1,721,041 research outputs found
Screening for abdominal aortic aneurysm. Questions and results
No full textA review focused on following key questions: Does AAA screening reduce AAA related mortality? For Induviduals who have no AAA on initial screening, does periodic repeated screening reduce AAA-related adverse outcome? What is the cpst effectiveness of screening? Are there any parameter identifying population at high risk for AAA? What are the harms associated with elective repair of AAA
Iatrogenic Intercostal Artery Aneurysm following Fogarty Balloon Occlusion in Open Thoracoabdominal Aneurysm Repair.
No full textOpen thoracoadbominal aortic aneurysm (TAAA) treatment presents a high complication rate such as spinal cord ischemia. Surgical technique includes the temporary occlusion of intercostal arteries with a balloon. In rare cases, the arterial injury can lead to development of an intercostal artery aneurysms (ICAA), probably because of a thin artery wall and a too high insufflation pressure. The aim of this study was to report the case of a 78-year-old woman, who underwent an open type-II TAAA repair and developed an asymptomatic 11-mm ICAA. According to the diameter, we successfully treated the patient with platinum coils, obtaining the complete aneurysm exclusion and an uneventful recovery. © 2014 Elsevier Inc. All rights reserved
“Patologia celiaco-mesenterica: accessi per le procedure endovascolari” In Coppi G. Editor. Diagnostica avanzata e accessi endovascolari
No full textEndovascular treatment for ruptured abdominal aortic aneurysm. Review of literature
No full textEndovascular repair (EVAR) has produced increasing interest in the treatment of ruptured abdominal aortic aneurysms (rAAAs). Experiences to support EVAR as first approach for patients with rAAA is drawn from three sources: results of single-centre series, systematic reviews, and population-based studies. In order to validate EVAR, this technique was compared to open repair (OR), considered as the conventional treatment. These studies are heterogeneous, and often failed to demonstrate any significant difference between EVAR and OR. More recently, some population-based studies from the USA suggested advantages of EVAR over OR with regard to 30-day mortality and morbidity. Some bias have influenced the reported RESULTS: Criteria for choice of EVAR varied across the studies according to the policy of the authors. Therefore, any meta-analysis should be interpreted with caution. Patients' conditions have directed the authors towards a technique instead of the other, i.e. pathophysiological factors of the patients, and anatomical conditions of the AAAs. Availability of the required endovascular equipment and trained staff allows EVAR and not always were present. Currently, according to the literature the role of EVAR in the management of rAAAs must to be further checked. Randomized trials could provide the evidence to define adequate indication to EVAR. EVAR could play an important role in the treatment of rAAAs, providing adequate selection of cases suitable for this technique
A Single-Center Experience of Aortic and Iliac Artery Aneurysm Treated with Multilayer Flow Modulator
No full textBackground The aim of this study was to analyze our series of endovascular treatments using a multilayer flow modulator (MFM) and to show the midterm results. Methods At our institution, 8 patients were treated with an MFM. Four patients presented with an aortic aneurysm (2 type II thoracoabdominal aortic aneurysms [TAAAs], 1 type IV TAAA, and 1 juxtarenal abdominal aortic aneurysm) and 4 with an aneurysm involving the common iliac artery. Mortality, rupture and secondary intervention, major complications, patency of collateral vessels, and volume analysis were evaluated. Treated patients were followed up with computed tomography angiography at 1, 3, 6, and 12 months. Results Results showed no 30-day mortality or major complications; technical success was achieved in 87.5% of patients, patency of collateral vessels was reached in all cases at intraoperative completion angiography. Mean follow-up was 22.1 months (range, 18-30), survival rate was 87.5%, and one case of death unrelated to MFM treatment was reported. During follow-up, MFM and collateral vessel patency were observed in all cases. Secondary endovascular or open surgical procedures were not needed during follow-up. Volume analysis showed a slight increase in patients with aortic aneurysm, and an overall trend to increase in thrombosis was observed in all cases. Conclusions Endovascular treatment of aneurysms with MFM seems to have encouraging midterm results. Should our results be confirmed by larger series and longer follow-up studies, MFM may become a viable alternative to other endovascular approaches
Stent-graft and multilayer stent for treatment of type II thoracoabdominal aortic aneurysm in a high-risk patient.
No full textThe aim of the present article was to present an alternative endovascular treatment for type II thoracoabdominal aortic aneurysm that would have the advantage of limiting the duration of the procedure and the use of contrast. A high-risk patient was admitted to our Vascular Unit for type II thoracoabdominal aneurysm according to Crawford's classification. Two thoracic stent-grafts (Valiant Captivia, Medtronic, Pewaukee, WI, USA), a bifurcated stent-graft (Endurant Medtronic) and two multilayer stents (Cardiatis SA, Isnes, Belgium) were deployed. No postoperative major complications were observed. Operative time and use of contrast material were 45 min and 80 mL, respectively. Computed angiography tomography at 1 and 6 months showed patency of visceral and renal arteries and progressive thrombosis of the aneurysmal sac. This stent-graft treatment in combination with multilayer stent could be an alternative treatment for thoracoabdominal aneurysm in high-risk patients.
