Endoluminal Repair of Abdominal Aortic Aneurysms: Strengths and Weaknesses of Various Prostheses Observed in a 4.5-Year Experience

1997 ◽  
Vol 4 (2) ◽  
pp. 147-151 ◽  
Author(s):  
James May ◽  
Geoffrey H. White ◽  
Weiyun Yu ◽  
Richard Waugh ◽  
Michael S. Stephen ◽  
...  
Keyword(s):  
Vascular Complications ◽  
Aortic Aneurysms ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endoluminal Repair ◽  
Abdominal Aortic ◽  
Contrast Enhanced ◽  
Fluoroscopic Control ◽  
Enhanced Computed Tomography

Purpose: To summarize the results of endovascular abdominal aortic aneurysm (AAA) treatment using several endograft designs over a 4.5-year experience and offer comparisons on the various devices. Methods: From May 1992 to August 1996, 121 AAA patients meeting the criteria for an endoluminal repair were treated with 1 of 5 endograft designs in three configurations. The endografts were implanted in the operating room under fluoroscopic control. Follow-up included contrast-enhanced computed tomography within 10 days of operation, 6 months postoperatively, and annually thereafter. Results: Endografts were successfully deployed in 106 patients (88%). Fifteen cases were converted to open repair. Six procedure-related deaths occurred within 30 days owing to myocardial infarction (3), combined renal failure and septicemia (2), and multisystem failure (1). There were 36 local/vascular complications (30%) and 18 systemic/remote complications (15%). Of the 121 patients undergoing endoluminal AAA repair, 93 (77%) are currently alive and well with their AAAs excluded from the circulation. Conclusions: Trends in endoluminal AAA repair and prosthetic design point toward simpler devices and earlier treatment of smaller aneurysms once the long-term outcome of aortic endografting has been determined.

scholarly journals Diagnosis and Outcome of Cardiac Paragangliomas: A Retrospective Observational Cohort Study in China

2022 ◽  
Vol 8 ◽  
Author(s):  
Xueqi Dong ◽  
Xu Meng ◽  
Ting Zhang ◽  
Lin Zhao ◽  
Fang Liu ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Contrast Enhanced ◽  
Octreotide Scintigraphy ◽  
Great Vessels ◽  
Observational Cohort ◽  
Biochemical Remission ◽  
Enhanced Computed Tomography

Background: Cardiac paragangliomas (CPGLs) are rare neuroendocrine tumors that are easily overlooked and difficult to diagnose. Detailed comprehensive data regarding CPGL diagnosis and outcome are lacking.Methods: We retrospectively analyzed a cohort of 27 CPGL patients. This cohort represents the largest such cohort reported to date.Results: The prevalence of trilogy symptoms (concurrent palpitations, hyperhidrosis, and headache) was frequent (9/27, 33.3%). Sensitivity of echocardiography and contrast-enhanced computed tomography for localization of CPGL were 81.8% and 87%, respectively. Octreotide scintigraphy showed 100% sensitivity for detecting GPCLs, while sensitivity of I131-metaiodoben-zylguanidine scintigraphy was only 32.9%. Multiple tumors were found in 29.6% of patients. Most CPGLs originated from the epicardium or root of the great vessels (92.9%) and were mostly supplied by the coronary arteries and their branches (95.7%). Twenty-four patients underwent surgical treatment. Although local invasion was present in 40.0% of patients, it did not affect long-term outcome. Mean follow-up was 6.9 ± 3.6 years. Biochemical remission was achieved in 85% of patients. The recurrence rate was 15%.Conclusions: Manifestations of CPGLs are non-specific and they can be difficult to detect on imaging examinations. Octreotide scintigraphy should be performed in patients with suspected paragangliomas to screen for multiple lesions. Surgical resection of CPGLs can achieve symptom relief and biochemical remission.

scholarly journals Perioperative, Postoperative, and Long-Term Outcomes Following Open Surgical Repair of Ruptured Abdominal Aortic Aneurysm

Angiology ◽  
2020 ◽  
Vol 71 (7) ◽  
pp. 626-632 ◽  
Author(s):  
Hashem M. Barakat ◽  
Yousef Shahin ◽  
Waqas Din ◽  
Bankole Akomolafe ◽  
Brian F. Johnson ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Surgical Repair ◽  
Aortic Aneurysms ◽  
Long Term Outcomes ◽  
Open Surgical Repair ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Abdominal Aortic ◽  
Postoperative Myocardial Infarction

