scholarly journals Custom-made Fenestrated Endograft for Patients with Type 1 Endoleak and Previous Endovascular Aneurysm Repairs: A Promising Endovascular Alternative Approach to Open Surgery

2017 ◽  
Author(s):  
Muhammad Affan Zamir ◽  
Nich Burfitt ◽  
Colin Bicknell ◽  
Michael Jenkins ◽  
Richard Gibbs ◽  
...  
2021 ◽  
Vol 09 (01) ◽  
pp. E35-E40
Author(s):  
Sharad Chandra ◽  
Urvashi Chandra

AbstractLiver abscess requiring drainage is conventionally managed by interventional radiology-guided percutaneous drainage (PCD). Radiologically inaccessible abscesses are managed with laparoscopic or open surgery, which carries high rates of morbidity and mortality.EUS-guided transluminal liver abscess drainage is minimally invasive and can be an alternative approach for caudate lobe, segment 4, and left lateral segment abscesses. We report on three consecutive patients with radiologically inaccessible left lobe liver abscess involving the caudate lobe, segment 4, and lateral segment in whom EUS-guided transluminal drainage using a modified technique was successful.


2017 ◽  
Vol 29 (1) ◽  
pp. 67-92 ◽  
Author(s):  
JAMES CHAPMAN ◽  
TARMO UUSTALU ◽  
NICCOLÒ VELTRI

The delay datatype was introduced by Capretta (Logical Methods in Computer Science, 1(2), article 1, 2005) as a means to deal with partial functions (as in computability theory) in Martin-Löf type theory. The delay datatype is a monad. It is often desirable to consider two delayed computations equal, if they terminate with equal values, whenever one of them terminates. The equivalence relation underlying this identification is called weak bisimilarity. In type theory, one commonly replaces quotients with setoids. In this approach, the delay datatype quotiented by weak bisimilarity is still a monad–a constructive alternative to the maybe monad. In this paper, we consider the alternative approach of Hofmann (Extensional Constructs in Intensional Type Theory, Springer, London, 1997) of extending type theory with inductive-like quotient types. In this setting, it is difficult to define the intended monad multiplication for the quotiented datatype. We give a solution where we postulate some principles, crucially proposition extensionality and the (semi-classical) axiom of countable choice. With the aid of these principles, we also prove that the quotiented delay datatype delivers free ω-complete pointed partial orders (ωcppos).Altenkirch et al. (Lecture Notes in Computer Science, vol. 10203, Springer, Heidelberg, 534–549, 2017) demonstrated that, in homotopy type theory, a certain higher inductive–inductive type is the free ωcppo on a type X essentially by definition; this allowed them to obtain a monad of free ωcppos without recourse to a choice principle. We notice that, by a similar construction, a simpler ordinary higher inductive type gives the free countably complete join semilattice on the unit type 1. This type suffices for constructing a monad, which is isomorphic to the one of Altenkirch et al. We have fully formalized our results in the Agda dependently typed programming language.


2018 ◽  
Vol 07 (04) ◽  
pp. 341-343 ◽  
Author(s):  
Benoit Mariotte ◽  
Gilles Candelier ◽  
Thomas Apard

AbstractSymptomatic lunotriquetral coalition is very rare and need open surgery after failure of conservative treatment. We report a case of a symptomatic congenital lunotriquetral coalition type 1 according to the Minaar classification, at the left wrist of a 14-year-old boy. We performed an arthroscopic treatment with two compression screws and without cancellous bone grafting. Healing was obtained at 2 months postoperatively.


2016 ◽  
Vol 24 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Tilo Kölbel ◽  
Christian Detter ◽  
Sebastian W. Carpenter ◽  
Fiona Rohlffs ◽  
Yskert von Kodolitsch ◽  
...  

