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Transapical Endovascular Aortic Aneurysm Repair in a Patient with Shaggy Aorta Syndrome
We report a case of a 68-year-old man with a large saccular aneurysm (70 mm) of the aortic arch. Although abundant atherosclerotic plaques or mural thrombi are generally considered to be a contraindication for endovascular repair, the patient’s multiple comorbidities and anatomical limitations with a patent internal thoracic artery graft adjacent to the aneurysm made him unfit for open repair. Transapical deployment of the endograft through the less diseased ascending aorta, with a concomitant chimney graft and carotid-carotid bypass, was performed, without evident stroke or embolism.
Source: Annals of Vascular Surgery - February 11, 2015 Category: Surgery Authors: Takashi Murakami, Yohei Kawatani, Yoshitsugu Nakamura, Takaki Hori Source Type: research

Endovascular Repair with Chimney Technique for Juxtarenal Aortic Aneurysm: A Single Center Experience.
CONCLUSION: Ch-EVAR can be used to treat JRAAs with suitable anatomical conditions. However, complications of type I endoleak were not uncommon, and, therefore, further studies are required to prove its efficiency for JRAAs. PMID: 25631457 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - January 24, 2015 Category: Surgery Authors: XiaoHui M, Wei G, ZhongZhou H, XiaoPing L, Jiang X, Xin J Tags: Eur J Vasc Endovasc Surg Source Type: research

Investigation of the surgical complications during thoracic endovascular aortic repair: experiences with 148 consecutive cases treated at a single institution in Japan
Conclusions The use of a debranching technique and sternotomy approach in patients with extensive atherosclerotic changes of the aortic arch were risk factors for major complications of TEVAR. Such patients may benefit from open surgery rather than TEVAR.
Source: Surgery Today - December 12, 2014 Category: Surgery Source Type: research

Early and late mortality and morbidity of elective infrarenal aortic aneurysm repair.
CONCLUSION: The early and late mortality was similar after open and endovascular AAA repair. Postoperative complications did not show significant difference between the two groups. We found significant difference in the use of blood products, the prevalence of incisional hernias and the number of reinterventions. According to our results, stent graft implantation is mainly recommended in high risk patients and open aortic repair still has a role in the low-moderate operative risk group. PMID: 25327404 [PubMed - in process]
Source: Magyar Sebeszet - October 1, 2014 Category: Surgery Authors: Kovács H, Fehérvári M, Forgó B, Gősi G, Oláh Z, Csobay-Novák C, Entz L, Szeberin Z Tags: Magy Seb Source Type: research

Embolic complications after endovascular repair of abdominal aortic aneurysms
Conclusions The presence of a shaggy aorta and a history of smoking are independent predictors of embolic complications associated with EVAR.
Source: Surgery Today - September 25, 2014 Category: Surgery Source Type: research

Open versus endovascular repair of abdominal aortic aneurysm: Incidence of cardiovascular events in 632 patients in a department of defense cohort over 6-year follow-up.
CONCLUSION: EVAR was associated with lower 30-day mortality rates; however, this benefit was not sustained in longer-term follow-up. There is no difference in the rates of stroke, myocardial infarction, or cardiac arrhythmia at 30 days or in long-term follow-up. PMID: 25134851 [PubMed - as supplied by publisher]
Source: Vascular - August 18, 2014 Category: Surgery Authors: Thomas D, Anderson D, Hulten E, McRae F, Ellis S, Malik JA, Villines TC, Slim AM Tags: Vascular Source Type: research

Upper extremity access for fenestrated endovascular aortic aneurysm repair is not associated with increased morbidity
Fenestrated endovascular aortic aneurysm repair (FEVAR) is an alternative to open repair in patients with complex abdominal aortic aneurysms who are neither fit nor suitable for standard open or endovascular repair. Chimney and snorkel grafts are other endovascular alternatives but frequently require bilateral upper extremity access that has been associated with a 3% to 10% risk of stroke. However, upper extremity access is also frequently required for FEVAR because of the caudal orientation of the visceral vessels.
Source: Journal of Vascular Surgery - August 2, 2014 Category: Surgery Authors: Martyn Knowles, David A. Nation, David E. Timaran, Luis F. Gomez, M. Shadman Baig, R. James Valentine, Carlos H. Timaran Tags: Clinical Paper Source Type: research

Parallel Endografts in the Treatment of Distal Aortic and Common Iliac Aneurysms
Conclusions: Successful exclusion of D-AAA and BCIAA was achieved in high-risk patients using parallel endografts, allowing antegrade blood flow to one IIA when needed. Commercially available endografts were used in a simple and effective approach, with excellent follow-up results.
Source: European Journal of Vascular and Endovascular Surgery - May 19, 2014 Category: Surgery Authors: S. Lepidi, M. Piazza, P. Scrivere, M. Menegolo, M. Antonello, F. Grego, P. Frigatti Tags: Aortic Disease Source Type: research

