Abstract:
OBJECTIVE:Treatment of type B aortic dissections with thoracic endovascular aortic repair (TEVAR) has been adopted in many centers with the goal of covering the proximal entry tear. Coverage of the left subclavian artery (LSCA) is commonly required to achieve a dissection-free proximal seal zone. A novel thoracic single side-branched (TSSB) endograft device offers a potential off-the-shelf option to achieve total endovascular incorporation of LSCA during zone 2 TEVAR. The aim of this study was to determine what percentage of patients with type B aortic dissection who require zone 2 TEVAR meet the anatomical requirements for this device. METHODS:All consecutive patients undergoing TEVAR for type B aortic dissections at a single institution from 2006 to 2016 were evaluated. Three-dimensional centerline reconstruction of preoperative computed tomography angiography was performed to identify the diameter of the aorta, distances between branch vessels, diameter of the target branch vessel, and location of the primary entry tear. Only patients who met criteria for zone 2 TEVAR were included in the analysis. The primary outcome was percentage of patients that meet all anatomical requirements for TSSB. Individual criteria were evaluated independently, and results were stratified by dissection chronicity. RESULTS:Eighty-seven patients who underwent TEVAR for Stanford type B aortic dissections were reviewed. Fifty-seven (66%) would have required zone 2 TEVAR. Indications for TEVAR were malperfusion (12), aneurysm (15), persistent pain (22), rupture (3), uncontrolled hypertension (5), and other (3). Mean follow-up was 19 months (range, 1-72 months). Only 16 of the 57 patients (28%) met all the requirements for anatomic suitability. The primary contributor was that only 49% of patients had sufficient length between arch branches to prevent coverage of a proximal branch. CONCLUSIONS:Although the new TSSB device can allow for a more proximal seal zone and eliminate the need for open aortic arch debranching, only 28% of patients with type B dissection who required zone 2 TEVAR met all the anatomic requirements for this device. Future devices will need to account for the short distance between the left carotid and LSCA to be more broadly applicable.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Magee GA,Veranyan N,Kuo EC,Ham SW,Ziegler KR,Weaver FA,Fleischman F,Bowdish ME,Han SMdoi
10.1016/j.jvs.2019.04.461subject
Has Abstractpub_date
2019-12-01 00:00:00pages
1776-1781issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(19)31128-0journal_volume
70pub_type
杂志文章abstract:BACKGROUND:Much of the brain is perfused by penetrating arteries that are the "single source" of blood to their surrounding tissues. These tissues should be equally vulnerable to ischemia from embolic occlusion, but there are questions about whether emboli have access to the penetrating arteries serving the deep brain ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.091
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The objective of this study is to provide an up-to-date meta-analysis on the short- and long-term mortality rates of elective repair of abdominal aortic aneurysms (AAAs) via the open and endovascular approaches. METHODS:MEDLINE, EMBASE, and Cochrane Central Register of Controlled trials, conference proceedi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2013.02.013
更新日期:2013-06-01 00:00:00
abstract:PURPOSE:Endovascular repair (EVR) is a less-invasive method for the treatment of abdominal aortic aneurysms (AAAs) as compared with open surgical repair (OSR). The potential benefits of EVR include increased patient acceptance, less resource utilization, and cost savings. This study was designed to determine whether th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70237-5
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVE:To evaluate our experience with the endovascular treatment of total occlusions of the mesenteric and celiac arteries. METHODS:We performed a retrospective review of endovascular stenting of 27 nonembolic total occlusions of the superior mesenteric artery (SMA) and celiac artery (CA) between July 2004 and Jul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.12.013
更新日期:2012-06-01 00:00:00
abstract::Surgical repair of proximal right subclavian artery aneurysms can be difficult. They typically require a combined mediastinal exposure to control the innominate and right common carotid arteries and a supra- or infraclavicular exposure for distal control, with either a segmental resection and bypass or a bifurcated re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.07.050
更新日期:2011-02-01 00:00:00