Purpose: To describe the combined use of a tubular stent-graft for the ascending aorta and an inner-branched arch stent-graft for patients with acute type A aortic dissection. Technique: The technique to deploy these modular, custom-made stent-grafts is demonstrated in 2 patients with acute DeBakey type I aortic dissections and significant comorbidities precluding open surgery. Both emergent procedures were made possible by the availability of suitable devices manufactured for elective repair in other patients. After preliminary carotid-subclavian bypass, a long Lunderquist guidewire was introduced from the right femoral artery to the left ventricle for delivery of the Zenith Ascend and Zenith Branched Arch Endovascular Grafts under inflow occlusion. Bridging stent-grafts were delivered to the innominate and left common carotid arteries to connect to the 2 inner branches; the left subclavian artery was occluded. Both cases were technically successful and resulted in exclusion of the false lumen in the ascending aorta. The operating and fluoroscopy times did not exceed those of comparable elective procedures. The patients were rapidly extubated shortly after the procedure and without serious immediate complications. One patient survived 11 months with a satisfactory repair; the other succumbed to complications of recurrent pneumonia after 23 days. Conclusion: Endovascular treatment of patients with acute type A aortic dissection using a combination of tubular and branched stent-grafts in the ascending aorta is feasible and offers an alternative strategy to open surgery.


Vascular ◽  
2021 ◽  
pp. 170853812110627
Author(s):  
Gino Gemayel GG ◽  
Michel Montessuit MM ◽  
Anouche Gemayel GA

Objectives We represent two cases of late proximal type I endoleak following EVAR with aneurysm expansion that were treated with a custom-made graft with inner branches. Methods Two patients of 87 and 82 years old were operated by EVAR 6 and 8 years ago for abdominal aortic aneurysm. Both had proximal type I endoleak with aneurysm sac expansion. Open surgery had a high risk, and a proximal aortic extension with a simple aortic cuff was not possible neither because previous EVAR grafts were already at the level of the renal arteries. A custom-made endograft with inner branches was planned as a fenestrated graft was not technically possible. Results We successfully treated both patients using a custom-made graft with four inner branches from Jotec (Cryolife, Kennesaw, GA). Three months’ follow-up CT scan did not show any endoleaks. All target vessels were patent with good conformability of the bridging stents. Conclusion The treatment of proximal type I endoleak using inner branches’ endografts is feasible. This novel technology might broaden the indications for complex aortic repair in a group of patients where fenestrated endografts are not possible.


2021 ◽  
Author(s):  
Yunqing Hu ◽  
Tingting Niu ◽  
Jianming Xu ◽  
Li Peng ◽  
Qinghua Sun ◽  
...  

Abstract The presence of negative air ions (NAI) is suggested to be a good factor in improving psychological status and used in treating depression as an alternative approach. However, the biological explanation for effects of NAI on alleviating depression symptoms has less been explored. In this study, the chronic mild stress (CMS) protocol was used to induce transcriptional depressive-like behaviors in mice, and the effects of NAI exposure on CMS-induced depression-like behaviors were examined. Thirty-day NAI exposure prevented the CMS-induced depression-like behaviors as shown by the restoration of sucrose preference and reduced immobility time in the suspension test. In addition, the elevation of serous corticosterone was present in CMS-treated mice but not existed in those with the NAI exposure. Furthermore, we observed a shifted balance between the cytokines secreted by type 1 T helper (Th1) cells and type 2 T helper (Th2) cells. In conclusion, NAI intervention is able to ameliorate CMS-induced depression-like behaviors in mice, and this effect is associated with the alteration of corticosterone and functional rebalance between Th1 and Th2 cells.


Aorta ◽  
2018 ◽  
Vol 06 (04) ◽  
pp. 102-106
Author(s):  
Arne de Niet ◽  
Paul van Schaik ◽  
Ben Saleem ◽  
Clark Zeebregts ◽  
Ignace Tielliu

AbstractAn 81-year-old patient presented to the emergency room 5 years after infrarenal endovascular aneurysm repair, with a Type Ia endoleak and a presumable infection of the graft material with Listeria monocytogenes. He was treated with a custom-made fenestrated endograft to seal the endoleak and lifelong antibiotic therapy to suppress the infection. Full explantation of graft material is not always preferable, and endovascular treatment combined with antibiotic suppressive therapy is in some cases an appropriate alternative.


Author(s):  
Fabio Verzini ◽  
Lorenzo Gibello ◽  
Gianfranco Varetto ◽  
Edoardo Frola ◽  
Michele Boero ◽  
...  

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