Publications
240 results found
Broyd CJ, Panoulas V, Mattar W, et al., 2018, Effect of Aortic Valve Calcium Quantity on Outcome After Balloon Aortic Valvuloplasty for Severe Aortic Stenosis, AMERICAN JOURNAL OF CARDIOLOGY, Vol: 122, Pages: 1036-1041, ISSN: 0002-9149
Naganuma T, Kawamoto H, Onishi H, et al., 2018, Six-Month Follow-up Images of 3D Transesophageal Echocardiography and Computed Tomography After SAPIEN3 Implantation in the Descending Aorta, CANADIAN JOURNAL OF CARDIOLOGY, Vol: 34, ISSN: 0828-282X
Iqbal MB, Smith RD, Lane R, et al., 2018, The prognostic significance of incomplete revascularization and untreated coronary anatomy following percutaneous coronary intervention: An analysis of 6,755 patients with multivessel disease, CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Vol: 91, Pages: 1229-1239, ISSN: 1522-1946
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- Citations: 6
Mittal T, Nicol E, Reichmuth L, et al., 2018, INFLUENCE OF FLOW AND VELOCITY PROFILE ON INCONSISTENCY IN ECHOCARDIOGRAPHIC AORTIC VALVE STENOSIS ASSESSMENT: A COMPUTED TOMOGRAPHY AND COMPUTATIONAL FLOW DYNAMICS STUDY, 67th Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC), Publisher: ELSEVIER SCIENCE INC, Pages: 1583-1583, ISSN: 0735-1097
Panoulas VF, Keramida K, Boletti O, et al., 2018, Association between fractional flow reserve, instantaneous wave-free ratio and dobutamine stress echocardiography in patients with stable coronary artery disease, EUROINTERVENTION, Vol: 13, Pages: 1959-1966, ISSN: 1774-024X
Panoulas VF, Francis DP, Ruparelia N, et al., 2018, Female-specific survival advantage from transcatheter aortic valve implantation over surgical aortic valve replacement: Meta-analysis of the gender subgroups of randomised controlled trials including 3758 patients, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 250, Pages: 66-72, ISSN: 0167-5273
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- Citations: 28
Panoulas VF, Nihoyannopoulos P, 2018, Pocket-Size Hand-Held Echocardiography, Echocardiography, Second Edition, Pages: 937-943, ISBN: 9783319716152
Pocket-size hand-held echocardiography (PHE) devices have recently emerged as a new category of miniaturized echo machines. They are relatively cheap, smartphone-size hand-held echo machines with limited technical capabilities. They aim to improve upon physician diagnostic skills rather than provide a tool for a comprehensive diagnostic echocardiographic examination. They are often used in both emergency and outpatient clinic settings, leading physicians to correct differential diagnoses and treatment pathways. With the exception of cardiologists who are certified for transthoracic echocardiography according to national legislation, specific training and certification is recommended by European and American guidelines for all other users, to avoid misuse and misinterpretation of the findings of PHE. The length and the duration of training, however, remains a matter of debate. In the current chapter we discuss the history, technical characteristics and use of PHE with examples taken from real-life scenarios.
