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Pearl Monica - - 2010
Aneurysmal subarachnoid hemorrhage is a deadly disease associated with high morbidity and mortality. Surgical clipping has been the gold standard treatment for more than 70 years. Endovascular therapy is now accepted as a valid alternative therapeutic modality. The authors' approach emphasizes collaboration between endovascular and surgical specialists. The array of ...
Carpenter Jeffrey P - - 2010
PURPOSE: To report the contemporary controlled trial experience with the fully supported unibody Powerlink stent-graft for endovascular treatment of abdominal aortic aneurysm (AAA). METHODS: Between 2000 and 2008, 3 prospective multicenter trials of the Powerlink system evaluated 157 AAA patients (141 men; mean age 72.0+/-9.1 years) with mean AAA sac ...
van Keulen Jasper W - - 2010
This study presented and validated a new standardized method for the measurement of the aortic angulation in patients with abdominal aortic aneurysms (AAA) and quantified the observer variability. A standardized method to quantify aortic angulation was introduced. To measure aortic angulation, a center lumen line (CLL) of the aorta was ...
Bertoni Hernán G - - 2010
PURPOSE: To report the use of a branched, balloon-deployable stent-graft to treat abdominal aortic aneurysm (AAA) in the setting of a solitary kidney. CASE REPORT: A 72-year-old man with a solitary intrapelvic kidney and multiple comorbid conditions was diagnosed with an asymptomatic 5.3-cm abdominal aortic aneurysm (AAA); the renal artery ...
Patel Himanshu J - - 2010
The presence of penetrating aortic ulcers (PAUs) of the descending thoracic aorta has been associated with a poor long-term prognosis. Although early results have suggested acceptable outcomes for thoracic endovascular aortic repair (TEVAR) for PAU, few studies have described the late outcomes of this approach. From 1993 to 2009, 37 ...
Kuratani Toru - - 2010
The treatment of thoraco-abdominal aortic aneurysms (TAAAs) is extremely laborious, due to the surgical complexity of this condition. In particular, postoperative spinal paraplegia poses a severe complication that significantly lowers patient's quality of life. In 1997, we devised a hybrid procedure consisting of extended endovascular aortic repair (EVAR) and visceral ...
Bosman Willem-Maarten P F - - 2010
One of the major concerns in the long-term success of endovascular aneurysm repair (EVAR) is stent graft migration, which can cause type I endoleak and even aneurysm rupture. Fixation depends on the mechanical forces between the graft and both the aortic neck and the blood flow. Therefore, there are anatomical ...
Rancic Zoran - - 2010
Endovascular aneurysm repair (EVAR) of ruptured thoracoabdominal aortic aneurysms may be compromised or even impossible due to short proximal and/or distal necks or landing zones, respectively. Supra-aortic branches may limit the proximal anchorage and visceral or renal arteries the distal anchorage of endografts. While solutions have been proposed to overcome ...
Ascher E - - 2010
OBJECTIVE: Our previously reported experience with balloon angioplasties and stenting for occlusive infra-inguinal arterial disease using duplex guidance encouraged us to expand the indication for this imaging modality to include endovascular repair of popliteal artery aneurysms (PAAs). The present study evaluated the feasibility of performing this procedure under duplex guidance ...
Heyer Kamaldeep - - 2010
Hybrid approaches for the treatment of thoracoabdominal aortic aneurysms (TAAAs) by using a combination of visceral revascularization followed by thoracic endovascular aneurysm repair (EVAR) have been reported with acceptable results. The authors present a case that required the addition of a bifurcated infrarenal EVAR to completely exclude a type III ...
Ouriel Kenneth - - 2010
Although repair of large abdominal aortic aneurysms (AAAs) is well accepted, randomized clinical trials have failed to demonstrate benefit for early surgical repair of small aneurysms compared with surveillance. Endovascular repair has been shown to be safer than open surgical repair in patients with large aneurysms, prompting a randomized trial ...
Manning B J - - 2010
OBJECTIVE: A prototype ready-to-fenestrate stent graft (RFSG) was designed with a fixed scallop, and eight potential fenestrations allowing for variation in the position of each renal artery (RA) relative to the superior mesenteric artery (SMA). We aimed to determine the proportion of juxtarenal aneurysms treatable using this potentially 'off-the-shelf' device. ...
