112 results match your criteria: "Intravascular Stents Thoracic Aorta"
Endoluminal rescue of false lumen graft deployment in TEVAR for type B aortic dissection: a case report and literature review.
Front Cardiovasc Med
September 2024
Department of Vascular Interventional Surgery, Zhangjiajie People's Hospital, Zhangjiajie, Hunan, China.
Article Synopsis
- TEVAR is increasingly used for treating Stanford type B aortic dissection, aiming to seal entry tears and promote aorta health, but it carries risks of complications, including stent misplacement into a false lumen.
- A case involving a 78-year-old man showed that improper stent placement during a TEVAR led to blood flow issues to his abdominal organs, requiring the insertion of an additional endograft to fix the problem.
- This incident highlights the importance of intraoperative imaging to promptly identify complications, and suggests that using intravascular ultrasound could help lower the risks associated with TEVAR.
Intravascular Ultrasound Enhances the PETTICOAT Technique in Endovascular Therapy for Complicated Type B Aortic Dissection with Malperfusion Syndrome.
Ann Vasc Surg
November 2024
Department of Vascular and Endovascular Surgery, University Hospital Muenster, Muenster, Germany.
Article Synopsis
- This study highlights the effectiveness of intravascular ultrasound (IVUS) in diagnosing and treating complicated type B aortic dissection with malperfusion, focusing on its impact on treatment strategies and outcomes.
- A retrospective analysis of 25 cases showed no significant differences in reoperation rates or complications between patients treated with IVUS and those without, despite the IVUS group using more complex procedures.
- Key findings included a 32% reoperation rate and a mortality rate of 20%, with the Provisional Extension To Induce Complete Attachment (PETTICOAT) technique being utilized more frequently in the IVUS group.
Jaw claudication and branch perfusion reduction as rare complications of fenestrated thoracic endovascular aortic repair.
J Vasc Surg Cases Innov Tech
June 2024
Department of Diagnostic and Interventional Radiology, Nara Medical University, Kashihara, Japan.
Article Synopsis
- * Two weeks post-surgery, the patient reported fatigue in the right side of the jaw during meals and low blood pressure in the right arm.
- * Angiography showed a flap in the brachiocephalic artery, leading to a high-pressure gradient, and subsequent stenting resolved the patient's symptoms.
Transesophageal Echocardiography-Guided Elephant Trunk Procedure for Repair of Descending Thoracic Aorta: A Case Report.
Ann Card Anaesth
April 2024
Department of Anesthesiology and Critical Care Medicine, Jichi Medical University School of Medicine, Yakushiji, Shimotsuke, Tochigi, Japan.
Article Synopsis
- - The elephant trunk procedure is an endovascular technique used to address retrograde type A acute aortic dissection, but it can lead to complications such as hemolytic anemia, which is uncommon.
- - In a case study, a patient with endovascular stent-graft insertion developed hemolytic anemia, and transesophageal echocardiography (TEE) successfully identified issues like turbulent jet flow and stenosis that were missed by other imaging methods like angiography and IVUS.
- - The findings demonstrate that intraoperative TEE is valuable for diagnosing complications and evaluating treatment outcomes during the endovascular repair process of the elephant trunk procedure, enhancing the effectiveness of surgical interventions.
Early results of transcatheter electrosurgical aortic septotomy for endovascular repair of chronic dissecting aortoiliac aneurysms.
J Vasc Surg Cases Innov Tech
June 2024
Division of Vascular and Endovascular Surgery, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
Article Synopsis
- The study focuses on the use of transcatheter electrosurgical aortic septotomy (TEAS) to improve endovascular repair outcomes for patients with chronic dissecting aortoiliac aneurysms, addressing challenges like a rigid septum and compressed true lumen.
- Over 17 patients underwent TEAS from 2021 to 2023, and the main goal was to achieve technical success, evaluated alongside various secondary outcomes related to vessel stability and aneurysm-related complications.
- Results showed a 100% technical success rate with no major complications, and all target vessels were successfully stented, allowing safe further repairs such as thoracic endovascular aneurysm repair and fenestrated/branched endovascular aneurysm repair.
Kissing balloon inflation for transcatheter aortic valve replacement and abutting ostial coronary artery stent.
J Cardiol Cases
October 2023
Department of Cardiovascular & Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, NY, USA.
Article Synopsis
- Patients with ostial coronary stents that protrude into the aorta risk potential stent injury during transcatheter aortic valve replacement (TAVR) procedures using balloon-expandable heart valves.
- An 82-year-old male patient with a history of aortic stenosis and coronary artery interventions was evaluated, showing his RCA stent was close to the aorta, raising concerns about injury from balloon inflation during TAVR.
