Search results for "endovascular procedures"
showing 10 items of 130 documents
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…
Incidence and prognostic factors related to major adverse cerebrovascular events in patients with complex aortic diseases treated by the chimney tech…
2018
Abstract Objective Endovascular aneurysm repair (EVAR) with the chimney technique (ch-EVAR) has been used for the treatment of aortic aneurysms as an alternative approach to fenestrated endografting or open repair. Nonetheless, the need for an upper extremity arterial access may contribute to a higher risk for periprocedural cerebrovascular events. This study reports on the perioperative cerebral and major adverse cardiac and cerebrovascular events (MACCE) after ch-EVAR. Methods The PERICLES registry (PERformance of the chImney technique for the treatment of Complex aortic pathoLogiES) is an international, retrospective multicenter study evaluating the performance of ch-EVAR for the treatme…
Collected World Experience About the Performance of the Snorkel/Chimney Endovascular Technique in the Treatment of Complex Aortic Pathologies
2015
OBJECTIVES: We sought to analyze the collected worldwide experience with use of snorkel/chimney endovascular aneurysm repair (EVAR) for complex abdominal aneurysm treatment. BACKGROUND: EVAR has largely replaced open surgery worldwide for anatomically suitable aortic aneurysms. Lack of availability of fenestrated and branched devices has encouraged an alternative strategy utilizing parallel or snorkel/chimney grafts (ch-EVAR). METHODS: Clinical and radiographic information was retrospectively reviewed and analyzed on 517 patients treated by ch-EVAR from 2008 from 2014 by prearranged defined and documented protocols. RESULTS: A total of 119 patients in US centers and 398 in European centers …
Endoluminal Stent-Graft Relining of Visceral Artery Bypass Grafts to Treat Perigraft Seroma
2013
PURPOSE: To describe the endovascular treatment of intra-abdominal perigraft seromas associated with small-caliber expanded polytetrafluoroethylene (ePTFE) grafts. CASE REPORTS: Two patients who underwent hybrid repair of thoracoabdominal aortic aneurysms in which renovisceral bypass grafts were implanted presented with large, symptomatic perigraft seromas. The 5- to 8-mm-diameter ePTFE bypass grafts believed to be involved in the seromas were successfully relined with self-expanding Viabahn stent-grafts in percutaneous procedures. The patients' symptoms were relieved, and imaging follow-up (18 and 10 months, respectively) has shown near complete resorption of the seromas. CONCLUSION: It is…
Management of Complex Cerebral Aneurysms
2022
BACKGROUND: Complex intracranial aneurysms (CIAs) are challenging pathologies to treat. Characteristics making an aneurysm complex include dimension, history of previous treatment, location, absence of collateral circulation, intraluminal thrombosis, and calcification of the wall. The goal of the therapeutic process is to exclude the malformation from the cerebral circulation and both endovascular and surgical treatments are valid procedures.METHODS: Between 1990 and 2020, 170 CIAs were treated at our institution (33 ruptured, 137 unruptured). They were 3 prepetrous segment of the internal carotid artery (ICA), 14 purely intracavernous sinus, 27 intracavernous with subarachnoid extension, 6…
FLOW DIVERTER DEVICE IN THE ACUTE SETTING OF RUPTURED BLISTER LIKE ANEURYSM: A CASE REPORT
2021
Blister-like aneurysms (BLA) are a rare half-dome-shaped aneurysm, with a broad-based appearance, originating more often from a non-branching site of the supraclinoid internal carotid artery (ICA). They are sometimes difficult to recognize due to their morphological changes and high tendency to rupture. BLAs are often undiagnosed and may be detected only after repeated angiograms in the case of acute subarachnoid hemorrhage (SAH). BLA are life-threatening and no consensus has so far been reached on the best management strategy. We describe a patient with a BLA in the left ICA successfully treated by flow-diverting device using intraoperative abciximab bolus, with successful results. Recentl…
ROLE OF ENDOVASCULAR EMBOLIZATION IN THE MULTIDISCIPLINARY MANAGEMENT OF RUPTURED BRAIN ARTERIOVENOUS MALFORMATIONS
2022
Brain arteriovenous malformations (bAVMs) are congenital defects of vasculogenesis, the natural history of which is characterized by a significant morbidity and mortality related to the risk of bleeding. Their management remains challenging, since complete eradication is often difficult. Embolization, surgery, or radiosurgery alone are safe and effective for small unruptured AVMs, while a multidisciplinary approach should be pursued for larger ones. We report a case of intracerebral haemorrhage due to the rupture of a large bAVM, for which a multidisciplinary approach was adopted: endovascular partial embolization followed by complete surgical removal.
2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism
2014
ACS : acute coronary syndrome AMPLIFY : Apixaban for the Initial Management of Pulmonary Embolism and Deep-Vein Thrombosis as First-line Therapy aPTT : activated partial thromboplastin time b.i.d. : bis in diem (twice daily) b.p.m. : beats per minute BNP : brain natriuretic peptide BP : blood pressure CI : confidence interval CO : cardiac output COPD : chronic obstructive pulmonary disease CPG : Committee for Practice Guidelines CRNM : clinically relevant non-major CT : computed tomographic/tomogram CTEPH : chronic thromboembolic pulmonary hypertension CUS : compression venous ultrasonography DSA : digital subtraction angiography DVT : deep vein thrombosis ELISA : enzyme-linked immunosorben…
Early abdominal aortic rupture after Nellix endovascular aneurysm sealing
2018
This case concerns a 73 year-old woman, that suffered from symptomatic aortic abdominal aneurysm. Due to the complex anatomy of the aneurysm she was treated with nellix endovascular aneurysm seal device. The implantation was successful, and the completion angiography showed no endoleak. On the 9th day after the procedure, the patient presented severe abdominal pain with peritoneal symptoms, significant anemia and hypovolemic shock. The patient was subject to emergency laparotomy. The aortic rupture was identified. The Nellix device was removed and replaced with bifurcated silver-covered PTFE graft.
Aneurismas complejos de la aorta abdominal: cirugía abierta frente a exclusión endovascular avanzada. Estudio comparativo.
2015
Justificación del estudio e hipótesis de trabajo: la enfermedad aneurismática de la aorta se estima que afecta al 2%-7% de los varones mayores de 60 años. Dichas estimaciones, extrapoladas a la población de España, se corresponderían con 140.000-350.000 personas portadoras de una aneurisma de aorta abdominal. En siete de cada cien personas acaece la rotura del aneurisma, siendo actualmente la décima causa de muerte en varones mayores de 55 años. En aquellos pacientes de alto riesgo para la cirugía abierta en los que la exclusión endovascular con endoprótesis de sellado infrarrenal está contraindicada por mala calidad del cuello aneurismático, la exclusión endovascular avanzada con endopróte…