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'Intravascular Stents Thoracic Aorta' (60)


Oct
2017

Accurate sizing of stent grafts during thoracic endovascular aortic repair (TEVAR) is critical for a successful outcome. Centerline measurements using three-dimensional reconstruction of preoperative computed tomography angiography (CTA) is the current standard for stent graft sizing. However, this technique is predicated on an idealized straightened aorta and does not account for the variability in the aortic diameter during the cardiac cycle or the overall status of the patient's volume.

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Jul
2017

Acute dissection of thoracic aorta carries a risk of renal ischemia followed by the development of a kidney failure. The optimal surgical and nonsurgical management of these patients, timing of intervention, and the factors predicting renal recovery are not well delineated and remain controversial. We present a case of acute type B thoracic aortic dissection with left kidney ischemia.

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Nov
2016

Metallic endovascular stents are utilized off-label in congenital heart disease. Biodegradable stents (BDS) offer potential advantages in a growing child. We have previously reported double opposed helical (DH) BDS up to 6 mm diameter (DH-6).

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Dec
2016

Trans-catheter endovascular stent grafting minimizes trauma and increases the benefitting patient population. However, the alignment between stent graft branches and vasculature branches remains time-consuming and challenging, and such techniques require a significant amount of contrast agent for imaging.
A new framework for intravascular reconstruction based on sensor fusion between intravascular ultrasound (IVUS) imaging and electromagnetic (EM) tracking was proposed.

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Feb
2016

Sutureless microvascular anastomosis has great translational potential to simplify microvascular surgery, shorten operative times, and improve clinical outcomes. The authors developed a transient thermoreversible microvascular stent using a poloxamer to maintain vessel lumen patency before application of commercially available adhesives to seal the anastomosis instead of sutures. Despite technical success, human application necessitates bovine serum albumin removal from existing formulations; rapid poloxamer transition between states; and increased stiffness for reliable, reproducible, and precise microvascular approximation.

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Sep
2015

Intravascular ultrasound (IVUS) examination can provide useful information during endovascular stent graft repair. However, its actual clinical utility in thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (type B-AD) remains unclear, especially in complicated aortic dissection. We evaluated the effect of IVUS as a complementary tool during TEVAR.

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Dec
1969

Intravascular ultrasound (IVUS) provides real-time imaging of aortic pathology during aortic interventions. The objective of the present study was to validate IVUS measurements using computed tomography (CT) angiography in a sufficiently large cohort.
From October 2010 to February 2014, 57 consecutive patients with acute aortic syndrome underwent both IVUS and spiral CT for a total of 509 comparable thoracic aorta segments.

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Dec
2015

The purpose of the present study was to evaluate the tissue characteristics of plaques with moderate or mild stenosis in the inner and outer curvature of the left anterior descending artery (LAD) using integrated backscatter intravascular ultrasound.
We evaluated 66 plaques with moderate stenosis (plaque burden >50% but ≤75%) and 49 plaques with mild stenosis (plaque burden >30% but ≤50%) in 66 patients undergoing percutaneous intervention to the LAD. All plaques were >10mm away from any side branch or previously implanted stents.

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Feb
2015

Left main compression by pulmonary artery dilation has been reported previously. Percutaneous or surgical interventions are treatment options. We report on a 78-year-old man with exertional chest pain and dyspnea.

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Mar
2015

This study evaluates the feasibility of delivery and deployment of low and medium molecular weight (LMW and MMW, respectively) double-opposing helical (DH) poly-l-lactic acid biodegradable stent (BDS) in rabbit descending aorta (DAO). Secondary objectives were to assess patency and inflammation of stented vessels at 9 months and to investigate safety following intentional embolization of stent fragments in DAO.
A BDS that will relieve aortic obstruction and disappears as the child grows older allowing for preservation of aortic wall elasticity and natural growth of aorta will be ideal to treat Coarctation (CoA).

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May
2014

Aortic sources of peripheral and visceral embolization remain challenging to treat. The safety of stent graft coverage continues to be debated. This study reports the outcomes of stent coverage of these complex lesions.

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May
2014

Endovascular treatments for catastrophic aortic conditions have gained increasing popularity over the past 20 years. Originally developed for abdominal aortic aneurysms (EVAR), treatment has been modified for use in thoracic aortic repair (TEVAR). As expanding numbers of patients with increasingly intractable conditions and more hostile anatomies are treated, endovascular stent designs are maturing to be suitable for these more demanding situations.

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Oct
2013

An interesting case report detailing the management of an aorta that was inadvertently screwed during spinal fixation. The management and imaging encompass the use of computer tomography and intravascular ultrasound to determine the trajectory of the screw and the successful management of the patient.

