AORTA Journal最新文献

{"title":"Aortoiliac Occlusion Disease","authors":"U. Rossi, A. Ierardi, M. Cariati","doi":"10.1055/s-0041-1729918","DOIUrl":"https://doi.org/10.1055/s-0041-1729918","url":null,"abstract":"Leriche syndrome is characterized by abdominal aorta and/or bilateral iliac occlusive disease, with a triad of clinical symptoms and signs such as claudication, erectile dysfunction, and decreased distal pulses. Diagnostic imaging is one of the key factors for diagnosis of the anatomic origin of the Leriche symptoms. We report the case of a 56-year-old man with diagnosis of abdominal aorta and bilateral iliac occlusive disease with a wide collateral vascular network.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128389904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct Innominate Artery Cannulation versus Side Graft for Selective Antegrade Cerebral Perfusion during Aortic Hemiarch Replacement","authors":"A. Gergen, C. Kemp, C. Ghincea, Zihang Feng, Y. Ikeno, Muhammad Aftab, T. B. Reece","doi":"10.1055/s-0042-1744136","DOIUrl":"https://doi.org/10.1055/s-0042-1744136","url":null,"abstract":"Background  Selective antegrade cerebral perfusion (SACP) has become our preferred method for cerebral protection during open arch cases. While the initial approach involved sewing a graft to the innominate artery as the arterial cannulation site, our access strategy has since evolved to central aortic cannulation with use of a percutaneous cannula in the innominate for SACP. We hypothesized that SACP delivered via direct innominate cannulation using a 12- or 14-Fr cannula results in equivalent outcomes to cases utilizing a side graft. Methods  This was a single-center, retrospective analysis of 211 adult patients who underwent elective hemiarch replacement using hypothermic circulatory arrest with SACP via the innominate artery between 2012 and 2020. Urgent and emergent cases were excluded. Results  A side graft sutured to the innominate was utilized in 81% ( n  = 171) of patients, while direct innominate artery cannulation was performed in 19% ( n  = 40) of patients. Baseline patient characteristics were similar between groups aside from a higher baseline creatinine in the direct cannulation group (1.3 vs. 0.9, p  = 0.032). Patients undergoing direct cannulation demonstrated shorter cardiopulmonary bypass time (132.7 vs. 154.9 minutes, p  = 0.020) and shorter circulatory arrest time (8.1 vs. 10.9 minutes, p  = 0.004). Nadir bladder temperature did not significantly differ between groups (27.2°C for side graft vs. 27.6°C for direct cannulation, p  = 0.088). There were no significant differences in postoperative outcomes. Conclusion  Direct cannulation of the innominate artery with a 12- or 14-Fr cannula for SACP during hemiarch replacement is a safe alternative to using a sutured side graft. While cardiopulmonary bypass and circulatory arrest times appear improved, this is likely attributable to accumulation of experience and proficiency in technique. However, direct innominate artery cannulation may facilitate quicker completion of these procedures by eliminating the time necessary to suture a graft to the innominate artery.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115063257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abdominal Aorta Anastomotic False Aneurysm Leading to Double Focal Vertebral Body Erosion","authors":"U. Rossi, F. Petrocelli, M. Cariati","doi":"10.1055/s-0041-1739485","DOIUrl":"https://doi.org/10.1055/s-0041-1739485","url":null,"abstract":"Anastomotic aortic false aneurysm with consequent erosion of vertebral bodies is a very rare event that needs prompt treatment. We report the case of a 71-year-old man with an aortobifemoral graft that was complicated by an uninfected proximal anastomotic pseudoaneurysm with double focal vertebral body erosion.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116528670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician-Modified Endovascular Grafts for Zone-2 Thoracic Endovascular Aortic Repair","authors":"A. Queiroz, J. B. Lopes, V. P. Santos, Pedro B A F Cruz, R. J. Fidelis, J. B. A. Filho, L. C. S. Passos","doi":"10.1055/s-0042-1742696","DOIUrl":"https://doi.org/10.1055/s-0042-1742696","url":null,"abstract":"Objective  This study aims to describe our technique and early experience with physician-modified endovascular grafts (PMEGs) for aortic arch diseases in zone 2. We used a total endovascular technique based on a single fenestrated endograft to preserve left subclavian artery (LSA) patency. Methods  From December 2019 to August 2020, six consecutive patients with a variety of thoracic aortic diseases were treated with handmade fenestrated thoracic aortic grafts: four aortic dissections, one penetrating aortic ulcer, and one intramural hematoma. The planning, endograft modification, surgical technique, and follow-up of the patients were described. We evaluated immediate technical success and after 30 days, the LSA patency, Type-1 endoleak, and postoperative complications. Results  Thoracic endovascular aortic repair (TEVAR) was performed for zone 2 in all cases. Immediate technical success, defined as successful alignment of the LSA with a covered stent and no Type-1 endoleak, was achieved in all cases. Patients had a 30-day follow-up computed tomography, which demonstrated LSA patency and no Type-I endoleaks. To date, no strokes, left arm ischemia, paraplegia, or conversions to open surgery have been reported; one patient operated for acute Type B dissection died during the early follow-up. Conclusion  TEVAR for zone 2 with a PMEG to maintain LSA patency achieved technical success and early durability. It is expected that with longer follow-up and a larger number of cases, these results will be confirmed.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122323981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blunt Traumatic Innominate Artery Pseudoaneurysm Endografting without Heparin Due to Severe Brain Injury","authors":"Derek Nieber, C. T. Lewis, R. Dayal, K. Khariton, S. Lang, Charles Mack","doi":"10.1055/s-0041-1739486","DOIUrl":"https://doi.org/10.1055/s-0041-1739486","url":null,"abstract":"Blunt traumatic innominate artery injuries occur in polytrauma victims who have suffered high-speed motor vehicle collisions. Their associated injuries may preclude the use of heparin and affect surgical management and perioperative neurological risk. The uniqueness of this case is combining the arterial injury repair with a severe progressive neurological injury that prohibited standard perioperative antiplatelet or anticoagulent use.