215 results found
Aung EY-S, Khan M, Williams N, et al., 2022, Endovascular Stenting in Superior Vena Cava Syndrome: A Systematic Review and Meta-analysis, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, ISSN: 0174-1551
Torsello G, Bertoglio L, Kellersmann R, et al., 2022, One-year results of the INSIGHT study on endovascular treatment of abdominal aortic aneurysms., J Vasc Surg, Vol: 75, Pages: 1904-1911.e3
OBJECTIVE: Endovascular repair of abdominal aortic aneurysms (AAAs) using the INCRAFT AAA Stent Graft System was safe and effective in regulatory approval studies. We herein report on the 1-year results of a real-world clinical study. METHODS: The INSIGHT study is a multi-center, prospective, open label, post-approval study conducted to continually evaluate the safety and performance of the INCRAFT System. Between 2015 and 2016, 150 consecutive patients with AAA at 23 centers in Europe were treated with the device in routine clinical practice. The primary endpoint was freedom from major adverse events (MAEs), namely death, myocardial infarction, cerebrovascular accident, and renal failure, within 30 days of the index procedure. End point data were assessed by a core laboratory. The secondary end points included technical success at the conclusion of the procedure and clinical success. RESULTS: All 150 patients studied (mean age, 73.6 ± 8.0 years; 89.3% men) met the primary end point without MAEs at 30-day follow-up. Technical success was achieved in 99.3% of patients without stent fractures at 30 days. Among the 146 patients eligible for 1-year follow-up, the MAE rate was 8.2% (ie, 12 patients suffered 13 MAEs: cerebrovascular accident in 8, myocardial infarction in 1, and 4 died, resulting in a 2.7% all-cause mortality rate). There were no reports of new onset renal failure requiring dialysis. Only 2.7% of patients had type I endoleak, and no type III endoleaks were identified through 1 year. The rate of clinical success at 1 year was 91.8%. CONCLUSIONS: The 1-year results of this multicenter real-world study underscore the safety and effectiveness of endovascular treatment of AAA with the INCRAFT System in routine clinical practice.
Sengupta S, Hamady M, Xu X-Y, 2022, Haemodynamic analysis of branched endografts for complex aortic arch repair, Bioengineering, Vol: 9, Pages: 1-17, ISSN: 2306-5354
This study aims to investigate the haemodynamic response induced by implantation of a double-branched endograft used in thoracic endovascular aortic repair (TEVAR) of the aortic arch. Anatomically realistic models were reconstructed from CT images obtained from patients who underwent TEVAR using the RelayPlus double-branched endograft implanted in the aortic arch. Two cases (Patient 1, Patient 2) were included here, both patients presented with type A aortic dissection before TEVAR. To examine the influence of inner tunnel branch diameters on localised flow patterns, three tunnel branch diameters were tested using the geometric model reconstructed for Patient 1. Pulsatile blood flow through the models was simulated by numerically solving the Navier–Stokes equations along with a transitional flow model. The physiological boundary conditions were imposed at the model inlet and outlets, while the wall was assumed to be rigid. Our simulation results showed that the double-branched endograft allowed for the sufficient perfusion of blood to the supra-aortic branches and restored flow patterns expected in normal aortas. The diameter of tunnel branches in the device plays a crucial role in the development of flow downstream of the branches and thus must be selected carefully based on the overall geometry of the vessel. Given the importance of wall shear stress in vascular remodelling and thrombus formation, longitudinal studies should be performed in the future in order to elucidate the role of tunnel branch diameters in long-term patency of the supra-aortic branches following TEVAR with the double-branched endograft.