We investigated factors that affected perioperative, postoperative, and long-term outcomes of patients who underwent open emergency surgical repair of ruptured abdominal aortic aneurysms (RAAA). All patients who underwent open emergency surgical repair from 1990 to 2011 were included (463 patients; 374 [81%] male; mean age 74.7 ± 8.7years). Logistic and Cox regression analyses were performed to explore the association of variables with outcomes. Preoperatively, median (interquartile range) hemoglobin was 11.2 (9.5-12.8) g/dL, and median creatinine level was 140 (112-177) µmol/L. Intraoperatively, the median operative time was 2.25 (2-3) hours, and median estimated blood loss was 1.5 (0.5-3) L; 250 (54%) patients required intraoperative inotropes, and a median of 6 (4-8) units of blood was transfused. Median length of hospital stay was 11 (7-20) days. In-hospital mortality rate was 35.6%, and 5-year mortality was 48%. Age, distance traveled, operation duration, postoperative myocardial infarction (MI), and multi-organ failure (MOF) were predictors of in-hospital mortality and long-term outcome. Additionally, postoperative acute renal failure predicted in-hospital mortality. In patients with RAAA undergoing open surgical repair, the strongest predictors of in-hospital mortality and long-term outcome were postoperative MOF and MI and operative duration.

scholarly journals OP0146 LONG TERM OUTCOME AND PROGNOSIS FACTORS OF ISOLATED AORTITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 93.1-93
Author(s):  
Y. Ferfar ◽  
S. Morinet ◽  
O. Espitia ◽  
C. Agard ◽  
M. Vautier ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Giant Cell Arteritis ◽  
Takayasu Arteritis ◽  
Vascular Complications ◽  
Event Free Survival ◽  
Prognosis Factors ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Survival

Background:Aortitis is a group of disorders characterized by the inflammation of the aorta. The most common causes of aortitis are the large-vessel vasculitis i.e. giant cell arteritis (GCA) and Takayasu arteritis (TA). However, aortitis may be isolated. Because of the wide variation in the course of aortitis, predicting outcome is challenging. The optimal management strategy of isolated aortitis (IA) is still unclear as IA is poorly defined, with data consisting of small retrospective and case control studies.Objectives:To assess the long-term outcome and prognosis factors for vascular complications in patients with isolated aortitis.Methods:Retrospective multicenter study of 353 patients with non-infectious aortitis including 136 giant cell arteritis (GCA), 96 Takayasu arteritis (TA) and 73 isolated aortitis (IA). Factors associated with event-free survival, vascular event-free survival and revascularization-free survival were assessed. Risk factors for vascular complications were identified in multivariate analysis.Results:After a median follow up of 52 months, vascular complications were observed in 32.3 %, revascularization in 30 % and death in 7.6%. The 5-year cumulative incidence of vascular complications was 58% (41; 71), 20% (13; 29), and 19 % (11; 28) in IA, GCA and TA, respectively. In multivariate analysis, IA [HR, 1.85 (1.19 to 2.88), p=0.017] and male gender [1.77 (1.26 to 2.49), p<0.0001] were independently associated with vascular events. The 5-year surgery-free survival was 45% (31; 65), 71% (62; 81) and 76% (68; 86) in IA, TA and GCA, respectively.Conclusion:IA has a worse vascular prognosis than GCA and TA. Sixty percent of IA patients will experience a vascular complication within 5 years from diagnosis.Disclosure of Interests:None declared

Long-term outcome after percutaneous closure of persistent left superior caval vein draining into the left atrium: a contrast-enhanced CT study

2017 ◽  
Vol 27 (8) ◽  
pp. 1550-1556 ◽  
Author(s):  
Davide Marini ◽  
Matteo Castagno ◽  
Michele Millesimo ◽  
Francesca Ferroni ◽  
Gaetana Ferraro ◽  
...  
Keyword(s):  
Left Atrium ◽  
Percutaneous Closure ◽  
Caval Vein ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Superior Caval Vein ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct

