scholarly journals SHORT-TERM RESULTS OF ENDOVASCULAR TREATMENT FOR OBLITERATING ATHEROSCLEROSIS OF THE LOWER EXTREMITIES ARTERIES IN PATIENTS OVER 70 YEARS OF AGE

2021 ◽  
Vol 20 (2) ◽  
pp. 38-44
Author(s):  
V.A. Yanushko ◽  
◽  
I.P. Klimchuk ◽  
S.V. Mshar ◽  
G.E. Kordzakhia ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cardiac Failure ◽  
Lower Extremities ◽  
Lower Limbs ◽  
Long Term Results ◽  
Technical Success ◽  
Short Term ◽  
Limb Preservation ◽  
Early Results

Objectives. To analyze short-term results of endovascular treatment for obliterating atherosclerosis of the lower extremities arteries in patients over 70 years of age. Material and methods. From 2015 to 2019, 75 lower limbs were revascularized in 72 patients. Their mean age was 74.7±4.51 years. There were 67 (93%) patients with ischemia of the 3rd - the 4th degree according to Fontaine-Pokrovsky classification. Revascularization of the iliac segment was performed in 35 (48.6%) patients, of the iliofemoral segment - in 5 (7%), the femoral-popliteal segment - in 24 (33.4%), the tibial segment - in 8 (11%) patients. Results. Technical success was attained in 97.2% of cases. The limb preservation was achieved in 100% of cases. Thrombosis of the revascularized artery developed in 2 (2.7%) cases (it was repaired endovascularly). Two patients (2.77%) died of acute cardiac failure. Conclusions. Our study has shown good early results of endovascular treatment for obliterating atherosclerosis of the lower limbs arteries in patients over 70 years of age. High amputations were avoided in 100% of cases. However, an assessment of long-term results is required.

The Evaluation of Aortic Diameter Changes During Long-Term Follow-Up After Endovascular Treatment of Acute Blunt Traumatic Thoracic Aortic Injuries

2018 ◽  
Vol 52 (5) ◽  
pp. 335-343 ◽  
Author(s):  
Federico Fontana ◽  
Edoardo Macchi ◽  
Filippo Piacentino ◽  
Larissa Nocchi Cardim ◽  
Giuseppe De Marchi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Stent Graft ◽  
Mean Value ◽  
Aortic Diameter ◽  
Long Term Results ◽  
Technical Success ◽  
Long Term Follow Up ◽  
Aortic Injuries

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.

Long-term outcomes of wide-necked intracranial bifurcation aneurysms treated with T-stent–assisted coiling

2021 ◽  
Vol 134 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Kubilay Aydin ◽  
Christian Paul Stracke ◽  
Mehmet Barburoglu ◽  
Elif Yamac ◽  
Mynzhylky Berdikhojayev ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Results ◽  
Long Term Results ◽  
Thromboembolic Complications ◽  
Short Term ◽  
Complete Occlusion ◽  
Permanent Morbidity ◽  
Double Stent

