purposes because an IVUS probe does not yet incorporate a duplex probe (group A), and 104 were angiography-assisted procedures (group B). All IVUS-assisted procedures were performed by vascular surgeons with basic duplex ultrasound (DUS) training. The primary study endpoints were mean radiation dose, duration of fluoroscopy, amount of contrast media…
Should intentional endovascular stent-graft coverage of the left subclavian artery be preceded by prophylactic revascularisation?
2011
Thoracic endovascular aortic repair (TEVAR) has emerged as a promising therapeutic alternative to conventional open aortic replacement but it requires suitable proximal and distal landing zones for stent-graft anchoring. Many aortic pathologies affect in the immediate proximity of the left subclavian artery (LSA) limiting the proximal landing zone site without proximal vessel coverage. In patients in whom the distance between the LSA and aortic lesion is too short, extension of the landing zone can be obtained by covering the LSA's origin with the endovascular stent graft (ESG). This manoeuvre has the potential for immediate and delayed neurological and vascular symptoms. Some authors, ther…
Current role of the chimney technique in the treatment of complex abdominal aortic pathologies: A position paper from the PERICLES Registry investiga…
2020
Historically, chimney/snorkel endovascular aortic repair (Ch-EVAR) emerged as a rescue technique to revascularize and/or preserve inadvertently covered critical branch vessels during infrarenal aortic endografting. Next, in its evolutionary path, Ch-EVAR offered a viable treatment option for complex aortic repair, and particularly in situations where fenestrated/ branched EVAR was not a therapeutic option due to the lack of availability and/or anatomical constraints. In this context, this technique offered distinct advantages such as off-the-shelf availability, straightforward implantation techniques, and lower resource use-intensity enabling performance by a large number of operators manag…
TEVAR and periscope graft technique to treatment of huge aneurysm of aortic isthmus: Case report
2021
Introduction Thoracic endovascular aortic repair (TEVAR) has revolutionized the treatment of thoracic aortic aneurysms. Innovative techniques as chimney and periscope grafts can improve the outcomes of procedure. Herein, we report a case in emergency of huge Thoracic aortic aneurism. Presentation of case An 86-year-old male with hypertension, diabetes mellitus, was referred to our hospital for chest pain. CT-angiography showed a huge aneurysm of aortic isthmus with signs of rupture. The patient was considered unfit for open surgery and an endovascular approach was chosen. This patient underwent endovascular repair with TEVAR, using the periscope graft technique to preserve patency in left s…
Wewnątrznaczyniowe dwuetapowe leczenie tętniaków aorty brzusznej z użyciem Heli-FX EndoAnchor System
2019
Wstęp: Wyniki leczenia tętniaków aorty brzusznej mimo wprowadzenia nowych technik wewnątrznaczyniowych nadal nie zawsze są zadowalające. Szczególnie trudną grupą pacjentów są osoby z krótką oraz stożkową szyją. W tej grupie chorych często występuje w okresie pooperacyjnym przeciek typu I. Jedną z metod mających temu powikłaniu zapobiec jest zastosowanie wkrętów wewnątrznaczyniowych Heli-FX. Ma to zwiększyć przyleganie systemu stentgraftu do ściany aorty brzusznej oraz zapobiec jego ewentualnej migracji. Materiał i metody: Autorzy niniejszego artykułu proponują zastosowanie leczenia dwuetapowego. Pierwszy etap stanowiła implantacja przedłużki aortalnej tuż poniżej odejścia tętnic nerkowych i…
Periscope endograft technique to revascularize the left subclavian artery during thoracic endovascular aortic repair.
2013
Purpose: To present early and midterm results of the periscope endograft (PG) technique to maintain left subclavian artery (LSA) blood flow in thoracic endovascular aortic repairs (TEVAR) involving zone 3. Methods: From April 2010 to January 2013, 14 consecutive high-risk patients (11 men; mean age 7068 years, range 56–87) underwent TEVAR with the PG technique for 10 thoracic aortic aneurysms (TAA), 2 traumatic aortic ruptures, and 2 aortic dissections without a suitable landing zone (.2 cm distal to the LSA). Five procedures were performed emergently for rupture (3 TAAs and the 2 trauma cases). Two patients had a periscope deployed in an aberrant right subclavian artery. The periscope endo…