Treatment of Traumatic False Aneurysm of the Thoracic Aorta with Endoluminal Grafts

1998 ◽  
Vol 5 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Arvind Deshpande ◽  
Peter Mossop ◽  
John Gurry ◽  
Gary Frydman ◽  
George Matalanis ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
False Aneurysm ◽  
Complex Problem ◽  
Great Accuracy ◽  
Stent Grafts ◽  
Computed Tomographic ◽  
Thoracic Approach ◽  
Male Patients ◽  
Conventional Open Surgery ◽  
Endoluminal Stent

Purpose: Traumatic false aneurysms of the thoracic aorta presenting at a time remote from the original injury are a rare but complex problem. The treatment of a traumatic false aneurysm by endovascular techniques may offer many advantages over conventional open surgery. Methods and Results: Two male patients presented with traumatic false aneurysm of the thoracic aorta after being treated emergently for visceral injuries from a gunshot wound in one and an automobile accident in the other. In both cases, the aneurysm was situated so that only the T11 intercostal artery would be sacrificed by endoluminal exclusion. Commercially available endoluminal stent-grafts (Talent) were deployed successfully. Recovery in both patients was rapid and uneventful with no neurological sequelae. Spiral computed tomographic scans at 1 year indicated sustained aneurysm exclusion and satisfactory endograft position. Conclusions: A customized endoluminal stent-graft can be used with great accuracy to exclude thoracic false aneurysms, avoiding the potential complexity and morbidity of an open thoracic approach.

Acute Traumatic Rupture of the Thoracic Aorta Treated with Endoluminal Stent Grafts

2002 ◽  
Vol 52 (6) ◽  
pp. 1173-1177 ◽  
Author(s):  
Charles S. Thompson ◽  
Julio A. Rodriguez ◽  
Venkatesh G. Ramaiah ◽  
Leanne DiMugno ◽  
Shoaib Shafique ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Traumatic Rupture ◽  
Stent Grafts ◽  
Endoluminal Stent

Thoracic Aortic Aneurysm Repair with Endovascular Stent-Grafts

1997 ◽  
Vol 2 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Charles P Semba ◽  
R Scott Mitchell ◽  
D Craig Miller ◽  
Noriyuki Kato ◽  
Stephen T Kee ◽  
...  
Keyword(s):  
High Risk ◽  
Aortic Aneurysm ◽  
Stent Graft ◽  
Aortic Aneurysms ◽  
Stent Grafts ◽  
Thoracic Aortic Aneurysms ◽  
Risk Patients ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair ◽  
Endoluminal Stent

The purpose of the study was to describe the clinical experience in using endoluminal stent-grafts for the treatment of thoracic aortic aneurysms in high-risk patients. Patients with aneurysms of the descending thoracic aorta who were considered high surgical risks underwent evaluation for endoluminal repair. The prosthesis was constructed from Z stents covered with polyester fabric using dimensions based upon preprocedural computed tomography scans and angiography. Through a femoral arteriotomy or left retroperitoneal flank incision, a 22–24 Fr delivery catheter was inserted and advanced through the aorta to the target site under fluoroscopic guidance in the operating suite. The stent-graft prosthesis was deployed at the site of the aneurysm. 44 patients (36 male, 8 female; mean age 36 years) underwent stent-graft repair for thoracic aneurysms (mean diameter 6.3 cm). The deployment was technically successful in all cases, with complete aneurysm thrombosis in 88%. The 30-day perioperative mortality rate was 6.8% and 35-month actuarial survival was 82%. There were no cases of stent migration, surgical conversion or intraprocedural death. Paraplegia occurred in two patients who underwent simultaneous surgical infrarenal aortic aneurysm repair immediately followed by stent-graft placement for a coexisting thoracic aneurysm. The conclusion was that placement of endoluminal stent-grafts for repair of thoracic aortic aneurysms is technically feasible in high-risk patients in whom conventional surgery is contraindicated. Long-term studies are needed to determine protection against aneurysm rupture and patient survival.