OBJECTIVEThe endovascular treatment of complex bifurcation aneurysms possessing a neck that incorporates multiple side branches remains a surgical challenge. Double-stent–assisted coiling techniques, such as those with stents in an X and Y configuration, enable the endovascular treatment of wide-necked complex intracranial bifurcation aneurysms. However, the intraluminal struts at the intersection point in X- and Y-stents are not amenable to endothelialization, which may lead to thromboembolic complications. Stenting in the T configuration is a relatively new double-stent coiling technique. T-stenting differs from X- or Y-stenting in that there are no overlapping or intersecting stent segments. Promising short-term results of T-stent–assisted coiling were recently reported. However, the long-term results have not yet been demonstrated. This retrospective study investigated the long-term angiographic and clinical results in patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent–assisted coiling.METHODSA retrospective review was performed to identify patients with wide-necked complex intracranial bifurcation aneurysms treated with T-stent–assisted coiling at 4 institutions. The technical success and the initial and follow-up clinical and angiographic outcomes were assessed. Aneurysm filling status was assessed according to the Raymond classification. Periprocedural and delayed complications were reviewed. The neurological status of the patients was evaluated using the modified Rankin Scale (mRS).RESULTSOne hundred two aneurysms in 102 patients (54 females), whose mean age was 57.9 ± 13.0 years, were included in the study. T-stenting was performed successfully in all patients. Immediate postprocedural angiography revealed complete occlusion in 83.3% of patients. Periprocedural complications developed in 13.7%, resulting in permanent morbidity in 1.9% and death in 1%. Eighty patients (78.4%) had at least one follow-up DSA examination performed at 6 months or later following the endovascular procedure. The mean duration of angiographic follow-up was 30.0 ± 16.3 months. The last follow-up examinations showed complete occlusion in 90.0% of patients. During the follow-up period, only 1 patient (1.3%) required retreatment. Delayed thromboembolic complications were observed in 4 patients (3.9%) without permanent morbidity. The mRS scores of all patients at the last clinical follow-up were between 0 and 2.CONCLUSIONSThe short-term angiographic findings showed that T-stent–assisted coiling is a feasible and effective endovascular method to treat wide-necked complex bifurcation aneurysms. The long-term angiographic follow-up results suggest that T-stent–assisted coiling provides a durable treatment for wide-necked complex bifurcation aneurysms with favorable clinical outcomes, demonstrating the long-term safety of T-stent–assisted coiling.

Endovascular treatment of visceral artery aneurysms and pseudoaneurysms - evaluation of efficacy and safety based on long-term results

2019 ◽  
Vol 92 (1) ◽  
pp. 1-5
Author(s):  
Krzysztof Pyra ◽  
Maciej Szmygin ◽  
Michał Sojka ◽  
Anna Drelich-Zbroja ◽  
Tomasz Jargiełło
Keyword(s):  
Endovascular Treatment ◽  
Clinical Success ◽  
Long Term Results ◽  
Visceral Artery ◽  
Covered Stents ◽  
Efficacy And Safety ◽  
Technical Success ◽  
Visceral Artery Aneurysms ◽  
Life Threatening

Background: With estimated prevalence of 1% of the general population, visceral artery aneurysms are not a frequent pathology, however, their rupture is a life-threatening occurrence with mortality rate ranging from 10% to 25%, up to 75% in case of pregnant women. Therefore, the identification and treatment of visceral artery aneurysms is of great importance in the prevention of early rupture. Purpose: To assess the effectiveness and safety of treatment of visceral artery aneurysms with various endovascular methods focusing on technical aspects, complications and long-term clinical outcome. Materials and Methods: 60 patients with visceral artery aneurysms were treated percutaneously. Various techniques were used: coiling (23), covered stents (15), thrombin (7), and other mixed techniques. Aneurysm characteristics, size and localization, procedural data, peri-procedural complications, technical success, 90- and 180-day clinical success and follow-up period (aneurysm exclusion, patency of the artery and complications) were prospectively analyzed. Results: Te procedure was performed in 57 of 60 patients. In 56 of 57 patients aneurysms ware effectively excluded. Te success rate was 93.3% (56 of 60 enrolled patients). Technical success after the intervention was 82.4%, after second 98.2%. Embolization with covered stents ware characterized by highest efficiency. Serious complications occurred in 1.8% of cases. Conclusions. The minimally invasive endovascular treatment of visceral artery aneurysms is characterized by high efficacy and safety. Good treatment results depend on proper assessment of the aneurysm’s morphology as well as on selection of the appropriate vascular approach and endovascular technique.

Anticoagulation in addition to dual antiplatelet therapy has no impact on long-term follow-up after endovascular treatment of (sub)acute lower limb ischemia

VASA ◽  
2019 ◽  
Vol 48 (4) ◽  
pp. 321-329
Author(s):  
Mariya Kronlage ◽  
Erwin Blessing ◽  
Oliver J. Müller ◽  
Britta Heilmeier ◽  
Hugo A. Katus ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Limb Ischemia ◽  
Bleeding Complications ◽  
Severe Bleeding ◽  
Short Term ◽  
Long Term Follow Up