Hamady M, Tsitsiou Y, Ekpe J, et al., 2021, Use and effectiveness of Pioneer Re-entry device for subintimal true lumen re-entry: single-centre data and a review of the literature., CVIR Endovascular, Vol: 4, Pages: 1-8, ISSN: 2520-8934
IntroductionDuring subintimal angioplasty (SIA), it is not always possible to re-enter the vessel lumen due to a variety of factors. Recanalization using hydrophilic wires and catheters alone, apart from its potential technical failure, is also limited by minimal control over the re-entry point. This is frequently well beyond the point of occlusion, thus often compromising important collaterals. In order to bypass the obstruction and attain controlled re-entry into the lumen of the diseased vessel, a re-entry device (RED) may be required. This paper assesses our centre’s experience with the safety and efficacy of the Pioneer re-entry system and systematically reviews the pertinent literature.MethodA single centre retrospective study of subintimal angioplasty involving the use of the Pioneer Plus intravascular guided reentry catheter was performed. Patient demographics including age, gender, risk factors, comorbidities clinical indication and complications were recorded. Lesion characteristics, including location and severity of calcification were also assessed.A systematic literature review of all reported studies where the Pioneer RED was used for iliac and lower limb revascularization was conducted by 2 of the authors using the PubMed (MEDLINE) and EMBASE databases.ResultsThe study comprised 30 cases. Technical success was 97%. A small, quickly resolved extravasation was the only device related complication. These results are in line with the systematic review which identified 16 studies using the Pioneer RED, reporting a technical success rate of 87.4–100% (median = 100%) and complication rate of 0–25.8% (median = 0%). However, due to heterogeneity in definitions of technical success, data was not pooled.
Hamady M, McCafferty I, 2021, The rocky road to recognizing interventional radiology as a full clinical speciality, CVIR Endovascular, Vol: 4
Morgan RA, Loftus I, Ratnam L, et al., 2021, Clinical experience with a shape memory polymer peripheral vascular embolisation plug: a case series, CVIR Endovascular, Vol: 4
Background: Shape memory polymers are materials that are manufactured in a certain shape, can be stored in a temporary deformed shape, and then return to – or remember – their original shape upon exposure to external stimuli such as temperature and moisture. This property lends itself to application in endovascular medical devices. Peripheral vasculature embolisation devices incorporating this novel technology have become commercially available and this case series, where the data were collected as part of a post market registry, outlines initial clinical experience with these novel devices. Results: Eight cases are described in this series. The disease state/conditions for which embolisation was indicated were right common iliac artery aneurysms (n = 3), a type II endoleak into the thoracic aorta following thoracic endovascular aneurysm repair (n = 1), a left inferior gluteal artery aneurysm (n = 1), left internal iliac artery aneurysms (n = 2), and a case of splenomegaly, where splenectomy was planned after the embolisation procedure (n = 1). Target arteries were 5–10 mm in diameter. In each case, at least one IMPEDE Embolization Plug (IMP-Device) of an appropriate diameter was used. All procedures were technically successful and target vessel thrombosis was achieved in all cases. Follow-up imaging available during the 45–90-day data collection timeframe showed sustained vessel occlusion. This case series includes examples of situations commonly encountered when embolising the peripheral vasculature, namely, the use of one or multiple devices in a single vessel and in combination with the use of other embolic devices (e.g., microcoils, gelatin sponge, and PVA particles) in the same case. There were no adverse events related to the specific use of the device. Conclusions: This small series illustrates the safety and efficacy of this novel sponge-based embolic device for the embolisation of small and medium sized arte
Morgan R, Cleveland T, Hamady M, et al., 2021, Interventional radiology in the 21st century: planning for the future., Clin Radiol, Vol: 76, Pages: 865-869
Hanna L, Abdullah A, Kashef E, et al., 2021, Four-year results of the Bolton relay proximal scallop endograft in the management of thoracic and thoracoabdominal aortic pathology with unfavorable proximal landing zone, JOURNAL OF VASCULAR SURGERY, Vol: 74, Pages: 1447-1455, ISSN: 0741-5214
Hanna L, Abdullah A, Gibbs R, et al., 2021, Technical Note: Left Subclavian Artery Scallop Endografts to Facilitate a Proximal Landing Zone and Upper Extremity Access for Branched Endovascular Aortic Repair of Type II Thoracoabdominal Aortic Aneurysms., Cardiovasc Intervent Radiol, Vol: 44, Pages: 1657-1662
PURPOSE: To describe the dual purpose of left subclavian artery (LSA) scallop endografts to create the proximal landing zone (PLZ) and facilitate antegrade left-sided upper extremity access for branched endovascular aortic repair (BEVAR) of Type II thoracoabdominal aneurysms (TAAA) with a short PLZ. TECHNIQUE: Three patients with an inadequate (< 20 mm) PLZ underwent a 2-stage repair of Type II TAAA. Following femoral cut-down, a custom-made LSA scallop endograft was deployed into zone 2 to create the PLZ and maintain perfusion to the LSA. In a second procedure 36-96 days after insertion of the scalloped thoracic stent-graft, a branched abdominal stent-graft was subsequently deployed to dock into the proximal scallop endograft as the second stage. Via a left axillary conduit, a 12Fr sheath was used to cannulate the LSA scallop to facilitate selective catheterisation of antegrade branch cuffs and renovisceral target vessels, and insertion and deployment of bridging stents. The LSA scallop was also used to selectively catheterise and stent the perfusion branches via left-sided brachial puncture that were left open in each of the three cases 8-14 days after the second procedure to minimise the risk of spinal cord ischaemia. There were no neurological or endoleak complications. CONCLUSION: LSA scallop endografts are a feasible and useful adjunct to create the PLZ and to provide antegrade access for visceral stenting of branches and target vessels through the LSA scallop in branched endovascular repair of Type II TAAA with short PLZ.