Parallel Endografts in the Treatment of Distal Aortic and Common Iliac Aneurysms.
CONCLUSIONS: Successful exclusion of D-AAA and BCIAA was achieved in high-risk patients using parallel endografts, allowing antegrade blood flow to one IIA when needed. Commercially available endografts were used in a simple and effective approach, with excellent follow-up results. PMID: 24846490 [PubMed - as supplied by publisher]
Source: PubMed: Eur J Vasc Endovasc ... - May 17, 2014 Category: Surgery Authors: Lepidi S, Piazza M, Scrivere P, Menegolo M, Antonello M, Grego F, Frigatti P Tags: Eur J Vasc Endovasc Surg Source Type: research

Subclavian Stump Syndrome Causing a Posterior Circulation Stroke after Thoracic Endovascular Aneurysm Repair (TEVAR) with Adjunctive Carotid to Subclavian Bypass and Endovascular Embolization of the Left Subclavian Artery
Conclusions: Consideration should be given to ligating the subclavian artery immediately proximal to the vertebral artery origin when performing adjunctive carotid subclavian bypass during TEVAR. If this is not done, surveillance computed tomography scans should monitor for the development of propagating thrombus in the subclavian stump.
Source: Annals of Vascular Surgery - February 6, 2014 Category: Surgery Authors: Ritesh Patel, Carl Muthu, Kwat Huat Goh Tags: Case Report Abstracts Source Type: research

The “Open” Chimney Graft Technique for Juxtarenal Aortic Aneurysms with Discrepant Renal Arteries
Conclusions: OCh-EVAR is a straightforward technique that can be employed in selected cases of JRAA, avoiding the more complex and expensive fenestrated EVAR.
Source: European Journal of Vascular and Endovascular Surgery - December 4, 2013 Category: Surgery Authors: E. Ducasse, S. Lepidi, C. Brochier, S. Deglise, X. Berard, D. Alberti, D. Midy Tags: Aortic Disease Source Type: research

Upper Extremity Access for Fenestrated Endovascular Aortic Aneurysm Repair Is not Associated with Increased Morbidity
Fenestrated endovascular aortic aneurysm repair (FEVAR) is an alternative to open repair in patients with complex abdominal aortic aneurysms, who are neither fit nor suitable for standard open or endovascular repair. Chimney and snorkel grafts are other endovascular alternatives, but require upper extremity access that has been associated to a 3.2%-9.5% risk of stroke. However, because of the caudal orientation of the visceral vessels, upper extremity access is also frequently required for FEVAR. The purpose of this study was to assess the use of upper extremity access for FEVAR and associated morbidity.
Source: Journal of Vascular Surgery - November 28, 2013 Category: Surgery Authors: Martyn Knowles, David A. Nation, David E. Timaran, Luis F. Gomez, M. Shadman Baig, R. James Valentine, Carlos H. Timaran Tags: Abstracts from the 2014 Southern Association for Vascular Surgery Annual Meeting Source Type: research

Five-year results for endovascular repair of acute complicated type B aortic dissection
Conclusions: This study confirms the excellent short-term outcomes of TEVAR for acute complicated type B dissection and demonstrates the results to be durable and sustained over long-term follow-up. Although aortic reinterventions were required in one-quarter of patients, no aortic-related deaths were observed. These data support the use of TEVAR for acute complicated type B aortic dissection but also highlight the importance of life-long aortic surveillance by an experienced aortic referral center in order to identify and treat complications of the underlying disease process and treatment, as well as new aortic pathologies, as they arise.
Source: Journal of Vascular Surgery - October 3, 2013 Category: Surgery Authors: Jennifer M. Hanna, Nicholas D. Andersen, Asvin M. Ganapathi, Richard L. McCann, G. Chad Hughes Tags: Clinical research studies Source Type: research

Endovascular Stenting With Open Surgery for Reconstructions of the Ascending Aorta and the Aortic Arch: A Review of Indications and Results of Hybrid Techniques
Hybrid approaches for repair of aneurysms involving the ascending aorta and the aortic arch have been developed to avoid or reduce duration of cardiopulmonary bypass and circulatory arrest and to decrease operative time, blood loss, hospital stay, morbidity, and mortality. These include ascending aorta–based debranching or cervical extra-anatomical bypasses followed by stent-grafting. In patients with associated descending aortic aneurysms, the elephant trunk technique is used followed by stent-grafting of the descending thoracic aorta. A review of the literature of hybrid aortic arch reconstructions, published over ...
Source: Perspectives in Vascular Surgery and Endovascular Therapy - September 19, 2013 Category: Surgery Authors: Rana, M. A., Gloviczki, P., Oderich, G. S. Tags: Featured Articles Source Type: research

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