82 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
Ultrasound-based mechanical modeling of abdominal aortic aneurysms: model input and boundary conditions
No full text
Abdominal Aneurysms
No full textKey Points• Endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms offers an important new alternative to open surgical procedure.• Compared with conventional open surgery, EVAR reduces operating time, blood transfusions, intensive care requirements, and length of hospital stay.• Perioperative mortality rates after EVAR in asymptomatic abdominal aortic aneurysms in the randomized trials is between 1.2% and 1.7%.• The perioperative survival advantage with endovascular repair as compared with open repair is not sustained after the first year.• Long-term reports are not available, but midterm follow-up of EVAR reveals a higher incidence of reinterventions compared to open surgical repair.• The perplexing problems of endoleaks and graft failure continue to be challenges that technological innovations must address.• Until solutions for endoleaks, endotension, and stent failure are found, EVAR remains an imperfect long-term treatment and requires regular, lifelong graft surveillance.• Based on the available evidence, EVAR is an appropriate treatment for selected patients
Management of complications during and after carotid angioplasty and stenting
No full textIn effort to minimize interventions, in the last decade carotid artery stenting (CAS) has beensuggested as an alternative to surgical endarterectomy for patients with symptomatic andasymptomatic extra cranial carotid artery obstructive disease. Acceptable technical successand complication rates have shown promise for the procedure. In major publications, there hasbeen much description of the technique and its technical success, but only brief overview ofcomplications and the management of neurological complications
In vivo regional wall thickness measurement of abdominal aortic aneurysms using intravascular ultrasound imaging
No full textObjective: To accurately assess abdominal aortic aneurysm wall thickness for evaluating local vascular geometry and potential rupture risk. This study applied a method based on intravascular ultrasound imaging to assess regional wall thickness in vivo, aiming to better understand abdominal aortic aneurysm wall morphology. Methods: Motorized intravascular ultrasound pullbacks were acquired intraoperatively in 28 patients with abdominal aortic aneurysms undergoing endovascular aneurysm repair. The intravascular ultrasound frames were spatially registered to preoperative computed tomography angiography, allowing precise reconstruction of three-dimensional, patient-specific catheter paths within the aorta. Wall thickness was quantified for circumferential and longitudinal regions, enabling high-resolution, in vivo assessment of regional wall thickness. Results: Substantial heterogeneity in wall thickness was observed within individual abdominal aortic aneurysms. The dilated region consistently demonstrated thinner walls compared with the neck, shoulders, and common iliac arteries (median: 2.02 mm vs 2.14-2.19 mm; P < .05). In addition, a significant asymmetry was found between the left and right lateral aspects of the aneurysm, with thinner walls on the right side (median: 1.96 mm vs 2.11 mm; P < .05). Conclusions: This study demonstrates the feasibility of high-resolution, in vivo assessment of regional wall thickness in abdominal aortic aneurysms using intravascular ultrasound imaging. The observed spatial variations provide insights into regional wall morphology. Furthermore, the heterogeneous patient-specific wall thickness data can provide more insights into the local remodeling of the wall. In the future, such detailed and patient-specific wall thickness information may support more personalized rupture risk evaluation and improve clinical decision-making in vascular practice by complementing existing prediction tools.</p
Evaluation of a non-contact Photo-Plethysmographic Imaging (iPPG) system for peripheral arterial disease assessment
No full textPeripheral Artery Diseases (PAD) are caused by the occlusions of arteries in the peripheral locations of the circulatory system. The severity of PAD is usually assessed using the Ankle Brachial Index (ABI) and the Ultrasound Doppler. Non-contact Photoplethysmography (PPG) imaging is a recent emerging technology capable of monitoring skin perfusion. Using an off-The-shelf camera and a light source, is possible to remotely detect the dynamic changes in blood volume in the skin and derive a map correlated to the blood perfusion. The aim of this study is the evaluation of a PPG imaging system (iPPG) for the assessment of Peripheral Arterial Diseases. Reduced blood flow is simulated on 21 volunteers by increasing the pressure in a pressure cuff. For each volunteer, measurements with iPPG, ultrasound, Laser Speckle Contrast Analysis (LASCA) and ABI were acquired. Our experiments show that iPPG can detect reduced perfusion levels, and correlates well with the other measurement systems. Medical Instruments & Bio-Inspired Technolog
Effect of simvastatin on restenosis after percutaneous transluminal angioplasty of femoropopliteal arterial obstruction
No full textSex differences in 30-day and 5-year outcomes after endovascular repair of abdominal aortic aneurysms in the EUROSTAR study
No full textObjectiveThe purpose of this study was to determine the effect of sex on 30-day and long-term outcomes after elective endovascular aneurysm repair.MethodsPatients entered into the European collaborators on stent graft techniques for abdominal aortic aneurysm repair (EUROSTAR) study formed the basis of our study. Data were analyzed by means of multivariable logistic regression for 30-day mortality and composite outcome of mortality, systemic complication, or conversion. Kaplan-Meier survival analyses were used to compare long-term survival and long-term event-free survival times between women and men. The log-rank test was used to test for differences. Cox proportional hazards regression was used to analyze survival and event-free survival (with end point mortality or reintervention). Multivariable analyses were adjusted for age, comorbidities, aneurysm characteristics, and treatment characteristics.ResultsThere were 623 women and 8604 men available for analysis. No difference in 30-day mortality was demonstrated for women compared with men (odds ratio, 0.89; 95% confidence interval [CI], 0.48-1.67), but women did have a significantly higher cumulative incidence of the composite end point (odds ratio, 1.32; 95% CI, 1.05-1.66). The Kaplan-Meier curves demonstrated worse outcomes for both long-term survival (P = .05) and long-term event-free survival (P =.005). Survival analyses adjusting for covariates demonstrated a higher albeit nonsignificant difference in long-term mortality for women compared to men (hazard rate ratio, 1.21; 95% CI, 0.96-1.53) and a significant higher rate of the composite end point mortality or reintervention (hazard rate ratio, 1.28; 95% CI, 1.07-1.54).ConclusionsWomen undergoing endovascular aortic repair have higher complication and reintervention rates compared with men, implying that the role of elective endovascular aneurysm repair in women needs to be examined more closely
A call for uniform reporting standards in studies assessing endovascular treatment for chronic ischaemia of lower limb arteries
No full textEndovascular therapy is a rapidly evolving field for the treatment of patients with peripheral arterial disease, and a magnitude of studies reporting on various modern revascularization concepts have been recently published. Thus, studies assessing the efficacy of endovascular therapy of peripheral arteries do not operate with uniformly defined endpoints, rendering a direct comparison of studies difficult. The purpose of this consensus statement is to highlight differences in the terminology used in the current literature and to propose some standardized criteria that must be considered when reporting results of endovascular revascularization for chronic ischaemia of lower limb arteries
- …
