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

Endovascular Aortic Arch replacement with Kawasumi Najuta Thoracic Stent Graft System

Endovascular treatment with custom made Najuta device of a 61mm saccular aortic arch aneurysm after carotid-carotid-subclavian by pass.
Previous surgical correction of 81 mm pararenal aortic aneurysm with extraperitoneal approach.

May 10, 2019 No Comments
Recorded video case

Right visceral rotation

Dr. Alan B Lumsden (Houston Methodist, DeBakey Heart and Vascular Center) presents in a unique video step by step how to perform a right visceral rotation for the removal of an IVC filter penetrating the aorta and creating aortic dissection.

May 6, 2019 No Comments
Recorded video case

Left visceral rotation

Dr. Alan B Lumsden (Houston Methodist, DeBakey Heart and Vascular Center) presents step by step how to perform a left visceral rotation for the treatment of aortic diseases

May 6, 2019 No Comments
Case report

Complex multi stage thoracoabdominal aneurysm correction. Branched endograft with forced femoral access and flap perforation

acute type B aortic dissection with thoracic aortic aneurysm. no proximal sealing zone for TEVAR landing and dilated ascending aorta.

-Car-car-sub by pass
-Ascending aortic replacement, ascending to innominate by pass and TEVAR

@ control CTA fast aneurysm enlargement

4 inner branches (two antegrade and two retrograde) custom made endograft.
access to RRA through hole performed in the lamella
forced femoral access (no arch vessel available) with steerable sheat

April 13, 2019 2 Comments
Basic vascular surgery skills

Aortic aneurysm repair

This is a step by step video of the open surgical of an abdominal aortic aneurysm with a tube Dacron graft through a median laparotomy. In this video, you will learn the surgical exposure of the aneurysm, the clamping and opening of the aneurysm sac, how to deal with the lumbar arteries, the proximal and distal anastomosis and how to close the abdomen by the right way.

April 2, 2019 No Comments
Live case

Step by step implantation of the first EVAR stent-graft with divided main body

This is a recorded case of the new Altura stent graft (Lombard). The device has kept well-known features of previous EVAR devices such as active suprarenal fixation, a fabric graft, and a robust nitinol stent. The flexibility produced by the division of the main body has the potential to significantly improve many issues of EVAR performance.

March 25, 2019 No Comments
Review of the literature

Abdominal compartment syndrome after EVAR: a serious issue

Dr. Martin Björck (Uppsala University, Sweden) summarizes in this presentation all important clinical and therapeutic aspects of abdominal compartment syndrome after EVAR for ruptured abdominal aortic aneurysms (AAA). Moreover, the author discusses the clinical consequences of ACS and provides important recommendations about monitoring techniques and treatment.

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

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