Rogers P, Al-Aidrous S, Banya W, et al., 2018, Cardiac rehabilitation to improve health-related quality of life following trans-catheter aortic valve implantation: a randomised controlled feasibility study: RECOVER-TAVI Pilot, ORCA 4, For the Optimal Restoration of Cardiac Activity Group., Pilot Feasibility Stud, Vol: 4, ISSN: 2055-5784
OBJECTIVES: Transcatheter aortic valve implantation (TAVI) is often undertaken in the oldest frailest cohort of patients undergoing cardiac interventions. We plan to investigate the potential benefit of cardiac rehabilitation (CR) in this vulnerable population. DESIGN: We undertook a pilot randomised trial of CR following TAVI to inform the feasibility and design of a future randomised clinical trial (RCT). PARTICIPANTS: We screened patients undergoing TAVI at a single institution between June 2016 and February 2017. INTERVENTIONS: Participants were randomised post-TAVI to standard of care (control group) or standard of care plus exercise-based CR (intervention group). OUTCOMES: We assessed recruitment and attrition rates, uptake of CR, and explored changes in 6-min walk test, Nottingham Activities of Daily Living, Fried and Edmonton Frailty scores and Hospital Anxiety and Depression Score, from baseline (30 days post TAVI) to 3 and 6 months post randomisation. We also undertook a parallel study to assess the use of the Kansas City Cardiomyopathy Questionnaire (KCCQ) in the post-TAVI population. RESULTS: Of 82 patients screened, 52 met the inclusion criteria and 27 were recruited (3 patients/month). In the intervention group, 10/13 (77%) completed the prescribed course of 6 sessions of CR (mean number of sessions attended 7.5, SD 4.25) over 6 weeks. At 6 months, all participants were retained for follow-up. There was apparent improvement in outcome scores at 3 and 6 months in control and CR groups. There were no recorded adverse events associated with the intervention of CR. The KCCQ was well accepted in 38 post-TAVI patients: mean summary score 72.6 (SD 22.6). CONCLUSIONS: We have demonstrated the feasibility of recruiting post-TAVI patients into a randomised trial of CR. We will use the findings of this pilot trial to design a fully powered multicentre RCT to inform the provision of CR and support guideline development to optimise health-r
Naganuma T, Kawamoto H, Panoulas VF, et al., 2017, Mid-term clinical outcomes of ABSORB bioresorbable vascular scaffold versus everolimus-eluting stent for coronary bifurcation lesions, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 246, Pages: 26-31, ISSN: 0167-5273
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- Citations: 7
Dowling C, Firoozi S, Doyle N, et al., 2017, Initial Experience of the Medtronic 34mm Evolut R Valve: The UK & Ireland Implanters' Registry, 29th Annual Symposium on Transcatheter Cardiovascular Therapeutics (TCT), Publisher: ELSEVIER SCIENCE INC, Pages: B263-B263, ISSN: 0735-1097
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- Citations: 1
Masoud S, Lim PB, Kitas GD, et al., 2017, Sudden cardiac death in patients with rheumatoid arthritis, WORLD JOURNAL OF CARDIOLOGY, Vol: 9, Pages: 562-573, ISSN: 1949-8462
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- Citations: 21
Dimitroulas T, Hodson J, Panoulas VF, et al., 2017, Genetic variations in the alanine-glyoxylate aminotransferase 2 (AGXT2) gene and dimethylarginines levels in rheumatoid arthritis, AMINO ACIDS, Vol: 49, Pages: 1133-1141, ISSN: 0939-4451
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- Citations: 4
Sulemane S, Panoulas VF, Nihoyannopoulos P, 2017, Echocardiographic assessment in patients with chronic kidney disease: Current update, ECHOCARDIOGRAPHY-A JOURNAL OF CARDIOVASCULAR ULTRASOUND AND ALLIED TECHNIQUES, Vol: 34, Pages: 594-602, ISSN: 0742-2822
Panoulas VF, Demir OM, Ruparelia N, et al., 2017, Longitudinal deformation of a third generation zotarolimus eluting stent: "The concertina returns!", WORLD JOURNAL OF CARDIOLOGY, Vol: 9, Pages: 60-64, ISSN: 1949-8462
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- Citations: 2
Sulemane S, Panoulas VF, Bratsas A, et al., 2017, Subclinical markers of cardiovascular disease predict adverse outcomes in chronic kidney disease patients with normal left ventricular ejection fraction, INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol: 33, Pages: 687-698, ISSN: 1569-5794
Emerging cardiovascular biomarkers, such as speckle tracking echocardiography (STE) and aortic pulse wave velocity (aPWV), have recently demonstrated the presence of subclinical left ventricular dysfunction and arterial stiffening in patients with chronic kidney disease (CKD) and no previous cardiovascular history. However, limited information exists on the prognostic impact of these biomarkers. We aimed to investigate whether STE and aPWV predict major adverse cardiac events (MACE) in this patient population. In this cohort study we prospectively analysed 106 CKD patients with no overt cardiovascular disease (CVD) and normal left ventricular ejection fraction. Cardiac deformation was measured using STE while aPWV was measured using arterial tonometry. The primary end-point was the composite of all-cause mortality, acute coronary syndrome, stable angina requiring revascularization (either using percutaneous coronary intervention or coronary artery bypass surgery), hospitalization for heart failure and stroke. Over a median follow up period of 49 months (interquartile range 11–63 months), 26 patients (24.5%) reached the primary endpoint. In a multivariable Cox hazards model, global longitudinal strain (GLS) (HR 1.12, 95% CI 1.02–1.29, p = 0.041) and aPWV (HR 1.31, 95% CI 1.05–1.41, p = 0.021) were significant, independent predictors of MACE. GLS and aPWV independently predict MACE in CKD patients with normal EF and no clinically overt CVD.