Halliday A, Bulbulia R, Bonati LH, et al., 2021, Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy., Lancet, Vol: 398, Pages: 1065-1073
BACKGROUND: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. METHODS: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. FINDINGS: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs fo
Abdelaziz MEMK, Tian L, Hamady M, et al., 2021, X-ray to MR: the progress of flexible instruments for endovascular navigation, Progress in Biomedical Engineering, Vol: 3, Pages: 1-38, ISSN: 2516-1091
Interventional radiology and cardiology are rapidly growing areas of minimally invasive surgery, covering multiple diagnostic and interventional procedures. Treatment via endovascular techniques has become the go-to approach, thanks to its minimally invasive nature and its effectiveness in reducing hospitalisation and total time to recovery when compared to open surgery. Although x-ray fluoroscopy is currently the gold standard imaging technique for endovascular interventions, it presents occupational safety hazards to medical personnel and potential risks to patients, especially paediatric patients, because of its inherent ionising radiation. Magnetic resonance imaging (MRI), with its unique ability to provide radiation-free imaging, and acquiring morphologic and functional information, holds great promise in the advancement of image-guided navigation through the vasculature. Moreover, MRI has the potential to combine diagnosis, therapy and early evaluation of therapy in the same intervention. However, MR-guided interventions face a major challenge due to the presence of a large magnetic field (1.5/3 Tesla), which limits the set of materials suitable for the construction of key instrumentation (sheaths, catheters and guidewires). Despite these challenges, in recent years, significant progress has been made in the development of interventional devices, which comprise biocompatible, MR safe and MR visible materials. In an attempt to encourage and accelerate the development of MR-guided endovascular instrumentation, we present a systematic and illustrated overview of the plethora of work targeting to overcome the aforementioned limitations which are underpinned by the interdependent advancements in science, technology, engineering, mathematics and medicine (STEMM).
Amiras D, Hurkxkens TJ, Figueroa D, et al., 2021, Augmented reality simulator for CT-guided interventions, EUROPEAN RADIOLOGY, Vol: 31, Pages: 8897-8902, ISSN: 0938-7994
Piffaretti G, Czerny M, Riambau V, et al., 2021, Endovascular repair of ascending aortic diseases with custom-made endografts., Eur J Cardiothorac Surg, Vol: 59, Pages: 741-749
OBJECTIVES: The aim of this article is to report the mid-term results of ascending thoracic endovascular aortic repair using a custom-made device (CMD). METHODS: This was a retrospective study performed at tertiary centres. Nine patients considered unfit for open surgery received elective total endovascular repair of the ascending aorta with a Relay® (Terumo Aortic, Sunrise; FL, USA) CMD: pseudoaneurysn (n = 5), localized dissection (n =3) and contained rupture (n = 1). RESULTS: Primary clinical success was achieved in all patients with no major complications and no early conversion to open surgery. All patients were discharged home and independent: median length of stay was 7 days (interquartile range, 6-18). No patient was lost to follow-up at a median 26 months (interquartile range, 12-36). Three patients died 2, 6 and 24 months after intervention; 1 was aorta related (late aorto-atrial fistula due to infection that required open surgery). At the last follow-up available, no endoleaks, migrations, fractures or ruptures were observed in the remaining 6 patients. CONCLUSIONS: Ascending thoracic endovascular aortic repair with Terumo Aortic CMDs was technically feasible, effective and safe in very selected lesions. CMDs showed good ascending aorta conformability with different configurations and diameters, and satisfactory mid-term durability as shown by both structural integrity and aortic lesion exclusion.
