Our Preliminary Experience and Short Term Results in Endovascular Treatment of Aortic Lesions

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.

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Endovascular treatment of PICA aneurysms with a Low-profile Visualized Intraluminal Support (LVIS Jr) device

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-012070 ◽

2015 ◽

Vol 8 (10) ◽

pp. 1030-1033 ◽

Cited By ~ 15

Author(s):

Edgar A Samaniego ◽

German Abdo ◽

Ricardo A Hanel ◽

Andrey Lima ◽

Santiago Ortega-Gutierrez ◽

...

Keyword(s):

Endovascular Treatment ◽

Acute Phase ◽

Posterior Inferior Cerebellar Artery ◽

Short Term ◽

Small Series ◽

Low Profile ◽

Procedural Complications ◽

Reconstructive Technique ◽

Pica Aneurysms

ObjectiveTo describe the treatment of posterior inferior cerebellar artery (PICA) aneurysms with the Low-profile Visualized Intraluminal Support Device (LVIS Jr) stent.Materials and methodsThe databases of three institutions were retrospectively reviewed. Patients who underwent endovascular treatment of PICA aneurysms using a reconstructive technique where the LVIS Jr stent was totally or partially deployed into the PICA were included in the analysis. Clinical presentation, aneurysm and PICA sizes, procedural complications, and clinical and angiographic follow-up information was recorded and analyzed.ResultsSeven patients who underwent endovascular treatment of PICA aneurysms with an LVIS Jr stent were identified. Four aneurysms were treated in the acute phase of subarachnoid hemorrhage (SAH). There were no symptomatic complications. One patient had spasm distal to the stent as a result of mechanical straightening of the vessel. One patient was treated in the acute phase of SAH and required a gycoprotein IIb/IIIa inhibitor after the stent was implanted. This patient needed to be re-treated to complete embolization. All patients had good clinical outcomes (Glasgow Outcome Scale 5). No in-stent stenosis or occlusion was seen on short-term angiographic follow-up and the aneurysms were occluded.ConclusionsThis small series suggests that the use of a reconstructive technique with the LVIS Jr stent for the treatment of PICA aneurysms is feasible, safe and effective in the short term.

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Procedural Complications During Early Versus Late Endovascular Treatment in Acute Stroke

Stroke ◽

10.1161/strokeaha.120.031349 ◽

2021 ◽

Author(s):

Errikos Maslias ◽

Stefania Nannoni ◽

Federico Ricciardi ◽

Bruno Bartolini ◽

Davide Strambo ◽

...

Keyword(s):

Endovascular Treatment ◽

Acute Stroke ◽

Time Window ◽

National Institutes Of Health ◽

Late Time ◽

Short Term ◽

Term Outcome ◽

Stroke Registry ◽

Short Term Outcome ◽

Procedural Complications

Background and Purpose: Endovascular treatment (EVT) in acute ischemic stroke is effective in the late time window in selected patients. However, the frequency and clinical impact of procedural complications in the early versus late time window has received little attention. Methods: We retrospectively studied all acute ischemic strokes from 2015 to 2019 receiving EVT in the Acute Stroke Registry and Analysis of Lausanne. We compared the procedural EVT complications in the early (<6 hours) versus late (6–24 hours) window and correlated them with short-term clinical outcome. Results: Among 695 acute ischemic strokes receiving EVT (of which 202 were in the late window), 113 (16.3%) had at least one procedural complication. The frequency of each single, and for overall procedural complications was similar for early versus late EVT (16.2% versus 16.3%, P adj =0.90). Procedural complications lead to a significantly less favorable short-term outcome, reflected by the absence of National Institutes of Health Stroke Scale improvement in late EVT (delta-National Institutes of Health Stroke Scale-24 hours, −2.5 versus 2, P adj =0.01). Conclusions: In this retrospective analysis of consecutive EVT, the frequency of procedural complications was similar for early and late EVT patients but very short-term outcome seemed less favorable in late EVT patients with complications.

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Fenestrated versus debranching TEVAR for endovascular treatment of distal aortic arch and descending aortic lesions

Journal of Vascular Surgery ◽

10.1016/j.jvs.2020.10.078 ◽

2020 ◽

Author(s):

Nikolaos Konstantinou ◽

Tilo Kölbel ◽

Eike S. Debus ◽

Fiona Rohlffs ◽

Nikolaos Tsilimparis

Keyword(s):

Endovascular Treatment ◽

Aortic Arch ◽

Aortic Lesions

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Study of Endovascular Treatment in Obstructive Aortoiliac Lesions: Acute and Short Term Results

Indian Heart Journal ◽

10.1016/j.ihj.2019.11.112 ◽

2019 ◽

Vol 71 ◽

pp. S51-S52

Author(s):

O.P.N. Arya ◽

N.U.N. Joshi

Keyword(s):

Endovascular Treatment ◽

Short Term

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Comparison between different modalities of Endovascular treatment in Carotid Cavernous Fistula (CCF) and its short term outcome – Our Experience

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v8i2.42347 ◽

2019 ◽

Vol 8 (2) ◽

pp. 68-76

Author(s):

Mst Shamima Sultana ◽

Md Shafiqul Islam ◽

Md Sumon Rana ◽

Kanij Fatema Ishrat Zahan Rifat ◽

Md Abul Kalam Azad ◽

...

Keyword(s):

Endovascular Treatment ◽

Carotid Cavernous Fistula ◽

Short Term ◽

Term Outcome ◽

Invasive Approach ◽

Cavernous Fistula ◽

Short Term Outcome ◽

Choice Of Treatment ◽

Glue Embolization ◽

Carotid Cavernous Fistulas

Introduction: Endovascular treatment offers different technique (Balloon assisted coiling / simple coiling, glue embolization) to treat Carotid Cavernous Fistula (CCF). This less invasive approach avoids morbidity and residual fistulas. The choice of treatment depends on the anatomy of the fistulas and cost effectiveness. Objective: To describe different endovascular treatment option of Carotid Cavernous fistulas (CCF), its short term outcome (clinical and angiographical) and to compare between trans-venous coiling and trans-arterial balloon assisted sinus coiling. Method: We have treated nine (9) cases of CCF during a period of three years. Out of them eight patients had direct CCF and one had indirect CCF. In two patients simple coiling done through trans-venous route and in another three patients through trans-arterial route. Balloon assisted coiling through trans-arterial route done in three patients. In two patients trans-arterial glue embolization was done. Results: Successful obliteration of fistula was achieved in all cases. Vision was improved in eight (8) patients. Postoperatively some proptosis remains in two patients. In one patient there was reappearance of proptosis two months after treatment, then balloon assisted coiling was done. One patient died from complication of glue (NBCA). Conclusion: Endovascular treatment is the mainstay of treatment in CCF. Trans-venous is the treatment of choice but recently balloon assisted sinus coiling through trans-arterial route is adopted. Bang. J Neurosurgery 2019; 8(2): 68-76

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