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Feb
2013

A 52-year-old man with fever and dyspnea was admitted to our hospital. Chest computed tomography showed a mass measuring 3.5×3.

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Sep
2012

It is desirable to reduce aortic stent graft installation time and the amount of contrast media used for this process. Guidance with augmented reality can achieve this by facilitating alignment of the stent graft with the renal and mesenteric arteries.
For this purpose, a sensor fusion is proposed between intravascular ultrasound (IVUS) and magnetic trackers to construct three-dimensional virtual reality models of the blood vessels, as well as improvements to the gradient vector flow snake for boundary detection in ultrasound images.

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Jan
2012

Acute traumatic transection of the aorta (ATAT) is a devastating event. Transluminal endovascular aortic repair (TEVAR) has meanwhile become an excellent alternative for such lesions. A 27-year old woman sustained a multiple trauma in a car accident including ATAT which was treated by aortic stent graft placement.

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Feb
2012

An innovative approach, the JAG tearing technique, was performed during thoracic endovascular aneurysm repair in a patient with previous surgical replacement of the ascending aorta with a residual uncomplicated type B aortic dissection who developed an aneurysm of the descending thoracic aorta with its lumen divided in two parts by an intimal flap. The proximal landing zone was suitable to place a thoracic stent graft. The distal landing zone was created by cutting the intimal flap in the distal third of the descending thoracic aorta with a radiofrequency guide wire and intravascular ultrasound catheter.

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Aug
2011

To investigate the thoracic aortic pulsatility during hypovolemic shock in an experimental porcine model.
The circulating blood volume of 7 healthy Yorkshire pigs was gradually lowered until the subjects had lost 40% of their normal blood volume. Intravascular ultrasound was used to assess the aortic pulsatility in normovolemic and hypovolemic state at the level of the ascending and descending thoracic aorta.

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Jan
2011

Surgical treatment for thoracoabdominal aortic aneurysm is still challenging and is associated with a high risk of paraplegia. Hybrid repair with stent graft insertion for the thoracoabdominal aorta excluding the branches of the lumbar and visceral arteries and bypass grafting to the visceral branches has been introduced as a less invasive treatment that reduces the risk of paraplegia. For hybrid repair, it is important to have appropriate management of the revascularized grafts to the 4 visceral arteries with sufficient inflow.

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Dec
2010

The risk of renal failure after thoracic endovascular aortic repair is not widely established. The aim of this study was to assess the incidence and risk factors of renal failure.
Between 1998 and 2008, 175 consecutive patients underwent 210 procedures at 2 tertiary academic institutions.

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Jul
2010

Primary malignant tumors of the aorta (PMTAs) are an extremely rare clinical entity. In most cases, the diagnosis is made either postmortem or late in the course of disease due to a low index of clinical suspicion and presenting symptoms that mimic far more common athero-embolic processes. Due to the intravascular origin of these tumors, peripheral and mesenteric embolic events represent a major source of morbidity and mortality.

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May
2010

Intravascular ultrasound (IVUS) has been successfully used to guide the implantation of stents in the thoracic aorta. However, its accuracy in measuring the diameter of the aortic lumen has not been clearly established. Thirteen patients with thoracic aortic disease underwent IVUS, and lumen diameter measurements were compared with those obtained by CT or magnetic resonance imaging.

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Sep
2010

Primary adult aortic coarctation (PAAC) is an unusual cause of hypertension. The standard of care includes surgical repair, which can be associated with considerable morbidity and operative risk. Although balloon angioplasty has been successfully used in paediatric and adolescent patients with coarctation, little information exists regarding the endovascular repair of PAAC.

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Oct
2009

Total aortic arch stenting--hemodynamical impact of carotid artery perfusion.

Interact Cardiovasc Thorac Surg 2009 Oct 9;9(4):562-4. Epub 2009 Jul 9.
Lars Niclauss, Ludwig K von Segesser
The aim of this experimental study is to evaluate the feasibility and the outcome of total endovascular stent implantation in the aortic arch. Indications for this operation-technique would be acute or chronic dissection of the aortic arch (non-A-non-B dissection) or type B dissection with retrograde extension. Four pigs were canulated via the distal abdominal aorta and a retrograde placement of a Djumbodis arch stent (4-9 cm) was controlled by using intravascular ultrasound and intracardiac ultrasound by the inferior cava vein and under radioscopic control.

