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Endovascular laser fenestration of a frozen elephant trunk stent graft for treatment of chronic cerebral malperfusion.
Vascular
January 2025
Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.
Objectives: Mal-deployment of the thoracic endovascular aortic repair (TEVAR) stent graft during a frozen elephant trunk (FET) procedure for an acute type A aortic dissection (ATAAD) leads to devastating complications. We report a hemiarch replacement with TEVAR stent graft covering the aortic arch vessels salvaged through an endovascular approach.
Methods: A 69-year-old man with ATAAD in 2018, status post-hemiarch repair with TEVAR, presented in 2023 with progressive dizziness/syncope and lower extremity hypertension with inability to tolerate anti-hypertensives.
Antegrade Fenestration During Thoracic Endovascular Aortic Repair for Preserving Isolated Left Vertebral Artery.
EJVES Vasc Forum
October 2024
Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Article Synopsis
- An isolated left vertebral artery (ILVA) is often affected by aortic arch pathologies, and preserving its blood flow during endovascular repair can be challenging, with no clear consensus on the best strategy.
- This case report details a successful endovascular procedure in a 72-year-old man with an ILVA, where a novel technique called antegrade needle-assisted fenestration was used to revascularize the artery without traditional surgical methods.
- The patient had a favorable outcome, with follow-up imaging showing a patent ILVA and good aortic remodeling, suggesting this technique could be a valuable option for similar cases.
Percutaneous Screw Fixation of Proximal Fifth Metatarsal Fractures.
JBJS Essent Surg Tech
November 2024
Department of Orthopaedics Foot and Ankle Surgery, The Ohio State University, Columbus, Ohio.
Article Synopsis
- Metatarsal fractures, particularly affecting the fifth metatarsal, are common injuries, making up 5-6% of outpatient fractures, with zone 2 fractures—specifically Jones fractures—being difficult to manage due to poor blood supply and higher nonunion rates.
- Surgical treatment, particularly open reduction and internal fixation (ORIF), is preferred for Jones fractures, as it leads to better healing rates compared to conservative treatment methods.
- The surgical technique involves careful anatomical marking and using a guidewire for screw placement to compress the fracture, followed by a recovery period that includes non-weight-bearing and gradual weight-bearing activities.*
Treatment of intractable bronchopleural fistula with a one-side-closed silicone stent using retrograde approach: A case report.
Respir Med Case Rep
October 2024
Department of Thoracic Surgery, Kochi Medical University, Kochi, Japan.
A male patient (age: 85 -years) with lung cancer underwent basal segmentectomy. Subsequently, he underwent emergency open window thoracotomy for a bronchial stump fistula. The general and nutritional conditions of the patient improved; nevertheless, natural closure of the fistula did not occur.
View Article and Find Full Text PDFIn situ needle fenestration for aortic arch conditions during thoracic endovascular aortic repair.
BMC Cardiovasc Disord
November 2024
Department of Cardiovascular Surgery, the First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing City, Jiangsu Province, 210029, China.
Article Synopsis
- The study evaluated the effectiveness of the in situ needle fenestration (ISNF) technique in thoracic endovascular aortic repair (TEVAR) for patients with conditions affecting the aortic arch, involving 115 patients treated from January 2018 to December 2021.
- The results showed a 100% technical success rate, with 30-day and overall mortality rates of 3.5% and 8.7%, respectively, while complications included retrograde dissection, strokes, and an endoleak.
- The authors concluded that the mid-term outcomes of the ISNF technique are promising but emphasized the need for long-term follow-up and improvement of fenestration devices.
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