Rajkumar CA, Qureshi N, Ng F, et al., 2017, Adenosine induced ventricular fibrillation in a structurally normal heart: a case report, Journal of Medical Case Reports, Vol: 11, ISSN: 1752-1947
BackgroundAdenosine is the first-line pharmacotherapy for termination of supraventricular tachycardia through its action on the atrioventricular node. However, pro-arrhythmic effects of adenosine are also recognised, most notably in the presence of pre-excited atrial fibrillation. In this case report, we describe the induction of ventricular fibrillation in a patient with no demonstrable accessory pathway, nor any other structural heart disease. This rare, idiosyncratic reaction has never previously been reported and is of relevance given the widespread and routine use of adenosine in clinical practice.Case presentationA 26-year-old woman of Cypriot origin presented to our emergency department with a sudden onset of palpitations and chest discomfort. She was healthy, with no previous medical history and no regular medications. An electrocardiogram demonstrated a narrow complex tachycardia with a rate of 194 beats per minute. Following failure of vagal maneuvers to terminate the tachycardia, the assessing physician administered a single intravenous dose of 6 mg adenosine. Our patient instantaneously developed coarse ventricular fibrillation and circulatory collapse. Cardiopulmonary resuscitation was initiated and our patient was rapidly defibrillated to sinus rhythm with a single 150 J direct current shock. A 900-mg loading dose of intravenous amiodarone was commenced and our patient was managed in the cardiac high dependency unit. No further arrhythmias were identified on continuous cardiac monitoring.On review, her presenting electrocardiogram had demonstrated rapidly conducted atrial fibrillation with no evidence of ventricular pre-excitation. Concordantly, her resting electrocardiogram was not suggestive of any accessory pathway. This was conclusively excluded on invasive electrophysiology study, with negative programmed ventricular stimulation up to three extrastimuli. Extensive laboratory investigations were unremarkable and failed to identify an underlying cau
Panoulas VF, Kawamoto H, Sato K, et al., 2016, Clinical Outcomes After Implantation of Overlapping Bioresorbable Scaffolds vs New Generation Everolimus Eluting Stents., Rev Esp Cardiol (Engl Ed), Vol: 69, Pages: 1135-1143
INTRODUCTION AND OBJECTIVES: There is limited evidence on procedural and clinical outcomes in patients treated with overlapping bioresorbable scaffolds vs overlapping everolimus-eluting stents. We evaluated the outcomes of propensity-matched patients treated with overlapping scaffolds vs everolimus-eluting stents. METHODS: After propensity matching, 70 consecutive stable angina patients treated with overlapping bioresorbable scaffolds and 70 patients treated with overlapping new generation everolimus stents were included in this study. The primary outcome was the 1-year rate of major adverse cardiovascular events, defined as the composite of all-cause mortality, nonprocedural myocardial infarction, and target-vessel revascularization. RESULTS: Patients in the 2 groups had similar age (scaffold vs stent: 64.5 ± 10.3 vs 66 ± 9.7 years; P=.381), sex, diabetes, previous cardiovascular history, and SYNTAX score (scaffold vs stent: 18.6 ± 9.2 vs 19.4 ± 10.4; P=.635). Postprocedural acute gain was significantly lower in patients treated with scaffolds (1.82±0.66 vs 2.03±0.68mm; P=.033). At 1-year follow up, the estimated major adverse cardiovascular event rate was not significantly different between the 2 groups (scaffold vs stent: 14.5% vs 14.6%; Plog-rank=.661). Similarly, no significant differences were seen in 1-year rates of target vessel (scaffold vs stent: 14.5% vs 10%; Plog-rank=.816) or target lesion revascularization (scaffold vs stent: 9.7% vs 8.3%; Plog-rank=.815). CONCLUSIONS: Treating long lesions with overlapping scaffolds is feasible with acceptable 1-year outcomes.
