1,722,543 research outputs found
Endovascular treatment: materials
No full textVisceral and renal artery aneurysms are rare but life-threatening pathologies. Many techniques have been proposed for their treatment, and both open surgery and endovascular strategies have proven to be safe and effective. Many specialists can be involved in the treatment of these aneurysms, from vascular surgeons to interventional radiologists, and the knowledge of every different possible approach is fundamental to offer the patient the best outcome. In this book, all the aspects of visceral and renal artery aneurysms have been widely discussed, from epidemiology and anatomical variations to surgical approaches and materials. To conclude, the authors reported a large series of case reports from different experts in order to obtain a better vision of the real-world practice on this topic
Special Issue on Materials and Technologies in Oral Research
No full textThe introduction of novel materials and technologies in oral research has permitted the rapid evolution of dentistry, as confirmed by the increasing number of publications on this topic [...
Endovascular occlusion of an aortic coarctation after thoracic endovascular aortic repair of an anastomotic aneurysm
Full text linkA 58-year-old man with a history of aortic and mitral mechanical valve replacement was referred to our hospital for symptomatic chronic heart failure. In 1988, he had undergone open surgical correction of an isthmic aortic coarctation (CoA), with the creation of an extra-anatomic bypass from the left subclavian artery to the descending thoracic aorta. The following findings were found: severe mitral valve failure with perivalvular leakage, severe aortic valve stenosis, pulmonary hypertension, distal anastomotic aneurysm with the apparent occlusion of the CoA. A thoracic endovascular aneurysm repair was performed. A postoperative high-pressure leak with no evident signs of ineffective sealing was observed. Computed tomography angiography (CTA) 3D reconstruction demonstrated the recanalization of the CoA. A second procedure was planned. The CoA was anterogradely cannulated. Three coils were deployed into the aneurysmal sac, followed by a vascular plug, positioned on the coarctation conduit, but it failed to anchor and dislocated into the sac. A second plug was deployed, but it also partially dislocated. Finally, a patent foramen ovale occluder device was deployed to occlude the communication. The final angiogram showed the complete occlusion of the coarctation and correction of the leak, which was confirmed by a 6-month post-operative CTA
Controllo dopo endoprotesi dell'aorta toracica
No full textLa Società Italiana di Diagnostica Vascolare (SIDV) è una società scientifico-professionale e come tale promuove la ricerca, e ne divulga i risultati, nel proprio campo di competenza, ma è anche coinvolta ed attiva nelle iniziative didattiche di aggiornamento e nel processo di armonizzazione e accreditamento delle procedure diagnostiche e dei professionisti che le eseguono. In quest’ottica si è ritenuto che fosse un dovere istituzionale l’elaborazione e la pubblicazione di un testo di “Diagnostica Vascolare Ultrasonografica” che contenesse, in forma snella ma non superficiale, tutte le informazioni essenziali in questo campo complesso. In questo testo di “vascolare multidisciplinare” che tratta la diagnostica delle malattie vascolari in un’ottica globale e non secondo prospettive settoriali; i vari capitoli riflettono le linee guida per l’esecuzione e la refertazione degli esami vascolari ultrasonografici già pubblicate nel passato. Questo libro è rivolto agli Specialisti di Discipline Vascolari ed agli Specializzandi, ma anche a tutti coloro che sono interessati e coinvolti nella Diagnostica Vascolare. In altre parole è rivolto e dedicato a tutti i Professionisti che, per coinvolgimento assistenziale quotidiano, per motivi di ricerca, per programmazione socio-sanitaria o per mera curiosità intellettuale, desiderano approfondire queste problematiche servendosi di un libro di facile consultazione
Anatomical Feasibility of an Off-the-shelf Single-Renal Scalloped Stent-Graft for Hostile Neck Abdominal Aortic Aneurysm: A Preclinical Study
No full textObjectives: To evaluate the feasibility of a standardized single-renal scallop stent-graft. Design: Preclinical, single-center, real-world, all-comers, retrospective cohort study. Methods: A total of 1347 abdominal aortic aneurysm (AAA) repairs (endovascular and open) performed between 2010 and 2020 were screened for elective treatment and retrievable preoperative high-quality computed tomography angiography (CTA) performed <6 months of the surgical procedure. Six hundred of the included CTAs involved prespecified measurements and a morphological assessment protocol (NCT05150873). The proximal sealing zones suitable for standard stent-graft implantations were further analyzed (N=547). The primary outcome assessed the feasibility of 2 single-renal scallop designs (10×10 mm and 15×10 mm, height × width). The feasibility was the inter-renal length ≥10 mm and ≥15 mm for prototypes #10 and #15, respectively. The secondary outcome quantified hypothetical length and surface improvements comparing those suitable for investigational devices implantation (study group) versus those not (control group). Results: Of the total, 24.7% (n=135) was feasible with prototype #10. The study versus control group sealing zones were shorter (p=0.008), with a smaller surface (p=0.009) and a higher alpha angle (p=0.039). The length and surface area increased by about 25% and 23%, respectively, (both p<0.001) within the study group and became significantly better versus the control group (standard stent-graft; both p<0.001). Of the total, 7.1% (n=39) was suitable for prototype #15. The study versus control group sealing zones were shorter (p=0.148), with a smaller surface (p=0.077) and a higher alpha angle (p=0.027). The length and surface area increased by about 34% and 31%, respectively, (both p<0.001) within the study group and became significantly higher versus the control group (standard stent-graft; both p<0.001). Conclusions: The use of single-renal scalloped stent-graft might be feasible in a considerable number of AAA patients. The breakthrough stands in treating hostile AAAs presenting in mismatched renal arteries, keeping the complexity of the repair as similar as possible to standard endovascular repair with a remarkable improvement in sealing. Clinical Impact: The anatomic feasibility of a single renal stent graft for the treatment of “hostile” abdominal aortic aneurysm (AAA) with mismatched renal arteries was evaluated. The experimental device could be feasible in a considerable number of patients with AAA, approaching 25%, and demonstrate significant improvements in sealing. As far as we know, this is the first paper to report the prevalence of mismatched renal arteries in a large cohort of AAA patients in the real world, while proposing a dedicated device. The breakthrough is to keep the complexity of the repair as close as possible to standard endovascular repair
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