scholarly journals Three-dimensional positional assessment of glenoid fossae and mandibular condyles in patients with Class II subdivision malocclusion

2017 ◽  
Vol 87 (6) ◽  
pp. 847-854 ◽  
Author(s):  
Juliana Macêdo de Mattos ◽  
Juan Martin Palomo ◽  
Antonio Carlos de Oliveira Ruellas ◽  
Paula Loureiro Cheib ◽  
Manhal Eliliwi ◽  
...  
Keyword(s):  
Three Dimensional ◽  
Sella Turcica ◽  
Class Ii ◽  
Cranial Base ◽  
Class Ii Malocclusion ◽  
Computed Tomographic ◽  
Anterior Cranial Base ◽  
Condylar Position ◽  
Male Patients ◽  
Anterior Posterior

ABSTRACT Objectives: To test the null hypotheses that the positions of the glenoid fossae and mandibular condyles are identical on the Class I and Class II sides of patients with Class II subdivision malocclusion. Materials and Methods: Retrospective three-dimensional (3D) assessments of the positions of the glenoid fossae and mandibular condyles were made in patients with Class II malocclusion. Relative to a fiducial reference at the anterior cranial base, distances from the glenoid fossae and condyles were calculated in pretreatment cone beam computed tomographic scans of 82 patients: 41 with Class II and 41 with Class II subdivision malocclusions. The 3D distances from glenoid fossae to sella turcica in the X (right-left), Y (anterior-posterior), Z (inferior-superior) projections were calculated. Results: Patients with Class II malocclusion displayed a symmetric position of the glenoid fossae and condyles with no statistically significant differences between sides (P > .05), whereas patients with Class II subdivision showed asymmetry in the distance between the glenoid fossae and anterior cranial base or sella turcica (P < .05), with distally and laterally positioned glenoid fossae on the Class II side. (P < .05). Male patients had greater distances between glenoid fossae and anterior cranial fossae (P < .05). The condylar position relative to the glenoid fossae did not differ between the two malocclusion groups nor between males and females (P > .05). Conclusions: The null hypotheses were rejected. Patients with Class II subdivision malocclusion displayed asymmetrically positioned right- and left-side glenoid fossae, with a distally and laterally positioned Class II side, although the condyles were symmetrically positioned within the glenoid fossae.

Mycotic Aneurysms of the Thoracic Aorta: Repair with Use of Endovascular Stent-Grafts

1998 ◽  
Vol 9 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Charles P. Semba ◽  
Toyohiko Sakai ◽  
Suzanne M. Slonim ◽  
Mahmood K. Razavi ◽  
Steven T. Kee ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Endovascular Stent ◽  
Stent Grafts ◽  
Mycotic Aneurysms

scholarly journals Chimney technique with endoanchors in treatment of late type 1a endoleak after endovascular aortic repair

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095301
Author(s):  
Emanuele Gatta ◽  
Gabriele Pagliariccio ◽  
Sara Schiavon ◽  
Carlo Grilli Cicilioni ◽  
Luciano Carbonari
Keyword(s):  
Open Repair ◽  
Endovascular Aortic Repair ◽  
Late Type ◽  
Stent Grafts ◽  
Computed Tomographic ◽  
Chimney Technique ◽  
Aortic Repair ◽  
Computed Tomographic Scan ◽  
Type Ia ◽  
Long Time

The late type Ia endoleak after endovascular aortic repair could be a challenging issue. Over the last years, in case of short or enlarged neck, fenestrated and branched stent grafts have been increasingly employed with improving results. However, these devices have limited use in urgent/emergent cases as custom graft manufacturing takes long time, and may not be fit in patients with particular anatomic features. In this setting, chimney and relining remain an alternative but sometimes may not be adequate. According to literature, the use of the endoanchors associated to chimney technique can improve the procedure results in primary endovascular aortic repair. We treated two patients with a late type Ia endoleak after endovascular aortic repair with a simultaneous relining, single renal chimney, and endoanchors implant. These patients were valuated unfit for open repair with neck configuration unadapt for a simple relining, ballooning, or stenting. The patient conditions were unfavorable for an endovascular repair with branched endovascular aortic repair–fenestrated endovascular aortic repair. The same procedure was performed in both patients. Postoperative angio-computed tomographic scan demonstrated the resolution of the endoleak with patency of renal graft. Our preliminary experience, in these selected cases, demonstrate the feasibility of the technique in late type Ia endoleak.