Panoulas VF, Colombo A, 2016, Predictors of Clinical Outcomes in Patients With Stable Coronary Artery Disease. Response., Rev Esp Cardiol (Engl Ed), Vol: 69, Pages: 1233-1234
Sheikh N, Papadakis M, Panoulas VF, et al., 2016, Comparison of hypertrophic cardiomyopathy in Afro-Caribbean versus white patients in the UK, HEART, Vol: 102, Pages: 1797-1804, ISSN: 1355-6037
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- Citations: 37
Basavarajaiah S, Naganuma T, Latib A, et al., 2016, Treatment of drug-eluting stent restenosis: Comparison between drug-eluting balloon versus second-generation drug-eluting stents from a retrospective observational study., Catheter Cardiovasc Interv, Vol: 88, Pages: 522-528
OBJECTIVES: To compare drug-eluting balloons (DEBs) versus second-generation DES in the treatment of drug-eluting stent restenosis (DES-ISR). BACKGROUND: The optimal treatment of DES-ISR remains unclear. Several modes of treatment ranging from plain-old balloon angioplasty to repeated use of DES have yielded disappointing results. DEBs are increasingly been used in restenotic lesions; however, their use in DES-ISR is less established. METHODS: We evaluated all procedures between 2009 and 2011, involving DES-ISR that were treated either with DEB or second-generation DES. The measured end-points during the follow-up period were cardiac-death, target-vessel MI, TLR, TVR, and MACE defined as composite of cardiac-death, TV-MI, and TVR. RESULTS: Two hundred and forty-seven patients (302 lesions) with DES-ISR were treated with either DEB (81 patients; 104 lesions) or second-generation DES (166 patients; 198 lesions). The mean age of patients was 66.1 ± 9.4 years. There were higher numbers of patients with diabetes in the DEB group (DEB 47% vs DES 33%; p = 0.03). The mean length of DEB was significantly longer than the DES (35.4 vs 19.8 mm; p < 0.001). During the 12-month follow-up, there were no significant differences in the MACE rates (12.3% vs 8.4%; p = 0.3) and TLR rates (9.9% vs 7.8%; p = 0.6) between DEB and DES, respectively. On the multivariate analysis, use of DEB or DES was not the predictor of MACE (hazard ratio: 0.84, 95% CI: 0.46-1.85; p = 0.6). There were no cases of definite or probable stent thrombosis in either group. CONCLUSION: There were no significant differences in the clinical outcomes between DEB and second-generation DES in the treatment of DES-ISR. These results should encourage operators to consider DEB in the treatment of DES-ISR, which offers certain advantages over DES. © 2015 Wiley Periodicals, Inc.
Panoulas VF, Ruparelia N, Franks R, et al., 2016, The Impact of Gender on Outcomes Following Transcatheter Aortic Valve Implantation: True Effect or Bias?, J Heart Valve Dis, Vol: 25, Pages: 552-556, ISSN: 0966-8519
Transcatheter aortic valve implantation (TAVI) is currently the treatment of choice for patients with severe aortic stenosis (AS) who are unsuitable for surgical aortic valve replacement (SAVR), and is an acceptable alternative for those at high and intermediate surgical risk. In published TAVI registries and meta-analyses, whilst women are significantly older they present with fewer comorbidities compared to men (including coronary artery disease, peripheral vascular disease, diabetes and chronic obstructive pulmonary disease). In response to chronic pressure overload from AS, women have been shown to develop greater levels of left ventricular hypertrophy than men, as well as having a greater preservation of LV ejection fraction (LVEF) and less fibrosis. Following aortic valve replacement, women have been shown to have a faster regression of myocardial hypertrophy, with a significant improvement in LVEF. Following TAVI, female gender seems to be associated with a significantly lower one-year mortality. In the current viewpoint, it is discussed whether these findings reflect a true differential treatment response to TAVI among women, or simply the higher comorbidity burden among males undergoing TAVI.