Summary. Background: To assess the impact of short- vs. long-term anticoagulation in addition to standard dual antiplatelet therapy (DAPT) upon endovascular treatment of (sub)acute thrombembolic occlusions of the lower extremity. Patient and methods: Retrospective analysis was conducted on 202 patients with a thrombembolic occlusion of lower extremities, followed by crirical limb ischemia that received endovascular treatment including thrombolysis, mechanical thrombectomy, or a combination of both between 2006 and 2015 at a single center. Following antithrombotic regimes were compared: 1) dual antiplatelet therapy, DAPT for 4 weeks (aspirin 100 mg/d and clopidogrel 75 mg/d) upon intervention, followed by a lifelong single antiplatelet therapy; 2) DAPT plus short term anticoagulation for 4 weeks, followed by a lifelong single antiplatelet therapy; 3) DAPT plus long term anticoagulation for > 4 weeks, followed by a lifelong anticoagulation. Results: Endovascular treatment was associated with high immediate revascularization (> 98 %), as well as overall and amputation-free survival rates (> 85 %), independent from the chosen anticoagulation regime in a two-year follow up, p > 0.05. Anticoagulation in addition to standard antiplatelet therapy had no significant effect on patency or freedom from target lesion revascularization (TLR) 24 months upon index procedure for both thrombotic and embolic occlusions. Severe bleeding complications occurred more often in the long-term anticoagulation group (9.3 % vs. 5.6 % (short-term group) and 6.5 % (DAPT group), p > 0.05). Conclusions: Our observational study demonstrates that the choice of an antithrombotic regime had no impact on the long-term follow-up after endovascular treatment of acute thrombembolic limb ischemia whereas prolonged anticoagulation was associated with a nominal increase in severe bleeding complications.

Long-Term Results of Radioscapholunate Fusion Following Fractures of the Distal Radius

1997 ◽  
Vol 22 (6) ◽  
pp. 705-710 ◽  
Author(s):  
L. NAGY ◽  
U. BÜCHLER
Keyword(s):  
Long Term Results ◽  
Short Term ◽  
Non Union ◽  
Partial Fusion ◽  
Traumatic Lesions ◽  
Residual Motion ◽  
Radioscapholunate Fusion ◽  
Wrist Fusion

Fifteen patients with radioscapholunate (RSL) fusion for traumatic lesions of the radiocarpal junction, whose short-term results have been previously reported, were reassessed after an average follow-up time of 8 years. Five patients had undergone wrist fusion because of non-union or early progressive arthritis. Of the ten wrists with retained mobility, eight continued to function satisfactorily. Two wrists were painful for reasons other than secondary midcarpal arthritis. Patient satisfaction was comparable in both groups with the wrist score better for wrists with residual motion. The survival of RSL partial wrist fusion corresponded inversely with the number of preceding operations and the range of motion before partial fusion. Secondary midcarpal arthritis, if present, arose early and was well tolerated. Failures were strongly linked to technical mistakes and complications.

Long-Term Deformations of Strengthened Reinforced Concrete Linear Elements

2016 ◽  
Vol 691 ◽  
pp. 51-60 ◽  
Author(s):  
Martin Krizma ◽  
Lubomir Bolha
Keyword(s):  
Reinforced Concrete ◽  
Long Term Results ◽  
Short Term ◽  
Limit States ◽  
Linear Elements ◽  
Repeated Load ◽  
The Moment ◽  
Concrete Elements ◽  
Fiber Fabric

The issue of strengthening the damaged linear reinforced concrete elements have been engaged since 2008. We focused on the analysis of resistance and the characteristics of limit states of serviceability in the damaged and subsequently strengthened elements at a short-term loading. In the introduction phase, the strengthening of the elements was carried out with the following procedures – installation of an overlayer on the coupling board or a combination of the board and use of glass – fiber fabric (GFRP). The strengthening was also affected by the type of contact (reinforced/non-reinforced) – the deformed element/coupling board and its effect on resistance, type of deformation and serviceability. In the non-reinforced contact, we applied some of the types of adjustments to the surface of the strengthened element. At the moment, we are dealing with the effects of time and repeated load on the strengthened elements. The results correspond to the reinforced contact. The values are compared with the short-term results of the strengthened beams and with the long-term results of the beams prepared for strengthening.

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