Search results for "endovascular"
showing 10 items of 201 documents
Thoracic Endovascular Aortic Repair (TEVAR) for the treatment of aortic diseases: a position statement from the European Association for Cardio-Thora…
2012
Thoracic endovascular aortic repair (TEVAR) is an emerging treatment modality, which has been rapidly embraced by clinicians treating thoracic aortic disease.1–4 Fundamentally, it is a far less invasive approach than open surgery and its availability and relative ease of application has changed and extended management options in thoracic aortic disease, including in those patients deemed unfit or unsuitable for open surgery. In the operating room, this requires considerable perceptual, cognitive and psychomotor demands on the operators. The dramatic expansion of TEVAR activity has necessarily prompted a requirement to systematically consider the indications, appropriateness, limitations and…
Computer Modeling for the Prediction of Thoracic Aortic Stent Graft Collapse
2011
OBJECTIVE: To assess the biomechanical implications of excessive stent protrusion into the aortic arch in relation to thoracic aortic stent graft (TASG) collapse by simulating the structural load and quantifying the fluid dynamics on the TASG wall protrusion extended into a model arch. METHODS: One-way coupled fluid-solid interaction analyses were performed to investigate the flow-induced hemodynamic and structural loads exerted on the proximal protrusion of the TASG and aortic wall reconstructed from a patient who underwent traumatic thoracic aortic injury repair. Mechanical properties of a Gore TAG thoracic endoprosthesis (W. L. Gore and Assoc, Flagstaff, Ariz) were assessed via experimen…
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…
Management of Patients With Aortic Dissection
2008
Cardiovascular diseases have become the leading cause of death in countries with high medical standards. Acute aortic syndromes—particularly acute aortic dissection—are playing an increasingly important part in this development (1). Acute aortic dissection has an extremely high mortality rate after the occurrence of an initial manifestation, so a standardized treatment algorithm is crucial for patient survival. On the basis of selected recent publications, the aim of this study was to review the current status of the management of aortic dissection and formulate recommendations for treatment.
Successful use of impella CP through femoral access in a patient with bilateral iliac and aortic endoprosthesis in the setting of cardiogenic shock
2019
We report the case of a 67-year-old male, with previous history of severe peripheral vascular disease (abdominal aorta aneurism and bilateral iliac stenosis) requiring the implantation of 3 endoprostheses 7 months ago (Figure 1(A)), and previous myocardial infarction 10 years ago. The left ventricular ejection fraction (LVEF) was preserved at last control (58%). The patient was referred for acute coronary syndrome complicated with pulmonary oedema and cardiogenic shock. Echocardiography showed a severe impairment of LVEF (18%) and the patient was transferred to cathlab for emergency percutaneous coronary intervention (PCI). Coronary angiography via right femoral 7Fr access showed a chronic …
Mortality of ruptured abdominal aortic aneurysm with selective use of endovascular repair
2009
The aim of this review was to examine the results over a seven-year period of treatment for ruptured abdominal aortic aneurysm (RAAA). From 2002 on, our tertiary referral centre offered both open and endovascular (EVAR) treatment modalities for RAAA. All patients with a proven RAAA who were admitted into our hospital were included. Primary outcome measure was surgical mortality. In total 261 patients were admitted with suspicion of acute AAA. Of these, 175 (67%) had a RAAA, confirmed by computed tomography-scanning or at laparotomy. One hundred and fifty-nine patients (90.9%) were treated, 114 by open repair and 45 by EVAR. Overall mortality of patients treated was 25.2%, with an open repai…
Flat Panel Computed Tomography Pooled Blood Volume and Infarct Prediction in Endovascular Stroke Treatment
2019
Background and Purpose— Patients with large-vessel stroke frequently need to be transferred to comprehensive stroke centers for endovascular treatment. An update of physiological perfusion parameters and stroke progression on arrival is desirable. We examined the reliability of preinterventional pooled blood volume (PBV)-maps acquired by flat-panel detector computed tomography (CT) in the interventional angiography suite. Methods— The volumes of preinterventional perfusion deficit in flat-panel detector CT-PBV source images were compared with final infarct volume on follow-up multislice-CT after endovascular treatment of 29 consecutive patients with occlusion of the middle cerebral artery …
Flow diversion for indirect carotid-cavernous fistula: Still an off-label indication?
2023
Background: Flow diversion (FD) is an established treatment for large or giant wide-necked unruptured intracranial aneurysms. In the past few years, the use of flow diverter devices was extended to several other “off-label” indications, including solitary or adjunctive treatment to coil embolization for direct (Barrow A type) carotid cavernous fistulas (CCFs). The use of liquid embolic agents still represents the first-line treatment for indirect CCFs. Typically, the ipsilateral inferior petrosal sinus or superior ophthalmic vein (SOV) is the preferred transvenous routes to access CCFs. In some cases, vessel tortuosity or different features make the endovascular access challenging, thus re…
Under Pressure: Comparison of Aspiration Techniques for Endovascular Mechanical Thrombectomy.
2018
BACKGROUND AND PURPOSE: Blood flow should be interrupted during mechanical thrombectomy to prevent embolization of clot fragments. The purpose of our study was to provide a handy overview of the most common aspiration devices and to quantify their flow characteristics. MATERIALS AND METHODS: We assessed volumetric flow rates generated by a 60-mL VacLok vacuum pressure syringe, a Pump MAX aspiration pump, and a Dominant Flex suction pump connected to the following: 1) an 8F long sheath, 2) an 8F balloon-guide catheter, 3) an ACE 64 distal aspiration catheter, and 4) an AXS Catalyst 6 Distal Access Catheter. We used a water/glycerol solution, which was kept at a constant temperature of 20°C (…