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Oct
2008

Endovascular stent graft repair of a traumatic thoracic aortic disruption (TTAD) is rapidly becoming an accepted alternative to open surgical repair. The use of currently approved thoracic stent grafts especially in younger patients with small, "steep," tapered aortas, remains a concern due to the acute thoracic endograft collapse and enfolding. The objective of this study, the largest report to date, was to evaluate the mid-term results of TTAD treated with abdominal aortic "stacked" extension cuffs, with follow-up extending to 41 months.

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Oct
2008

Percutaneous stenting of both native and recurrent coarctation of the aorta has become an acceptable alternative to surgical repair in most centers throughout the world. Severe complications such as aortic rupture, dissection, and late pseudo aneurysm formation are rare but worrisome complications. In many countries, commercially available balloon expandable covered stents designed for intravascular use are used either for primary stenting, or in treating complications once identified.

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Apr
2008

Consumptive coagulopathy is known to occur in patients with aneurysm, especially in the thoracic localization. Compared to open chest surgery, the endovascular treatment leaves in place a large thrombosed aneurysmal sac, which might induce and/or exacerbate the coagulopathy. Although exceptional, some recent reports have raised the potential disastrous issue related to this complication.

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Oct
2007

We report a multiinstitutional study on intermediate-term outcome of intravascular stenting for treatment of coarctation of the aorta using integrated arch imaging (IAI) techniques.
Medical records of 578 patients from 17 institutions were reviewed. A total of 588 procedures were performed between May 1989 and Aug 2005.

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Dec
2006

In patients with advanced oesophageal carcinoma with aortic invasion, any therapy potentially causes fatal haemorrhage. We describe here the successful application of intra-aortic stent graft to prevent haemorrhage before radical oesophagectomy for advanced oesophageal cancer. Four patients with advanced oesophageal cancer complicated by invasion of the aorta.

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Mar
2006

We report the successful treatment of blunt thoracic aortic trauma with a self-expanding stent lined with commercially available aortic extender cuffs. A 24 x 70 mm Wallstent was positioned distal to the left subclavian artery via a left femoral approach. The stent was then lined with three overlapping Gore Excluder aortic extender cuffs.

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Feb
2006

Intravascular stenting of the superior vena cava (SVC) is an established therapy in patients with SVC syndrome. Late complications include re-occlusion, stent infection, migration, and perforation. Affection of the greater thoracic vessels is rare and life-threatening when it occurs.

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Aug
2005

Despite growing interest in stent-graft implantation for type-B aortic dissection, there are no established recommendations to prepare and perform an implantation procedure.
We directly compared angiography (ANGIO), transesophageal echocardiography (TEE), and intravascular ultrasound (IVUS) intraprocedually before and after placement of 48 stent grafts in 42 consecutive patients (12 women, 61+/-11 years of age) with acute and chronic type-B aortic dissection for both usefulness and capability to guide aortic stent-graft implantation. Both IVUS and TEE are superior to ANGIO to identify multiple entries (52 and 43 versus 34; P<0.

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Mar
2005

A right-sided aortic arch with an aberrant left subclavian artery is a congenital vascular anomaly that is easily detectable in utero at the level of the three vessels and trachea view, but which is rarely symptomatic in the neonate. We present a newborn with prenatally diagnosed right-sided aortic arch and aberrant subclavian artery who showed a clinically relevant stenosis of the subclavian artery during the first week of life. An intravascular stent was implanted into the stenosis of the aberrant left subclavian artery by catheterization.

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Feb
2005

To report a case of intimal dehiscence associated with endovascular intervention in patients with aortic dissection.
A 65-year-old man presented with a type B dissection extending to the level of the common iliac arteries. Two Talent stent-grafts were placed in the descending thoracic aorta to close the entry point, but 2 lumens remained.

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Jun
2004

A case of a 26-year-old female with aortic coarctation and Recklinghausen disease is presented. At the age of 14 years the patient underwent thoracic aortic bypass grafting. Twelve years later she developed arterial hypertension.

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Jun
2004

Endovascular stent-graft placement is a new concept for the treatment of aortic dissection and aneurysm. Intravascular ultrasound (IVUS) with established diagnostic features may be instrumental in guiding endovascular procedures.
We performed IVUS and digital angiography before, during, and after implantation of 47 stent grafts in 40 patients with Stanford type B dissection (26 patients, 28 stent grafts), thoracic aneurysm (9 patients, 11 stent grafts), and abdominal aneurysm (5 patients, 8 stent grafts).

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Apr
2003

To report our learning experience using an intracardiac echocardiography (ICE) probe to guide endovascular aortic procedures.
Between November 1999 and July 2001, 17 patients (12 men; mean age 73.1+/-2.

