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Chellasamy RT, Krishnaswami M. Reinterventions after TEVAR. Indian J Thorac Cardiovasc Surg 2023; 39:325-332. [PMID: 38093920 PMCID: PMC10713966 DOI: 10.1007/s12055-023-01646-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 12/17/2023] Open
Abstract
Thoracic cardiovascular aortic repair is an alternative procedure to open surgery for degenerative thoracic aortic aneurysm and thoracic aortic dissection. The advancements in graft design and imaging techniques have expanded its utility. However, the long-term patency of thoracic endovascular aortic repair (TEVAR) graft is still a concern. This review delves into the literature on re-intervention following TEVAR, highlighting factors that influence the re-intervention rate.
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Affiliation(s)
| | - Murali Krishnaswami
- Department of Radiology, Institute of Cardiac and Aortic Disorders, SIMS Hospital, Chennai, 600026 India
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2
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Ameli-Renani S, Pavlidis V, Morgan RA. Secondary Endoleak Management Following TEVAR and EVAR. Cardiovasc Intervent Radiol 2020; 43:1839-1854. [PMID: 32778905 PMCID: PMC7649162 DOI: 10.1007/s00270-020-02572-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 06/22/2020] [Indexed: 11/01/2022]
Abstract
Endovascular abdominal and thoracic aortic aneurysm repair and are widely used to treat increasingly complex aneurysms. Secondary endoleaks, defined as those detected more than 30 days after the procedure and after previous negative imaging, remain a challenge for aortic specialists, conferring a need for long-term surveillance and reintervention. Endoleaks are classified on the basis of their anatomic site and aetiology. Type 1 and type 2 endoleaks (EL1 and EL2) are the most common endoleaks necessitating intervention. The management of these requires an understanding of their mechanics, and the risk of sac enlargement and rupture due to increased sac pressure. Endovascular techniques are the main treatment approach to manage secondary endoleaks. However, surgery should be considered where endovascular treatments fail to arrest aneurysm growth. This chapter reviews the aetiology, significance, management strategy and techniques for different endoleak types.
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Affiliation(s)
- Seyed Ameli-Renani
- Department of Radiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Vyzantios Pavlidis
- Department of Radiology, St George's University Hospitals NHS Foundation Trust, London, UK
| | - Robert A Morgan
- Department of Radiology, St George's University Hospitals NHS Foundation Trust, London, UK.
- Vascular & Cardiac Surgery Research Centre, St George's University of London, Cranmer Terrace, London, SW17 ORE, UK.
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Watts MM. Percutaneous Endovascular Aneurysm Repair: Current Status and Future Trends. Semin Intervent Radiol 2020; 37:339-345. [PMID: 33041479 PMCID: PMC7540639 DOI: 10.1055/s-0040-1714728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Endovascular aneurysm repair (EVAR) is a common, safe, and effective method of treating abdominal aortic aneurysms. Traditionally treated via surgical cutdown over the common femoral arteries, many recent studies demonstrate percutaneous access techniques to avoid the surgical cutdown. Developing familiarity with these percutaneous techniques, including risks, complications, adjuncts, and alternative accesses, can help improve the outcomes and availability of EVAR. As these techniques become increasingly common, it is not unlikely that they can be practiced safely in select patients in an outpatient setting.
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Affiliation(s)
- Micah M. Watts
- Vascular Institute of Atlantic Medical Imaging, Galloway, New Jersey
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George JM, Price LZ, Korayem AH, Marin ML, Faries PL, Tadros RO. Transradial renal salvage after complex endovascular aneurysm repair complicated by left renal artery thrombosis. JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES 2019; 5:239-242. [PMID: 31304431 PMCID: PMC6600808 DOI: 10.1016/j.jvscit.2018.12.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 12/26/2018] [Indexed: 11/27/2022]
Abstract
Transradial access has been used for percutaneous coronary interventions with success; however, there is limited literature on its use for visceral stenting in the setting of complex endovascular aneurysm repair. We present a case of transradial left renal salvage after renal artery thrombosis in the setting of complex endovascular aneurysm repair.
