Publications by authors named "Marilisa Soto-Gonzalez"
Objective: Short distances between the lowest visceral/renal artery and the aortic bifurcation are technically challenging during complex endovascular aortic aneurysm repair (EVAR), particularly after previous infrarenal repair. Traditionally, inverted limb bifurcated devices have been used in addition to fenestrated-branched (FB) endografts, but short overlap, difficult cannulation, and potential crushing of bridging stents are limitations for their use. This study reviews the early experience of patient-specific company manufactured devices (PS-CMDs) with a unibody bifurcated FB design for complex EVAR.
View Article and Find Full Text PDFArticle Synopsis
- The study focuses on the use of transcatheter electrosurgical aortic septotomy (TEAS) to improve endovascular repair outcomes for patients with chronic dissecting aortoiliac aneurysms, addressing challenges like a rigid septum and compressed true lumen.
- Over 17 patients underwent TEAS from 2021 to 2023, and the main goal was to achieve technical success, evaluated alongside various secondary outcomes related to vessel stability and aneurysm-related complications.
- Results showed a 100% technical success rate with no major complications, and all target vessels were successfully stented, allowing safe further repairs such as thoracic endovascular aneurysm repair and fenestrated/branched endovascular aneurysm repair.
Objective: Adverse iliofemoral anatomy may preclude complex endovascular aortic aneurysm repair (EVAR). In our practice, staged iliofemoral endoconduits (ECs) are planned prior to complex EVAR to improve vascular access and decrease operative time while allowing the stented vessel to heal. This study describes the long-term results of iliofemoral ECs prior to complex EVAR.
View Article and Find Full Text PDFWe report our initial experience using Fiber Optic RealShape (FORS), an innovative real-time three-dimensional visualization technology that uses light instead of radiation, to achieve upper extremity (UE) access during fenestrated/branched endovascular aortic aneurysm repair (FBEVAR). An 89-year-old male patient with a type III thoracoabdominal aortic aneurysm, unfit for open aortic repair, underwent FBEVAR. Dual fluoroscopy, intravascular ultrasound, and three-dimensional fusion overlay were used, in addition to FORS.
View Article and Find Full Text PDFObjective: Upper extremity (UE) access is frequently used for fenestrated-branched endovascular aortic aneurysm repair (F-BEVAR), particularly for complex repairs. Traditionally, left-side UE access has been used to avoid crossing the arch and the origin of the supra-aortic vessels, which could potentially result in cerebral embolization and an increased risk of perioperative cerebrovascular events. More recently, right UE has been more frequently used as it is more convenient and ergonomic.
View Article and Find Full Text PDFBackground: Spinal drains are used to ameliorate spinal cord ischemia (SCI), but their use may result in inherent morbidity and mortality. Although prophylactic spinal drain has proven of benefit in open repairs, that is not the case for endovascular repairs. The aim of this study was to assess the outcomes of spinal cord protection with and without the routine use of spinal drains during fenestrated-branched endovascular repair (F-BEVAR).
View Article and Find Full Text PDFObjective: Target artery stenosis might affect the outcomes of fenestrated/branched endovascular aortic aneurysm repair (F-BEVAR). The aim of the present study was to assess the effects of preoperative stenosis of the celiac artery (CA) and superior mesenteric artery (SMA) on the target artery outcomes after F-BEVAR.
Methods: During a 4-year period, 287 consecutive patients, 204 men (71%) and 83 women (29%), had undergone F-BEVAR using fenestrated (83%), fenestrated-branched (4.
Objective: Fenestrated-branched endovascular aneurysm repair (F/B-EVAR) is a complex procedure that generates high radiation doses. Magnification aids in vessel cannulation but increases radiation. The aim of the study was to compare radiation doses to patients and operating room staff from two fluoroscopy techniques, standard magnification vs dual fluoroscopy with live-image digital zooming during F/B-EVAR.
View Article and Find Full Text PDFObjective: Renal function impairment is a common complication after open repair of complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs). The purpose of this study was to assess renal perioperative outcomes and renal function deterioration after fenestrated-branched endovascular aneurysm repair (F/BEVAR) in patients with chronic kidney disease (CKD).
Methods: The study included 186 patients who underwent F/BEVAR between 2013 and 2018 for suprarenal, juxtarenal, and type I to type IV TAAAs.
Article Synopsis
- The study investigates how gender impacts perioperative outcomes after fenestrated endovascular aortic aneurysm repair (FEVAR) in patients with complex abdominal aortic aneurysms using premanufactured devices over a 2-year period.
- A total of 79 patients, mostly men, underwent FEVAR, revealing that while overall complication rates were similar for both genders, women experienced longer hospital stays and higher reintervention rates.
- Multivariate analysis indicated that female gender significantly correlates with an increased risk of renal function deterioration post-procedure, establishing gender as an important factor in FEVAR outcomes.