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

IVUS guided kissing endovascular lithoplasty and bare-metal-stent implantation for a coral reef aortic stenosis in visceral segment

Recorded case of a 72 yrs old woman with CLTI (Rutherford V,  TASC D lesion), not suitable for open repair, treated in a hybrid setting with IVUS guided kissing endovascular lithoplasty and bare-metal-stent implantation for a coral reef aortic stenosis in visceral segment, with a stent-graft for the right CIA and bare-metal-stent for the right CEA for the iliac high-grade stenosis and a femorofemoral bypass.

May 14, 2020 No Comments
Live case

The GORE cTAG conformable thoracic stent-graft with ACTIVE CONTROL system for the endovascular repair of a challenging thoracic aortic aneurysm

This is a case of 63 yrs old female with a very challenging TAA (7.8 cm, massive elongation of the aorta, short proximal neck and type III aortic arch), who was treated endovascularly with the new cTAG endograft. The proximal landing zone was extended through a left carotid subclavian bypass up to the LCCA and the device showed an excellent conformability to this challenging anatomy. In this video, all the important steps of TEVAR as well as of cTAG implantation are illustrated.

April 5, 2020 1 Comment
Technical note

Surgeon Modified Fenestrated EVAR 2.0

Clinical case video describing urgent correction of a proximal type I endoleak, in previous standard EVAR procedure, which caused a rapid growth of the residual aneurysmal sac. The patient was unfit for open surgery due to multiple severe comorbidities. Considering the urgency setting, the use of a market available custom-made device was not reasonable. For this reason, the patient underwent endovascular correction using a “surgeon modified” endograft (Medtronic Valiant Navion Thoracic Endograft) designed with four custom fenestrations for visceral and renal vessels.

April 5, 2020 4 Comments
Case report

Type A dissection: The endovascular solution

We report a case of a type A dissection after TAVI procedure in 82-year-old fragile high-risk patient.

This work could be of interest because we decided to perform a bailout TEVAR procedure to treat a type A dissection with a primary entry tear in middle segment of the ascending aorta because the severe comobordities of the patient do not allow to proceed to the standard surgical repair.

The current endovascular stent graft technology could offer an alternative and emerging treatment option in selected high-risk patients with acute type A dissection who are unfit for surgical repair

April 5, 2020 1 Comment
Recorded video case

Transaxillary TEVAR with an in situ fenestrated Endurant tube endograft for a ruptured thoracoabdominal aortic aneurysm

This patient was admitted at Athens Medical Center with a contained rupture of the thoracoabdominal aorta. The CT scan revealed complete occlusion of the infrarenal aorta with collateralisation of the profunda arteries at both sites through the SMA and the Riolan anastomosis. In his previous history, the patient was treated with an aortobifemoral bypass for Leriche syndrome (2008) with graft infection (2010) and replacement of the aorta with femoral veins (2010). We planned a transaxillary TEVAR (diameter of proximal left axillary artery: 6.5cm) and triple puncture of the right axillary artery.

March 17, 2020 1 Comment
Technical note

How to use a 20 mL-syringe to explant an infected stentgraft with suprarenal fixation?

Suprarenal fixation of aortic stentgraft can be left in place when explantation is performed in uninfected situations such as ruptured endoleak or acute thrombosis. In case of infections and especially in stentgraft-enteric fistula, this strategy can promote reinfection and recurrence of the fistula. Total control of the suprarenal aorta and visceral arteries revascularisation can be achieved through a left retroperitoneal approach but with poor access to repair the bowel in case of fistula. In this situation midline laparotomy is the best approach to perform the repair of the bowel and syringe extraction represents a valuable option to explant the stentgraft

February 26, 2020 No Comments
Awareness

A patient perspective on Aortic Disease

The article provide the personal views, experiences and thoughts of one patient diagnosed with Bicuspid Aortic Valve syndrome (BAV), Familial Thoracic Aortic Aneurysm and Dissection (FTAAD) and Atrioventricular Block (AV block) since 2012. The author has no medical education. The contents are written in layman’s terms. You can read about one patient’s personal experience of aortic diseases.

February 10, 2020 2 Comments
Recorded video case

Total extraction of infected aortic and iliac branched stentgrafts.

Step by step procedure on how to explant an aortic and iliac branch endoprosthesis with minimal duration of suprarenal aortic cross clamping in a patient with altered renal function.

January 28, 2020 No Comments
Poll 06/01/2020 – 31/01/2020

VASCUPEDIA@LINC – ENDOLEAKS-CASE-BASED SOLUTIONS

The topic of this month is called ENDOLEAKS-CASE-BASED SOLUTIONS and aims to provide more information to the discussants of the session about endoleaks that will take place on Thursday, January 30, 2020 in Leipzig, during the LINC symposium. Take the opportunity to answer the questions and to inform the experts about your current practice for the treatment of all type of endoleaks.

Your participation will provide unique data for an interesting discussion and your answers will challenge the experts during the session.

Case report

J MINISTERNOTOMY FOR ASCENDING AORTA AND RAPID DEPLOYMENT VALVE REPLACEMENT

We present a case of ascending an rapid deployment aortic valve replacement (Edwards Intuity Elite Prosthesis) thorough a J Ministernotomy approach in old patient.

January 4, 2020 No Comments
Technical note

How to perform a clampless hybrid aortic anastomosis

In various circumstances of aortic repairs, such as heavy circumferential calcifications or shaggy aorta with extensive thrombus, open and endovascular techniques are at high risk. In such cases, aortic clamping is fraught with risks of aortic rupture or emboli while endovascular techniques may not be successful with also a risk of emboli. Hybrid techniques may be an elegant solution. We describe here a hybrid technique that allows performing an aortic anastomosis without clamping thereby avoiding the above-cited risks. This educational video will allow other vascular surgeons to reproduce the technique.

December 4, 2019 1 Comment
Case report

Surgeon modified Fenestrated EVAR: step by step procedure

This is a tutorial about performing on table standard EVAR fenestration and subsequent aneurysm repair in the present case the patient was unfit for surgery and had a large left accessory renal artery. He was treated with infrarenal surgeon modified endograft and accessory renal artery overstenting. Successful treatment and satisfying control CT scan

 

November 30, 2019 3 Comments
Case report

ChEVAR for a juxtarenal aneurysm with impending rupture using brazilian endovascular devices

Totally percutaneous chimney technique for a juxtarenal impending rupture aneurysm using off-the-shelf brazilian devices in a fragile, comorbid patient. #casereport #chevar #pevar #juxtarenal

October 25, 2019 No Comments