Impact of preoperative risk factors on 5-year survival after fenestrated/branched endovascular aortic repair.

Objective: To investigate which preoperative factors most impact the 5-year survival of patients undergoing fenestrated/branched endovascular aortic repair (F/BEVAR) and to identify modifiable elements that, if time allows, should be actively managed and adequately controlled preoperatively.

Methods: Patients treated for aortic aneurysms with complex anatomy using either patient-specific company-manufactured or off-the-shelf F/BEVAR devices were included. The exposure of interest was aneurysm type (group I: type I-III thoracoabdominal aneurysms vs group II: type IV thoracoabdominal aneurysms vs group III: juxtarenal or suprarenal aneurysms), and the primary outcome was 5-year risk of all-cause mortality.

Endovascular (stent-graft)-assisted open vascular anastomosis.

Endovascular and open surgical approaches are an integral part of treating patients with complex vascular disease and are often considered separately. In some situations, traditional open surgical techniques can be used to facilitate an endovascular approach, as example: iliac conduit use for EVAR/TEVAR, subclavian or axillary conduits for complex endovascular aortic repairs (chimney, B-FEVAR), and bypass to great vessels or visceral artery (celiac, superior mesenteric and renal arteries) debranching. As devices and techniques evolve, the open and endovascular approaches can be utilized in more complimentary fashion.

Multicenter Study on Physician-Modified Endografts for Thoracoabdominal and Complex Abdominal Aortic Aneurysm Repair.

Background: Physician modified endografts (PMEGs) have been widely used in the treatment of complex abdominal aortic aneurysm and thoracoabdominal aortic aneurysm, however, previous data are limited to small single center studies and robust data on safety and effectiveness of PMEGs are lacking. We aimed to perform an international multicenter study analyzing the outcomes of PMEGs in complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms.

Methods: An international multicenter single-arm cohort study was performed analyzing the outcomes of PMEGs in the treatment of elective, symptomatic, and ruptured complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms.

Effect of fenestration configuration on renal artery outcomes during fenestrated-branched endovascular aortic repair.

Objective: The aim of this study was to evaluate the effect of fenestration configuration and fenestration gap on renal artery outcomes during fenestrated-branched endovascular aortic repair (F/BEVAR).

Methods: A retrospective multicenter analysis was performed, including patients with complex aortic aneurysms treated with F/BEVAR that incorporated at least one small fenestration to a renal artery. The renal fenestrations were divided into groups 1 (8 × 6 mm) and 2 (6 × 6 mm).

Five-year outcomes of fenestrated and branched endovascular repair of complex aortic aneurysms based on aneurysm extent.

Objective: The aim of this study was to evaluate the 5-year outcomes of fenestrated/branched endovascular aortic repair (F/BEVAR) for the treatment of complex aortic aneurysms stratified by the aneurysm extent.

Methods: Patients with the diagnosis of complex aortic aneurysm, who underwent F/BEVAR at a single center were included in this study and retrospectively analyzed. The cohort was divided according to the aneurysm extent, comparing group 1 (types I-III thoracoabdominal aneurysms [TAAAs]), group 2 (type IV TAAAs), and group 3 (juxtarenal [JRAAs], pararenal [PRAAs], or paravisceral [PVAAs] aortic aneurysms).

Case Series on Double-Barrel Stenting for the Renal Arteries Associated With Fenestrated Repair (FEVAR) of Complex Anatomy Aortic Aneurysms.

The double-barrel stenting (DBS) is a technique in which 2 parallel stents are simultaneously deployed through the same reinforced fenestration, into 2 adjacent target vessels. Prior reports describe the application of this technique for the treatment of superior mesenteric artery dissection with aneurysmal degeneration, coronary artery bifurcations, aortic arch branches, and intracranial aneurysms. The DBS technique is particularly useful in the context of fenestrated repair (FEVAR) of complex anatomy aortic aneurysms when the origin of visceral arteries branch off the aorta very close to each other or present early branches.

Rare Case of Abdominal Aortic and Multiple Visceral Aneurysms in a Pediatric Patient With PIK3CA Mutation and Vasculitis.

Abdominal aortic aneurysms (AAA) are most commonly observed in elderly male patients and are particularly rare in children. Among the pediatric population, they are usually diagnosed in the context of connective tissue disorders, genetic mutations, or vasculitis. The same is true of visceral arteries aneurysms.

Gore thoracoabdominal branched endoprosthesis: early results and impressions.

