1,721,291 research outputs found
Endovascular and Hybrid Management of Patients Affected by Abdominal Aortic Aneurysm and Occlusion of the Iliac Arteries
No full textThe presence of a concomitant aortoiliac occlusive disease and abdominal aortic aneurysm (AAA) is rare and limits the implant of a bifurcated endograft.Background: The objective of the study was to evaluate early and midterm results of an endovascular or a hybrid approach in patients undergoing iliac revascularization and AAA exclusion.Methods: We reviewed our clinical series of patients from January 2016 to February 2018. Inclusion criterion was an iliac occlusion with concomitant aortic aneurysm.Results: We treated 8 male patients: 8 common iliac arteries (CIAs) and 5 external iliac arteries (ElAs). We implanted 8 bifurcated devices and 13 covered stents, 8 in CIA and 5 in EIA. In 5 cases, when the EIA was involved, we also performed a common femoral artery endarterectomy with a patch. During a mean follow-up of 10 months, the primary patency of the recanalized iliac arteries was 100%, no endoleaks, sac growth, or rupture were also recorded.Conclusions: Endovascular or hybrid treatment of the iliac occlusion combined with infrarenal aortic aneurysm is feasible with favorable early and midterm results
Management of a large hepatic artery aneurysm
Full text linkWe present a rare case of a giant hepatic artery aneurysm in a 61-year-old man that was successfully treated by aneurysmectomy
with prosthesis bypass grafting. Because the gastroduodenal artery was occluded, an adequate collateral
circulation was not ensured after simple ligation, so a direct arterial flow to the liver was restored to avoid the risk of
significant liver or biliary tract ischemia. A computed tomography scan at 1 month showed occlusion of the bypass. The
patient remained asymptomatic, despite the supposed lack of adequate collateral circulation. The unpredictable blood supply to the liver is discussed
Endovascular repair using parallel grafts to treat a suprarenal pancreatitis‐related abdominal aortic pseudoaneurysm
No full text: Arterial pseudoaneurysms represent an uncommon complication of acute pancreatic inflammation or chronic pancreatitis. We describe a contained rupture of a suprarenal abdominal aortic pseudoaneurysm. An aorto-uni-iliac stent-graft was adopted as the aortic main body and was combined with two chimneys and two periscope stents for celiac/superior mesenteric artery and renal arteries, respectively. The procedure was complicated by the entrapment of the celiac sheath into the barbs of the aortic stent-graft and the attempts to remove the sheath resulted in an upward migration of the stent-grafts. A bail-out endovascular procedure was used to reline the stent-grafts and the pseudoaneurysmal sac was embolized with coils
IP119. Early and Long-Term Results of Viabahn Endograft for Treatment of Supra-Aortic Trunk Aneurysm∗
No full text
Covered versus Bare-metal Kissing Stents for the Reconstruction of the Aortic Bifurcation in the ILIACS registry
No full textTo compare early and mid-term outcomes of polytetrafluoroethylene-covered stents (CS) versus bare-metal stents (BMS) used in the kissing conformation for the reconstruction of the aortic bifurcation in aorto-iliac obstructive disease
A pilot study on a new model for the study of patient-perceived quality of life in the surgical treatment of PAOD: The Surgical Peripheral Artery Disease Interview questionnaire
Full text linkBACKGROUND: The aim of this study was to develop a structured interview for functional evaluation of surgical treatment of peripheral arterial obstructive disease (PAOD), in terms of postoperative quality of life (QoL), including both the constructs already present in the literature and the ones derivable from direct clinical experience. METHODS: We identified the most relevant constructs, including physical symptoms (PS), discomfort with bodily integrity (DBI), satisfaction for care (SC), impact on daily life (IDL) and social functioning (SF). We developed an 11-item questionnaire with answers on 5 points to be administered in form of structured interview by physicians, namely the Surgical Peripheral Artery Disease Interview (SPADI). A pilot administration of the