Publications
252 results found
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
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- Citations: 8
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, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 44, Pages: 1657-1662, ISSN: 0174-1551
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).
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
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- Citations: 8
Mollier J, Amoah A, Patel N, et al., 2021, Retrospective case-control study investigating clinical, imaging and procedural risk factors for infective complications postuterine fibroid embolisation, Publisher: WILEY, Pages: 9-9, ISSN: 1470-0328
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.
Makris GC, Burrows V, Lyall F, et al., 2021, Vascular and Interventional Radiology Training; International Perspectives and Challenges, CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 44, Pages: 462-472, ISSN: 0174-1551
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- Citations: 8
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
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- Citations: 3
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
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- Citations: 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.
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
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- Citations: 8
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
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- Citations: 1
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.
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, 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
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- Citations: 10
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.
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
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
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- Citations: 185
Zhu Y, Zhan W, Hamady M, et al., 2020, A pilot study of aortic hemodynamics before and after thoracic endovascular repair with a double-branched endograft, Medicine in Novel Technology and Devices, Vol: 4, Pages: 1-17, ISSN: 2590-0935
Branched endografts have been developed to treat complex pathology in the aortic arch and ascending aorta. This study aims to evaluate the haemodynamic performance of a double-branched thoracic endograft by detailed comparison of flow patterns and wall shear stress in the aorta and supra-aortic branches before and after stent-graft implantation. Pre- and post-intervention CT images were acquired from two patients who underwent thoracic endovascular aortic repair (TEVAR) with a double-branched endograft for thoracic aortic aneurysms. These images were used to reconstruct patient-specific models, which were analysed using computational fluid dynamics employing physiologically realistic boundary conditions. Our results showed that there was sufficient blood perfusion through the arch branches. The presence of inner tunnels caused flow derangement and asymmetric wall shear stress in the ascending aorta, where shear range index was up to 6 times higher than in the pre-intervention model. Wall shear stress in the aortic arch increased considerably after intervention as a result of accelerated flow. The maximum flow-induced displacement forces on the branched endografts were around 22 N for both patients, which was below the threshold for device migration. Results from this pilot study demonstrated that aortic flow patterns were significantly altered by the branched endograft which caused increased spatial variation of wall shear stress in the ascending aorta and the arch. Although no obvious adverse hemodynamic features were found immediately after intervention for the cases we analysed, follow-up studies will be needed to assess durability of the device.
Hamady M, Hakim W, 2020, Fenestrated Stent-Grafting of Juxtarenal Aortic Aneurysms, Image-Guided Interventions: Expert Radiology Series, Third Edition, Pages: 179-187.e2, ISBN: 9780323612050
Continuous development in endovascular treatment of abdominal and thoracic aortic aneurysms, together with growing experience and encouraging results, have paved the way for a new generation of stent-grafts to treat those previously unsuitable for conventional endovascular repair. One such advancement is the fenestrated graft, which allows extension of the proximal landing zone and preservation of the renal and visceral arteries. Since the first reported fenestrated endovascular repair of an aortic aneurysm (FEVAR) by Park et al. in 1996, 1 several large published studies and data from registries (including the Global Star Registry), 2 have demonstrated high technical success rates, and promising short- and mid-term results. Nevertheless, FEVAR still presents unique challenges to the endovascular interventionist. These include appropriate patient selection, graft selection, accurate endograft planning, and demanding technical skills.
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
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- Citations: 1
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
Hammad S, Kim NH, Corbett R, et al., 2019, POOR OUTCOME FOLLOWING STENT PLACEMENT IN DSA POSITIVE TRANSPLANT RENAL ARTERY STENOSIS DEMONSTRATES THE HETEROGENEITY OF MACROVASCULAR DISEASE IN TRANSPLANTATION, Publisher: WILEY, Pages: 44-45, ISSN: 0934-0874
Patel N, Amoah A, Mallon D, et al., 2019, Treatment of giant uterine fibroids with uterine artery embolisation: an effective and safe therapeutic option?, Publisher: WILEY, Pages: 118-118, ISSN: 1470-0328
Kousios A, Storey R, Troy-Barnes E, et al., 2019, Plasmacytoma-like post-transplant lymphoproliferative disease in a disused arterio-venous fistula: the importance of histopathology., Kidney International Reports, Vol: 4, Pages: 749-755, ISSN: 2468-0249
Common causes of swelling in arteriovenous fistulae (AVFs) include thrombosis, infection, aneurysm, and superior vena cava (SVC) obstruction secondary to previous dialysis vascular catheter use. Malignancies confined in AVFs are rare and have been described in case series and case reports, mostly in immunosuppressed patients.1 Patients who undergo transplantation frequently have functioning or nonfunctioning AVFs. The risk of malignancy is increased in this patient group and thus should be considered in patients presenting with symptomatic AVF. The most common histopathological diagnosis is angiosarcoma.1, 2 Plasmacytoma-like posttransplant lymphoproliferative disease (PTLD) confined in an AVF has not been previously described.
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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- Citations: 5
Zamir M, Jenkins M, Burfitt N, et al., 2019, Short-term and Midterm Results of Fenestrated Anaconda Endograft in Patients with Previous Endovascular Aneurysm Repair, JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, Vol: 30, Pages: 546-553, ISSN: 1051-0443
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- Citations: 5
Grover G, Perera AH, Hamady M, et al., 2018, Cerebral embolic protection in thoracic endovascular aortic repair, JOURNAL OF VASCULAR SURGERY, Vol: 68, Pages: 1656-1666, ISSN: 0741-5214
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- Citations: 28
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