Amer Zanabili

Dr.
  • Country: ES

Activities

Comment on Jun 17, 2020

Amer Zanabili commented on presentation CERAB technique in AIOD lesion.

»Thanks Martin for your useful answers and explanations. In my opinion, the CERAB technique is a useful tool when there is a lesion like stenosis or thrombus at the level of the IMA. However, it has some disadvantages like more collateral need to be sacrificed with uncertain consequences (inferior mesenteric artery, lumbar arteries, accessory renal arteries); in up to 45 – 50% of cases it is necessary to use 4 or 5 stents, and it could be less practical when the aortic diameter is larger than 16 mm. Best regards and thanks again for your excellent work!!!«
Comment on Jun 17, 2020

Martin Schroeder commented on presentation CERAB technique in AIOD lesion.

»Dear Amer , thank you for your feedback and questions. 1) we use Bentley covered stents (Begraft Aortic) the reason for this is the large radial force and the corresponding diameter in the area of the aorta. In our case 16mm (11F) post dilation 18mm (BD Atlas Ballon) with easy adjustability. 2) normally you need 3 covered stents for the CERAB technique - which refers to the infrarenal aorta and the bifurcation of the iliac vessels. however, additional interventions in the iliac vessels are sometimes necessary in complex situations (TASC II D lesions with extension of the CS, chimney, coiling, etc.) In our case it was a bilateral occlusion of the ICA and IEA. In this case, a stent is particularly helpful in cases of severe calcification and possible dissection during revascularization and protects against an early re-occlusion. 3) predilatation, I think it makes sense to create a certain space for the sheats which are important to get the covered stents in place. Distal embolization is of course an issue, two comments to avoid: A) if you use a cut down in the area of the groin as access - flush. B) A preoperative CT angiography and the medical history should provide information about the duration of the occlusion. depending on that i would plan my procedure. Thank you again for your questions, best regards«
Comment on Jun 16, 2020

Amer Zanabili commented on presentation CERAB technique in AIOD lesion.

»Thanks Martin for sharing this interesting case. To create a debate around this technique, I would like to ask you some questions. 1. Which kind of CS have you used and the dimension of them? 2. In your clinical practice, in which percentage do you usually use more than 3 CS to perform the CERAB technique in complex AIOD? Was it necessary to perform any treatment in the external iliac or common femoral arteries in this case? 3. And the last one, do you always predilate the lesion before the stenting implantation? I usually avoid to do it to minimize the risk of distal embolization.«
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.

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Poll 04/10/2019 – 31/10/2019

Choice of antiplatelet therapy around complex revascularisation

A 79-year-old diabetic male patient with no history of coronary disease is referred to you to undergo angioplasty for tissue loss on the tips of the hallux and second toe. He is taking Aspirin 75mg. From preoperative imaging he needs a 20cm SFA occlusion stopping before the adductor hiatus recanalizing as well as multilevel tibial disease which appears to be a combination of short occlusions and stenoses. The dorsal pedal is seen in the foot and is in continuity with the arch. The PT artery appears occluded through it’s whole length.

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Poll 05/09/2019 – 30/09/2019

Online education in vascular medicine

Shape your learning experience on Vascupedia

 

Dear colleagues, our mission is to help physicians worldwide to bring their interventions to perfection. Our hope is to indirectly contribute to safety and well-being of patients with vascular diseases.

Over a year ago, we started Vascupedia as a unique online project that we believe fulfills the need for free education in the challenging field of Vascular Medicine. Now it’s time to ask you to help us to become better for you! Are we offering the right information in the right way at the right level? Is there anything missing to support you in your quest to grow your knowledge to treat your patients in the best possible way? Please complete this short survey to make sure we will work on improving the platform to serve YOUR educational needs!

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Poll 01/08/2019 – 31/08/2019

The Type II Endoleak

Patient’s characteristics

 

Gender: Male

Age: 68 years old

Comorbidity: Arterial hypertension, active smoker

Underwent EVAR 2 years ago

Symptoms:  None

DUS/CT A: Aneurysm sac growth > 7mm compared to last CT scan with evidence of type II Endoleak (Inferior mesenteric artery)

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Poll 13/04/2018 – 30/06/2018

Topic: Asymptomatic juxta- and pararenal aortic aneurysms

Patient’s characteristics

Gender: Female
Age: 75 years old
Comorbidity: Arterial hypertension, hypercholesterinemia, previous aortocoronary bypass grafting, previous myocardial infarction, previous smoker, peripheral arterial disease, atrial fibrillation
Symptoms: None
Previous operations: None

 

Aneurysm characteristics:

Max. aneurysm diameter: 54 mm

Length of proximal infrarenal neck: 0 mm

Distance between SMA and LRA: 20 mm

Diameter of renal arteries: RRA: 5,3 mm, LRA: 6 mm

Suprarenal angulation: 60°

Diameter of distal neck: 30 mm

Minimum diameter of common iliac arteries: R: 11 mm, L:9 mm

Maximum diameter of common iliac arteries: R: 11 mm, L: 14 mm

Minimum diameter of external iliac arteries: R: 7 mm, L: 6,2 mm

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Poll 02/02/2019 – 28/02/2019

The acute limb ischemia

Patient’s characteristics

Gender: Female

Age: 65 years old

Comorbidity: Arterial hypertension, Dyslipidemia

Symptoms:  Acute onset of claudication (<2 weeks), Rutherford class 3 of the left limb

Previous operations: None

ABI: 0.5

DUS: Occlusion of the left popliteal artery

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Poll 01/11/2018 – 30/11/2018

Ilio-femoral deep vein thrombosis

45 years old female patient presenting with painful swelling of the right limb during the last 24 hours. Wells score on admission was 4 points. The duplex ultrasound scanning revealed a femoropopliteal and iliac deep vein thrombosis. No other risk factors were present. No previous operations. No thrombophilia documented.

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Poll 01/10/2018 – 31/10/2018

Critical limb-threatening ischemia – CLI Global Society

Patient’s characteristics

 

Gender: Male

Age: 79 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, chronic kidney disease (GFR: 53 ml/min/1,73m²), NYHA II, Coronary artery disease, previous CABG

Symptoms:  Toe ulceration of the left limb

Previous operations: None

ABI: incompressible, Toe pressure: 32 mmHg

Vascular Imaging – Duplex ultrasound: Isolated tibial vessel disease

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Poll 01/08/2018 – 31/08/2018

Asymptomatic carotid artery disease

Patient’s characteristics

 

Gender: Female

Age: 72 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, previous smoker

Symptoms: None

Previous operations: None

Vascular Imaging of the left internal carotid artery: Duplex ultrasound with peak systolic velocity (PSV)> 230 cm/sec

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Poll 01/08/2018 – 31/08/2018

Asymptomatic carotid artery disease

Patient’s characteristics

 

Gender: Female

Age: 72 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, previous smoker

Symptoms: None

Previous operations: None

Vascular Imaging of the left internal carotid artery: Duplex ultrasound with peak systolic velocity (PSV)> 230 cm/sec

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Poll 01/03/2019 – 31/03/2019

The chronic mesenteric ischemia

Patient’s characteristics

 

Gender: Female

Age: 69 years old

Comorbidity: Arterial hypertension, Dyslipidemia, coronary heart disease (DES deployment 2 years ago)

Symptoms:  Postprandial pain

Previous abdominal operations: None

DUS: Occlusion of the superior mesenteric artery

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