Library

Welcome to the Library of Vascupedia. Use our filters on the left side of the page to quickly find the content of your interest. You may select an area of interest and the respective indication or the media type.

Recorded video case

Use of endoanchors for EVAR sealing in case of ruptured AAA

63 y.o. patient treated in the emergency setting for ruptured AAA
Endovascular repair planned despite proximal hostile anatomy and left iliac aneurysm with thrombus.
procedure details:
-bilateral percutaneous access
-bifurcated endurant endograft implant (left hypogastric embolization)
-partial left renal artery coverage @ control angio (intentional aggressive deployment)
-renal stenting
-type Ia endoleak after renal stenting, persistent after re-ballooning
-endoleak correction with endoanchors

December 2, 2018 No Comments
Case report

Decision making by a complex case of iatrogenically created A-V fistula with concomitant AAA and fem-pop bypass occlusion

This is a complex case of a 74-year-old female with an acute onset of rest pain of the right limb. Previous Rx: primary stenting of both renal arteries, endovascular repair of both CIA in CERAB technique and fem-pop 1 bypass right limb.
During her current readmission, the CT-scan revealed a high-flow AV fistula of the right CFA, an abdominal aortic aneurysm (4.7 cm), an occluded stent in the right renal artery as well as an occluded fem-pop bypass. What would you do in this case?

November 29, 2018 No Comments
Recorded video case

Preloaded custom-made fEVAR. Step by step procedure

Preloaded custom-made fEVAR (Cook) in a 63 y.o. male with pararenal abdominal aortic aneurysm 55 mm. This video shows all the procedural steps and the CT scan at 1 month.

- Chronic ischaemic heart disease with left ventricular apex aneurysm
- Left mild intermittent claudication 500 mt (Left common iliac artery chronic occlusion)
- COPD
- Chronic celiac artery occlusion

We used Begraft 10x37 in SMA, 8x27 for left renal and 7x18 in right renal.

November 21, 2018 No Comments
Recorded video case

Emergency triple chimney in a patient with giant symptomatic pararenal pseudoaneurysm and subsequent gutter embolization

We report a case of pararenal pseudoaneurysm endovascular correction with triple chimney technique and the following gutter embolization procedure

Key points:

-Previous fEVAR attempt (failed because of extremely tortuous accesses)
-Emergency procedure during the night
-Bilateral percutaneous femoral access
-Double axillary puncture on both sides
-Challenging endograft advancement on through and through guidewire
-Triple ChEVAR (SMA, RRA, LRA)
-Subsequent gutter embolization

November 18, 2018 3 Comments
Recorded video case

Step by step bilateral common iliac aneurysm endovascular repair with Gore IBE (iliac branched endograft) and C3 device.

Bilateral common iliac aneurysm endovascular repair with an iliac branched device in a 63 years old patient. This video demonstrates the procedural steps and the CT scan at 3 years of surveillance.
Notice: Intentional cross-leg because of short lowest renal to hypogastric distance.

November 14, 2018 No Comments
Recorded video case

Giant proper hepatic aneurysm endovascular treatment with covered stent deployment

Total endovascular treatment of a huge visceral artery aneurysm (proper hepatic) with covered stent deployment.

-Flexor 6 Fr delivered into common hepatic artery
-Bentley BeGraft 8*37 mm positioned over Rosen guidewire and balloon inflated
-Patency of gastroduodenal artery and both efferent branches @ final angio
-Complete aneurysm exclusion with collateral's patency at control CT Scan

November 14, 2018 No Comments
Recorded video case

Percutaneous large bore axillary artery access technique for complicated EVAR

This video demonstrates step by step the technique of percutaneous axillary artery access for the endovascular repair of complex aortic aneurysms. The technique includes the ultrasound-based identification of the vessels and the nerve, the introduction of the closure system, the performance of the intervention and the angiographic control after closing the puncture site.

November 11, 2018 No Comments
Recorded video case

Step by step deployment of a branched endograft for TAAA repair

Dr. Bisdas (Vascular Surgeon, Muenster, Germany) explains step by step the deployment of a branched endograft for the endovascular treatment of thoracoabdominal aortic aneurysms. Check out important technical issues about the positioning of the anterior markers, the right recognition of the markers for each branch and the importance of the J tip for a precise and successful implantation of the branched endograft.