Ruparelia N, Panoulas VF, Frame A, et al., 2016, Impact of clinical and procedural factors upon C reactive protein dynamics following transcatheter aortic valve implantation, World Journal of Cardiology, Vol: 8, Pages: 425-431, ISSN: 1949-8462
AIM: To determine the effect of procedural and clinical factors upon C reactive protein (CRP) dynamics following transcatheter aortic valve implantation (TAVI). METHODS: Two hundred and eight consecutive patients that underwent transfemoral TAVI at two hospitals (Imperial, College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom and San Raffaele Scientific Institute, Milan, Italy) were included. Daily venous plasma CRP levels were measured for up to 7 d following the procedure (or up to discharge). Procedural factors and 30-d safety outcomes according to the Valve Academic Research Consortium 2 definition were collected. RESULTS: Following TAVI, CRP significantly increased reaching a peak on day 3 of 87.6 ± 5.5 mg/dL, P < 0.001. Patients who developed clinical signs and symptoms of sepsis had significantly increased levels of CRP (P < 0.001). The presence of diabetes mellitus was associated with a significantly higher peak CRP level at day 3 (78.4 ± 3.2 vs 92.2 ± 4.4, P < 0.001). There was no difference in peak CRP release following balloon-expandable or self-expandable TAVI implantation (94.8 ± 9.1 vs 81.9 ± 6.9, P = 0.34) or if post-dilatation was required (86.9 ± 6.3 vs 96.6 ± 5.3, P = 0.42), however, when pre-TAVI balloon aortic valvuloplasty was performed this resulted in a significant increase in the peak CRP (110.1 ± 8.9 vs 51.6 ± 3.7, P < 0.001). The development of a major vascular complication did result in a significantly increased maximal CRP release (153.7 ± 11.9 vs 83.3 ± 7.4, P = 0.02) and there was a trend toward a higher peak CRP following major/life-threatening bleeding (113.2 ± 9.3 vs 82.7 ± 7.5, P = 0.12) although this did not reach statistical significance. CRP was not found to be a predictor of 30-d mortality on univariate analysis. CONCLUSION: Careful attention should be paid to baseline clinical characteristics and procedura
Ruparelia N, Panoulas VF, Frame A, et al., 2016, Transfemoral Valve-in-Valve Transcatheter Aortic Valve Implantation (TAVI) in a Patient With Previous Endovascular Aortic Repair (EVAR), JOURNAL OF INVASIVE CARDIOLOGY, Vol: 28, Pages: E69-E70, ISSN: 1042-3931
Sulemane S, Panoulas VF, Konstantinou K, et al., 2016, Erratum to: ‘Left ventricular twist mechanics and its relation with aortic stiffness in chronic kidney disease patients without overt cardiovascular disease’, Cardiovascular Ultrasound, Vol: 14, ISSN: 1476-7120
Sulemane S, Panoulas VF, Konstantinou K, et al., 2016, Left ventricular twist mechanics and its relation with aortic stiffness in chronic kidney disease patients without overt cardiovascular disease., Cardiovascular Ultrasound, Vol: 14, ISSN: 1476-7120
BACKGROUND: Recent studies hypothesized left ventricular (LV) twist as a potential biomarker for evaluation of sub clinical myocardial disease, however its relationship with aortic stiffness has yet to be investigated. Chronic kidney disease (CKD) has been identified as a risk factor for both myocardial and arterial disease. As such we sought to explore the relationship between aortic stiffness and LV twist in CKD patients without known cardiovascular disease (CVD). METHODS: In this prospective, observational study we enrolled 106 CKD patients (Stages 1 to 5) with normal LVEF as assessed by conventional echocardiography. Aortic stiffness was measured using aortic pulse wave velocity (aPWV). We defined increased aPWV as ≥10 m/s. LV Twist was measured using two-dimensional speckle tracking echocardiography. RESULTS: Patients with increased aPWV had higher LV twist (p = 0.002) but similar LVEF (p = 0.486). Aortic PWV correlated crudely with age (p < 0.001), the presence of diabetes (p < 0.001), hypertension (p < 0.001), eGFR (p < 0.001), LVMI (p = 0.01), e/e' (p < 0.001) and LV twist (p = 0.003). In multivariable analyses after adjusting for age, gender, cardiovascular risk factors and hypertensive medication, aPWV was independently associated with LV twist (β = 0.163, p = 0.025). CONCLUSIONS: Aortic stiffness independently associates with LV Twist in asymptomatic CKD patients. These findings suggest a close interaction between LV twist mechanics and arterial remodeling even before CVD becomes clinically relevant.