PMID: 2401354
A True Giant Aneurysm of the Anterior Tibial Artery.
No full textAneurysms of the anterior tibial artery are rare. We will describe a case of a woman with an asymptomatic true aneurysm of the anterior tibial artery. The patient presented with a pulsatile mass in the lateral face of the distal portion of the left leg, and both ultrasound examination and CTA scan showed a giant aneurysm of the anterior tibial artery. We chose open treatment
Midterm Follow-up Geometrical Analysis of Thoracoabdominal Aortic Aneurysms Treated with Multilayer Flow Modulator
No full textBackground: Aim of our study is the analysis of clinical results and aneurysmal sac evolution after multilayer flow modulator (MFM) placement, in patients with thoracoabdominal aortic aneurysms (TAAs). Methods: All patients with asymptomatic TAA treated at our institution between 2012 and 2014 with MFM were retrospectively analyzed. Thirty-day evaluated outcomes were mortality and complications. Follow-up evaluated outcomes were mortality, aneurysm collateral branches patency, and reintervention. A geometrical analysis of 2-year follow-up computed tomography scans was carried out to evaluate the total aneurysm volume, the percentage of aneurysm growth, and the evolution of maximum aneurysm diameter. Results: Seven patients (mean age: 71.8 years, range: 63–85 years) were considered in the study. Mean preoperative aneurysm diameter was 6.8 cm (range 6–8.3 cm). No 30-day mortality or complications were observed. Mean follow-up was 29.4 months. During follow-up, 3 deaths (42.8%) were observed, not related to MFM complications. Reintervention rate was 42.8%, occurred in all cases after 2-year follow-up; in 2 cases, the reintervention was necessary due to an excessive increase of the aneurysmal sac. During the follow-up, a mean growth rate of 6 mm/year (4 patients) for the diameter of the aneurysm external wall and a total aneurysm volume increase from 2.45 × 105 mm3 to 3.50 × 105 mm3 (4 patients) was evaluated. Conclusions: Our results have shown no mortality related to aneurysm rupture during the follow-up and high rate of reinterventions after MFM placement. Further geometrical analyses, based on the proposed approach, regarding a larger group of patients with long-term follow-up are required to draw indications about the MFM use
District-based abdominal aortic aneurysm screening in population aged 65 years and older
No full textAIM: Screening for abdominal aortic aneurysms (AAAs) has been carried out in an area of Genoa (Italy) for subjects aged 65 years or more to evaluate prevalence of this disease.
METHODS: Between March 2007 and September 2009 8234 subjects were screened. Ultrasound examination of the abdominal aorta and the iliac arterial segments was carried out on each subject and all data related to risk factors were collected.
RESULTS: Five hundreds-twelve (6.2%) subjects were found to have an AAA: 469 (10.8%) males and 43 (1.1%) females (significant difference, P < 0.01). Based on the aortic diameter, 403 (4.9%), 80 (1.0%) and 29 (0.3%) had an AAA of 3.0-3.9 cm, 4.0-4.9 cm and ≥ 5.0 cm diameter, respectively. With regards to risk factors, family history of cardiovascular disease only resulted more frequent in subjects with AAA than in those without AAA.
CONCLUSION: The prevalence of patients with AAA (6.2%) was similar to previously published estimates. Nevertheless, AAA resulted very high in males. This observation is likely due to screening in a city with a very high percentage of elderly subjects. Family predisposition to cardiovascular disease resulted significant risk factor for AAA. Results of our epidemiological study provide evidence of the usefulness of AAA screening thanks to early diagnosis and appropriate treatment of AAA
A retrospective study on short term results with straight graft vs. bifurcated graft in abdominal aortic aneurysms: a single center experience.
No full textAim: The aim of this paper was to compare in a retrospective study the outcome of aortoaortic graft (straight graft) versus aortoiliac graft (bifurcated graft) with regards to periprocedural and 30-day after surgery complications. Methods: From January 2004 to December 2009 377 patients underwent elective open surgery for infrarenal abdominal aortic aneurysm. Data were collected in a dedicated database. Group A includes patients treated with straight graft (N.=186) whereas group B, patients treated with bifurcated graft (N.=191). Outcome data include duration of surgical procedure, blood loss, peri- and postprocedural complications, hospital stay, 30-day mortality and complications. Following some authors, we set our cut-off for choosing a bifurcated graft when one or both Iliac Arteries were wider than 18 mm in diameter and the patient had a reasonable life expectancy. Results: duration of surgical procedure was 183 minutes in the group A vs. 216 minutes in the group B (P<0.01). Blood loss was 554 mL and 720 mL, in the groups A and B respectively (P<0.01). The difference between other results evaluated was not statistically significant. Conclusion: In statistics terms, this retrospective study showed no relevant differences between straight graft and bifurcated graft with regard to mortality and major complications during the peri- and postoperatory period. Hence, as a conclusion, we could assert that if the iliac artery diameter is 18 mm a bifurcated graft could be used, without any increase in morbidity and mortality rates
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