Publications by authors named "Timothy A Resch"

Article Synopsis
  • The study investigates the effectiveness of bare metal stents (BMS) versus covered stents (CS) in treating chronic and acute-on-chronic mesenteric ischemia (CMI and AoCMI).
  • It involves a randomized trial with 98 patients at Copenhagen University Hospital, where participants are assigned to either BMS or CS during surgery.
  • The research aims to fill a gap in the existing literature, as there are no previous prospective controlled trials comparing these two stent types, and it will also assess the impact of a more detailed postoperative monitoring plan.
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Objective: Management of follow-up protocols after endovascular aortic repair (EVAR) varies significantly between centers and is not standardized according to sac regression. By designing an international expert-based Delphi consensus, the study aimed to create recommendations on follow-up after EVAR according to sac evolution.

Methods: Eight facilitators created appropriate statements regarding the study topic that were voted, using a 4-point Likert scale, by a selected panel of international experts using a three-round modified Delphi consensus process.

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Objective: The European Society for Vascular Surgery (ESVS) has developed clinical practice guidelines for the care of patients with aneurysms of the abdominal aorta and iliac arteries in succession to the 2011 and 2019 versions, with the aim of assisting physicians and patients in selecting the best management strategy.

Methods: The guideline is based on scientific evidence completed with expert opinion on the matter. By summarising and evaluating the best available evidence, recommendations for the evaluation and treatment of patients have been formulated.

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Objective: Endovascular aortic repair (EVAR) is being used increasingly for the treatment of infrarenal abdominal aortic aneurysms. Improvement in educational strategies is required to teach future vascular surgeons EVAR skills, but a comprehensive, pre-defined e-learning and simulation curriculum remains to be developed and tested. EndoVascular Aortic Repair Assessment of Technical Expertise (EVARATE), an assessment tool for simulation based education (SBE) in EVAR, has previously been designed to assess EVAR skills, and a pass limit defining mastery level has been set.

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Purpose: To evaluate the diagnostic capabilities of a supplementary color ramped iodine density map compared to virtual monoenergetic images (VMIs) at 74 keV in the diagnosis of acute bowel ischemia (ABI).

Methods: Data for this study were prospectively gathered and retrospectively evaluated. Patients referred to the Department of Diagnostic Radiology between October 2020 and August 2022 on the suspicion of ABI and underwent surgery < 12 h following fast kV-switching venous phase abdominal dual-energy CT (DECT) were consecutively included.

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Objective: We assessed the suitability of two triple branch arch devices (aBranch) (Terumo aortic and Cook Medical) and a balloon-expandable covered stent (VBX, W. L. Gore & Associates, Johnson & Johnson) to incorporate the brachiocephalic trunk (BCT) in a cohort previously treated with hybrid thoracic endovascular repair (TEVAR).

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Background: The ultimate goal of treating patients with abdominal aortic aneurysms (AAAs) is to repair them when the risk of rupture exceeds the risk of repair. Small AAAs demonstrate a low rupture risk, and recently, large AAAs just above the threshold (5.5-6.

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Objective: This study aimed to describe surgical trends, survival, and infection related complications (IRC) in a Danish cohort of patients with infective native aortic aneurysms (INAAs).

Methods: A retrospective nationwide cohort study including all patients in Denmark who were surgically treated for abdominal INAA between 2000 and 2020 was conducted. Patients were identified through the Danish vascular registry, Karbase, which is a database registering all patients treated with vascular surgery in Denmark.

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We present the case of a 75-year-old man with a symptomatic penetrating aortic ulcer located in zone 2 on the arch inner curve between the left subclavian artery and left carotid artery treated using a single branch thoracic endovascular aortic repair combined with in situ laser fenestration. The patient underwent a successful procedure with no neurologic impairment and was discharged on the second postoperative day. The postoperative follow-up showed a well-excluded penetrating aortic ulcer.

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Introduction: Endovascular procedures have become commonplace in vascular surgery. This development calls for new training strategies for future specialists. Most simulation-based education (SBE) programs have a monodisciplinary focus on physicians, although successful surgery is a multidisciplinary team effort.

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Article Synopsis
  • Incidental findings from abdominal CT scans are common and can lead to further tests that have both financial and health implications for patients.
  • This study compared dual-energy CT (DECT) and conventional contrast-enhanced CT in identifying and characterizing incidental mass lesions in the abdomen with 96 patients involved.
  • Results showed that DECT enhanced the detection of relevant lesions, indicating it may be a better option for immediate assessment than standard CT.
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A 60-year male patient presented with a thoracoabdominal aortic aneurysm rupture, which was treated emergently with a modified off-the-shelf t-Branch stent-graft (COOK Medical Inc). The sole renal branch occluded 1 month after TEVAR due to branch compression, and the patient became anuric and temporarily dialysis-dependent. Despite the prolonged renal ischemia time, the occluded renal branch was successfully opened with thrombolysis and reinforced with a bare-metal stent.

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Dual-energy computed tomography (DECT) can estimate tissue vascularity and perfusion via iodine quantification. The aim of this systematic review was to outline current and emerging clinical applications of iodine quantification within the gastrointestinal tract using DECT. The search was conducted with three databases: EMBASE, Pubmed and The Cochrane Library.

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Article Synopsis
  • The study investigates the long-term outcomes of endovascular aneurysm repair (EVAR) for symptomatic versus asymptomatic abdominal aortic aneurysms (AAAs) at a tertiary center, focusing on patients treated with a Cook Zenith stent graft between 1998 and 2012.
  • Researchers analyzed data from 680 patients, finding no significant difference in technical success rates and freedom from reinterventions between the two groups, but higher 30-day mortality in symptomatic AAAs.
  • Although symptomatic AAAs showed lower rates of assisted clinical success and higher late AAA-related death rates compared to asymptomatic AAAs, overall survival rates were comparable when considering long-term outcomes.
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To propose a new simplified technique to occlude multiple segmental arteries for staging and preconditioning of the spinal cord to decrease the potential for spinal cord ischemia after thoracic and thoracoabdominal aortic aneurysm repair. A thoracic stent-graft that flares out to a maximum of 51 mm is deployed in a standard fashion covering all segmental arteries where graft-wall apposition occurs in the first ~20 cm of the aneurysm. The segmental arteries are always closed at their ostia in contrast to selective coil embolization, where there is a risk of more peripheral closure.

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