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T-branch by partial deployment technique in the endovascular repair of complex aortic and thoracoabdominal aneurysms with narrow or severe angulated para-visceral aorta.
J Vasc Surg
January 2025
Vascular Surgery, University of Bologna, DIMEC, Bologna, Italy; Vascular Surgery Unit, IRCCS Sant'Orsola, Bologna, Italy.
Introduction/aim: The partial deployment technique (PDT) is an unconventional option of T-branch deployment to allow target arteries (TAs) cannulation/stenting from the upper arm access, in case of narrow (NPA: <25mm) or severely angulated (APA: >60°) aorta. Aim of this study was to report outcomes of the endovascular repair of complex aortic (c-AAAs) and thoracoabdominal (TAAAs) aneurysms by T-branch and PDT.
Methods: All consecutive patients underwent urgent endovascular repair of c-AAAs and TAAAs by T-branch (Cook-Medical, Bloomington, IN, US) and PDT from 2021 to 2023 were analyzed.
Distribution and Maturity of Medial Collagen Fibers in Thoracoabdominal Post-Dissection Aortic Aneurysms: A Comparative Study of Marfan and Non-Marfan Patients.
Int J Mol Sci
December 2024
Department of Vascular Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany.
Thoracoabdominal aortic aneurysms (TAAAs) are rare but serious conditions characterized by dilation of the aorta characterized by remodeling of the vessel wall, with changes in the elastin and collagen content. Individuals with Marfan syndrome have a genetic predisposition for elastic fiber fragmentation and elastin degradation and are prone to early aneurysm formation and progression. Our objective was to analyze the medial collagen characteristics through histological, polarized light microscopy, and electron microscopy methods across the thoracic and abdominal aorta in twenty-five patients undergoing open surgical repair, including nine with Marfan syndrome.
View Article and Find Full Text PDFImplementation of a Comprehensive Endovascular Aortic Programme and Maintenance of Clinical Excellence during Fenestrated Branched Endovascular Aortic Repair in Two Centres.
Eur J Vasc Endovasc Surg
November 2024
Advanced Aortic Research Program, Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science Centre at Houston, John P. and Kathrine G. McGovern Medical School, Houston, TX, USA. Electronic address:
Objective: Comprehensive endovascular aortic programmes need optimal infrastructure and multidisciplinary teams to manage complex aortic aneurysms. This study assessed the implementation of such a programme in two centres and its impact on fenestrated or branched endovascular aortic repair (FB-EVAR) outcomes.
Methods: A retrospective review of patients treated for complex abdominal and thoraco-abdominal aortic aneurysms (TAAAs) by FB-EVAR between 2013 and 2023 was undertaken.
Biomechanical stress analysis of Type-A aortic dissection at pre-dissection, post-dissection, and post-repair states.
Comput Biol Med
January 2025
Department of Computer Science, University of Miami, Coral Gables, FL, USA. Electronic address:
Acute type A aortic dissection remains a deadly and elusive condition, with risk factors such as hypertension, bicuspid aortic valves, and genetic predispositions. As existing guidelines for surgical intervention based solely on aneurysm diameter face scrutiny, there is a growing need to consider other predictors and parameters, including wall stress, in assessing dissection risk. Through our research, we aim to elucidate the biomechanical underpinnings of aortic dissection and provide valuable insights into its prediction and prevention.
View Article and Find Full Text PDFModified deployment technique of off-the-shelf Gore thoracoabdominal multibranch endoprosthesis for post-dissection thoracoabdominal aortic aneurysm repair.
J Vasc Surg Cases Innov Tech
December 2024
Department of Surgery, Comprehensive Aortic Center, Keck Medical Center of University of Southern California, Los Angeles, CA.
The Thoracoabdominal Multibranch Endoprosthesis (TAMBE) is a commercially available off-the-shelf four-vessel inner branched endograft for complex abdominal and thoracoabdominal aortic aneurysms. As post-dissection thoracoabdominal aortic aneurysms (PD-TAAAs) were excluded from the pivotal trials, there is paucity of data on the use of TAMBE in PD-TAAAs. Here, we present a case demonstrating the feasibility of TAMBE in conjunction with iliac branch endoprosthesis to repair PD-TAAAs, with focus on the deployment technique specific to PD-TAAAs.
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