216 research outputs found
Mechanical analysis of aortic aneurysms using 3D ultrasound : towards patient-specific risk assessment
No full textStijfheid van verwijde buikslagader is mogelijke indicator voor chirurgische ingree
Intravascular Ultrasound and Peripheral Endovascular Interventions
No full textIn recent years the interest in minimal invasive surgery has been growing and the same trend
can be observed in vascular surgery, leading to what is commonly referred to as
lIendovascular surgery". Although the 1990s represent an era of technical revolution in
vascular surgery, it is a misunderstanding to consider endovascular treatment a recent
development. In 1947 J050 Cid dos Santos described the thrombo-endarterectomy'; this
technique was modified by Vollmar in 1964, to a semi-closed endarterectomy using ringstrippers'>
In the same year other pioneers, including Dotter and Judkins, published
prelinlinary results on what they called "angioplasty" of the femoropopliteal artery using coaxial
eatheters.3 This technique was later modified by Griintzig in 1974, who replaced the coaxial
catheters with dilatation balloons.' In the early 1990s, Volodos and Parodi introduced
the endovascular treatment of the abdominal aortic aneurysm with a device composed of a
Dacron graft and Palmaz stents.5
,6
The collaboration between interventional radiologists and vascular surgeons has been of
eminent importance for further evolution of endovascular teclmiques. Nowadays a great
variety of obstmctive and aneurysmal peripheral vascular diseases can be treated with
catheter-guided, endovascular and, therefore, less invasive techniques.
The development of these endovascular techniques prompted the need for improved vascular
imaging and better diagnostics. Since angiography displays only a "lumenogram II of the
vessel, tills prechldes qualitative evaluation of atherosclerotic plaque and quantitative
assessment of plaque and vessel. Sophisticated modalities such as colour duplex, computed
tomographic angiography and magnetic resonance imaging can be important in the pre- and
postintervention assessment of vascular disease. These techniques, however, do not always
give accurate information on the dimensions of the vessel or the extent of the disease and at
the present time cannot be used during intervention.7 Intravascular ultrasound depicts both the
vascular lumen and vascular wall: thus, information can be obtained on the atheromatous
plaque constituents and the size of the lumen, vessel wall and arterial disease
Ultrasound-based mechanical modeling of abdominal aortic aneurysms: model input and boundary conditions
No full textExploring the boundaries of endovascular aneurysm repair:studying an all-comers population
No full textAn abdominal aortic aneurysm can be treated endovascularly since the early 1990s. In the endovascular technique, a stent is placed through the groin, which is less invasive than the open technique. An important limitation is that ruptured and complex aneurysms are less suitable and more long-term complications are seen. With the help of registration studies, this thesis investigated how stents function at the extremes of the manufacturers' instructions for use. The thesis shows that in the case of ruptured aneurysms, the technical results are good. Additionally, it is shown that in complex aneurysms the short-term number of complications is not unacceptable, despite the challenging anatomy. The long-term results will have to be determined in the future. The above results can contribute to determining the optimal treatment strategy of ruptured and complex aneurysms
Carotid artery stenting 2008
No full textIn an effort to minimize interventions, in the last decade carotid artery stenting (CAS) has been suggested as an alternative to surgical carotid endarterectomy (CEA) for patients with symptomatic and asymptornatic extra cranial obstructive disease. CAS is relatively new compared to CEA and it should be acknowledged that CAS is an evolving technique. As technology has improved, procedural risks have declined and are approaching those reported for CEA. From the individual randomised clinical trial it can be concluded that in patients at high risk for CEA, CAS is an equivalent, maybe better alternative. In symptomatic patients at standard risk for CEA, CAS has not proven non-inferior, and is worse when performed by relatively inexperienced operators without embolic protection device compared to highly experienced CEA surgeons
Factors influencing restenosis after carotid aretery stenting
No full textMany studies have published perioperative clinical results, but the incidence of restenosis and late stroke after carotid artery stenosis is poorly documented. Duplex ultrasonography is the most commonly used technique to follow in-stent restenosis after carotid aretery stenting (CAS), but, the ultrasound criteria for determining a restenosis after stent implantation are very heterogeneous. This review of the literature showed that the long-term in-stent restenosis rate after CAS appears to be acceptable and that restenosis is mainly asymptomatic. Suggested predictors of in-stent restenosis after CAS are advanced age, female gender, implantation of multiple stents, prior revascularization treatment, suboptimal result with residual stenosis, elevated postprocedural serum levels of acute-phase reactants, asymptomatic lesion, use of balloon expandable stents
Carotid artery stenting 2008
No full textIn an effort to minimize interventions, in the last decade carotid artery stenting (CAS) has been suggested as an alternative to surgical carotid endarterectomy (CEA) for patients with symptomatic and asymptornatic extra cranial obstructive disease. CAS is relatively new compared to CEA and it should be acknowledged that CAS is an evolving technique. As technology has improved, procedural risks have declined and are approaching those reported for CEA. From the individual randomised clinical trial it can be concluded that in patients at high risk for CEA, CAS is an equivalent, maybe better alternative. In symptomatic patients at standard risk for CEA, CAS has not proven non-inferior, and is worse when performed by relatively inexperienced operators without embolic protection device compared to highly experienced CEA surgeons
Factors influencing restenosis after carotid aretery stenting
No full textMany studies have published perioperative clinical results, but the incidence of restenosis and late stroke after carotid artery stenosis is poorly documented. Duplex ultrasonography is the most commonly used technique to follow in-stent restenosis after carotid aretery stenting (CAS), but, the ultrasound criteria for determining a restenosis after stent implantation are very heterogeneous. This review of the literature showed that the long-term in-stent restenosis rate after CAS appears to be acceptable and that restenosis is mainly asymptomatic. Suggested predictors of in-stent restenosis after CAS are advanced age, female gender, implantation of multiple stents, prior revascularization treatment, suboptimal result with residual stenosis, elevated postprocedural serum levels of acute-phase reactants, asymptomatic lesion, use of balloon expandable stents
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