Jones B, Riga C, Bicknell C, et al., 2021, Robot-Assisted Carotid Artery Stenting: A Safety and Feasibility Study, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 44, Pages: 795-800, ISSN: 0174-1551
Hamady M, Müller-Hülsbeck S, 2020, European Society for Vascular Surgery (ESVS) 2020 clinical practice guidelines on the management of acute limb ischaemia; a word of caution!, CVIR Endovascular, Vol: 3
Mollier J, Patel NR, Amoah A, et al., 2020, Clinical, Imaging and Procedural Risk Factors for Intrauterine Infective Complications After Uterine Fibroid Embolisation: A Retrospective Case Control Study., Cardiovasc Intervent Radiol, Vol: 43, Pages: 1910-1917
INTRODUCTION: This was a retrospective case-control study at a single tertiary centre investigating all UFE procedures between January 2013 and December 2018 for symptomatic fibroids. The aim was to determine the clinical, imaging and procedural risk factors which impact upon the risk of post-uterine fibroid embolisation (UFE) intrauterine infection. Cases were patients which developed intrauterine infection post-procedure, and controls were the background UFE population without infection. METHODS: Clinical demographics, presenting symptoms, uterine and fibroid characteristics on imaging and procedural variants were analysed. A p value of less than 0.05 was considered statistically significant. The main outcome measures were presence of infection and requirement of emergency hysterectomy. RESULTS: 333 technically successful UFE procedures were performed in 330 patients. Infection occurred after 25 procedures (7.5%). 3 of these patients progressed to overwhelming sepsis and required emergency hysterectomy. Clinical obesity (BMI > 30) (OR 1.53 [1.18-1.99]) and uterine volume > 1000cm3 (2.94 [1.15-7.54]) were found to increase the risk of infection CONCLUSIONS: UFE is generally safe in patients with symptomatic fibroids. Obese patients (BMI > 30) and those with large volume uteri (> 1000cm3) are at slight increased risk of developing infection and require appropriate pre-procedural counselling, as well as careful post-UFE follow-up. BMI and uterine volume may be useful to assess before the procedure to help to determine post-UFE infection risk.
Makris GC, Burrows V, Lyall F, et al., 2020, Vascular and Interventional Radiology Training; International Perspectives and Challenges, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 44, Pages: 462-472, ISSN: 0174-1551
Cheung S, Rahman R, Bicknell C, et al., 2020, Comparison of manual versus robot-assisted contralateral gate cannulation in patients undergoing endovascular aneurysm repair, INTERNATIONAL JOURNAL OF COMPUTER ASSISTED RADIOLOGY AND SURGERY, Vol: 15, Pages: 2071-2078, ISSN: 1861-6410
Staniszewska A, Anwar M, Hamady M, et al., 2020, Hybrid repair of proximal subclavian artery transection, Trauma (United Kingdom), Vol: 22, Pages: 316-319, ISSN: 1460-4086
Although rare, subclavian artery injuries are associated with significant mortality and morbidity, with almost two-thirds of patients dying before reaching hospital. Recent advances in technology have resulted in increasing use of endovascular therapy in management of these injuries. In this report, we present a case of a successful hybrid repair of traumatic left proximal subclavian artery transection. The employment of an Amplatzer Vascular Plug to control a short proximal subclavian artery stump and subsequent ligation of the distal segment of subclavian artery with its anastomosis to the carotid artery resulted in excellent clinical outcome without performing a sternotomy in a young patient.
