Project description:A 74-year-old woman expired from ascending aortic rupture 3 months following branched zone 2 endovascular aortic repair. Multiparametric image-based computational evaluation of this case suggested that the stiffness mismatch between the endograft and the native aorta increased haemodynamic loads and likely led to the rupture of the ascending aorta. This under-recognized phenomenon should be considered in preoperative planning and presents suggestions for endograft development.

| S-EPMC6704387 | biostudies-literature

Reverse extra-anatomic aortic arch debranching procedure allowing thoracic endovascular aortic repair of a chronic ascending aortic aneurysm.

Project description:A 79-year-old woman was admitted with a large chronic dissecting ascending aortic aneurysm starting 5 mm distal to the ostia of the left coronary artery and ending immediately proximal to the innominate artery. A reverse extra-anatomic aortic arch debranching procedure was performed. During the same operative time, through a transapical approach, a thoracic stent graft was deployed with the proximal landing zone just distal to the coronary ostia and the distal landing zone excluding the origin of the left common carotid artery. The postoperative course was uneventful. Computed tomography at 12 months documented patent extra-anatomic aortic arch debranching and no evidence of endoleak.

| S-EPMC6012997 | biostudies-literature

Multimodality Imaging in the Evaluation of Ascending Aortic Pseudoaneurysms to Guide Complex Surgical Management.

Project description: Not available

| S-EPMC7581650 | biostudies-literature

Preloaded contralateral gate techniques during endovascular aortic repair for aneurysms and occlusive disease.

Project description:We present two preloaded techniques to facilitate gate cannulation during endovascular aortic repair. In the first case, we relined the aorta using a Gore iliac branch endoprosthesis (WL Gore and Associates, Flagstaff, Ariz) for acute occlusion. This allowed for preloading the contralateral gate, which was compressed when deployed, and subsequently dilated open over the preloaded wire to allow for cannulation. The second patient had had an infrarenal aneurysm. A Gore Excluder was partially deployed extracorporeally to preload the gate from the ipsilateral side. The "snare ride" technique was used to rapidly cannulate the gate. Preloaded wire techniques during endovascular aortic repair can facilitate rapid gate cannulation, especially in patients with challenging anatomy.

| S-EPMC7903463 | biostudies-literature

Endovascular repair of abdominal aortic aneurysm.

Project description: Not available

| S-EPMC10749584 | biostudies-literature

Influence of measurement and sizing techniques in thoracic endovascular aortic repair on outcome in acute complicated type B aortic dissections.

Project description:ObjectivesThoracic endovascular aortic repair (TEVAR) is the first-line therapy in acute complicated type B aortic dissections (cTBAD). Nevertheless, no evidence-based consensus on the optimal measurement technique and sizing for TEVAR in cTBAD exists. The aim was to evaluate how different measurement and sizing techniques for TEVAR affect long-term outcomes.MethodsRetrospective analysis investigating the association between sizing and postoperative results after TEVAR in patients with cTBAD, treated between January 2003 and December 2020. Diameter measurements were performed perpendicular to a centreline in pre-interventional Computed tomography angiographies. Oversizing was determined by measuring aortic diameter in zone 2 of the aortic arch in relation to the implanted stent graft, and categorized into 2 sizing groups (≤10% and >10%). The primary outcome was freedom from aortic-related events. Secondary outcomes included mortality and a comparison of 3 alternative measurement techniques considering the estimated pre-dissection diameter.ResultsFifty-seven patients (median age 69, interquartile range 59.6-78.2 years) were included. Stent graft oversizing by ≤10% showed a trend towards fewer aortic-related events hazard ratio 0.455 (95% confidence interval 0.128-1.624, P = 0.225).The 3 measurement techniques using the pre-dissection aortic diameter differed by a mean of 1.7-4.0 mm with a variability of up to 8.4 mm. In none of the 57 patients, the same stent graft would have been chosen based on the different measurement techniques using an oversizing ≤10%.ConclusionsTEVAR oversizing of ≤10% in patients with cTBAD might reduce aortic-related events up to 50%. Consensus on measurement techniques of the pre-dissection aortic diameter and stent graft sizing is of paramount importance.

| S-EPMC8972260 | biostudies-literature

Endovascular repair of thoracic aortic aneurysms.

Project description:Degenerative aneurysms of the thoracic aorta are increasing in prevalence; open repair of descending thoracic aortic aneurysms is associated with high rates of morbidity and mortality. Repair of isolated descending thoracic aortic aneurysms using stent grafts was introduced in 1995, and in an anatomically suitable subgroup of patients with thoracic aortic aneurysm, repair with endovascular stent graft provides favorable outcomes, with decreased perioperative morbidity and mortality relative to open repair. The cornerstones of successful thoracic endovascular aneurysm repair are appropriate patient selection, thorough preprocedural planning, and cautious procedural execution, the elements of which are discussed here.

| S-EPMC3140248 | biostudies-other

Patient-specific total endovascular aortic arch repair using custom fenestration of an off-the-shelf thoracic endovascular aortic repair aortic-stent.

Project description: Not available

| S-EPMC8213262 | biostudies-literature

Percutaneous Closure of Iatrogenic Ascending Aortic Pseudoaneurysms Following Surgical Aortic Repair.

Project description:We present a case series of 4 iatrogenic ascending aortic pseudoaneurysms that were all successfully repaired with a percutaneous approach. Pre-procedural imaging, device selection, and procedural techniques are described. With careful preparation and patient selection, catheter closure of iatrogenic ascending aortic pseudoaneurysms can be performed reliably and safely. (Level of Difficulty: Advanced.).

| S-EPMC8310988 | biostudies-literature

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