Holt Peter J - - 2010
This study was conducted to define the outcomes of treating aortic aneurysms involving the arch vessels with a hybrid approach using extra-anatomic reconstruction and endovascular repair with nonfenestrated stents. A single-center review was done of arch aneurysm endovascular repairs during an 8-year period. Data were collected for patient demographics and ...
Clough Rachel E - - 2010
Mycotic aortic aneurysms are rare and it is unlikely that any center will obtain extensive experience in their management. The aim of treatment is to repair the aorta and eradicate the infection with minimal operative and postoperative risk. We describe a case in which a custom-made endovascular stent graft provided ...
Verhoeven E L G - - 2010
OBJECTIVES: To present an 8-year clinical experience in the endovascular treatment of short-necked and juxtarenal abdominal aortic aneurysm (AAA) with fenestrated stent grafts. METHODS: At our tertiary referral centre, all patients treated with fenestrated and branched stent grafts have been enrolled in an investigational device protocol database. Patients with short-necked ...
Larzon Thomas - - 2010
Occasionally, standard stent grafts are not usable in emergency aortic bleeding, and custom-made stent grafts are not practical as a replacement. We describe a novel technique for the repair of such aneurysms by using the catheter-delivered liquid to solid embolic agent Onyx (Micro Therapeutics Inc., Irvine, CA). Two patients with ...
Silingardi Roberto - - 2010
Our goal was to achieve complete proximal sealing in severe aortic neck angulation (SNA) during endovascular aneurysm repair (EVAR) of a patient with an abdominal aortic aneurysm (AAA) unfit for surgery. An 82-year-old patient with an infrarenal AAA of 9.8 cm with an SNA of 90 degrees was admitted for ...
Coscas Raphael - - 2010
In contrast to internal iliac artery (IIA) occlusion, the use of branch stent-graft (BSG) has been developed as an efficient adjunct in preserving pelvic blood flow. However, the risk of post-procedural type 2 endoleak (EL) remains. We present the case of an 80-year-old man with a juxtarenal aneurysm extending to ...
Ferreira Marcelo - - 2010
This study presents technical aspects and initial results with iliac bifurcated devices (IBDs). Since 2006, 47 IBDs were scheduled for 37 patients who were followed up between 2 and 31 months. Iliac aneurysms were unilateral in 27 patients and bilateral in 10. Two patients with bilateral common iliac artery aneurysms ...
Goldstein Lee J - - 2010
Spinal cord ischemia is a rare complication after abdominal aortic surgery and has been attributed to surgical devascularization of the spinal cord, atheroembolization of the cord circulation, or hypoperfusion of cord structures secondary to hypotension or cord edema. We present a diabetic, hypertensive 75-year-old male with endstage renal disease who ...
Desai Mital - - 2010
Endovascular aneurysm repair (EVAR) has quickly gained popularity for infrarenal abdominal aortic aneurysm repair during the last two decades. The improvement of available EVAR devices is critical for the advancement of patient care in vascular surgery. Problems are still associated with the grafts, many of which can necessitate the conversion ...
O'Neill Stephen - - 2012
This case aims to highlight the need for careful scrutiny of the distal aorta during endovascular aneurysm repair (EVAR) planning to avoid potentially avoidable graft limb occlusion. We present a case of graft limb occlusion after EVAR, unresponsive to endovascular re-intervention requiring surgical extra-anatomic revascularization, due to a narrow distal ...
Lamoca Luis Miguel Izquierdo - - 2010
INTRODUCTION: We here present a case of a ruptured giant popliteal artery aneurysm (PAA) successfully treated with endovascular surgery. CASE REPORT: A 88-year-old male presented with left limb massive swelling and pain. His general status was critical with acute respiratory insufficiency. CT scan showed massive haematoma in the thigh and ...
Tsilimparis Nikolaos - - 2010
BACKGROUND: We sought to present endovascular management options of persistent or recurrent aneurysm sac flow ("endoleak") after operative retroperitoneal exclusion of infrarenal abdominal aortic aneurysm (AAA). METHODS: Recurrent or persistent aneurysm perfusion was diagnosed in three patients primarily treated with aneurysm exclusion and bypass. The medical history, course of disease, ...