abstract::Serial platelet deposition, surface topography, and patency were evaluated in control (N = 28) and endothelial cell-seeded (N = 28) small-diameter (4 mm inner diameter) USCI Dacron grafts implanted in the carotid and femoral arteries of dogs. All dogs received aspirin (325 mg) daily for 2 weeks starting 24 hours prior...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:Aortic reconstruction for complex thoracoabdominal aortic aneurysms (TAAAs) can be challenging, especially in patients with connective tissue disorders (CTDs) in whom tissue fragility is a major concern. Branched graft reconstruction is a more complex operation compared with inclusion patch repair of the aort...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.03.451
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The effects of a new long-term subcutaneous vascular access device were studied in access-challenged patients who were poor candidates for fistulas or grafts due to venous obstruction. Bacteremia rates, patency, and function of the Hemodialysis Reliable Outflow (HeRO) Vascular Access Device (Hemosphere Inc, M...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jvs.2009.04.014
更新日期:2009-09-01 00:00:00
abstract::Primary portal venous aneurysms are rare; however, they are the most common visceral venous aneurysms, and their pathogenesis is not fully understood. Complications include thrombosis, rupture, and mass effect on adjacent structures. The optimal management of these patients is not known. We describe a patient whose la...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.07.063
更新日期:2011-01-01 00:00:00
abstract:PURPOSE:Although the United Kingdom small aneurysm trial reported no survival benefit for early operation in patients with small (4. 0-5.5 cm) abdominal aortic aneurysms (AAAs), the trial lacked statistical power to detect small but potentially meaningful gains in life expectancy, particularly for specific subgroups. W...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0741-5214(00)90152-6
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVE:Lifelong imaging follow-up is essential to the safe and appropriate management of patients who undergo endovascular abdominal aortic aneurysm repair (EVAR). We sought to evaluate the rate of compliance with imaging follow-up after EVAR and to identify factors associated with being lost to imaging follow-up. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.06.006
更新日期:2015-01-01 00:00:00
abstract::Albeit uncommon, delayed renal dysfunction after endovascular abdominal aortic aneurysm repair (EVAR) can be attributed to proximal stent graft migration or unrecognized partial renal artery coverage. We report two patients who were found to have renal artery occlusion 1 week after EVAR with Zenith (Cook, Bloomington,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.019
更新日期:2008-02-01 00:00:00
abstract::We report a patient with a transient ischemic attack presumably caused by an entrapment of the internal carotid artery by the hyoid bone and without a significant carotid artery stenosis. The patient was operated on, with a release of the right internal and external carotid artery and resection of the right greater co...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.04.062
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate sex-related differences in outcome, defined as amputation rate and survival in patients treated for lower limb ischemia. MATERIAL AND METHOD:Age, sex, and type of procedure for all patients undergoing vascular interventions for lower limb ischemia in Stockholm, Sw...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.120043
更新日期:2002-03-01 00:00:00
abstract::We report the case of an acute type B aortic dissection in association with an unknown isthmic coarctation in a 53-year-old man. An intimal tear was located just distal to the coarctation, and the intimal flap extended to the level of the renal arteries. Hybrid repair was performed successfully 4 months later, without...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.089
更新日期:2014-05-01 00:00:00
abstract::Connective tissue disorders (CTDs) predispose patients to dilation of the entire aorta, resulting in the development of extensive aneurysms. Aortic reconstruction in CTD patients can be challenging and demands specific approaches to ensure initial success and lasting stability of aortic repair. Herein, we describe tec...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.04.044
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Hybrid procedures have gained momentum as less invasive operations that can potentially improve outcomes for patients. However, there is a paucity of data comparing hybrid procedures with traditional bypass. This study compares the perioperative outcomes of hybrid and bypass surgery for femoropopliteal (FP) r...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.01.058
更新日期:2018-11-01 00:00:00
abstract::We present a case of Viabahn (W. L. Gore & Associates, Flagstaff, Ariz) collapse during popliteal artery aneurysm treatment. An elderly man with severe comorbidities presented with a 34-mm popliteal artery aneurysm. Proximal and distal landing sites of 11 and 9 mm, respectively, demonstrated by preoperative computed t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.024
