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.

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 No Comments
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 No Comments
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 4 Comments
Question to the Vascupedians

Results – Polling Station June 18

This presentation summarizes the results of the first topic of the polling station about asymptomatic juxta- and suprarenal aortic aneurysms.
Total number of votes: 103.
The results are now open for discussion.

July 2, 2018 No Comments
Review of the literature

Gutters after Chimney EVAR: How „PERICLES and PROTAGORAS“ can protect ACHILLES heel?

One of the main topics at each meeting is the discussion about the importance and clinical relevance of gutter-related endoleaks after ch-EVAR. Herein, we present you an overview of the most important causative mechanisms for the development of persistent gutters and tips to treat and minimize the risk of appearance.

July 1, 2018 2 Comments
Review of the literature

Hemodynamic and mechanical interpretation of the clinical performance of abdominal aortic endografts: principles and considerations

What are the factors predisposing to migration of endografts after EVAR? How are the stresses, pressure and forces distributed postiperatively? Can the geometric parameters predict future adverse effects? How are mechanical, hemodynamic and geometrical changes interconnected postinterventionally? This presentation introduces some basic hemodynamic pronciples and terminology as a means to comprehend the phenomena taking place after endograft implantation.

June 19, 2018 1 Comment
Recorded video case

Endovascular treatment of bilateral hypogastric artery aneurysms

This is a recorded case of bilateral hypogastric artery aneurysm treated by coil embolization on the one side and an iliac-side branch device on the other side. In this video, you will learn about access vessels, decision making, how to embolize the aneurysm of the hypogastric artery, how to implant the iliac-side branch device as well as further relevant technical aspects and features of the device.

June 18, 2018 No Comments
Case report

TAAA: Back table surgeon-modified stent-graft with internal branches

We report some cases performed with a stent-graft modified by the surgeon with internal branches for the treatment of TAAAs. In total, we have 34 cases performed with this technique and we developed and patented a low profile device to be used in almost all anatomical types of TAAAs. This device may be considered off-the-shelf graft. See also: https://vascupedia.com/presentation/an-off-the-shelf-and-low-profile-stentgraft-for-treatment-of-thoracoabdominal-aneurysms/

June 18, 2018 No Comments
Review of the literature

Differences between 2D3D and 3D3D Fusion Imaging – why it matters

Fusion Imaging, Vessel Navigation, 3D guidance... the list of names for integrating preoperative imaging into fluoroscopy is long. This presentation attempts to clarify the differences between 2D3D and 3D3D fusion imaging and why this can have an impact on how you structure your procedure.

June 13, 2018 No Comments
Case report

Fully Percutaneous Transaxillary Transcatheter Aortic Valve Implantation in patients with a patent left internal mammary graft

We report a clinical experience with fully percutaneous transaxillary TAVI in patients with a patent left internal mammary graft.

June 11, 2018 5 Comments
Recorded video case

Total endovascular treatment of the aortic arch after type A dissection with chimney and sandwich technique

This is a very advanced case of a total endovascular repair of a post-type A dissection aneurysm of the aortic arch with chimney endografts for the brachiocephalic trunk and the LCCA and a periscope in Sandwich technique for the LSA. See the procedure in chapters for the different steps under: https://vascupedia.com/video/total-endovascular-treatment-of-the-aortic-arch-after-type-a-dissection-with-chimney-and-sandwich-technique/

June 11, 2018 9 Comments
Review of the literature

Diagnostic algorithms for endoleaks

This is a current overview of the evidence and techniques regarding the time and type of endoleak treatment as well as information about postoperative anticoagulation. Moreover, we provide our institution's algorithm about the surveillance protocol of endoleaks after EVAR procedures.

June 7, 2018 3 Comments
Recorded video case

Principles of EVAR planning and sizing – Chapter 1: Drawing & Measurements

This short tutorial is the first chapter of an online workshop about the principles of EVAR planning. Herein, you will find all important steps for a successful preparation of your EVAR procedure. What about drawing? What should I draw? What are the anatomic issues need to be addressed and considered? and much more information.

June 6, 2018 5 Comments
Experimental investigation

An off the shelf and low profile stentgraft for treatment of thoracoabdominal aneurysms

I recently developed an off the shelf stentgraft for treatment of thoracoabdominal aortic aneurysms involving the visceral branches. With this off the shelf device, aneurysms can be treated with any anatomical configuration of the visceral vessels, such as only 1, 2, 3 or 4 branches. I began to have the idea of developing this device from a technique of internal branches that I developed for treatments of thoracoabdominal aneurysms. We performed almost 40 patients with this technique.

June 4, 2018 3 Comments
Recorded video case

Two technical tips for severely angulated infrarenal necks during EVAR

This is a short video with two technical tips for the treatment of severely angulated necks with standard EVAR (Endurant, Medtronic) if an open surgical repair is not indicated. The first tip starts with the release of the top cap before the opening of the contralateral gate and the second tip is a solution to pull safely back the top cap if you have a conflict with the suprarenal stent. However, do not forget that this is an outside the IFU implantation of the device.

June 2, 2018 5 Comments

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