DESIGN IMPLICATIONS FOR ENDOVASCULAR STENTS AND THE ENDOTHELIUM

Author(s):  
JUAN M. JIMÉNEZ ◽  
PETER F. DAVIES
Keyword(s):  
Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 620
Author(s):  
Muzammil H. Syed ◽  
Mark Wheatcroft ◽  
Danny Marcuzzi ◽  
Hooman Hennessey ◽  
Mohammad Qadura

The aim of this paper is to share our experience in managing a patient with Klebsiella pneumoniae mycotic abdominal aortic aneurysm who was also infected with COVID-19. A 69-year-old male was transferred to our hospital for the management of an infra-renal mycotic abdominal aortic aneurysm. During his hospital course, the patient contracted severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He was intubated due to respiratory distress. Over a short period, his mycotic aneurysm increased in size from 2.5 cm to 3.9 cm. An emergency repair of his expanding aneurysm was achieved using our previously described protocol of coating endovascular stents with rifampin. The patient was managed with a rifampin-coated endovascular stent graft without any major complications. Postoperatively, the patient did not demonstrate any neurological deficits nor any vascular compromise. He remained afebrile during his postoperative course and was extubated sometime thereafter. He was then transferred to the ward for additional monitoring prior to his discharge to a rehab hospital while being on long-term antibiotics. During his hospital stay, he was monitored with serial ultrasounds to ensure the absence of abscess formation, aortic aneurysm growth or graft endoleak. At 6 weeks after stent graft placement, he underwent a CT scan, which showed a patent stent graft, with a residual sac size of 2.5 cm without any evidence of abscess or endoleak. Over a follow-up period of 180 days, the patient remained asymptomatic while remaining on long-term antibiotics. Thus, in patients whose surgical risk is prohibitive, endovascular stent grafts can be used as a bridge to definitive surgical management.


1994 ◽  
Vol 5 (6) ◽  
pp. 843-847 ◽  
Author(s):  
Joseph W. Yedlicka ◽  
Hector Ferral ◽  
Haraldur Bjarnason ◽  
David W. Hunter ◽  
Wilfrido R. Castaneda-Zuniga ◽  
...  

1994 ◽  
Vol 4 (4) ◽  
pp. 390-394 ◽  
Author(s):  
Jassim M. Abdulhamed ◽  
Saad Al Yousef ◽  
Mohamed A. Ali Khan ◽  
Martin O'Laughlin

AbstractThree patients aged five years, five years four months and 14 years with obstruction of the systemic venous baffle following the Mustard operation were treated with balloon dilation and implantation ofstents. Balloon dilation of the baffle obstruction was performed initially in the first two cases. In the third case, the obstruction was complete and was punctured with atranseptal needle via a 6 French transeptal sheath followed by a balloon dilation. in all three patients, a Palmaz stent (Johnson & Johnson, Summerville, New Jersey, USA) was loaded onto the balloon catheter and delivered into the stenotic area. There was complete relief of obstruction in allcases. The first case developed supraventricular tachycardia at the time ofcatheterization, the morning following implantation of the stent and thentwo weeks after that. There were no complications with catheterization and noshort-term side effects in the other cases. These cases illustrate the use of endovascular stents in the treatment of baffle obstruction.


Author(s):  
Jun Arai ◽  
Kiyotaka IWASAKI ◽  
Xiaodong ZHU ◽  
Takafumi OBA ◽  
Hirotsugu TOKUTAKE ◽  
...  

2000 ◽  
Author(s):  
R. O. Ritchie

Abstract The human heat rate is roughly 40 million beats per year. To prosthetic implants such as mechanical heart valves and endovascular stents, this means that they must endure almost 109 fatigue cycles during the patient’s lifetime. To prevent premature mechanical failures of such devices, which inevitably lead to patient fatalities, considerations of damage-tolerant design and life-prediction methodologies represent a preferred approach. In this presentation, a damage-tolerant approach to life prediction and “quality control” for both metallic and ceramic heart valve prostheses is presented, based on the notion that the useful life of the device is governed by the time for incipient defects in the material to propagate, by stress corrosion or more critically fatigue, to failure. Based on these analyses, the relative benefits of metallic (Co-Cr, Ti-6Al-4V) vs. ceramic (pyrolytic carbon) valves are discussed. Finally, analogous considerations are presented for endovascular stents, particularly those processed by laser cutting of the superelastic Ni-Ti alloy Nitinol. Again, the relative benefits of Nitinol vs. more traditional metallic implant materials (stainless steel, Co-Cr, titanium, titanium alloys) are discussed.