Hamady M, Bicknell C, 2020, Challenges of Total Endovascular Repair of Chronic Type B Aortic Dissection, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 43, Pages: 1735-1737, ISSN: 0174-1551
Johari NH, Hamady M, Xu XY, 2020, A computational study of the effect of stent design on local hemodynamic factors at the carotid artery bifurcation, Artery Research, Vol: 26, Pages: 161-169, ISSN: 1872-9312
Background: Previous clinical studies have shown that the incidence of restenosis after carotid and coronary stenting varies with stent design and deployment configuration. This study aims to determine how stent design may affect in-stent hemodynamics in stented carotid arteries by means of Computational Fluid Dynamics (CFD).Methods: A robust computational method was developed to integrate detailed stent strut geometry in a patient-specific carotid artery reconstructed from medical images. Three stent designs, including two closed-cell stents and one open-cell stent, were reproduced and incorporated into the reconstructed post-stent carotid bifurcation. CFD simulations were performed under patient-specific flow conditions. Local hemodynamic parameters were evaluated and compared in terms of Wall Shear Stress (WSS), Oscillatory Shear Index (OSI) and Relative Residence Time (RRT).Results: All simulated stent designs induced some degree of flow disruption as manifested through flow separation and recirculation zones downstream of stent struts and quantified by WSS-related indices. Compared to the simulated open-cell stent, closed-cell stents created slightly larger areas of low WSS, elevated OSI and high RRT, due to a greater number of stent struts protruding into the lumen.Conclusion: Detailed stent design and patient-specific geometric features of the stented vessel have a strong influence on the evaluated hemodynamic parameters. Our limited computational results suggest that closed-cell stents may pose a higher risk for in-stent restenosis (ISR) than open-cell stent design. Further large-scale prospective studies are warranted to elucidate the role of stent design in the development of ISR after CAS.
Rostampour S, Cleveland T, Haslam P, et al., 2020, Response of UK interventional radiologists to the COVID-19 pandemic – survey findings, CVIR Endovascular, Vol: 3, Pages: 1-5, ISSN: 2520-8934
BackgroundThe COVID-19 pandemic has had an unprecedented effect upon the National Health Service (NHS).Like other specialties, Interventional Radiology (IR) rapidly adapted to the evolving situation.Members of BSIR were surveyed to obtain a snapshot of the experiences of UK IRs in response to COVID-19.An electronic survey was compiled using Google Forms, approved by the BSIR Council Officers and distributedto BSIR members by email on 18thApril 2020.A total of 228 responses were received.The survey was open for a 14-day period and the data analysed in Microsoft Excel 365.The response rate was 29% (228/800).ResultsTwo thirds of respondents work in aTertiary unit and 33% deliver IR in a District Hospital.84% have a day-case facility. After the COVID-19 crisis, 81% of respondents were able to maintain 24-7 On-call service.59% of respondents had been required change their day to day practice to allow the on-call service to continue.55% of respondents were involved in providing a central line service.Of those questioned, 91% continued to offer endovascular services, 98% genitourinary and 92% hepatobiliary services, although a degree of service reduction was described. 38% have provided IR trainees with additional training material during this pandemic.ConclusionsThis survey has confirmed that the responses of UK IR departments to the COVID-19 crisis have ensured vital on-call and urgent services have continued, including ongoing availability of most IR sub-specialties.Availability of a day case facility has possibly influenced the positive response.
Anwar MA, Hamady M, 2020, Various Endoluminal Approaches Available for Treating Pathologies of the Aortic Arch, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 43, Pages: 1756-1769, ISSN: 0174-1551
Llewellyn O, Patel NR, Mallon D, et al., 2020, Uterine Artery Embolisation for Women with Giant Versus Non-giant Uterine Fibroids: A Systematic Review and Meta-analysis., Cardiovasc Intervent Radiol, Vol: 43, Pages: 684-693