The remarkable advances in technology and devices in the last two decades have made possible the endovascular repair of complex abdominal (cAAA) and thoracoabdominal (TAAA) aortic aneurysms with challenging anatomy. To date, despite the creation of multiple fenestrated/branched endografts intended to treat these difficult cases, in the USA, many of them remain available only under physician sponsored investigational device exemption (PSIDE) protocols in few institutions. The Gore Thoracoabdominal Branched Endoprosthesis (TAMBE; W.

Outcome Analysis Comparing Asymptomatic Juxtarenal Aortic Aneurysms Treated with Custom-Manufactured Fenestrated-Branched Devices and the "Off-The-Shelf" Zenith p-Branch Device.

Background: Numerous endovascular options have been used for the repair of juxtarenal aortic aneurysms (JRAAs) over the last 15 years. This study aims to compare the performance between the Zenith p-branch device and custom-manufactured fenestrated-branched devices (CMD) for the treatment of asymptomatic JRAA.

Methods: A single-center retrospective analysis of prospectively collected data was performed.

Biomechanical Analysis of Cadaveric Thoracic Aorta Zones: The Isthmus is the Weakest Region.

Background: The thoracic aorta is a site of multiple pathological processes, such as aneurysms and dissections. When considering the development of endovascular devices, this vessel has been extensively manipulated because of aortic diseases, as well as to serve as a route for procedures involving the head and neck vessels. Therefore, the aim of the present study was to obtain biomechanical experimental information about the strength and deformability of this vessel.

Biomechanical and histological data from abdominal aortas harvested in autopsy.

This data article describes biomechanical and histological information of abdominal aortas harvested in autopsy. Eight abdominal aorta aneurysms (AAA) and 30 normal diameter abdominal aortas were collected and submitted to an inflation test up to their rupture. This inflation procedure was part of the research entitled "Experimental study of rupture pressure and elasticity of abdominal aortic aneurysms found at autopsy", submitted to Annals of Vascular Surgery.

Biomechanical Properties of the Periaortic Abdominal Tissue: It is Not as Fragile as It Seems.

Background: The perivascular adipose tissue has been studied as a critical element that could influence physiological and disease processes of the vessel covered by it. In terms of anatomy, during the abdominal aorta's dissection, it is possible to identify the periaortic adipose tissue and the periaortic parietal peritoneum lying over it, sealing the retroperitoneal space. They seem to be fragile layers, with apparently no biomechanical role in the abdomen.

Biomechanics data of human supra-aortic trunks and abdominal visceral arteries harvested during autopsy.

The present dataset describes the biomechanical properties of the supra-aortic trunks (brachiocephalic trunk, left common carotid artery, and left subclavian artery) and some of the visceral branches of the abdominal aorta (celiac trunk, superior mesenteric artery, and renal arteries). The specimens have been harvested from 27 adult donors during the autopsy procedure. The vessels were submitted to uniaxial biomechanical tensile tests, and values of failure stress, failure tension, and failure strain were obtained.

Experimental Study of Rupture Pressure and Elasticity of Abdominal Aortic Aneurysms Found at Autopsy.

Background: Resistance and elasticity of normal and aneurysmal aorta walls are directly associated with this vessel's growth and rupture. This study aims to experimentally analyze the biomechanical behavior of aneurysmal specimens found at autopsy, comparing them with normal diameter aortas removed from age-matched donors.

Methods: Thirty-eight human aortas (30 normal aortas; 8 infrarenal abdominal aortic aneurysms) were harvested during autopsy.

Left Common Carotid Artery Biomechanical Properties in Individuals over 80 years: Women Have Stiffer Vessels.

Background: Considering the longevity of the worldwide population, the cardiovascular diseases deserve particular attention, especially the carotid artery disease in the ≥80-year-old population. The stiffness of the common carotid artery, for example, has been showed in numerous clinical studies as a marker of increased risk of stroke, dementia, and depression. Besides, with the emergence of new surgical techniques such as the transcarotid artery revascularization that uses the common carotid artery as a workstation, the biomechanical and histological features of this vessel, more than ever, must be detailed.

[Occult metastasis in sentinel lymph node in early-stage breast cancer].

Purpose: sentinel lymph node biopsy in early-stage breast cancer patients has been substituting the total axillary lymph node is presented dissection. The technique of processing the sentinel lymph node and the aim of this study was to investigate the efficacy of occult metastasis identification based on the standard histological and immunohistochemical examination.

Methods: between 2002 and 2005, 266 sentinel lymph nodes were harvested from axillary biopsy of 170 patients with early stage breast cancer.