2010 ◽  
Vol 10 (3) ◽  
pp. 128-135 ◽  
Author(s):  
Clifton R. Johnston ◽  
Kogan Lee ◽  
Jacqueline Flewitt ◽  
Randy Moore ◽  
Gary M. Dobson ◽  
...  

Urology ◽  
2018 ◽  
Vol 118 ◽  
pp. 239-240
Author(s):  
Juan D. Garisto ◽  
Julien Dagenais ◽  
Yaw Nyame ◽  
Daniel Sagalovich ◽  
Riccardo Bertolo ◽  
...  

TH Open ◽  
2020 ◽  
Vol 04 (03) ◽  
pp. e189-e196
Author(s):  
Deepti M. Warad ◽  
Amulya Nageswara Rao ◽  
Haraldur Bjarnason ◽  
Vilmarie Rodriguez

Abstract Introduction May–Thurner syndrome (MTS) is a vascular anatomic variant resulting in compression of the left common iliac vein by the right common iliac artery, affecting approximately 22% of the population. In adults, following acute deep vein thrombosis (DVT) of the iliofemoral veins, the incidence of postthrombotic syndrome (PTS) and recurrent DVT are high if treated with anticoagulation alone, warranting adjunctive treatment with thrombolysis and stent placement. However, there is paucity of literature documenting the course of treatment and associated outcomes in pediatric patients with MTS. Methods A retrospective chart review of pediatric patients (≤ 18 years of age) with radiologic confirmation of MTS with or without DVT evaluated and/or treated at our institution from January 1, 2005 through December 31, 2015 was conducted. Results Seventeen patients (4 male; 13 female) were identified. Median age was 15.4 years (range 8.8–17.1 years) with a median follow-up of 1.2 years (range 0.4–7.5 years). Thirteen (76.5%) patients presented with left lower extremity DVT. Management included catheter-directed thrombolysis (n = 5), systemic thrombolysis (n = 1), and mechanical thrombectomy (n = 1). Fifteen patients were treated with anticoagulation including two patients with endovascular stents without DVT. Median duration of anticoagulation was 6.3 months (range 3.2–18.7 months). Ten patients (59%) underwent stent placements.Complete and partial thrombus resolution was noted in six patients each and no resolution in one patient. Four patients had recurrence/progression of thrombus (n = 3 with stents) at a median time of 29 days (range 12–495 days). No bleeding complications were observed. Clinically documented or self-reported PTS was noted in 8 patients (62%). Conclusion There are no clear guidelines for MTS management in children and adolescents. In our cohort, thrombolysis, anticoagulation, or stent placements were not associated with bleeding risks, with recurrence/progression of DVT and signs and symptoms of PTS noted in 30 and 62%, respectively. Further studies are needed to determine a standardized treatment approach of the pediatric patient with MTS with or without thrombosis.


2001 ◽  
Vol 711 ◽  
Author(s):  
Alisa S. Morss ◽  
Philip Seifert ◽  
Adam Groothius ◽  
Danielle Bornstein ◽  
Campbell Rogers ◽  
...  

ABSTRACTEndovascular stents can be altered to improve radioopacity by applying a gold coating. We examined the vascular response in porcine coronary arteries to implantation of 9 mm NIR® stents that were either left intact, gold-coated, or heat-treated following gold coating. Our results show that while gold coating exacerbates neointimal hyperplasia and the inflammatory response, heat treatment removes this negative effect. Heat treatment was shown to increase the diffusion at the gold-steel interface and reduce the surface roughness.


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