scholarly journals The Mini-Cross Prefenestration for Endovascular Repair of Aortic Arch Pathologies

2022 ◽  
Vol 8 ◽  
Author(s):  
Yifei Pei ◽  
Hongqiao Zhu ◽  
Yu Xiao ◽  
Jian Zhou ◽  
Zaiping Jing
Keyword(s):  
Aortic Dissection ◽  
Light Microscopy ◽  
Aortic Arch ◽  
Fatigue Test ◽  
Endovascular Repair ◽  
The Novel ◽  
Efficacy And Safety ◽  
Stent Grafts ◽  
Novel Technique

Objective: To examine the feasibility, integrity, efficacy, and safety of endovascular repair of the aortic arch pathologies with the mini-cross prefenestration (MCPF) on stent grafts.Methods: First, to prove the feasibility of the MCPF, an in-vitro prefenestration experiment was conducted. Second, to examine the integrity of the MCPF stent grafts, a fatigue test was conducted. Then, the membranes and metal structures of stent grafts were examined by light microscopy and scanning electron microscopy (SEM). Third, a clinical experiment was conducted to investigate the efficacy and safety of this novel technique (ClinicalTrials.gov Identifier: NCT04544579).Results: All the 12 branch stents were successfully implanted and flared in vitro. After the fatigue test stimulating a 5-year cardiac cycle, no obvious disintegration or fracture was found in light microscopy or SEM. From December 2017 to February 2020, 26 patients with left subclavian arteries and/or left common carotid arteries involved received the novel technique. The endovascular repair with the MCPF was successfully performed on all the 26 (100%) patients. Eighteen (69.2%) patients underwent the reconstruction of the left subclavian artery (LSCA) only. The fenestrations of both the LSCA and left common carotid artery (LCCA) were conducted in 8 (30.8%) patients. Median operative time was 120 [interquartile range (IQR), 95–137.5] min and median revascularization time of the LSCA and LCCA was 30.5 (IQR, 22.8–42.0) s and 20.0 (IQR, 18.0–32.0) s separately. During the median follow-up duration of 38.9 (range, 18.8–44.2) months, one case needed an open surgery because of retrograde type A aortic dissection 3 months after implantation and no other complications or mortality occurred. The maximum aortic diameters were significantly decreased in patients with thoracic aortic dissection and thoracic aortic aneurysm (p < 0.05).Conclusion: The existing evidence demonstrated the safety, rapid branch artery revascularization, and positive aortic remodeling of the novel technique. Long-term observation is warranted to prove the durability.

scholarly journals Development of a gel dedicated to gel immersion endoscopy

2021 ◽  
Vol 09 (06) ◽  
pp. E918-E924
Author(s):  
Tomonori Yano ◽  
Atsushi Ohata ◽  
Yuji Hiraki ◽  
Makoto Tanaka ◽  
Satoshi Shinozaki ◽  
...  
Keyword(s):  
Electrical Conductivity ◽  
Porcine Model ◽  
Ex Vivo ◽  
In Vitro Experiments ◽  
Efficacy And Safety ◽  
Coagulative Necrosis ◽  
Novel Technique ◽  
In Vivo Experiments

Abstract Backgrounds and study aims Gel immersion endoscopy is a novel technique to secure the visual field during endoscopy. The aim of this study was to develop a dedicated gel for this technique. Methods To identify appropriate viscoelasticity and electrical conductivity, various gels were examined. Based on these results, the dedicated gel “OPF-203” was developed. Efficacy and safety of OPF-203 were evaluated in a porcine model. Results  In vitro experiments showed that a viscosity of 230 to 1900 mPa·s, loss tangent (tanδ) ≤ 0.6, and hardness of 240 to 540 N/cm2 were suitable. Ex vivo experiments showed electrical conductivity ≤ 220 μS/cm is appropriate. In vivo experiments using gastrointestinal bleeding showed that OPF-203 provided clear visualization compared to water. After electrocoagulation of gastric mucosa in OPF-203, severe coagulative necrosis was not observed in the muscularis but limited to the mucosa. Conclusions OPF-203 is useful for gel immersion endoscopy.

Rapid Novel Aortic Arch Replacement for Thoracic Aortic Aneurysm Using Three Continuous Sutures and a Felt Cylindrical Collar

2011 ◽  
Vol 6 (5) ◽  
pp. 344-346
Author(s):  
Go Watanabe ◽  
Hiroshi Ohtake ◽  
Shigeyuki Tomita
Keyword(s):  
Aortic Arch ◽  
Circulatory Arrest ◽  
Prosthetic Graft ◽  
Hospital Death ◽  
Anastomotic Site ◽  
The Novel ◽  
Aortic Arch Replacement ◽  
Descending Aorta ◽  
Novel Technique ◽  
The Mean

This report describes the novel parachute technique of open distal anastomosis at the aortic arch replacement. Two Teflon felt cylindrical collars were initially placed on the anastomotic site of the descending aorta. All four to five outer loops of the stitches used in the parachute technique were tracked by the gathering suture. The anastomotic sutures and three gathering sutures were finally pulled simultaneously. The prosthetic graft and the aortic stump with Teflon felt were safely and completely anastomosed. Surgical or hospital death and serious complications were not found. The mean anastomotic duration (circulatory arrest duration) in 16 patients was 23 minutes. Our novel technique using a Teflon felt cylindrical collar and modified continuous suturing was not only safe but also reduced the duration of anastomosis and minimized blood loss. This technique is simple and can be applied to aortic valve replacement.

scholarly journals Aortic Dissection with Rare Anatomical Aortic Arch Variation Depicted by Computed Tomography Angiography

2021 ◽  
Vol 24 (2) ◽  
pp. E407-E408
Author(s):  
Xin Wang ◽  
Bofu Liu ◽  
Haifang Yu
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Aortic Dissection ◽  
Effective Treatment ◽  
Aortic Arch ◽  
Endovascular Repair ◽  
Computed Tomography Angiography ◽  
Chest Trauma ◽  
Life Threatening ◽  
Treatment Surgery

Aortic dissection (AD) is a life-threatening disease, and endovascular repair by stent graft is an effective treatment. Surgery often fails for a variety of reasons, such as aortic arch variation. We present the case of a 27-year-old female with aortic dissection with a rare anatomical aortic arch variation caused by chest trauma. This patient recovered well after endovascular repair. This case report demonstrates endovascular repair can be applied to aortic dissection patients with rare anatomical aortic arch variation.

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