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.

Technical note

Management and tricks in treating aortic endograft infections

Dr. Xavier Berard (Bordeaux University Hospital) presents in a unique way a comprehensive overview of all currently available treatment strategies for the challenging aortic endograft infections. This includes information about the optimal surgical approach and access, tips and tricks on how to remove the endograft with or without suprarenal fixation and the ideal material (biologic or synthetic) to repair the aortic root.

Technical note

Complex endovascular repair

Dr. Gustavo Oderich summarizes in his presentation all important aspects of the endovascular repair of complex aortic aneurysms. The evolution from EVAR to more complex techniques, the upcoming trials, the different stent designs, the current strategies regarding the reduction of SCI, first data about the quality of life in these patients and the impact of simulation on the outcomes of complex endovascular repair are some key issues that are discussed in this paper.

Technical note

Open Conversion for Failed EVAR: Increasing Need and Different Strategies

Late open conversion after EVAR shows an increasing incidence and is mostly related to arterial degeneration and/or material fatigue. Dr. Michael Makaroun provides a unique overview of different techniques for the challenging open conversion for failed EVAR.

Awareness

Ruptured Aneurysm Protocol: Lessons From a Busy Aortic Center

Dr. Benjamin Starnes (Seattle, WA, USA) demonstrates all important features of a well-organized and 'busy' aortic center and analyzes the added value of centralization of the aortic treatment. Moreover, Dr. Starnes summarizes all lessons learned during the establishment of the aortic center, which may help physicians to further optimize the EVAR outcomes in the treatment of ruptured AAAs.

Review of the literature

Treatment results of descending thoracic aortic graft and endograft infection: a systematic review

Dr. Andrea Kahlberg (Milan, Italy) provides a comprehensive overview of their paper about the treatment strategies and outcomes of openr repair in case fo infected graft and endograft infections in the descending aorta.

Case report

Ministernotomy for ascending aorta and aortic arch replacement with left carotid artery, right carotid artery and left axillary artery debranching.

Clinical Summary
- 28 year old male
- Traumatic aortic injury (TAI)
- Endovascular treatment
Complications
- Aortic arch and brachiocephalic trunk dissection
- Right carotid artery and left sublcavian artery occlusion
- Stroke
- Orthostatic Hypotension (Extracranial Steal Syndromes from Disease of the Aortic Branches?)
Surgery Technique
- Femoro-femoral and right axillary artery cannulation
- The aorta was accessed through a Ministernotomy

February 7, 2019 No Comments
Case report

Aortic dissection treatment with the new Medtronic Navion

Male patient, 68 y.o. presented chronic type a aortic dissection with descending aneurysm 57 mm in axial diameter (20 mm increment during 20 months period)

was treated with carotid-carotid-subclavian by pass. subsequent arch replacement with ascending to innominate artery by pass.
finally controlled flap rupture after deployment of thoracic endograft with very good result at CTA, obtaining complete exclusion of the false lumen (type ll endoleak arising from intercostal arteries)

January 11, 2019 No Comments
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
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

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

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