Application of transmesenteric vein extrahepatic portosystemic shunt in treatment of symptomatic portal hypertension with cavernous transformation of portal vein.

Purpose: To evaluate the feasibility and efficacy of a transmesenteric vein extrahepatic portosystemic shunt (TmEPS) for the treatment of cavernous transformation of the portal vein (CTPV).

Materials And Methods: The clinical data of 20 patients with CTPV who underwent TmEPS between December 2020 and January 2022 ​at Henan Provincial People's Hospital were retrospectively collected. The superior mesenteric vein (SMV) trunk was patent or partially occluded in these patients.

Cardiovascular risk in chronic myeloid leukaemia: A multidisciplinary consensus on screening and management.

Introduction: Tyrosine kinase inhibitors (TKIs) have become the mainstay of treatment for chronic myeloid leukaemia (CML), but cardiovascular (CV) risk and exacerbation of underlying risk factors associated with TKIs have become widely debated. Real-world evidence reveals little application of CV risk factor screening or continued monitoring within UK CML management. This consensus paper presents practical recommendations to assist healthcare professionals in conducting CV screening/comorbidity management for patients receiving TKIs.

A canine model of aortic arch aneurysm created with autologous pericardium.

Background: To establish a canine model of aortic arch aneurysm that is suitable for research on new devices and techniques applied to the aortic arch.

Materials And Methods: Fifteen mongrel dogs underwent surgery. The autologous pericardial patch was sewn on the aortotomy site in the anterior wall of the aortic arch.

Umbilical artery catheter, aortic dissection, carotid cannulation, and pseudoaneurysm in a neonate: A tale of propagating pathology.

Arterial dissections are uncommon in neonates. Complications include thrombosis, bleeding, dissection, aneurysm and pseudoaneurysm. We report an unusual case of multisite pathology (dissection and pseudoaneurysm) following common vascular interventions.

investigation of a new thrombus aspiration and autologous blood reinfusion system.

Purpose: The aim of the study was to evaluate the feasibility of a new venous-thrombus aspiration and autologous blood (auto-blood) reinfusion system.

Materials And Methods: We constructed the venous model from polyvinyl chloride (PVC) tubes and three-way unions using a fresh clot of chicken blood as the venous thrombus. Eight French and 12F aspiration catheters were used to aspirate the thrombus in the right-pulmonary-artery model, 8 French and 14F aspiration catheters were used in the inferior-vena cava model, and 8 French and 10F aspiration catheters were used in the left-iliofemoral-vein model.

The use of video motion analysis to determine the impact of anatomic complexity on endovascular performance in carotid artery stenting.

Objective: Video motion analysis (VMA) uses fluoroscopic sequences to derive information on catheter and guidewire movement and is able to calculate two-dimensional catheter tip path length (PL) on the basis of frame-by-frame pixel coordinates. The objective of this study was to evaluate the effect of anatomic complexity on the efficiency of completion of defined stages of simulated carotid artery stenting as measured by VMA.

Methods: Twenty interventionists each performed a standardized easy, medium, and difficult carotid artery stenting case in random order on an ANGIO Mentor (Simbionix, Airport City, Israel) simulator.

Targeted genetic analysis in a large cohort of familial and sporadic cases of aneurysm or dissection of the thoracic aorta.

Purpose: Thoracic aortic aneurysm/aortic dissection (TAAD) is a disorder with highly variable age of onset and phenotype. We sought to determine the prevalence of pathogenic variants in TAAD-associated genes in a mixed cohort of sporadic and familial TAAD patients and identify relevant genotype-phenotype relationships.

Methods: We used a targeted polymerase chain reaction and next-generation sequencing-based panel for genetic analysis of 15 TAAD-associated genes in 1,025 unrelated TAAD cases.

Preoperative thoracic false lumen branches relate to aortic remodeling after thoracic endovascular aortic repair for DeBakey IIIb aortic dissection.

Objective: This study evaluated the association between thoracic false lumen branches (TFLBs; dissected thoracic branches fed by a false lumen) and distal thoracic aortic enlargement (DTAE) after thoracic endovascular aortic repair (TEVAR) for DeBakey IIIb aortic dissection.

Methods: We retrospectively analyzed the records of 67 patients with DeBakey IIIb dissection initially treated with TEVAR between January 2011 and December 2013. Preoperative and postoperative computed tomography angiography images were reviewed to evaluate the number of preoperative TFLBs and aortic diameter change after TEVAR.

Thoracic endovascular aortic repair (TEVAR) in proximal (type A) aortic dissection: Ready for a broader application?

Objective: Thoracic endovascular aortic repair (TEVAR) has demonstrated encouraging results and is gaining increasing acceptance as a treatment option for aortic aneurysms and dissections. Yet, its role in managing proximal aortic pathologies is unknown-this is important because in proximal (Stanford type A) aortic dissections, 10% to 30% are not accepted for surgery and 30% to 50% are technically amenable for TEVAR. We describe our case series of type A aortic dissections treated by using TEVAR.

Robot-assisted uterine artery embolization: a first-in-woman safety evaluation of the Magellan System.

