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 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
Experimental investigation

In-vitro experimental investigation of different bridging stent-grafts for fEVAR

Giovanni Torsello (Vascular Surgeon, GER) presents and discusses with the experts the latest results from an experimental head-to-head investigation of different bridging stent-grafts (BSG) used in fenestrated aortic endografting.
How does the material respond to balloon dilatation? Which are the forces that might lead to the dislocation of the BSG from a fenestration? Endoleak of unknown origin after fEVAR: could be associated with material fatigue?

September 28, 2018 No Comments
Recorded video case

The new low-profile Valiant Navion TEVAR endograft

Dr. Lovato (Interventional Radiologist, Bologna, Italy) presents exclusively in Vascupedia and discusses with the experts his first experience with the brand new low-profile thoracic endograft from Medtronic (Valiant Navion) for the treatment of different thoracic aortic pathologies. In the recorded case you will see the case planning, the new characteristics of the device, the comfortable deployment mechanism, and the intra- and postoperative performance of the endograft.

September 20, 2018 No Comments
Technical note

Endovascular treatment of malperfusion syndrome in acute type B dissection

Professor Trimarchi (Vascular Surgeon, Milan, Italy) provides a unique overview of different endovascular treatment options of malperfusion syndrome in patients suffering acute type B dissection.
Which is the definition of malperfusion?
Which are the clinical and laboratory signs of malperfusion?
How to treat the malperfusion?
Finally, Professor Trimarchi describes important technical tips and tricks to have a successful outcome in the devastating complication after aortic type B dissection

September 20, 2018 No Comments
Case report

Periscope and Chimney-EVAR for a ruptured AAA following infrarenal EVAR

Despite the latest advances in both endovascular field and open repair, a ruptured AAA still remains one of the most challenging situations in vascular medicine. This case shows the use of chimney and periscope grafts for the treatment of a Type Ia Endoleak in patient presenting with a ruptured AAA.

September 19, 2018 No Comments
Recorded video case

Kommerell’s diverticulum in right-sided aortic arch treatment

This video case-report show a case of debranching-TEVAR in our hybrid room on fusion imaging and final procedure CBCT, with a CT scan at 2 years follow up.

September 18, 2018 1 Comment
Review of the literature

Paraplegia after endovascular TAAA-repair:

Why does the endovascular TAAA repair increase the risk of spinal cord ischemia (SCI)? Which are the challenges? How can you prevent SCI during complex endovascular TAAA repair? Do we have enough evidence for the prohylactic use of cerebrospinal fluid drainage in the endovascular treatment of complex TAAAs?

September 18, 2018 No Comments
Recorded video case

Open surgical repair of a pararenal AAA

In this video case, we present our standard practice of open surgical repair for pararenal AAA. In general, we performed open repair with the “clamp and sew” technique, and the application of cold renal perfusion is limited to the cases with renal revascularization. Sometimes, division of left renal vein is imperative for better access to the suprarenal aorta. Retrospective analysis of our series revealed no negative impact of the division on long-term renal function - J Vasc Surg 2018;67:1042-1

August 29, 2018 1 Comment
Case report

Treatment of a large thoracoabdominal aneurysm with narrow access vessels

This case report describes the treatment of a thoracoabdominal aneurysm with narrow access vessels and an upward facing right renal artery. The use of a flexible self expanding covered stent facilitates the attachment of the target vessel with your branch. To reduce the risk of paraplegia, a staged procedure was performed.

August 12, 2018 1 Comment
Vascular images

Step-by-Step. OFF-PUMP TRIPLE EXTRA-ANATOMICAL BY-PASS

1. The heart is accessed through a full midline sternotomy
2. An off-pump coronary artery bypass graft is performed on the left anterior descending artery using a saphenous vein graft and 7-0 prolene continuous suture
3. The aorta is partially clamped with a side clamp and is opened through a longitudinal incision, about 2 cm length
4. A prosthesis is sutured onto the aorta with a continuous 4-0 prolene suture
5. One branch of the prosthesis is passed behind the ascending aorta,

August 8, 2018 1 Comment
Technical note

Principles of EVAR planning and sizing – Chapter 2: Sizing & Oversizing

This is the second chapter of the EVAR tutorial about planning and sizing of the endovascular AAA repair. Following topics are included:
- How to measure exactly the right diameter of our proximal landing zone?
- How to oversize in angulated necks?
- Which ancillary products should be available in challenging cases?
- How to select the length and diameter of the iliac limbs?
- Specific scenarios

July 4, 2018 5 Comments

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