Important risk factors for aortic dissection
Most common risk factor for aortic dissection in the International Registry of Acute Aortic Dissection (IRAD) was hypertension. Hypertension was noted in 76.6% in the IRAD, while Marfan syndrome was noted only in 4.4% and diabetes mellitus in 7.8%. Twenty year data from IRAD has been published. It is a study involving over 7300 cases from over 51 sites in 12 countries. Two thirds were type A dissection and one third type B. Two thirds were men and the mean age was 63 years. In general type A cases underwent surgery and type B cases underwent endovascular repair. There has been a decrease in overall in hospital mortality i...
Source: Cardiophile MD - November 22, 2022 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
PerQseal+ for Large Diameter Arterial Closure: Interview with Andrew Glass, CEO of Vivasure Medical
Vivasure Medical, a medtech company based in Galway, Ireland, has developed the PerQseal device, a synthetic implant designed to seal large bore blood vessel punctures. The implant has utility in a wide variety of transcatheter endovascular procedures, such as transcatheter aortic valve replacement (TAVR), thoracic endovascular aneurysm repair (TEVAR), and endovascular abdominal aneurysm repair (EVAR), and aims to significantly improve on current approaches to close large vessel punctures.
The implant is an intravascular patch that is applied to the puncture from inside the vessel and is fully absorbable. The patch does...
Source: Medgadget - May 26, 2021 Category: Medical Devices Authors: Conn Hastings Tags: Cardiac Surgery Cardiology Exclusive Radiology Vascular Surgery Vivasure Source Type: blogs
Management of aortic dissection
Aortic dissection is the most common aortic emergency. It is one of the three acute aortic syndromes, the others being aortic intramural hematoma and penetrating aortic ulcer. It has a grave prognosis with 20% pre hospital and 30% in hospital mortality. Aortic dissection is generally considered as acute when diagnosis is made within 14 days of onset and chronic after that. An intimal and medial tear in the aorta causes blood to seep into the media and the false lumen usually progresses along a variable extend of the aorta. Important risk factors for aortic dissection are hypertension, Marfan syndrome and bicuspid aortic ...
Source: Cardiophile MD - May 4, 2021 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Angiography and Interventions Cardiac Surgery Source Type: blogs
A woman in her 60s with VFib arrest and no STEMI on her post-ROSC ECG.
This study had a fatal flaw: they did not keep track of all the " Non-STEMI patients " who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very reluctant to enroll patients whom they suspected had Occlusion MI (OMI), even if they didnot have STEMI. These physicians did not want a patient with an OMI that was not a STEMI to be randomized to no angiogram. This strong suspicion is supported by their data: only 22 of 437 ...
Source: Dr. Smith's ECG Blog - November 17, 2020 Category: Cardiology Authors: Pendell Source Type: blogs
Endoleaks after EVAR – Cardiology MCQ – Answer
Endoleaks after EVAR – Cardiology MCQ – Answer
Graft porosity causing endoleak after endovascular aortic repair is classified as — type of endoleak – Correct answer: 4. Type IV.
Types of endoleaks after EVAR [1]
I – Proximal or distal attachment site
II – Branch vessel with collateral flow into the aneurysm sac
III – Modular disconnection and fabric tear
IV – Graft porosity
V – Endo tension
Reference
Sarah B White, S William Stavropoulos. Management of Endoleaks following Endovascular Aneurysm Repair. Semin Intervent Radiol. 2009 Mar;26(1):33-8.
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Source: Cardiophile MD - August 10, 2020 Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Endologix Alto Abdominal Stent Graft for AAA Cleared in Europe
Endologix, based in Irvine, California, won clearance in the European Union for its ALTO Abdominal Stent Graft System. The implant is intended to open up endovascular aortic repair to a wider range of abdominal aortic aneurysm (AAA) patients, particularly those with short and challenging aortic necks.
Ideally, the aortic neck where the stent graft creates a seal is regular and smooth. In many cases, this is simply not so and a conventional mechanical seal doesn’t work sufficiently. The ALTO features a novel polymer seal that seals tightly even irregularly shaped lumens, and which has been shown to keep a stable ne...
Source: Medgadget - August 6, 2020 Category: Medical Devices Authors: Medgadget Editors Tags: Vascular Surgery Source Type: blogs
Non- A, Non -B Aortic dissection : Incidence ,classification & outcome
Aortic dissection is a unique cardiac emergency that tests our collective understanding of vascular anatomy and pathology .It poses the ultimate challenge to the expertise and wisdom of both cardiologists, and surgeons.
Freezing the Aortic Time machine
The philosophy of management swings between total inaction* in some (As in most Type B & few Type A as well ) to “No holds barred” approach in others. (In most Type A and few Type B).
*Read it (also) as medical management that includes powerful Aortic pulse attenuation therapy with beta-blockers ( Unfortunately medical management is considered as Inaction by ...
