Outcome of Single Versus Dual Antiplatelet Therapy After Complex Endovascular Aortic Repair.

Introduction: Despite the widespread use of branched (bEVAR) and fenestrated endovascular aortic repair (fEVAR) for complex aortic pathologies, there are no reliable recommendations regarding postsurgery antiplatelet therapy. We therefore evaluated the outcome of single (SAPT) and dual antiplatelet therapy (DAPT) following fEVAR and bEVAR.

Methods: A total of 63 patients from two German centers treated for complex aortic pathologies were included in this retrospective study.

VE-cadherin shedding in vitro and in patients with aortic aneurysm and dissection.

VE-cadherin (VEC) is a major endothelial adhesion protein, which controls vascular homeostasis. During vascular diseases, VEC can be shed from the endothelial surface by proteases like ADAM10/17, which cleave the extracellular domain of VEC in response to inflammatory cytokines like TNF-α. The resulting, soluble fragments (sVEC) are discussed as a potential marker for endothelial barrier breakdown.

The frozen elephant trunk technique in acute aortic dissection: the ultimate solution? An institutional experience.

Objective: Acute aortic dissection remains a serious emergency in the field of cardiovascular medicine and a challenge for cardiothoracic surgeons. In the present study, we seek to compare the outcomes of different surgical techniques in the repair of type A acute aortic dissection.

Methods: Between April 2015 and May 2023, 213 patients (82 women, aged: 63.

Predictors for reintervention and survival during long-term follow-up after thoracic endovascular aortic repair for descending thoracic aortic aneurysm.

Background: Several studies have reported short- and intermediate-term outcomes after thoracic endovascular aortic repair (TEVAR) for descending thoracic aortic aneurysm (DTAA); however, reports on long-term (10 years) outcomes are sparse. Therefore, the aim of this study was to analyze predictors impacting long-term outcome after TEVAR for DTAA.

Methods: Databases from four academic institutions were reviewed and consecutive cases of TEVAR for DTAA between 1999 and 2021 were included in this retrospective multicenter study (case series).

The Semibranch: A New Tool for Complex Aortic Pathologies.

Purpose: To describe the semibranch as new tool to treat patients with thoracoabdominal, para- and juxtarenal aortic pathologies.

Technique: The technique is demonstrated in 2 patients with aortic pathologies. First, a 76-year-old woman with a type Ia endoleak after endovascular repair of abdominal aneurysm (EVAR).

The Role of Spatial Aortic Arch Architecture in Type B Aortic Dissection.

Objective: The incidence of type B aortic dissection (TBAD) is increasing worldwide; however, the underlying pathomechanisms are not conclusively understood. This study explores the geometric architecture of the aortic arch and supra-aortic branches in TBAD patients as opposed to non-TBAD patients.

Methods: Patient characteristics were retrieved from archived medical records.

The NephroCheck bedside system for detecting stage 3 acute kidney injury after open thoracoabdominal aortic repair.

Acute kidney injury (AKI) is a common complication after complex aortic procedures and it is associated with relevant mortality and morbidity. Biomarkers for early and specific AKI detection are lacking. The aim of this work is to investigate the reliability of the NephroCheck bedside system for diagnosing stage 3 AKI following open aortic surgery.

Effect of Gelatin-Based Hemostats on Fibroblasts and Relevant Growth Factors in Wound Healing.

Gelatin-based hemostats have been used in various surgical fields and showed advantageous effects on central aspects of wound healing when compared to cellulose-based hemostats. Nevertheless, the influence of gelatin-based hemostats on wound healing has not been fully explored yet. Hemostats were applied to fibroblast cell cultures for 5, 30, 60 min, 24 h, 7 and 14 days and measurements were taken at 3, 6, 12, 24 h and 7 or 14 days, respectively.

Patient Selection Criteria and Procedural Standardization for Carotid Artery Stenting-A Single Center Experience.

The gold standard for the treatment of carotid artery stenosis is the carotid endarterectomy (CEA). According to current guidelines, carotid artery stenting (CAS) is an alternative. Randomized control trials (RCTs) show significantly higher rates of peri-interventional strokes after CAS compared to CEA.

The short-chain fatty acid butyrate exerts a specific effect on VE-cadherin phosphorylation and alters the integrity of aortic endothelial cells.

Short-chain fatty acids (SCFAs) like butyrate (BUT) largely influence vascular integrity and are closely associated with the onset and progression of cardiovascular diseases. However, their impact on vascular endothelial cadherin (VEC), a major vascular adhesion and signaling molecule, is largely unknown. Here, we explored the effect of the SCFA BUT on the phosphorylation of specific tyrosine residues of VEC (Y731, Y685, and Y658), which are reported to be critical for VEC regulation and vascular integrity.