Thoracic Aorta False Aneurysm: What Surgical Strategy Should Be Recommended?

2006 ◽  
Vol 82 (1) ◽  
pp. 81-89 ◽  
Author(s):  
Mauricio A. Villavicencio ◽  
Thomas A. Orszulak ◽  
Thoralf M. Sundt ◽  
Richard C. Daly ◽  
Joseph A. Dearani ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
False Aneurysm ◽  
Surgical Strategy

MDCT Angiography of Thoracic Aorta Endovascular Stent-Grafts: Pearls and Pitfalls

2009 ◽  
Vol 192 (2) ◽  
pp. 515-524 ◽  
Author(s):  
Jenny K. Hoang ◽  
Santiago Martinez ◽  
Lynne M. Hurwitz
Keyword(s):  
Thoracic Aorta ◽  
Endovascular Stent ◽  
Stent Grafts ◽  
Mdct Angiography

Intraoperative Gutter Leaks That Merit Our Attention

2017 ◽  
Vol 51 (8) ◽  
pp. 555-561 ◽  
Author(s):  
Adam Tanious ◽  
Mathew Wooster ◽  
Marcelo Giarelli ◽  
Paul A. Armstrong ◽  
Martin R. Back ◽  
...  
Keyword(s):  
De Novo ◽  
Computed Tomographic Angiography ◽  
High Flow ◽  
High Rate ◽  
Low Flow ◽  
Stent Grafts ◽  
Index Procedure ◽  
Computed Tomographic ◽  
Tomographic Angiography

Introduction: The natural history and potential morbidity of gutter endoleaks are unclear. We present our experience with intraoperative gutter endoleaks and strategies to determine which of these require intervention. Methods: This is a retrospective review of all patients treated with parallel stent grafts from January 2010 to September 2015. We reviewed all operative records and intraoperative angiograms as well as all postoperative imaging and secondary interventions. All gutter leaks were classified as low-flow/nonsac-enhancing gutter endoleaks or high-flow/sac-enhancing gutter endoleaks. Adjunctive interventions to manage the gutter leaks were noted, as were all subsequent interventions for gutter leak and endoleak management. Results: Seventy-eight patients had 144 parallel stents placed over a 5-year period with an average of 1.8 stents per patient. Twenty-eight patients (36%) had gutter endoleaks diagnosed intraoperatively. Seventeen patients had adjunctive procedures to reduce gutter leaks prior to leaving the operating room (OR). Patients selected for treatment had gutters filling early during completion angiography and/or contrast enhancement of the aneurysm sac. Twenty-two patients (28%) left the OR with low-flow/delayed/nonsac-enhancing gutter endoleaks. At 30 days, a total of 6 persistent gutter endoleaks were diagnosed on computed tomographic angiography. This gives a 73% rate of resolution for low-flow/nonaneurysm sac-enhancing endoleaks. There were 2 de novo endoleaks not detected at the index procedure diagnosed at 6-month follow-up. Of the 8 total postoperative endoleaks, 5 required additional intervention with a 100% success rate. Multivariate analysis revealed that the only significant predictor of having a postoperative endoleak is leaving the OR with an endoleak. Conclusions: Intraoperative treatment of gutter endoleaks has an acceptable rate of resolution. It does have a high rate of converting high-flow endoleaks to low-flow endoleaks. Low-flow/nonsac-enhancing gutter endoleaks have a high rate of spontaneous resolution. Intraoperative gutter endoleaks are not predictive of future aneurysm sac growth.

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