Source: Dr.S.Venkatesan MD - March 13, 2020 Category: Cardiology Authors: dr s venkatesan Tags: Aortic diseases aortic dissection Non A Non B Aortic dissection tem debakey stanford classification dissect penn Source Type: blogs
The First EVAR (Endovascular Abdominal Aortic Aneurysm Repair)
The whole field of endovascular repair and intervention has grown exponentially since the first endovascular repair of an abdominal aortic aneurysm (EVAR) was performed by Dr. Juan Parodi in 1990, but it took quite some time to be accepted as a standard of care. Today the endovascular approach is the preferred procedure to repair an AAA and this is because of the advances in medical device design and manufacturing and the dedication of physicians to this less invasive non-surgical approach, physicians who will be attending this year ’s Veith Symposium. (Source: Burts Stent Blog : The Voice in the Ear)
Source: Burts Stent Blog : The Voice in the Ear - November 13, 2018 Category: Medical Devices Source Type: blogs
PerQseal Absorbable, Sutureless Large-Bore Closure Device Coming to Europe
Vivasure Medical, a Galway, Ireland company, is launching in Europe its PerQseal closure device for use in large vessel femoral arteriotomies following large-bore transcatheter procedures, such as aortic valve replacements. Though minimally invasive transcatheter procedures have revolutionized cardiovascular care, closing the access sites created for them can be challenging.
The PerQseal device is sutureless and, once placed, fully absorbable into the body. The synthetic-material patch seals the vessel from the interior, slowly dissolving and letting the vessel heal naturally.
“In my first clinical experience with PerQ...
Source: Medgadget - November 13, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Radiology Thoracic Surgery Vascular Surgery Source Type: blogs
GORE Molding & Occlusion Balloon Approved in US, EU, Japan
Gore is releasing its GORE Molding & Occlusion Balloon following regulatory approvals in the U.S., Japan, and Europe. The device is a compliant polyurethane balloon catheter designed for use in opening up self-expanding stent grafts or to temporarily occlude wide vessels.
The company believes that the device “meets all endovascular aortic repair (EVAR) procedural requirements – a single balloon that replaces the need for multiple molding and occlusion balloons,” according to the announcement.
Having one balloon with an even delivery of pressure regardless of size of vessel can help prevent endoleaks and...
Source: Medgadget - August 29, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Cardiology Radiology Vascular Surgery Source Type: blogs
Aortic dissection risk factor – Cardiology MCQ – Answer
Most common risk factor for aortic dissection in the International Registry of Acute Aortic Dissection (IRAD):
Correct answer: b) Hypertension
Hypertension was noted in 76.6% in the IRAD, while Marfan syndrome was noted only in 4.4% and diabetes mellitus in 7.8%. Twenty year data from IRAD has been published. It is a study involving over 7300 cases from over 51 sites in 12 countries. Two thirds were type A dissection and one third type B. Two thirds were men and the mean age was 63 years. In general type A cases underwent surgery and type B cases underwent endovascular repair. There has been a decrease in overall in...
Source: Cardiophile MD - May 4, 2018 Category: Cardiology Authors: Prof. Dr. Johnson Francis, MD, DM, FACC, FRCP Edin, FRCP London Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
Cardiology MCQ Test 5
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Source: Cardiophile MD - October 22, 2017 Category: Cardiology Authors: Johnson Francis Tags: General Cardiology Source Type: blogs
Health Affairs Web First: Significant Racial Disparities Found In Hospital Readmissions
This study will also appear in the July issue of Health Affairs.
(Source: Health Affairs Blog)
Source: Health Affairs Blog - June 21, 2017 Category: Health Management Authors: Lucy Larner Tags: Elsewhere@ Health Affairs Web First Source Type: blogs
Gore ’s New DrySeal Flex Introducer Sheath for EVAR Procedures
Gore is making available its new DrySeal Flex Introducer Sheath following regulatory clearance in the U.S., EU, Canada, and Australia. It’s intended to be used with the firm’s EXCLUDER Iliac Branch Endoprosthesis for endovascular repair of iliac artery aneurysms and aortoiliac aneurysms.
The DrySeal Flex was designed to minimize blood loss as different guidewires and catheters are pushed into and out of the patient. To do this it has a so called “DrySeal” valve that prevents blood from exiting through the same channel that instruments are introduced through.
It is a 12 Fr x 45 cm sheath availab...
Source: Medgadget - August 30, 2016 Category: Medical Equipment Authors: Editors Tags: Radiology Vascular Surgery Source Type: blogs
Endologix Ovation Alto Abdominal Stent Graft Implanted In First Patients
Endologix (Irvine, California), a company that recently merged with TriVascular (Santa Rosa, California), announced that its Ovation Alto Abdominal Stent Graft System has been implanted in two patients for the first time.
Still an investigational device and not approved for sale in any market, the Ovation Alto is designed to allow more patients to benefit from endovascular aortic repair (EVAR) that have short and difficult to work with aortic necks. This is thanks to shape changing O-rings that have been positioned at the end of the device, sealing the lumen just below the renal arteries.
The implantations took place at ...
Source: Medgadget - August 22, 2016 Category: Medical Equipment Authors: Editors Tags: Vascular Surgery Source Type: blogs
