29 research outputs found
Mufty Mathewson's Education and First Job
No full textNotes - King's Hall Compton school yearbook. Letter and pay stub from Montreal General Hospital. Mufty Mathewson's 1954 graduation speech from McGill University, Diploma of Physio and Occupational Therapy (111 pages
Correspondence during European Trip
No full textLetters and Notes - Letters and postcards written to and from Mufty Mathewson with her family while on vacation. Telegram from her future husband, Bill Mathewson (126 pages
A Five-Year Computed Tomography Follow-up Study of Proximal Aortic Neck Dilatation After Endovascular Aortic Repair Using Four Contemporary Types of Endograft Reply
No full textstatus: Publishe
Miscellaneous Correspondence
No full textLetter - Two letters to Mufty Mathewson from her mother and brother (14 pages
Correspondence from England
No full textNotes - Letter written by Mufty Mathewson describing life and work in England, along with other letters and newspaper article (24 pages
A Five-Year Computed Tomography Follow-up Study of Proximal Aortic Neck Dilatation After Endovascular Aortic Repair Using Four Contemporary Types of Endograft
No full textOBJECTIVE: This study analysed the progression of proximal aortic neck diameter in patients with asymptomatic abdominal aortic aneurysms, treated by endovascular aortic repair using four different, contemporary types of endograft. METHODS: This is a retrospective study of four cohorts of 30 patients presenting with asymptomatic abdominal aortic aneurysms and treated with endovascular aortic repair using four different types of contemporary endografts, namely Endurant® (Medtronic), Excluder® (W.L. Gore), Zenith® (Cook Medical) and Ovation® (Endologix) endografts. Patients' demographics and aortic aneurysm measurements, including suprarenal aortic, proximal infrarenal neck and maximum aortic aneurysmal diameter, were gathered from the patients' electronic medical records, pre- and post-interventional computed tomography studies, respectively. Diameter measurements were modelled as a function of endograft type; an interaction test was used to test whether the evolutions over time were different between the four types of endograft. RESULTS: Suprarenal aortic diameter increased over time (P = 0.0235) and maximum aortic aneurysm diameter decreased over time (P = 0.0008) in the four types of endograft. The progressive increase in proximal neck diameter from preoperative baseline up to five years of follow-up was 1.20 mm for Endurant (P = 0.0054), 1.72 mm for Ovation (P = 0.0006), 1.14 mm for Excluder (P = 0.0102) and 2.83 mm for Zenith (P < 0.0001), respectively. Five patients (4%) presented with a late-type 1a endoleak: Endurant (n = 1); Ovation (n = 2) and Zenith (n = 2). CONCLUSION: All endografts were associated with a progressive dilatation of the proximal aortic neck over a time interval of five years and may be associated with late-type 1a endoleak.status: Publishe
Ventriculo-peritoneal shunt alone does not guarantee spinal cord protection after complex aortic aneurysm repair
No full textINTRODUCTION: Spinal cord ischaemia (SCI) is a devastating complication of the treatment of thoraco-abdominal aneurysms. Peri-operative cerebrospinal fluid (CSF) drainage, typically using a spinal catheter, is a possible preventive measure. There are no reports or guidelines on peri-operative CSF drainage for this indication in patients with a ventriculoperitoneal (VP) shunt. REPORT: A single case of a patient suffering SCI after fenestrated endovascular aortic repair for the treatment of a pararenal aneurysm after previous open repair of an infrarenal aortic aneurysm is presented. Despite the presence of a patent VP shunt, elevated CSF pressures were observed after placement of a CSF drain. DISCUSSION: A VP shunt with a gravitational component may drain insufficiently in bedridden patients who often lie with their head tilted on a cushion. In this position, both the differential pressure component and the gravitational component become active, thereby increasing the overall resistance to CSF outflow, hence increasing intracranial and intraspinal pressure. VP shunts with gravitational components should be managed with caution in the setting of prophylactic or therapeutic drainage of CSF to prevent SCI in extensive aortic repair. For reliable CSF pressure monitoring or active drainage in case of symptoms, the insertion of a spinal drain is indicated.status: Accepte
Dealing with symptomatic stenosis of the subclavian artery: Open or endovascular approach? A case report
No full textAbstractINTRODUCTIONStenosis of the subclavian artery is uncommon and it rarely causes symptoms. Only symptomatic patients should be treated.PRESENTATION OF CASEWe report a case of chronic left upper limb ischemia caused by subclavian artery stenosis after repetitive clavicular fixation. The stenosis was first treated with carotid-subclavian bypass and soon followed by angioplasty and stenting of the subclavian artery because of occlusion of the bypass. Finally, failure of these procedures necessitated a subclavian-axillary crossover bypass.DISCUSSIONBoth extra-anatomic bypass and percutaneous transluminal angioplasty are safe and effective. If feasible, many authors use endovascular treatment. According to literature, extra-anatomic bypass still remains the first choice of treatment for symptomatic patients. However, the introduction of routine stent implantation is equalling these results. Because of its lower long-term patency rate, endovascular treatment is favorable for patients at high risk.CONCLUSIONOur case is a good example of difficulties involved in choosing the best treatment option for subclavian artery stenosis
External Validation of a Prognostic Model for Survival of Patients With Abdominal Aortic Aneurysms Treated With Endovascular Aneurysm Repair.
No full textOBJECTIVE
Current guidelines recommend diameter monitoring of small and asymptomatic abdominal aortic aneurysms (AAAs) due to the low risk of rupture. Elective AAA repair is recommended for diameters ≥ 5.5 cm in men and ≥ 5.0 cm in women. However, data supporting the efficacy of elective treatment for all patients above these thresholds are diverging. For a subgroup of patients, life expectancy might be very short, and elective AAA repair at the current threshold may not be justified. This study aimed to externally validate a predictive model for survival of patients with asymptomatic AAA treated with endovascular aneurysm repair (EVAR).
METHODS
This was a multicentre international retrospective observational cohort study. Data were collected from four European aortic centres treating patients between 2001 and 2021. The initial model included age, estimated glomerular filtration rate (eGFR), and chronic obstructive pulmonary disease (COPD) as independent predictors for survival. Model performance was measured by discrimination and calibration.
RESULTS
The validation cohort included 1 500 patients with a median follow up of 65 months, during which 54.6% of the patients died. The external validation showed slightly decreased discrimination ability and signs of overfitting in model calibration. However, a high risk subgroup of patients with impaired survival rates was identified: octogenarians with eGFR < 60 OR COPD, septuagenarians with eGFR < 30, and septuagenarians with eGFR < 60 and COPD having survival rates of only 55.2% and 15.5% at five and 10 years, respectively.
CONCLUSION
EVAR is a valuable treatment option for AAA, especially for patients unsuitable for open repair. Nonetheless, not all these patients will benefit from EVAR, and an individualised treatment recommendation should include considerations on life expectancy. This study provides a risk stratification to identify patients who may not benefit from EVAR under the present diameter threshold
Antithrombotic Therapy and Freedom From Bridging Stent Occlusion After Elective Branched Endovascular Repair: A Multicenter International Cohort Study.
No full textBased on our study, no antithrombotic therapy is significantly associated with bridging stent occlusion, and no evidence of the superiority of other antithrombotic therapy exists. Nevertehless, due to the low number of bridging stent occlusions, this study can neither support nor reject the PRINCE2SS recommendations. Further studies with larger cohorts are needed to determine clear guideliness of the best antithrombotic treatment regimen after complex enfovascular aortic repair