November 5, 2018 No Comments
Case report

Giant Aneurysm of the Ascending Aorta: Replacement of the Ascending Aorta and the Aortic Root with a Porcine Bioprosthesis (Freestyle Inclusion Technique)

In this case report, we present a special freestyle technique treating a gigantic ascending aortic aneurysm, replacing the aortic root and ascending aorta with a porcine bioprosthesis.

November 4, 2018 No Comments
Recorded video case

Performance of chEVAR for a juxtarenal penetrating ulcer

Dr. Bisdas (Vascular Surgeon, Muenster, Germany) performs a chimney endografting for a penetrating and symptomatic aortic ulcer. In this live case, you will see the most important steps for a successful chEVAR. Moreover, the experts discuss extensively important technical issues and potential challenges during the procedure.

November 3, 2018 No Comments
Recorded video case

Use of the TREO stent-graft for the treatment of AAA

Dr. Bisdas (Vascular Surgeon, Athens, Greece) performs a live implantation of the new TREO stent-graft (Terumo Aortic) for the treatment of an infrarenal AAA. In this video, you will see all the new features of the device and important intraprocedural steps for a successful EVAR. Furthermore, the panelists will discuss the need for a new EVAR endograft and they express their opinion about the TREO stent-graft. In the end, the operator answers questions about the aim and scope of Vascupedia.

October 22, 2018 No Comments
Recorded video case

Use of the Ankura stent-graft for the treatment of thoracic aortic aneurysms

Dr. Kratimenos (Interventional Radiologist, Athens, Greece) presents a new thoracic endograft (Ankura, Lifetech) for the treatment of a challenging thoracic aortic aneurysm. In this recorded case, you will see the features of the device, the intraoperative steps and the performance of the endograft. At the end of the video, the panelists discuss the features and the benefits on the endoprosthesis and Dr. Kratimenos answers the questions of the audience.

October 15, 2018 No Comments
Review of the literature

Thoracoabdominal aortic aneurysm: when to treat open and when endo?

Professor Dr. Böckler (Vascular Surgeon, Heidelberg, Germany) provides an overview of the current evidence regarding decision making in the treatment of TAAA. Which patients' characteristics should influence your decision, do we have head-to-head comparisons between open surgery and endo-repair, what about the risk of spinal cord ischemia, and many other relevant questions will be answered in this presentation and discussed between the panelists.

October 5, 2018 No Comments
Technical note

Removing stent grafts and implications for putting them in

"Who will do my aortic surgery when my time comes" was a common refrain among my mentors, only half jokingly. Now, the question has gained a sharpness. I think the tide will turn and the kids will do fine, but we all have to do a bit of reclamation, or open surgery will become the habit of strange eccentric artisans. I recommend calling up the retired surgeon and inviting them in for conferences and cases. Reprint masterwork atlases like Wiley's. Connect with likeminded. Before it's too late.

September 30, 2018 1 Comment
Technical note

Management of the false lumen in chronic aortic dissection

False lumen (FL) thrombosis and aortic remodeling is a major predictor of survival in chronic aortic dissection (AD). Chronic AD (> 3 months) is associated with a non-compliant intimal flap, multiple fenestrations in the intimal flap and aortic branch artery communication with the FL. This makes FL thrombosis and subsequent aortic remodeling difficult to achieve with conventional thoracic EVAR devices. This presentation provides an overview of different methods to manage FL in chronic AD.

September 29, 2018 1 Comment
Review of the literature

A brief history of surgical repair of the abdominal aortic aneurysm

Since India’s Sushruta (800-600 BC) first reported that "aneurysms can be cured only with the greatest difficulty", the majority of surgeons shared a fear of aortic surgery till the first half of the 20th century. The surgical treatment of AAA became available only in the second half of the 20th century. This presentation summarizes the most important historical milestones in AAA surgery.

September 29, 2018 No Comments

Please confirm