Paravastu S - - 2010
BACKGROUND: We report the use of the common carotid artery as an alternate access in endovascular therapy. METHODS/RESULTS: A 77-year-old man with an enlarging abdominal aortic aneurysm in whom previous attempts at standard endovascular repair had failed because of difficult iliac access underwent endovascular repair via the left common carotid ...
Metcalfe Matthew J - - 2010
The treatment of internal iliac artery aneurysms is aimed at the prevention of rupture. Traditionally, this is undertaken surgically; however, endovascular techniques are an acceptable alternative and these techniques are also not without complication. Herein, the authors describe the endovascular treatment of two patients with internal iliac aneurysms. Although the ...
Gemmete Joseph J - - 2011
This report describes two cases of successful treatment of an internal iliac artery aneurysm (IIAA) type II endoleak utilizing a percutaneous transosseous access that could not be treated using an endovascular or standard percutaneous approach. A direct percutaneous approach through bone was chosen to avoid vital structures and the surrounding ...
Volders David - - 2010
BACKGROUND: We examined the reasons for missing a type III endoleak on conventional imaging and the pathophysiology of paraparesis after relining this stent graft. METHODS AND RESULTS: A 46-year-old man was treated with a thoracic stent graft for thoracic rupture of a chronic type B thoracoabdominal dissection with aneurysm formation. ...
Resch T - - 2010
Endovascular treatment of complex aortic aneurysms with fenestrated and branched stentgrafts is in rapid development. Early and midterm results from centers of excellence are very promising but the technique is still in its infancy. With the introduction of EVAR for complex aneurysms a new set of failure modes have also ...
Roche-Nagle G - - 2010
In recent years, major improvements have been made, making elective repair of abdominal aortic aneurysm (AAA) a safe procedure. In selected series, mortality rates are less than 5%. Many of the patients with AAA, however, remain asymptomatic until they present with rupture. Once rupture has occurred, the overall mortality approaches ...
Choong A M T L - - 2010
Thoraco-abdominal aortic aneurysm repair remains a formidable challenge to vascular surgeons. The traditional repair of thoraco-laparotomy with aortic cross-clamping is associated with a high morbidity and mortality despite significant advances in perioperative critical care, anaesthetic and surgical techniques. The advent of the endovascular revolution has shown a marked paradigm in ...
Cao P - - 2010
Endoleak is a common and unique complication of endovascular aortic repair (EVAR) and its persistence represents a failure of the endovascular treatment. Accurate detection and classification is essential for the proper management since the method of endoleak treatment is determined by the different source. In general, high-pressure leaks (type I ...
Reilly Linda M - - 2010
PURPOSE: To describe a direct anatomical treatment approach using an induced type Ib endoleak to increase spinal cord perfusion and reverse paraplegia occurring after endovascular exclusion of a type 2 thoracoabdominal aortic aneurysm (TAAA). TECHNIQUE: The approach is illustrated in an 82-year-old woman who underwent branched endovascular repair of an ...
Kilian Michael - - 2010
BACKGROUND: Our objective was to identify morphologic trends in elective and emergency endovascular aneurysm repair (EVAR). This work will inform hospitals with endovascular programs about the diameters and lengths of endostents that should be available to efficiently care for patients with these conditions. METHODS: We performed a retrospective review of ...
Berland T L - - 2010
Endovascular repair is becoming the mainstay of treatment for aneurysmal disease of the abdominal and thoracic aorta. Access related issues comprise a major reason for failure or conversion to open repair and can contribute to a significant amount of morbidity and mortality. This article will discuss a multitude of access ...
Foster Jake - - 2010
Endovascular aneurysm repair (EVAR) has become widely adopted as the primary treatment modality for abdominal aortic aneurysm in the elective setting. However, equipoise exists regarding the use of this technology for acute ruptured aneurysms. A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question ...
Ricotta Joseph J JJ - - 2010
Rupture of an abdominal aortic aneurysm (AAA) carries a high morbidity and mortality despite vast improvements in the care of critically ill patients over the past two decades. Between 50% and 80% of all patients with ruptured AAA do not survive. Endovascular treatment of ruptured AAA has recently become popularized ...
