Mid- and Long-Term Results of Endovascular Treatment in Thoracic Aorta Blunt Trauma

Study Aim. Evaluation of results in blunt injury of the thoracic aorta (BAI) endovascular treatment. Materials and Methods. Sixteen patients were treated for BAI. Thirteen patients had associated polytrauma, 4 of these had a serious hypotensive status and 4 had an hemothorax. In the remaining 3, two had a post-traumatic false aneurysm of the isthmus and 1 had a segmental dissection. In those 13 patients a periaortic hematoma was associated to hemothorax in 4. All patients were submitted to an endovascular treatment, in two cases the subclavian artery ostium was intentionally covered. Results. One patient died for disseminated intravascular coagulation. No paraplegia was recorded. No ischemic complications were observed. A type I endoleak was treated by an adjunctive cuff. During the followup (1–9 years) 3 patients were lost. A good patency and no endoleaks were observed in all cases. One infolding and 1 migration of the endografts were corrected by an adjunctive cuff. Conclusion. The medium and long term results of the endovascular treatment of BAI are encouraging with a low incidence rate of mortality and complications. More suitable endo-suite and endografts could be a crucial point for the further improvement of these results

Midterm results of proximal aneurysm sealing with the ovation stent-graft according to On-vs off-label use

Purpose: To compare the use of the Ovation stent-graft according to the â\u89¥7-mm neck length specified by the original instructions for use (IFU) vs those treated off-label (OL) for necks 2 mm). Results: At 3 years, there was no aneurysm-related death, rupture, stent-graft migration, or neck enlargement. There were no differences in terms of freedom from type Ia endoleak (98.2% IFU vs 96.8% OL, p=0.6; hazard ratio [HR] 0.55, 95% CI 0.02 to 9.71 or freedom from any device-related reintervention (92.8% IFU vs 96.4% OL, p=0.4; HR 2.42, 95% CI 0.34 to 12.99). In the sealing zone, the mean change in diameters was-0.05±0.8 mm in the IFU group and -0.1±0.5 mm in the OL group. Conclusion: Use of the Ovation stent-graft in patients with neck length <7 mm achieved midterm outcomes similar to patients with â\u89¥7-mm-long necks. These midterm data show that the use of the Ovation system for the treatment of infrarenal abdominal aortic aneurysm is not restricted by the conventional measurement of aortic neck length, affirming the recent Food and Drug Administration-approved changes to the IFU

chirurgia endovascolare:endograftsdisponibili per il trattamento dell'aneurisma aortico

Rassegna di tutti gli endografts utilizzati ,loro caratteristiche, uso, utilit

Aortic rupture of acute aortic dissection type treated with thoracic endovascular aortic repair (TEVAR)

Acute aortic dissection (AAD) is one of the most frequent aortic emergencies, which occurs to the vascular specialist. Endovascular reconstruction of the true lumen using minimally invasive stent grafting or stenting has become increasingly popular and widespread among institutions. The aim of this paper is to report a case series composed by twenty-eight patients, who underwent endovascular intervention for acute type B aortic dissections complicated by rupture using thoracic endovascular aortic repair (TEVAR)

Type IB and type III endoleak 8 years after endovascular aneurysm repair

[No abstract available

Simultaneous stent grafting of the descending thoracic aorta and aortofemoral bypass for “shaggy aorta” syndrome

Conventional repair of lesions of the descending thoracic aorta (TA) carries a definite risk of postoperative mortality and serious complications.1 The treatment of a TA aneurysm is more complex when a significant stenosis of the internal carotid artery (ICA) is associated. Endograft repair is a less invasive treatment method for TA lesions, for which encouraging results have been reported.2–3 It may be assumed that adding simultaneous carotid endarterectomy (CEA) to endograft TA repair will be well tolerated and will not increase the overall risk significantly

Artery transposition and carotid endarterectomy done simultaneously with stent–graft repair of an aneurysm of the aortic isthmus

Conventional repair of lesions of the descending thoracic aorta (TA) carries a definite risk of postoperative mortality and serious complications.1 The treatment of a TA aneurysm is more complex when a significant stenosis of the internal carotid artery (ICA) is associated. Endograft repair is a less invasive treatment method for TA lesions, for which encouraging results have been reported.2–3 It may be assumed that adding simultaneous carotid endarterectomy (CEA) to endograft TA repair will be well tolerated and will not increase the overall risk significantly

Treatment of high-flow arteriovenous malformations (AVMs) of the head and neck with embolization and surgical resection

AIM: Arteriovenous malformations (AVMs) with a high flow of the head and neck are quite rare compared to their low-flow counterparts, but when they do occur they are often accompanied by massive bleeding or present with significant esthetic defects. The treatment of these high-flow vascular anomalies is often highly risky. The multidisciplinary approach required for the assessment and treatment of these lesions should include angioradiology with preoperative superselective embolization, followed by surgical resection of the lesion within 24 hours and esthetic reconstruction. MATERIALS OF STUDY: We studied a series of 55 patients with AVMs of the head and neck that were treated surgically between 1999 and 2009. RESULTS: Of the 55 patients with AVMs, 7 had hemangiomas and 48 had vascular malformations, of which 28 were low-flow lesions and 20 were high-flow lesions (AVMs). The high-flow lesions were most commonly located on the lip. All 48 AVMs underwent surgical resection for concerning symptoms, diagnostic purposes, or esthetic problems. Of the 20 high-flow AVMs, 20% were classified as Schobinger stage I, 55% as stage II, and 25% as stage III. A combined treatment of embolization and resection was used to resolve 13 of the high-flow AVMs (stages II and III), of which 4 required a flap reconstruction. CONCLUSION: Recent advances in microsurgery and interventional angioradiology have greatly improved the prognosis for patients with these malformations. Combined embolization-resection is the treatment of choice for high-flow AVMs, and esthetic reconstruction with flaps can prevent their recurrence

Re-TEVAR for complications after blunt aortic traumatic injury stenting

We report an endovascular approach that was used to treat two patients with previous thoracic aortic repair or endovascular repair (TEVAR) for blunt thoracic aortic injury. The first patient was a 38-year-old man who presented with distal intragraft thrombosis 24 months after TEVAR. The second patient, a 32-year-old man, developed a symptomatic distal device collapse at 39th month follow-up, associated with buttock claudication. Both patients were offered an endograft relining, complicated in the first case by distal embolizatio