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"99 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124695652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Misdiagnosed Case of Endoleak Type-III Caused by Inadvertent Bilateral Limb Insertion in the Same Limb Gate of the Ovation Endograft","authors":"E. Georgakarakos, A. Koutsoumpelis, P. Kostoglou, K. Tasopoulou, C. Argyriou","doi":"10.1055/s-0042-1743197","DOIUrl":"https://doi.org/10.1055/s-0042-1743197","url":null,"abstract":"We describe an infrequent case of endoleak Type-III due to an unrecognized, inadvertent bilateral limb deployment into the same limb gate of the Ovation aortic endograft, accompanied by thrombosis and acute ischemia. The following computed tomography angiography revealed the open limb gate with the characteristic of radio-opaque polymer in the sealing rings. Intraoperative angiographies via the brachial route identified the open limb gate and facilitated the successful use of an occluding plug to manage the Type-III endoleak.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"110 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134456088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Through-and-Through Brachio/Radio-Femoral Access Technique for Endovascular Recanalization of the Left Subclavian Artery","authors":"Y. Erben, Michelle Lin, C. Franco-Mesa, Josephine F. Huang, Sukhwinder S. Sandhu, David Miller, R. Tawk","doi":"10.1055/s-0042-1743198","DOIUrl":"https://doi.org/10.1055/s-0042-1743198","url":null,"abstract":"The authors illustrate the use of through-and-through brachio/radio-femoral access technique in two patients who presented with subclavian steal syndrome. This is an additional tool in the armamentarium of the endovascular specialist to improve management of complex cases with subclavian steal syndrome. This technique provides several advantages to improve efficiency and precision of the procedure while reserving the open surgical bypass option if needed.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"13 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120889160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celebrating 10 Years of AORTA","authors":"J. Elefteriades, B. Ziganshin","doi":"10.1055/s-0042-1745865","DOIUrl":"https://doi.org/10.1055/s-0042-1745865","url":null,"abstract":"","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131967779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Measures, Old Conclusions: Obesity Does Not Worsen Outcomes after Elective Abdominal Aortic Aneurysm Repair","authors":"Joshua John Sommerville Wall, K. Boag, M. Waduud, Keleabetswe Pabale, B. Wood, M. Bailey, Julian A Scott","doi":"10.1055/s-0042-1742699","DOIUrl":"https://doi.org/10.1055/s-0042-1742699","url":null,"abstract":"Background  The “obesity paradox,” whereby the body mass index (BMI) mortality curve is “U-shaped,” is a well-studied phenomenon in vascular surgery. However, there has been an overreliance on BMI as the measure of obesity, which has shown to poorly correlate with clinical outcomes. Robust measures such as waist-hip ratio (WHR) have been suggested as a more accurate marker reflecting central obesity. Objectives  The objectives of this study were to evaluate the correlation between BMI and WHR on postoperative morbidity and mortality after elective abdominal aortic aneurysm (AAA) repair. Methods  Data were collected from the Leeds Vascular Institute between January 2006 and December 2016. The primary outcome was mortality and secondary outcomes included length of stay (LOS) and all-cause readmission. Binary logistic regression, linear regression, and correlation analysis were used to identify associations between BMI and WHR in relation to outcome measures. Results  After exclusions, 432 elective AAA repairs (281 open surgical repair [OSR] and 151 endovascular aneurysm repairs [EVARs]) were identified to be eligible for the study. The combined 30-day and 4-year mortality was 1.2 and 20.1%, respectively. The 30-day readmission rate was 3.9% and the average LOS was 7.33 (standard deviation 18.5) days. BMI data was recorded for 275 patients (63.7%) and WHR for 355 patients (82.2%). Logistic regression analysis highlighted no association between BMI and WHR with mortality, readmission, or LOS following OSR or EVAR. Conclusion  The results of this study suggest patients should not be denied treatment for AAA based on obesity alone.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"181 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114164833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transesophageal Ultrasound Guidance for Endovascular Interventions on the Aorta","authors":"M. Castro-Verdes, X. Yuan, A. Mitsis, Wei Li, C. Nienaber","doi":"10.1055/s-0042-1743107","DOIUrl":"https://doi.org/10.1055/s-0042-1743107","url":null,"abstract":"Aortic pathologies in general require a multidisciplinary approach and decision-making to integrate elements of clinical acuity, vascular pathology, individual comorbidity, and risk assessment; thus, ideally it is a center with access to multiple imaging modalities and expertise in all treatment options. Besides classic open surgical options, endovascular procedures have been accepted for a variety of aortic pathologies. More recently, novel transcatheter interventions even to the proximal aorta have been introduced, particularly for patients unfit for open surgery. Nevertheless, the role of transesophageal echocardiography to guide percutaneous aortic interventions is not well established, notwithstanding the growing potential as an ancillary tool to guide the procedure and document success.","PeriodicalId":233871,"journal":{"name":"AORTA Journal","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133516498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}