- Successful TAVR was achieved without stent fracture, highlighting the importance of measuring the distance from the stent to the aortic wall and using techniques like kissing-balloon inflation to avoid injury.
Surgical treatment of double aortic arch malformation combined with descending aortic arch dissection in adults: a case series.
J Cardiothorac Surg
May 2023
Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, No. 9 ZhangZhiDong Street, Wuchang District, Wuhan, 430060, Hubei, China.
Article Synopsis
- Double aortic arch (DAA) with descending aortic arch dissection (DAAD) is a rare condition in adults that presents unique clinical challenges and requires different surgical approaches compared to standard aortic dissection.
- The study analyzed three patients with DAA and DAAD, detailing their symptoms, surgical methods, and the outcomes of the interventions performed between 2010 and 2019.
- The results indicated that while total arch replacement improved outcomes for most patients, there were significant complications in one case, and follow-up showed improvements in specific symptoms like hoarseness and dysphagia following hybrid procedures.
[Off-pump Coronary Artery Bypass Grafting for Anomalous Origin of the Left Coronary Artery: Report of a Case].
Kyobu Geka
May 2023
Department of Cardiovascular Surgery, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
Article Synopsis
- A 58-year-old male patient experienced acute coronary syndrome, leading to the discovery of critical stenosis in his right coronary artery and an anomalous left coronary artery, which was confirmed through 3D-CTA.
- After an initial ineffective stent placement and persistent angina, the patient underwent successful off-pump coronary artery bypass grafting, and two years later, he reported no chest discomfort.
Emergent Total Endovascular Arch Repair for Contained Aortic Arch Rupture: Another Tool in the Box.
Vasc Endovascular Surg
October 2023
Division of Vascular Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
Article Synopsis
- A 67-year-old female with a mediastinal sarcoma was found to have tumor extension into the thoracic aorta, leading to worsening symptoms and concern for a possible rupture.
- The patient underwent an emergency endovascular repair of the aortic arch using a modified fenestrated graft, successfully stenting major arteries without complications.
- The successful procedure allowed the patient to begin chemotherapy, indicating that total endovascular repair can be a viable option for high-risk patients unsuitable for traditional surgery.
Single-Center Experience with Simultaneous Mural Aortic Thrombosis and Peripheral Obstructive Disease in Pre-COVID-19 and COVID-19 Era.
Diagnostics (Basel)
March 2023
Department of Biomedical Sciences and of Morphological and Functional Image, University of Messina, 98100 Messina, Italy.
Article Synopsis
- Mural aortic thrombosis with chronic lower limb obstruction is a rare complication in patients with peripheral artery disease (PAD), leading to acute ischemia.
- A study of 54 patients treated from 2013 to 2022 found that many underwent combined endovascular and bypass surgeries, with some experiencing complications such as renal failure and strokes, particularly among those with COVID-19.
- The findings suggest that stent coverage for aortic lesions, whether alone or with bypass surgery, can be effective, but the COVID-19 pandemic has been linked to higher rates of mortality and amputation.
Intravascular lithotripsy angioplasty for treatment of atherosclerotic coral-reef occlusion of the infrarenal aorta and its bifurcation.
J Vasc Surg Cases Innov Tech
March 2023
Division of Vascular and Endovascular Surgery, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, School of Medicine, University of Padua, Padua, Italy.
Article Synopsis
- - The report discusses the use of intravascular lithotripsy angioplasty to treat severe calcifications in the infrarenal aorta and its bifurcation in two patients.
- - The first patient had two lithotripsy balloons used together to expand the aorta while keeping the renal artery open, followed by stenting in the iliac arteries.
- - For the second patient, a single lithotripsy balloon was used first, then covered stenting was applied, suggesting that this technique could improve treatment outcomes for complex aortic conditions.
Planning and sizing of fenestrated/branched stent grafts.
Semin Vasc Surg
September 2022
Division of Vascular Surgery, University of Washington, 1959 NE Pacific Street, Box 356410, Seattle, WA 98195.
Article Synopsis
- Precise preoperative planning using high-quality CT angiography is crucial for successful fenestrated and branched endovascular repairs of aortic aneurysms, involving detailed assessments of the aorta and its branches.* -
- Assessments include checking for aberrant anatomy, disease extent, and appropriate seal zones in healthy vessels to ensure proper device sizing and selection.* -
- Comprehensive evaluations of target vessels and access options, along with optimal imaging angles for the procedure, are necessary for effective surgical outcomes.*
Rescue of False Lumen Frozen Elephant Trunk Deployment Intraoperatively.