Panoulas VF, Miyazaki T, Sato K, et al., 2016, Procedural outcomes of patients with calcified lesions treated with bioresorbable vascular scaffolds., EuroIntervention, Vol: 11, Pages: 1355-1362
AIMS: To compare the feasibility, procedural and clinical outcomes after implantation of bioresorbable vascular scaffolds (BVS) in patients with calcified lesions. METHODS AND RESULTS: We assessed the feasibility of BVS implantation and procedural outcomes in patients with and without calcific lesions. The primary outcome was angiographic and procedural success. Secondary outcomes included major adverse cardiovascular events (MACE). Of 163 patients, 62 (38%) had calcified lesions. Patients with calcific lesions had a higher prevalence of diabetes (35.5% vs. 22.8%, p=0.078) and chronic kidney disease (31.1% vs. 13.9%, p=0.008), and higher SYNTAX scores (18.9±9.7 vs. 15.1±9.0, p=0.017). Calcific lesions required longer procedures (126.4±39.8 vs. 106.9±37.1 min, p=0.015), more frequent use of dedicated devices and IVUS. Acute gain (1.83±0.6 vs. 1.86±0.6, p=0.732) and angiographic success were similar (98% non-calcific vs. 95.2% calcific, p=0.369), whereas procedural success was reduced in patients with calcific lesions (94.1% vs. 83.9%, p=0.034) due to higher rates of periprocedural myocardial infarction (MI) (5% vs. 13.1%, p=0.067). During the median follow-up time of 14 months MACE rates (10.9% non-calcific vs. 12.9% calcific, plog-rank=0.546) were similar. CONCLUSIONS: Treating calcific lesions with BVS is feasible with high angiographic success rates, at the expense of longer procedure times, aggressive lesion preparation and increased rates of periprocedural MI.
Ruparelia N, Panoulas VF, Frame A, et al., 2016, Successful Treatment of Very Early Thrombosis of SAPIEN 3 Valve with Direct Oral Anticoagulant Therapy., J Heart Valve Dis, Vol: 25, Pages: 211-213, ISSN: 0966-8519
Thrombosis of transcatheter aortic valve implantation (TAVI) is an uncommon complication that commonly occurs weeks to months following the procedure. Herein are described the details of a patient who presented with a recurrence of symptoms days after intervention with a bioprosthesis thrombosis that was successfully treated with direct oral anticoagulant (DOAC) therapy and resulted in hemodynamic improvement and resolution of symptoms. Whilst a previous trial of DOAC therapy with mechanical valves was stopped due to elevated events in comparison to warfarin, a TAVI valve may be different, and the rapid onset of action and reduced bleeding risk may be beneficial in this patient group.
Panoulas VF, Montorfano M, Latib A, et al., 2016, Transarterial Endoleak Closure After Endovascular Thoracoabdominal Aneurysm Repair: When the "Sandwich" Goes Wrong., J Endovasc Ther, Vol: 23, Pages: 220-224
PURPOSE: To describe the use of vascular plugs to close a complex type Ib endoleak following the sandwich procedure used in conjunction with endovascular thoracoabdominal aortic aneurysm (TAAA) repair. CASE REPORT: A 59-year-old man with a 6.5-mm TAAA was treated with initial deployment proximally of 2 Zenith TX2 stent-grafts. In preparation for the sandwich technique to preserve flow to the celiac trunk, a 10×100-mm Viabahn covered stent was delivered from a brachial access into the celiac trunk unprotected by the sheath of the introducer. The trigger wire system became snagged on the struts of the distal aortic stent-graft; when the wire was pulled, the proximal end of the Viabahn migrated outside the aortic stent-graft, which migrated upward. The main body extension intended for the aortic component of the sandwich technique was deployed close to the distal end of the aneurysm sac, but a large type Ib endoleak formed in the gutter between the Viabahn, aortic extension, and sac wall. The leak perfused the celiac trunk, and the procedure was terminated. Increasing sac size on 3-month imaging prompted closure of the leak with 2 type II Amplatzer vascular plugs aiming to occlude the endoleak outflow into the Viabahn and the endoleak outflow at the site of the gutter. Imaging follow-up at 6 months demonstrated successful exclusion of the TAAA with no residual endoleak and excellent perfusion of the celiac trunk. CONCLUSION: Transarterial treatment of complex endoleaks is feasible when preceded by meticulous imaging and detailed preprocedural planning.
Naganuma T, Ishiguro H, Panoulas VF, et al., 2016, Which child catheter should we choose to deliver a bulky bioresorbable vascular scaffold?, Int J Cardiol, Vol: 203, Pages: 781-782
Panoulas VF, Sutaria N, Sen S, et al., 2016, Transcatheter aortic valve implantation in the young, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 203, Pages: 626-628, ISSN: 0167-5273
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