AbstractBackgroundData regarding long-term outcome after percutaneous closure of left superior caval vein draining into the left atrium are lacking. The aim of the present study was to report the long-term follow-up by using contrast-enhanced CT.MethodsIn all, three patients underwent percutaneous closure of left superior caval vein draining into the left atrium between 2005 and 2015. All of them were evaluated clinically and underwent contrast-enhanced CT.ResultsIn one patient, the Amplatzer® Septal Occluder was used. In two patients, the Amplatzer® Vascular Plug type-1 was preferred: the device size/LSVC diameter ratio was 1.7 in the child and 1.2 in the adult. There were no early-onset or long-term onset complications. CT was performed 1, 2, and 10 years after the procedure, respectively. Complete occlusion of the vessel was documented in all. After 10 years since the procedure, CT revealed a persistent trivial residual shunt through the accessory hemiazygos vein in one patient, in whom the device was implanted above its drainage into the left superior caval vein. When an Amplatzer® Vascular Plug type-1 is oversized compared with the venous vessel diameter, it immediately assumes a dog-bone shape that disappears early to regain its shape memory and nominal size.ConclusionsPercutaneous occlusion of left superior caval vein draining into the left atrium has excellent early and long-term outcomes. The optimal implantation of the device is below the drainage of the accessory hemiazygos vein, when present. The device might be oversized compared with the left superior caval vein diameter according to the age of the patient.

Abstract 2008: Impact of Hyperglycemia on Myocardial Damage and its Prognostic Implications in Patients with Acute ST-Segment Elevation Myocardial Infarction (STEMI) Assessed by Contrast-Enhanced Cardiac Magnetic Resonance Imaging (CMR)

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Christoph J Jensen ◽  
Markus Jochims ◽  
Kai Nassenstein ◽  
Michael Bell ◽  
Thomas Schlosser ◽  
...  
Keyword(s):  
Logistic Regression Model ◽  
Microvascular Obstruction ◽  
Myocardial Damage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Glucose Levels ◽  
Contrast Enhanced ◽  
Lv Mass ◽  
The Impact

To investigate the impact of admission glucose levels on myocardial damage and long term outcome in patients with acute STEMI using contrast-enhanced CMR. 130 consecutive patients (104 males; mean age 59.4±11.8 years) with first reperfused STEMI were included. Hyperglycemia was defined as glucose levels above 7.8mmol/l. CMR was performed within 3.9±2.2 days after admission on a 1.5 Tesla MR System. The imaging protocol included SSFP cine sequences for the calculation of LV function, volumes and mass. Total no reflow volumes (NRV) and delayed enhancement volumes (DEV) were calculated from planimetry of the IR-SSFP stacks of short axis images by disc-summation performed early / late following administration of 0.2mmol/kg/BW of gadodiamid. NRV and DEV were expressed as percent of LV Mass (NR%, DE%). Continuous variables were compared by Mann-Whitney test. Correlation of admission hyperglycemia and NR% was tested by spearman rank test. Patients were prospectively followed for 30±9 months. A stepwise logistic regression model was used to analyze the impact of hyperglycemia and CMR parameters on NR% and outcome. 55 of 130 (42%) patients had hyperglycemia on admission. Patients with admission hyperglycemia had lower LV ejection fraction (38.6±12.9% vs. 47.7±11.9%, p=0.001), greater ESV (89.2±39.2ml vs. 71.7±34.1ml, p=0.002), greater LV Mass (156.7±40.4g vs. 136.3±36.7g, p=0.003), larger DE% (19.3±13.8% vs. 9.7±8.5%, p<0.001) and larger NR% (8.1± 9.2% vs. 2.3± 4.2%, p<0.001). Admission hyperglycemia correlated moderate but significant to DE% (r=0.386, p<0.001) and NR% (r=0.421, p<0.001). In a multivariable logistic regression model admission hyperglycemia was an independent predictor (OR 6.8; CI 2.8 −16.6) of extensive (> median) microvascular obstruction, extensive delayed enhancement (OR 3.2; CI 1.5–7.1) and was associated with an increased risk for death and reinfarction (OR 4.7; CI 1.2–18.3) during follow up. Admission hyperglycemia in acute, reperfused STEMI is independently related to the extent of microvascular obstruction on early contrast-enhanced CMR and is associated with worse long-term outcome. Thus, CMR may play a major role in monitoring effects of glucose control on myocardial damage in AMI.

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