Ann Thorac Surg
August 2023
Division of Cardiothoracic Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address:
Article Synopsis
- - Endovascular devices, especially frozen elephant trunk stents, are becoming more common for repairing type A aortic dissection, which can involve complicated procedures.
- - While deploying these stents, they can sometimes end up in the wrong place, specifically the false lumen, which can cause serious issues like increased pressure and reduced blood flow to organs.
- - The text introduces a new, straightforward rescue method for correcting this issue during surgery, utilizing transesophageal echocardiography and intravascular ultrasound to guide the procedure.
Anatomical Factors That Impede Using the Radial Artery Approach for Carotid Artery Revascularization.
World Neurosurg
April 2022
Department of Neurosurgery, International University of Health & Welfare, Tokyo, Japan.
Article Synopsis
- The study examined the challenges of using the radial artery approach (RAA) for treating craniocervical lesions, focusing on anatomical factors that create complications.!
- Out of 73 lesions treated in 65 patients, RAA was difficult for 13.7% of cases, with a notable increase in difficulty for left-sided lesions compared to right-sided ones.!
- The findings indicate that a small angle between the brachiocephalic artery and the aortic arch hinders successful RAA, providing insights into factors influencing the success of catheter introduction.
When echocardiography fails, intravascular ultrasound as an alternative for adequate graft patency in hybrid elephant trunk surgery.
Ann Card Anaesth
November 2021
Anesthesiology Institute, Cleveland Clinic; Department of Cardiothoracic Anesthesia, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Article Synopsis
- In a case study, a 54-year-old man underwent Hybrid Elephant Trunk Surgery for a complex aortic repair, where various imaging methods were used to ensure the graft was functioning correctly.
- Ultimately, intravascular ultrasound proved to be the most effective tool for providing real-time anatomical confirmation of graft patency and positioning during open aorta reconstruction.
Endovascular Management of Malperfusion Syndromes in Aortic Dissection.
Tech Vasc Interv Radiol
June 2021
Department of Radiology, University of Michigan, Ann Arbor, MI.
Article Synopsis
- - Malperfusion Syndrome (MPS) occurs when blood supply to vital organs is insufficient due to blockages in the aorta and its branches, leading to increased health risks.
- - Type A or complex type B aortic dissections with MPS usually require hybrid treatments, combining endovascular techniques with careful imaging and monitoring to assess blood flow status before, during, and after the procedure.
- - Interventions for MPS include addressing dynamic obstructions first, often through specialized surgical methods, while static obstructions may need stenting or other vascular procedures, all involving a collaborative approach with a multi-disciplinary medical team.
Effect of intravascular ultrasound on clinical outcomes after thoracic endovascular aortic repair for blunt thoracic aortic injury.
J Vasc Surg
February 2022
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio. Electronic address:
Article Synopsis
- The study investigates the impact of intravascular ultrasound (IVUS) on clinical outcomes after thoracic endovascular aortic repair (TEVAR) for blunt traumatic aortic injuries (BTAIs), noting that current methods may lead to inaccurate aortic measurements due to patient conditions like hypovolemic shock.
- An analysis of 919 TEVAR patients revealed that those who underwent IVUS had more severe injuries but did not show significant differences in mortality or reintervention rates either in the hospital or after one year, compared to those who did not use IVUS.
- Although there was a trend towards reduced blood loss and the potential for delays in using IVUS, the study concluded that IVUS did not meaningfully change clinical
Extensive Aortic Stent Graft Coverage for Thoracoabdominal Aortic Aneurysm is Associated With Hemorrhagic Complications Induced by Disseminated Intravascular Coagulation.
Ann Vasc Surg
January 2022
Department of Cardiovascular Surgery, Oita University, Yufu, Oita, Japan.
Article Synopsis
- This study examines the risks of hemorrhagic complications after hybrid endovascular repair for thoracoabdominal aortic aneurysms (TAAA), noting that it's a less invasive alternative to traditional open repair.
- Out of 61 patients, a significant decrease in platelet count was found post-surgery, with a high incidence of disseminated intravascular coagulation (DIC) both before and after stent graft placement.
- Findings indicate that aortic coverage length is a key risk factor for hemorrhagic complications, suggesting that patients with coverage longer than 304 mm require closer monitoring after surgery.
Endovascular rescue for malpositioned frozen elephant trunk into the false lumen.
J Card Surg
October 2021
Department of Cardiovascular Surgery, Akita University Graduate School of Medicine, Akita, Japan.