BACKGROUND: Evidence supporting uterine artery embolisation (UAE) for giant fibroids (≥ 10 cm and/or uterine volume ≥ 700 CC) remains sparse. We performed a systemic review and meta-analysis of UAE outcomes for symptomatic giant versus non-giant fibroids. METHODS: The literature was systematically reviewed. Research studies of UAE as an adjunct to surgery, and those not using peri-operative MRI were excluded. Primary outcomes were fibroid size and uterine volume reduction, procedure time, length of hospital stay, reinterventions, patient symptom improvement/satisfaction and complications. RESULTS: We identified four observational studies (839 patients; giant = 163, non-giant = 676). Both groups demonstrated reduction in fibroid size and uterine volume after UAE, with equivocal difference in uterine volume reduction (Mean difference (MD) - 0.3 95% confidence interval (CI) - 3.8 to 3.1, p = 0.86) and greater reduction in non-giant dominant fibroid size (MD - 5.9 95% CI - 10.3 to - 1.5, p < 0.01). Giant fibroids were associated with 5.6 min longer mean operative time (MD 5.6 min 95% CI 2.6-8.6, p < 0.01) and 4.8 h longer mean hospital stay (MD 4.8 h 95% CI 1.1-8.6, p = 0.01). Patient symptoms/satisfaction outcomes were summarised, but too heterogeneous for meta-analysis. Major complication and reintervention rates were low, with a statistically higher rate of major complications (Odds ratio (OR) 4.7 95% CI 1.5-14.6, p < 0.01) and reinterventions (OR 3.6 95% CI 1.7-7.5, p < 0.01) in giant fibroids. CONCLUSIONS: Current evidence shows UAE is a safe and effective option to treat giant fibroids. However, the limited available data indicate a relatively higher risk of complications and reinterventions when compared with non-giant fibroids. Patients should be selected
Rostampour S, Hamady MS, Alsafi A, 2020, To Tweet or Not to Tweet? A Look at Radiology Societies' Use of Twitter, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 43, Pages: 1070-1074, ISSN: 0174-1551
Salim S, Locci R, Martin G, et al., 2020, Short- and long-term outcomes in isolated penetrating aortic ulcer disease, Journal of Vascular Surgery, Vol: 72, Pages: 84-91, ISSN: 0741-5214
BACKGROUND: The optimum management of isolated penetrating aortic ulceration (PAU), with no associated intramural hematoma or aortic dissection is not clear. We evaluate the short- and long-term outcomes in isolated PAU to better inform management strategies. METHODS: We conducted a retrospective review of 43 consecutive patients (mean age, 72.2 years; 26 men) with isolated PAU (excluding intramural hematoma/aortic dissection) managed at a single tertiary vascular unit between November 2007 and April 2019. Twenty-one percent had PAU of the arch, 62% of the thoracic aorta, and 17% of the abdominal aorta. Conservative and surgical groups were analyzed separately. Primary outcomes included mortality, PAU progression, and interventional complications. RESULTS: Initially, 67% of patients (29/43) were managed conservatively; they had significantly smaller PAU neck widths (P = .04), PAU depths (P = .004), and lower rates of associated aneurysmal change (P = .004) compared with those initially requiring surgery. Four patients (4/29) initially managed conservatively eventually required surgical management at a mean time interval of 49.75 months (range, 9.03-104.33 months) primarily owing to aneurysmal degeneration. Initially, 33% of patients (14/43) underwent surgical management; 7 of the 14 procedures were urgent. Of the 18 patients, 17 eventually managed with surgical intervention had an endovascular repair; 2 of the 17 endovascular cases involved supra-aortic debranching, six used scalloped, fenestrated, or chimney stents. The overall long-term mortality was 30% (mean follow-up, 48 months; range, 0-136 months) with no significant difference between the conservatively and surgically managed groups (P = .98). No aortic-related deaths were documented during follow-up in those managed conservatively. There was no in-hospital mortality after surgical repair. Of these 18 patients, two required reintervention within 30 days for t
Bjorck M, Earnshaw JJ, Acosta S, et al., 2020, Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia, EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Vol: 59, Pages: 173-218, ISSN: 1078-5884
Alsafi A, Jenkins MP, Hamady MS, 2019, Use of Stent Grafts to Preserve a Large Inferior Mesenteric Artery during Endovascular Aortic Aneurysm Repair, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 30, Pages: 1980-1981, ISSN: 1051-0443
Hanna L, Gibbs R, Fadl A, et al., 2019, Midterm to long-term outcomes of scallop endografts in the management of aortic disease with unfavorable proximal landing zone in the arch, Fall Meeting of the Frank-J-Veith-International-Society / VEITH Symposium, Publisher: Elsevier, Pages: E145-E145, ISSN: 0741-5214
Rolls AE, Riga CV, Rahim SU, et al., 2019, The use of video motion analysis to determine the impact of anatomic complexity on endovascular performance in carotid artery stenting, JOURNAL OF VASCULAR SURGERY, Vol: 69, Pages: 1482-1489, ISSN: 0741-5214
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