Massi?re Bernardo - - 2010
The association of aortic and common iliac artery aneurysms requires a special strategy to achieve distal seal during the endovascular exclusion of abdominal aortic aneurysms. Coil embolization of the internal iliac artery before the placement of a bifurcated endograft limb into the external iliac artery is a usual option. Such ...
Cina Claudio S - - 2010
Endovascular repair is an established modality of treatment for abdominal aortic aneurysms. It is therefore reasonable to expect its application to other less common aneurysmal conditions, including isolated iliac and popliteal artery aneurysms (PAA). There are, however, essential differences between aortic aneurysms and peripheral aneurysms: smaller arterial caliber, mobility of ...
Moore Randy D - - 2010
A 72-year-old male presents with a large asymptomatic aneurysm of his left popliteal artery. He has a history of noninsulin dependent diabetes, hypertension, and a prior history of a percutaneous intervention for a coronary artery stenosis. He is anatomically and physiologically a candidate for surgical or endovascular repair of his ...
Rusu M C - - 2010
The iliolumbar artery (ILA) of Haller is the largest nutrient pedicle of the ilium and its detailed knowledge is important for various surgical procedures that approach the lumbosacral junction, the L4/L5 disk space, the sacroiliac joint, the iliac and psoas muscles, or the lumbar spine. Also the ILA is relevant ...
Jaoudé Maroun Abou - - 2010
Arterial hypertension is a leading cause of both vascular diseases and chronic renal failure. With the increasing incidence of patients suffering from hypertension, an increasing number of patients with hypertensive vascular disease are reported, namely aortoiliac atherosclerosis and aneurysms, needing kidney transplantation (KT). Staged or simultaneous surgical repair of aortoiliac ...
Alhan Cem - - 2010
We report the case of a 53-year-old woman with claudication in both legs. Her angiographic examination revealed thrombosis with a critical stenosis of distal abdominal aorta. The patient was treated successfully with endovascular stenting.
Hurks R - - 2010
Elective repair of abdominal aortic aneurysms (AAA) is associated with significant morbidity and mortality. Large amounts of AAA tissue are necessary to assess heterogeneity among AAA and to correct for potential confounders such as known risk factors. The Aneurysm-express study aims to identify different types of AAA using inflammatory markers ...
Higashiura Wataru - - 2010
The purpose of this report was to demonstrate initial Japanese cases of abdominal aortic aneurysm (AAA) with complex anatomy of proximal neck treated using a Zenith fenestrated endograft with branched endovascular technique and to describe the device's design and technical considerations. Planning and sizing of endografts were performed using high-resolution ...
Sommer Wieland H - - 2010
We report discordant imaging findings of a small persistent type II endoleak in a 72-year-old man who had undergone endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm. Although the aneurysm was growing in size digital subtraction angiography could not detect an endoleak, but time-resolved CT-angiography and contrast enhanced ultrasound ...
Manning B J - - 2010
Stent graft placement for aneurysmal disease of the aortic arch and proximal descending aorta is limited by the need to preserve flow to the supra-aortic trunks. Whilst extra-anatomical bypass and procedures combining open and endovascular arch repair are currently used in this setting, less invasive totally endovascular solutions have been ...
Thompson A R - - 2010
BACKGROUND: This retrospective analysis of prospectively collected abdominal aortic aneurysm (AAA) screening data aimed to identify predictors of AAA-related events (surgery or death) with a view to better targeting of screening. METHODS: For the interval 1984-2007, data for 1649 subjects with an AAA were collected prospectively as part of the ...
Izgarevic D - - 2010
We describe the case of a young man admitted with acute onset of pain and defense in the left iliac fossa a few hours after rectal introduction of a dildo. At laparotomy a retroperitoneal haematoma was found along with a dissection of the left common iliac artery. No rectal perforation ...
Paraskevas Kosmas I - - 2010
The main criterion for abdominal aortic aneurysm (AAA) repair is an AAA diameter >/=5.5 cm. However, some AAAs rupture when they are smaller. Size alone may therefore not be a sufficient criterion to determine rupture risk. Fluorodeoxyglucose (FDG) uptake is increased in the presence of inflammation and it was suggested ...
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