Article Synopsis
- - An 83-year-old patient had a total arch repair using a frozen elephant trunk technique for a serious heart condition called type A acute aortic dissection, which was further complicated by reduced blood flow to the intestines.
- - During surgery, doctors noticed that the frozen elephant trunk was incorrectly placed in the false lumen (an abnormal channel) of the descending aorta, which raised concerns about potential complications.
- - To address this issue, the surgical team successfully performed a less invasive procedure using ultrasound guidance to create a new opening in the dissecting flap and place an endograft in the correct position within the true lumen of the aorta.
Laser in situ Fenestration in Thoracic Endovascular Aortic Repair: A Single-Center Analysis.
Ann Vasc Surg
October 2021
Medical University of South Carolina, Ashley River Tower, Charleston, SC. Electronic address:
Article Synopsis
- Laser in situ fenestration (LISF) is an emerging procedure used alongside thoracic endovascular aortic repair (TEVAR) to treat different arch vessel pathologies in patients unfit for traditional surgery.
- In a study of 24 patients, 30 fenestrations were successfully created, with a technical success rate of 100%, though there were significant complication rates, including strokes and mortality.
- LISF shows potential as a viable treatment option for complex aortic conditions, with both elective and emergency applications evident in the results.
Thoracic endovascular repair for disseminated intravascular coagulation associated with chronic type B aortic dissection.
Vascular
December 2020
Department of Cardiovascular Surgery, The 274892Sakakibara Heart Institute of Okayama, Japan.
Article Synopsis
- * The patient underwent a thoracic endovascular aortic repair, which successfully addressed his repeated hemorrhagic issues.
- * Three months post-surgery, imaging showed a completely thrombosed false lumen and stable laboratory results, indicating that the endovascular approach was effective and the patient was recovering well.
Delayed disseminated intravascular coagulopathy post thoracic endovascular aortic repair (TEVAR).
J Card Surg
December 2020
Department of Cardiothoracic and Vascular Surgery, Evangelismos General Hospital, Athens, Greece.
Article Synopsis
- Disseminated intravascular coagulopathy (DIC) is a rare complication following aortic aneurysm repairs, specifically after thoracic endovascular aortic repair (TEVAR).
- The case study focuses on a 70-year-old male who developed DIC due to a type 1A endoleak after the procedure, requiring initial treatment with blood products.
- When the patient's condition did not improve, he underwent a hybrid arch replacement, highlighting the need for better understanding and management of DIC following TEVAR procedures.
Important issues regarding planning and sizing for emergent TEVAR.
J Cardiovasc Surg (Torino)
December 2020
Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, the Netherlands.
Article Synopsis
- Treatment for acute thoracic aortic syndrome has evolved significantly, with thoracic endovascular aortic repair (TEVAR) playing a key role.
- Accurate sizing of the endograft is crucial, as both under- and oversizing can lead to serious complications, particularly due to changes in aorta diameter caused by the underlying disease.
- Real-time imaging techniques, such as intravascular ultrasound (IVUS), enhance sizing accuracy during emergencies, and further research is needed to explore the impact of various imaging methods on patient outcomes.
Intravascular Ultrasound-Assisted Endovascular Exclusion of Penetrating Aortic Ulcers.
Ann Vasc Surg
January 2021
Department of Clinical Research, University Hospital of Poitiers, Poitiers, France.
Article Synopsis
- Penetrating aortic ulcer (PAU) is a serious condition that can lead to severe complications like aorta rupture, and this study examined whether using intravascular ultrasound (IVUS) for endovascular treatment of PAU is effective.
- Thirteen patients, averaging 66 years old, underwent this IVUS-assisted procedure, with key measures including fluoroscopy time, radiation exposure, and the effects on postoperative health.
- Results showed a short average fluoroscopy time, no initial complications, and only one minor follow-up issue over a median follow-up period of about 25 months, suggesting that IVUS is a promising method for treating PAU without needing contrast media.
Intravascular Lithotripsy Facilitated Percutaneous Endovascular Intervention of the Aortic Arch: A Single-Center Experience.
Cardiovasc Revasc Med
August 2020
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States of America.
Article Synopsis
- - Intravascular lithotripsy (IVL) is a new technology designed to treat heavily calcified plaque in blood vessels, aiding in procedures like coronary interventions, and is being researched for use in calcified stenotic coronary arteries.
- - The study involved 5 patients treated with IVL for complex lesions in the aortic arch, with 4 patients experiencing successful outcomes and one patient developing a complication (right eye blindness) that was treated effectively.
- - The findings suggest that IVL may be beneficial for complex vascular issues in the aortic arch, but further clinical trials are needed to fully understand its safety and effectiveness.