Endovascular Rerouting the Errant Aortic Endoprosthesis.

The anatomic complexity of aortic dissection remains a challenge in endovascular treatment. The dissection flap may contain defects allowing accidental guidewire passage from one lumen into the other, and inadvertent device placement into the false lumen can occur. The description of this complication and its bailout maneuvers are sparse in the literature.

Hybrid venous recanalization and cardiac implantable electronic device lead revision procedures: A single-center retrospective analysis of 38 patients.

Purpose: The purpose of this study was to describe the safety and efficacy of hybrid recanalization procedures in a series of patients with obstructed central veins requiring cardiac implantable electronic device (CIED) revision.

Methods: Between 2008 and 2016, 38 consecutive patients (24 M; age 60.5 ± 16.

Intra-arterial ampicillin and gentamicin and the incidence of splenic abscesses following splenic artery embolization: A 20-year case control study.

Purpose: Splenic abscesses represent a major complication following splenic artery embolization. The purpose of this study was to assess the effectiveness of intra-arterial antibiotics administered during splenic artery embolization in reducing splenic abscess formation.

Materials And Methods: 406 patients were screened.

Endovascular Fenestration/Stenting First Followed by Delayed Open Aortic Repair for Acute Type A Aortic Dissection With Malperfusion Syndrome.

Background: Immediate open repair of acute type A aortic dissection is traditionally recommended to prevent death from aortic rupture. However, organ failure because of malperfusion syndrome (MPS) might be the most imminent life-threatening problem for a subset of patients.

Methods: From 1996 to 2017, among 597 patients with acute type A aortic dissection, 135 patients with MPS were treated with upfront endovascular reperfusion (fenestration/stenting) followed by delayed open repair (OR).

Technical success and outcomes in pediatric patients undergoing transjugular intrahepatic portosystemic shunt placement: a 20-year experience.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) placement has been extensively studied in adults. The experience with TIPS placement in pediatric patients, however, is limited.

Objective: The purpose of this study was to report technical success and clinical outcomes in pediatric patients undergoing TIPS placement.

Erratum: Pediatric Portal Interventions.

[This corrects the article DOI: 10.1055/s-0038-1642043.].

Interventional Radiology-Operated Cholecystoscopy for the Management of Symptomatic Cholelithiasis: Approach, Technical Success, Safety, and Clinical Outcomes.

Objective: The objective of our study was to report the technique, complications, and clinical outcomes of interventional radiology-operated cholecystoscopy with stone removal for the management of symptomatic cholelithiasis.

Materials And Methods: Ten (77%) men and three (23%) women (mean age, 65 years) with symptomatic cholelithiasis underwent cholecystostomy followed by interventional radiology-operated cholecystoscopy with stone removal. Major comorbidities precluding cholecystectomy included prior cardiac, pulmonary, or abdominal surgery; cirrhosis; sepsis with hyponatremia; seizure disorder; developmental delay; and cholecystoduodenal fistula.

Intra-arterial Thrombolysis for Extremity Frostbite Decreases Digital Amputation Rates and Hospital Length of Stay.

Purpose: To report outcomes of intra-arterial thrombolysis versus non-thrombolytic management of severe frostbite with respect to digital amputation rates and hospital length of stay (LOS).

Materials And Methods: Seventeen patients with severe frostbite were identified from 2000 to 2017. Eight (47%) patients with mean age of 40 years underwent intra-arterial thrombolysis and served as the treatment group.

Transsplenic endovascular recanalization and stenting of a completely occluded portal vein with jejunal variceal embolization in a pediatric liver transplant recipient.

Portal vein thrombosis occurs in 1.4% of pediatric liver transplant candidates and 3.7% of liver transplant recipients.

Internal iliac venous aneurysm associated with pelvic venous insufficiency.

Aneurysmal disease of the internal iliac vein is rare, with no standard indication for or accepted modality of treatment. Here we report an instance of unilateral, primary left internal iliac venous aneurysm and associated pelvic venous insufficiency. Following extensive workup for alternative causes, the aneurysm and left gonadal vein were coil embolized with good effect.

Management of type A dissection with malperfusion.

Malperfusion is a common lethal complication of acute aortic dissection following rupture, for which the optimal management strategy has yet to be clearly established. The objective of this study was to reassess the management of acute type A aortic dissection (Type A-AAD) with malperfusion. We retrospectively analyzed the outcomes of all patients with Type A-AAD with malperfusion at the University of Michigan and compared the results from patients that directly underwent open surgical repair versus those who had percutaneous reperfusion prior to open surgical repair.

Remedial operations for failed endovascular therapy of 32 renal artery stenoses in 24 children.

Background: Percutaneous transluminal angioplasty (PTA) for the treatment of pediatric renovascular hypertension (RVH) in contemporary practice is accompanied with ill-defined complications. This study examines the mode of pediatric renal PTA failures and the results of their surgical management.

Methods: Twenty-four children underwent remedial operations at the University of Michigan from 1996 to 2014 for failures of renal PTA.