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:This randomized clinical trial compared endovenous laser ablation (EVLA) and surgical ligation with attempted stripping in the treatment of small saphenous vein (SSV) insufficiency. The early results demonstrated that EVLA was more likely to eradicate axial reflux and was also associated with a faster recove...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2014.09.037
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Simultaneous treatment of multilevel aortic disease is controversial due to the theoretic increase in morbidity. This study was conducted to define the outcomes in patients treated electively with simultaneous thoracic endovascular aortic aneurysm repair (TEVAR) and abdominal aortic endovascular endografting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.272
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:Risk of death in dialysis patients is lowest with arteriovenous fistulas (AVFs), followed by arteriovenous grafts (AVGs) and then intravenous hemodialysis catheters (HCs). Our aim was to analyze the effects of age at hemodialysis initiation on mortality across different access types. METHODS:All patients ≥18...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.07.091
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Spinal cord ischemia is a rare complication after open surgical repair for ruptured abdominal aortic aneurysms (rAAA). The use of emergency endovascular aortic aneurysm repair (eEVAR) is increasing, and paraplegia has been observed in a few patients. The objective of this study was to assess the incidence an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.06.023
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:Studies on the safety of carotid endarterectomy (CEA) under different anesthetic techniques are sometimes contradictory. The aim of this study was to compare real-world outcomes of CEA under general anesthesia (GA) vs regional or local anesthesia (RA/LA). METHODS:A retrospective analysis of the Vascular Qual...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.028
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND:The ankle-brachial index (ABI) may underestimate the severity of peripheral arterial disease (PAD) in patients with noncompressible vessels. This study analyzed limitations of the ABI and toe-brachial index (TBI), if done alone, in patients with symptomatic PAD, diagnosed by duplex ultrasound (DUS) examinati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.050
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:We studied the ability of recombinant adeno-associated virus (rAAV) vectors to achieve gene transfer in vivo to intact rat carotid arteries. METHODS:Isolated segments of uninjured rat carotid arteries were incubated with (1) rAAV vectors that expressed a beta-galactosidase gene, (2) a related vector with no pr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70357-4
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Endovascular procedure simulators are now commercially available and in use for physician training. The purpose of this study was to evaluate the role of simulation-based training in vascular surgery residencies. METHODS:Residents from vascular surgery programs in a five-state area were invited to participa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.09.003
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVES:Increasing evidence points to the inflammatory character of atherosclerosis, and several parameters of inflammation have been proposed as cardiovascular risk markers. We analyzed associations among serum high-sensitivity C-reactive protein (hs-CRP) concentrations, carotid plaque structure, and immunocytology...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00709-2
更新日期:2003-11-01 00:00:00
abstract::In a series of six patients, a single-bar anterior external fixator was used to treat combined vascular and orthopedic injuries of the leg. This method of external fixation facilitated operative vascular exposure without sacrificing bony stability or alignment. It may be the preferred method of external fixation for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract:BACKGROUND:Objective scoring systems have been developed for risk stratification of open infrarenal aneurysm repair. To date, none have been applied for the selection of patients who would most benefit from either an open or an endovascular approach. This study assessed the utility of comorbidity-based objective scorin...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.02.036
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:Construction of prosthetic arteriovenous access for hemodialysis in the thigh results in a high incidence of graft failure and infection. Autogenous femoral artery-common femoral thigh transposition (transposed femoral vein [tFV]) arteriovenous accesses have superior patency, but our previous report documented ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.10.039
更新日期:2005-02-01 00:00:00