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Jun
2003

Thrombosis is common in aneurysms immediately after stent-grafting, because of exclusion from systemic blood flow. We studied changes in blood coagulation and the fibrinolytic system in patients with thoracic aortic aneurysm or dissection after stent-grafting to examine risk for consumption coagulopathy.
Thirty-one thoracic aortic aneurysms were treated with stent-grafting (aneurysm group), and 29 aortic dissections were treated with entry closure with stent-grafting (dissection group).

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Jun
2002

Spontaneous and isolated dissection of the limb arteries without involvement of the aorta is extremely rare. We present a 36-year-old male who has 95% tapering stenosis and dissection of the left external iliac artery with abrupt onset with total thrombosis in the false lumen until the level of the inguinal ligament. We also suggest that endovascular stent graft placement is a useful treatment for isolated arterial dissections prior to operation in consideration of the technical ease and safety of guiding intravascular ultrasound like in this case.

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Dec
2002

Endoluminal thoracic aortic stenting is a new therapeutic tool in reducing the operative trauma of the patient. However, the inherent risks of aortic stent grafting are perivascular leakage, stent dislocation, blunt rupture of the aorta, side branch occlusion and neurological sequelae. To reduce these risks, in our institution all stent implantations were performed in close collaboration with our fellow cardiologists under biplane X-ray control supported by simultaneous intravascular and transoesophageal ultrasound imaging.

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Apr
2002

To study the feasibility of treatment of aortic arch aneurysm with graftstent by intravascular surgery.
Animal model of aortic arch aneurysm was established using 10 piglets. An aortic arch-shaped graftstent was transferred and implanted to the site of aortic arch aneurysm through femoral artery under angiography.

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Jul
2002

Intravascular stent placement for relief of vascular stenoses often requires that a stent be positioned across the origin of side-branch vessels. Most currently available peripheral vascular stents have a closed-cell design that will not allow catheter manipulation, dilation, or stenting through the stent cells. Therefore, if a side branch arising off a previously stented vessel is stenotic or if its origin has been compromised, transcatheter dilation of the branch vessel has not been possible.

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Jan
2001

In this case report, an iatrogenic dissection of the descending aorta occurred during balloon angioplasty and stenting of a recurrent coarctation. The dissection was not seen by transesophageal echocardiography, but intravascular ultrasonography, performed routinely during such procedures at this institution, identified the dissection and guided further therapeutic stent placement.

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Jun
1998

Delivery of a balloon-expandable stent was complicated by a systemic embolisation. The radio-opaque stent was lost in the descending aorta, but then removed by using a loop basket intravascular retriever set without any peripheral arterial complication.

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Dec
1997

Vascular injuries caused by blunt or penetrating trauma can be challenging to diagnose and treat, particularly when they involve central vessels. Endovascular treatment for vascular trauma includes the placement of embolization coils and intravascular stents and the employment of stented grafts. The use of stented grafts appears to be associated with decreased blood loss, a less invasive insertion procedure, reduced requirements for anesthesia, and a limited need for an extensive dissection in a traumatized field.

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Dec
1996

We present a 45 year old man with massive hemoptysis due to an aortopulmonary fistula. Our patient had a history of a previous patent ductus arteriosus repair which was complicated by a previous aortopulmonary fistula. Computed tomography of the chest and aortography made the diagnosis of a recurrent aortopulmonary fistula.

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Dec
1969

We examined whether the Inoue endovascular graft could be used as a device for the treatment of aortic dissection. This graft consists of a cylinder made from a thin Dacron sheet suspended by several extra-flexible wire rings. Aortic dissections were experimentally created in 11 dogs.

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Jan
1996

A clinical study aiming at examining the implantation technique and the clinical results of a new vascular prosthesis in endovascular therapy of aneurysms of the aorta.
In 21 patients (20 men of 55 to 87 years of age, average age 70 years) with aneurysms of the infrarenal abdominal aorta (AAA n = 19) and the thoracic aorta (n = 2), a self-expanding nitinol stent with outer Dacron sheath (tubular prosthesis n = 4; bifurcation prosthesis n = 17) was implanted by means of an F-18 introductory set after surgical opening of the inguinal artery.
By means of the 4 tubular prostheses and 13 of the 17 bifurcation prostheses the aneurysm was bypassed completely.

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Jan
1996

To test the effectiveness of endoluminal exclusion of the false lumen in experimental thoracic aortic dissection by occlusion of the entry site with a balloon-expandable endograft.
Thoracic aortic dissections were induced surgically in six beagles. The endograft consisted of an ultrathin, 12-mm-wide polyester tube sutured over a Strecker stent that was already crimped onto an angioplasty balloon.

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