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Affiliation(s)
- Justin M George
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lucyna Z Price
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Adam H Korayem
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Michael L Marin
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Peter L Faries
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
| | - Rami O Tadros
- Division of Vascular Surgery, Department of Surgery, The Icahn School of Medicine at Mount Sinai, New York, NY
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5
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Early and midterm outcomes after transcatheter embolization of type I endoleaks in 25 patients. J Vasc Surg 2017; 65:346-355. [DOI: 10.1016/j.jvs.2016.06.101] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 06/05/2016] [Indexed: 11/20/2022]
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Azevedo AI, Braga P, Rodrigues A, Ferreira N, Fonseca M, Dias A, Gama Ribeiro V. Persistent Type I Endoleak after Endovascular Treatment with Chimney Technique. Front Cardiovasc Med 2016; 3:32. [PMID: 27703967 PMCID: PMC5028720 DOI: 10.3389/fcvm.2016.00032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 09/06/2016] [Indexed: 11/17/2022] Open
Abstract
Thoracic endovascular aortic repair (TEVAR) is increasingly used in the treatment of acute type B aortic dissection. Type Ia endoleaks are a common complication of the procedure, but its clinical significance and the best treatment strategy remain poorly defined. We present a case of a type Ia endoleak following TEVAR in the treatment of acute type B aortic dissection. Chimney technique approach was used in an attempt to seal the endoleak. Although technical success was suboptimal, the patient remained clinically stable and event free. Data regarding the natural course and management of type Ia endoleaks following TEVAR for aortic dissection are sparse. Future research is required to establish the clinical and technical determinants of the need to treat these endoleaks and the best treatment strategy.
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Affiliation(s)
- Ana Isabel Azevedo
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
| | - Pedro Braga
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
| | - Alberto Rodrigues
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
| | - Nuno Ferreira
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
| | - Marlene Fonseca
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
| | - Adelaide Dias
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
| | - Vasco Gama Ribeiro
- Department of Cardiology, Vila Nova de Gaia/Espinho Hospital Center , Vila Nova de Gaia , Portugal
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Schiattarella GG, Perrino C, Magliulo F, Carbone A, Bruno AG, De Paulis M, Sorropago A, Corrado RV, Bottino R, Menafra G, Abete R, Toscano E, Giugliano G, Trimarco B, Esposito G. Physical activity in the prevention of peripheral artery disease in the elderly. Front Physiol 2014; 5:12. [PMID: 24624088 PMCID: PMC3939939 DOI: 10.3389/fphys.2014.00012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022] Open
Abstract
Aging is a well-known cardiovascular risk factor and cardiovascular diseases (CVD) are estimated to be the most common cause of death in the elderly. Peripheral arterial disease (PAD) represents an important clinical manifestation of CVD leading to increase morbidity and mortality, especially in elderly population. The correct management of PAD population includes the prevention of cardiovascular events and relief of symptoms, most commonly intermittent claudication. Progressive physical activity is an effective treatment to improve walking distance and to reduce mortality and cardiovascular events in patients with PAD, however the ability to effectively engage in physical activity often declines with increasing age. The maintenance and increase of reserve functional capacity are important concepts in the elderly population. Ultimately, the goal in participation of physical activity in the healthy elderly population is maintenance and development of physical functional reserve capacity. Therefore, for individuals suffering of PAD, appropriate physical activity in the form of supervised exercise may serve as a primary therapy. Although there are few direct comparisons of therapeutic exercise programs vs. pharmacological or surgical interventions, these increases in walking distance are greater than those reported for the most widely used agents for claudication, pentoxyphylline, and cilostazol. Despite a reduction in mortality and improvement of quality of life caused by physical activity in the PAD population, the molecular, cellular, and functional changes that occur during physical activity are not completely understood. Therefore, this review article aims at presenting an overview of recent established clinical and molecular findings addressing the role of physical activity on PAD in the older population.
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Affiliation(s)
| | - Cinzia Perrino
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Fabio Magliulo
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Andreina Carbone
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Antonio G Bruno
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Michele De Paulis
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Antonio Sorropago
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Roberto V Corrado
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Roberta Bottino
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Giovanni Menafra
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Raffaele Abete
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Evelina Toscano
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Giuseppe Giugliano
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Bruno Trimarco
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
| | - Giovanni Esposito
- Department of Advanced Biomedical Sciences, University of Naples Federico II Naples, Italy
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