2 research outputs found
A Novel Microwave Sensor to Detect Specific Biomarkers in Human Cerebrospinal Fluid and Their Relationship to Cellular Ischemia During Thoracoabdominal Aortic Aneurysm Repair
Thoraco-abdominal aneurysms (TAAA) represents a particularly lethal vascular disease that without surgical repair carries a dismal prognosis. However, there is an inherent risk from
surgical repair of spinal cord ischaemia that can result in paraplegia. One method of reducing
this risk is cerebrospinal fluid (CSF) drainage. We believe that the CSF contains clinically
significant biomarkers that can indicate impending spinal cord ischaemia. This work
therefore presents a novel measurement method for proteins, namely albumin, as a precursor
to further work in this area. The work uses an interdigitated electrode (IDE) sensor and
shows that it is capable of detecting various concentrations of albumin (from 0 to 100 g/L)
with a high degree of repeatability at 200 MHz (R2 = 0.991) and 4 GHz (R2 = 0.975)
Endovascular aneurysm sealing (EVAS) alone or in combination with chimney grafts (chEVAS) for treating complications of previous endovascular aneurysm repair (EVAR) procedures
Objective
Late complications after previous endovascular
aneurysm repair (EVAR) procedures include type I/III
endoleaks causing aneurysm growth and rupture. We
reviewed our results from the management of such complications with endovascular aneurysm sealing (EVAS)
techniques.
Methods
Analysis of our prospectively maintained aneurysm
database was performed (December 2013–May 2017).
Primary outcomes were: (1) success of the procedure in
excluding the primary complication, (2) perioperative
mortality, (3) post-operative complications and (4)
survival.
Results
Ten consecutive patients were treated for complications
of EVAR procedures performed 2–12 years previously.
All patients underwent EVAS with/without chimney
grafts for 6 type Ia,1 type IIIb and 3 undetermined (but
presumed type IIIb) endoleaks. Overall, 19 Nellix devices
were used. The technical success with type Ia endoleaks
was 100%. All sealed using proximal extension through
chimney EVAS with 1 target vessel loss. There were no
perioperative deaths. All but 1 type Ia endoleak remained
eliminated at follow-up (range 2–29 months) as did the
proven type IIIb endoleak. Two of the 3 undetermined
endoleaks demonstrated continued sac expansion requiring
surgical exploration by laparotomy, during which type II
endoleaks were identified.
Conclusions
EVAS provides effective short-term treatment
of type Ia/IIIb endoleaks after EVAR. However, late
complications may occur due to disease progression