Purpose: To provide a technical description of robot-assisted uterine artery embolization and to investigate the safety and feasibility of the Magellan (Hansen Medical, Mountain View, California, USA) robotic catheter in this complex arterial bed.

Materials And Methods: Five women (mean age, 48.8 y) underwent robot-assisted bilateral uterine artery embolization over a 10-month period using the Magellan robotic catheter.

The role of teamworking in error reduction during vascular procedures.

Background: To examine the associations between teamworking processes and error rates during vascular surgical procedures and then make informed recommendations for future studies and practices in this area.

Methods: This is a single-center observational pilot study. Twelve procedures were observed over a 3-week period by a trained observer.

Experience with a novel custom-made fenestrated stent graft in the repair of juxtarenal and type IV thoracoabdominal aneurysms.

Objective: Fenestrated stent grafting has become increasingly popular as a means to manage complex aortic pathology, including juxta- and pararenal aneurysms. The design of a recently developed custom-made fenestrated stent graft, in theory, confers advantages when managing anatomically challenging aortic morphology. This study evaluated its feasibility in anatomically challenging scenarios.

Thoracic endovascular aortic repair: the basics.

Endografting for the treatment of thoracic aortic pathology continues to gain popularity; in some countries, numbers of endovascular aortic repairs now exceed those of open surgical cases. The skills and understanding of open surgical teams are not always translated into endovascular intervention teams, which may be led by cardiologists or vascular surgeons with little knowledge of thoracic pathology. Our experience with more than 400 thoracic interventional cases leads us to believe that that the cardiovascular surgeon is crucial to the success of any thoracic endovascular aortic repair program.

An instantiability index for intra-operative tracking of 3D anatomy and interventional devices.

The tracking of tissue deformation, imaging probes and surgical instruments is an integral part of intra-operative surgical guidance. While the recent introduction of shape instantiation provides a systematic framework for tracking 3D anatomy in real-time, deviations to the desired imaging location can affect the accuracy of the predicted shape. To examine the sensitivity of the prescribed image planes to such errors, we introduce in this paper a new Instantiability Index for providing the intrinsic level of robustness while using such scan planes for the tracking of anatomy and interventional devices.

Preliminary comparative study of small amplitude helical and conventional ePTFE arteriovenous shunts in pigs.

Intimal hyperplasia (IH), which causes occlusion of arterial bypass grafts and arteriovenous (A-V) shunts, develops preferentially in low wall shear, or stagnation, regions. Arterial geometry is commonly three-dimensional, generating swirling flows, the characteristics of which include in-plane mixing and inhibition of stagnation. Clinical arterial bypass grafts are commonly two-dimensional, favouring extremes of wall shear.

Fluid structure interaction of patient specific abdominal aortic aneurysms: a comparison with solid stress models.

Background: Abdominal aortic aneurysm (AAA) is a dilatation of the aortic wall, which can rupture, if left untreated. Previous work has shown that, maximum diameter is not a reliable determinant of AAA rupture. However, it is currently the most widely accepted indicator.

Transoesophageal echocardiogram identifying the source of endoleak after combined open/endovascular repair of a type 3 thoracoabdominal aortic aneurysm.

Open repair of thoracic aortic aneurysms is associated with significant morbidity and mortality. The introduction of endovascular repair has reduced both the morbidity and mortality. However, endovascular stent repair can be complicated by endoleaks.

Apical suction device facilitating off-pump bypass for recurrent coarctation: case report.

Apical suction devices to perform complete surgical revascularization without cardiopulmonary bypass have been recently introduced in cardiac surgical practice. We have increasingly explored the possibility of using these devices to perform other procedures on a beating heart that have previously necessitated the need for cardiopulmonary bypass. We present a case of recurrent coarctation in which an ascending-to-abdominal aorta bypass graft was successfully facilitated by the use of an apical suction device.

Recent developments in vascular surgery.

The authors of this review discuss the changing role of vascular surgery and the impact of developments such as endovascular interventions and new techniques for treating varicose veins

Laparoscopic remodeling of abdominal aortic aneurysms after endovascular exclusion: a technical description.

We report our experience with a novel combined laparoscopic-endovascular procedure to treat endoleaks and graft migration. The operative procedure consisted of the following steps: laparoscopic exposure of the aorta, clipping of lumbar arteries and of the inferior mesenteric artery, incision of the sac of the aneurysm without clamping the aorta, and removal of thrombus material. Laparoscopic sutures were placed externally to attach the endograft to the aortic neck.

Enhancing foot skin blood flux in peripheral vascular disease using intermittent pneumatic compression: controlled study on claudicants and grafted arteriopaths.

Intermittent pneumatic leg compression (IPC) increases arterial calf inflow and foot skin blood flux in normal subjects and claudicants. Our hypothesis was that IPC could enhance foot skin blood flux after infrainguinal grafting and thus promote distal perfusion in limbs with tissue loss. The aim of this study was to compare the effects of three IPC modes [applied to the foot (IPCfoot), the calf (IPCcalf), or both (IPCfoot+calf)] on foot skin perfusion in healthy individuals, claudicants, and patients after infrainguinal arterial revascularization performed for critical or subcritical limb ischemia.