interview was performed in 30 patients undergone femoro-popliteal bypass for PAOD in the previous months. Data were collected in a specific answer form, containing also information about the patients, the risk factors, the kind of treatment and the follow-up outcomes. RESULTS: We found excellent correlations between items and theoretical constructs. The exploratory factor analysis confirms four constructs, with functioning composed by impact on daily life and social functioning. The internal consistency of scales was good. The indices of physical and mental functioning were similar to those of general population. Data showed a low level of aggression, depression, tension, confusion and fatigue, confirmed by the results of Self Rating Depression Scale. About SPADI items, PS was in the average range, while DBI seemed to be almost absent; SC was good and, in the postoperative setting, patients perceived themselves as efficient (IDL) and their SF appeared to be good. CONCLUSIONS: In this preliminary study, SPADI was able to investigate dimensions that were not considered before and it may become a useful tool for supporting surgeons to an even more effective management of PAOD. Prospective validation of this questionnaire is mandatory
Iliac branch device: A possible solution for the preservation of the inferior mesenteric artery in complex aortic endovascular procedure
Full text linkA 76-year-old man was admitted with a bilateral iliac obstructive disease and an abdominal aortic aneurysm. The
right internal iliac artery was patent as well as the inferior mesenteric artery (IMA) that measured 5 mm. Patient
performed TEVAR one year before for a thoracic descending aorta aneurysm. He underwent an endovascular
aneurysm repair with an inner abdominal branch device and an iliac branch device (IBD) was used to preserve
IMA patency. The IBD may be an alternative endovascular device to save IMA in extensive aortic coverage in patients at high risk of spinal cord ischemia
Outcomes of Endovascular Reconstructive Techniques in Trans-Atlantic Inter-Society Consensus II C-D Aortoiliac Lesions
No full textBackground: To describe the outcomes of the endovascular reconstruction of TASC C/D lesions involving the infrarenal aorta and aortic bifurcation with different techniques. Methods: This is an observational, retrospective, single-center study. In a 5-year period, we selected all the patients treated with an endovascular procedure for an aorto-iliac TASC C/D lesion involving the infrarenal aorta and/or the aortic bifurcation. Early (<30 days) outcomes were mortality, major amputation, and thrombosis. Late mid-term (1 and 3 years) outcomes were primary, assisted primary and secondary patency, limb salvage rate, and freedom from reintervention. Results: A total of 87 patients were treated during the index period. Kissing covered stent (cKS), covered reconstruction of aortic bifurcation (CERAB), and unimodular bifurcated AFX Unibody stent-graft (Bif-SG) implantation were performed in 35 (40.4%), 26 (29.8%), and 26 (29.8%) cases, respectively. Bif-SG group included 11 (11/26, 42.3%) patients treated for abdominal aortic aneurysm associated with the obstruction of the aortic bifurcation. Technical success was achieved in all cases and no ruptures or conversions to open surgery were recoded. Median follow-up age was 18 months (interquartile range [IQR], 8-34). Overall primary patency rate was 91.2% (95% confidence interval [CI]: 81.3-95.9) at 1 year and 83.5% (95% CI: 69.6-91.4) at 3 years. Assisted primary patency was 96.9% (95% CI: 87.8-99.2) at 1 and 3 years. Secondary patency was 97.8% (95% CI: 85.5-99.6) at 3 years. Limb salvage rate was 98.6% (95% CI: 90.1-99.7) at 1 and 3 years and, freedom from reintervention was 98.4% (95% CI: 88.9-99.7) at 1 year and 87% (95% CI: 66.1-95.4) at 3 years. Univariate analysis did not identify any factor affecting primary patency rate. Conclusions: Endovascular reconstruction in severe aorto-iliac obstructions using advanced techniques offered promising mid-term patency rates and profiles of safety. The variety of reconstructive configurations allows surgeons to customize on patients' anatomies the type of revascularization
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