Propensity adjusted analysis of open and endovascular thoracic aortic repair for chronic type B dissection: a twenty-year evaluation.

Background: Optimal treatment of chronic type B aortic dissection (CBAD), whether open (open descending aortic repair, OAR) or endovascular (thoracic endovascular aortic repair, TEVAR), is controversial, suggesting a comparative analysis is warranted.

Methods: One hundred twenty-two of 1,049 patients (1993 to 2013) undergoing descending aortic repair required intervention for CBAD 29.2 ± 34.

A 20-year experience with thoracic endovascular aortic repair.

Background: Endovascular approaches (thoracic endovascular aortic repair) have revolutionized treatment of thoracic aortic disease.

Objective: We report our 20-year experience with this therapy.

Methods: Four hundred twenty patients (mean age = 69.

Alternative access techniques with thoracic endovascular aortic repair, open iliac conduit versus endoconduit technique.

Background: Iliac artery endoconduits (ECs) have emerged as important alternatives to retroperitoneal open iliac conduits (ROICs) to aid in transfemoral delivery for thoracic endovascular aortic repair (TEVAR). We present, to our knowledge, the first comparative analysis between these alternative approaches.

Methods: All patients undergoing TEVAR with either ROIC (n = 23) or internal EC (n = 16) were identified.

Preoperative splenic artery embolization in klippel-Trenaunay syndrome with massive splenomegaly: A case report.

The authors describe a case of Klippel-Trenaunay syndrome (KTS) with massive splenomegaly in a 29-year-old woman. Preoperative splenic artery embolization using the "double embolization technique" (a combination of distal selective splenic artery embolization and proximal splenic artery occlusion) facilitated open splenectomy.

The impact of acute renal failure on early and late outcomes after thoracic aortic endovascular repair.

Background: The incidence of acute kidney injury (AKI) after thoracic aortic endovascular repair (TEVAR) is variably reported at 1% to 34%. This study utilized the RIFLE (risk, injury, failure) criteria to evaluate the incidence, risk factors, and late implications of AKI after TEVAR.

Methods: In all, 350 patients without prior dialysis requirement underwent TEVAR (1993 to 2013).

Open and endovascular repair of the nontraumatic isolated aortic arch aneurysm.

Objective: Repair of isolated aortic arch aneurysms (nontraumatic) by either open (OAR) or endovascular (TEVAR) methods is associated with need for hypothermic circulatory arrest, complex debranching procedures, or use of marginal proximal landing zones. This study evaluates outcomes for treatment of this cohort.

Methods: Of 2153 patients undergoing arch repair (1993-2013), 137 (mean age, 60 years) were treated with isolated arch resection for nontraumatic aneurysms.

Iliofemoral complications associated with thoracic endovascular aortic repair: frequency, risk factors, and early and late outcomes.

Background: Risk factors and outcomes after iliofemoral complications after thoracic aortic endovascular repair remain poorly characterized. This study was performed to characterize factors influencing perioperative iliofemoral complications during thoracic aortic endovascular repair.

Methods: All patients undergoing transfemoral thoracic aortic endovascular repair since 2005 with adequate preoperative aortoiliac 3-dimensional imaging (n = 126) were identified.

Alternative treatment for bleeding peristomal varices: percutaneous parastomal embolization.

Purpose: To describe how peristomal varices can be successfully embolized via a percutaneous parastomal approach.

Methods: The medical records of patients who underwent this procedure between December 1, 2000, and May 31, 2008, were retrospectively reviewed. Procedural details were recorded.

Early open and endovascular thoracic aortic repair for complicated type B aortic dissection.

Background: Aortic repair for acute (<2 weeks) or subacute (2 to 8 weeks) type B dissection is performed for rupture, impending rupture, or malperfusion. Thoracic aortic endovascular repair (TEVAR) has been suggested as a more suitable, less invasive alternative to open descending aortic repair for type B dissection, but a comparative analysis is warranted.

Methods: Seventy-three patients with type B dissection (1995 to 2012) underwent early open descending aortic repair (n = 24) or TEVAR (n = 49).

Composite stent-grafts are not associated with increased endoleak or reintervention rates after endovascular abdominal aneurysm repair.

Background: Although present-generation endografts have expanded the indications for endovascular abdominal aneurysm repair, arterial anatomy frequently dictates the use of a combination of commercially available endografts and components for successful aneurysm repair. This study sought to determine whether there was an increase in endoleak or secondary intervention rates in individuals treated with composite endografts compared with noncomposite, or standard, endografts.

Methods: From 1999 to 2009, 421 endovascular abdominal aneurysm repairs were performed at a single institution.

Late outcomes with repair of penetrating thoracic aortic ulcers: the merits of an endovascular approach.

Background: Penetrating aortic ulcers (PAU) often occur in a debilitated elderly population. Although early results of repair for PAU are well described, late outcomes remain poorly characterized and are the focus in this report.

Methods: Ninety-five patients (mean age 70.