The optimal operative protocol to accomplish CO-EVAR resulting from a prospective interventional multicenter study.

Objectives: Carbon dioxide (CO) angiography for endovascular aortic repair (CO-EVAR) is used to treat abdominal aortic aneurysms (AAAs), especially in patients with chronic kidney disease or allergy to iodinated contrast medium (ICM). However, some technical issues regarding the visualization of the lowest renal artery (LoRA) and the best quality image through angiographies performed from pigtail or introducer sheath are still unsolved. The aim of this study was to analyze different steps of CO-EVAR to create an operative standardized protocol.

Analysis of Spinal Ischemia after Frozen Elephant Trunk for Acute Aortic Dissection: An Observational, Single-Center Study.

Background: This observational study aimed to evaluate the perioperative risk factors for spinal cord ischemia (SCI) in patients who underwent aortic repair with the frozen elephant trunk technique (FET) after acute aortic Stanford A dissection.

Methods: From May 2015 to April 2019, 31 patients underwent aortic arch replacement with the FET technique, and spinal ischemia was observed in 4 patients. The risk factors for postoperative SCI were analyzed.

Snare-Dragging Technique to Target the Hypogastric Artery in an Iliac Bifurcation Dissection.

Purpose: To describe snare-assisted vessel targeting to selectively overcome a dissection in the iliac bifurcation and gain antegrade access to the hypogastric artery (HA).

Technique: The technique is demonstrated in a 64-year-old woman with an asymptomatic Crawford type III thoracoabdominal aneurysm. A 2-stage endovascular repair, consisting of a thoracic endovascular aortic repair (TEVAR) and a branched endovascular aortic repair was planned.

Volume Changes in the Descending Aorta after Frozen Elephant Trunk and Conventional Hemi-Arch Repair after Acute Type A Aortic Dissection.

The aim of this study was to compare the mortality rates, re-intervention rates, and volumetric changes in aortas following surgery, in terms of the true lumen and false lumen changes, using conventional hemi-arch repair (CET) and frozen elephant trunk (FET) techniques. During the period from 2015 to 2018, 66 patients underwent surgical treatment for acute aortic dissection (Debakey type 1). Demographic and procedure-related data were evaluated.

Impact of Frozen and Conventional Elephant Trunk on Aortic New-Onset Thrombus and Inflammatory Response.

(1) Aim: The primary endpoint of this study was to evaluate the impact of frozen elephant trunk (FET) and conventional elephant trunk (CET) on aortic mural thrombus. The secondary endpoint was to investigate the incidence of persistent inflammatory response (IR) in the form of post-implantation syndrome (PIS) or persistent fever without infection focus after FET and CET, respectively, as well as the risk factors associated with its occurrence. (2) Methods: A single-center, retrospective, observational study of 57 consecutive patients treated with FET and CET between April 2015 and June 2020 was performed.

Spinal Stroke: Outcome Attenuation by Erythropoietin and Carbamylated Erythropoietin and Its Prediction by Sphingosine-1-Phosphate Serum Levels in Mice.

Spinal strokes may be associated with tremendous spinal cord injury. Erythropoietin (EPO) improves the neurological outcome of animals after spinal cord ischemia (SCI) and its effects on ischemia-induced endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) are considered possible molecular mechanisms. Furthermore, sphingosin-1-phosphate (S1P) is suggested to correlate with SCI.

Fever Management after TEVAR in Patients with Aortic Dissection.

Background: Post-implantation syndrome (PIS) is characterised as a noninfectious continuous fever and a concomitant rise in inflammatory markers shortly after thoracic endovascular aortic repair (TEVAR). This current study aims to analyse the risk factors of PIS, postoperative major adverse cardiac events (MACE), and overall survival as well as the correlation between new-onset mural thrombus and the risk of developing PIS after TEVAR in patients with type B aortic dissection (TBAD). Patients were included who had a B dissection, both acute and chronic forms.

Physician-Modified TEVAR versus Hybrid Repair of the Proximal Descending Thoracic Aorta.

There are different surgical options for the treatment of proximal lesions of the descending thoracic aorta. The aim of this study was to compare the outcome of physician-modified TEVAR (pmTEVAR) vs. hybrid repair of the thoracic aorta in terms of TEVAR with carotid-subclavian bypass (hdTEVAR).