Endovascular Treatment of Acute Aortic Emergencies: Early Results Badr Aljabri, MD, FRCSC King Khalid University Hospital Riyadh, Saudi Arabia.

Slides:

Advertisements

Similar presentations

Ross Milner, MDUniversity of Chicago Mark Russo, MD, MS Center for Aortic Diseases.

Advertisements

William Beaumont Hospital Royal Oak, Michigan

Menaka Nadar, MD University of Virginia. CC: Acute onset abdominal pain HPI: 43 year old male with a history of Marfan’s syndrome presented to outside.

Aortic Pathology Angioclub Case Alex Copelan M.D. William Beaumont Hospital October 24, 2013.

KAREN L. WALKER MS JONATHAN J. SHUSTER PHD THOMAS M. BEAVER MD, MPH DIVISION OF THORACIC AND CARDIOVASCULAR SURGERY DIVISION OF BIOSTATISTICS UNIVERSITY.

Antegrade Stent Grafting of Descending Thoracic Aorta During Acute Debakey I Dissection: Early and Midterm Outcomes Prashanth Vallabhajosyula MD, Joseph.

Angioclub Case Series: Aortic Pathology Candace L. White MA, MD Mount Sinai Medical Center of Florida.

Division of Cardiovascular Surgery Xijing Hospital, Xi’an, China

TEVAR is Superior to Open Repair for Blunt Aortic Injury Royce Calhoun, MD, Stephanie Mayberg, PA-C, Bill Pevec, MD, Danh Nguyen, PhD^, Lisa Mu^ J. Nilas.

Viabahn Covered Stents for Cephalic Arch Stenosis Can Improve Patency and Longevity of Upper Arm AV Fistulas Toufic Safa, MD, FACS Vascular & Endovascular.

Epidemiology, Risk Factors, Diagnosis and Intervention of Abdominal Aortic Aneurysms By, Sultan O Al-Sheikh.

Associate professor and consultant Vascular Surgery

MedPix Medical Image Database COW - Case of the Week Case Contributor: Christopher J Manganello Affiliation: Uniformed Services University.

New York Aortic Surgery Symposium 2010 Mohamad Bashir, Aaron Ranasinghe, David Quin, Ben Holloway, Jorge Mascaro, Robert Bonser The limited potential for.

Aneurysms & Aneurysm Screening

SIR-RFS AngioClub Ethan M. Dobrow, PGY-4 Maine Medical Center, Portland, Maine (The Freeman Hospital, Newcastle-Upon-Tyne, UK)

Endovascular management of complicated AAA 复杂腹主动脉瘤的腔内修复治疗 Department of Vascular Surgery, Xiang-Ya Second Hospital, Central-South University 中南大学湘雅二医院血管.

P Narayan, A Wong, I Davies, A J Bryan, P Wilde, G J Murphy Does TEVAR provide a financial benefit for management of descending thoracic aortic pathologies?

What Is Being Done Where

LAUREN SINNENBERG BS, WILSON SZETO, MD, PATRICK MOELLER BS, PRASHANTH VALLABHAJOSYULA, MD, G. WILLIAM MOSER, CRNP, NIMESH DESAI, MD PHD, JOSEPH BAVARIA,

Dr R H Stables Cardiothoracic Centre Liverpool, UK Thoracic Aortic Stent Grafting.

Joint Hospital Surgical Ground Round The Management of Mycotic Aneurysm Chan Hoi Yee Princess Margaret Hospital.

The Use of Thoracic Endovascular Stent Grafting in Acute Aortic Tragedies as Compared to Open Surgical Repair Tyler J. Wallen, BA, Wilson Y. Szeto, MD,

Usefulness of fenestrated stent graft for thoracic aortic aneurysms

Osaka University Department of Cardiovascular Surgery Osaka University Department of Cardiovascular Surgery The efficacy of debranching TEVAR for arch.

Central Cannulation Strategy Via Left Thoracotomy in the Treatment of Chronic or Residual Type B Dissection Extent I Thoracoabdominal + Distal Aortic Arch.

One-stage repair for Stanford Type B Aortic Dissection concomitant with cardiac diseases Open stented elephant trunk technique combined with cardiac operation.

AORTIC ANEURYSM Prepared by: Dr. Hanan Said Ali. Objectives Define aortic aneurysm. Enumerate causes. Classify aortic aneurysm. Enumerate clinical manifestation.

Aneurysm. It is a blood sac that communicates with the lumen of an artery They are classified according to –Etiology congenital Acquired –pathological,

AL Estrera, MD, D Gochnour, MD, CC Miller III, PhD, A Azizzadeh, MD, S Coogan, MD,J Holcomb, MD, H Safi, MD Progress in the Treatment of Blunt Thoracic.

Aortic Remodeling after Endovascular Repair of the Descending Thoracic Aorta G. William Moser CRNP, Patrick Moeller BS, Thomas Bavaria Jr. BS, Ahmad Zeeshan.

Department of Cardiothoracic and Vascular Surgery 1 School of Public Health 2 The University of Texas Medical School at Houston Memorial Hermann Heart.

Aortic Emergencies LISA BROUGHTON, PHD, RN, CCRN.

Traumatic arterial injuries: endovascular treatment Martha A. Quiodettis May 25, 2010.

Mesenteric Ischemia: A Minimally Invasive Approach

Surgery for chronic ruptured contained abdominal aortic aneurysm- a case report Grant Medical College Mumbai Dr Suraj.

Restrictive bare stent for prevention of stent graft-induced distal redissection after thoracic endovascular aortic repair for type B aortic dissection

Open Repair of Ruptured Descending Thoracic and Thoracoabdominal Aortic Aneurysms in 100 Consecutive Cases Mario F. Gaudino, Christopher Lau, Monica Munjal,

Directional tip control technique for optimal stent graft alignment in angulated proximal aortic landing zones Toshio Takayama, MD, PhD, Patrick J. Phelan,

Endovascular repair of proximal endograft collapse after treatment for thoracic aortic disease Markus G.M. Steinbauer, MD, Alexander Stehr, MD, Karin.

Thoracic Aortic Frontier: Review of Current Applications and Directions of Thoracic Endovascular Aortic Repair (TEVAR) Jehangir J. Appoo, MDCM, FRCSC,

Acute blunt traumatic injury to the descending thoracic aorta

Thoracic Endovascular Aortic Repair Including Total Debranching on Femoral Artery for Arch Rupture Yu Inaba, MD, Tsutomu Ito, MD, PhD, Sachiko Hayashi,

Infectious complications after elective vascular surgical procedures

Thoracic Stent Grafting for Acute Aortic Pathology

The feasibility of endovascular aortic repair strategy in treating infected aortic aneurysms Chung-Dann Kan, MD, PhD, Hsu-Ting Yen, MD, Chung-Ben Kan,

Saphenous vein graft aneurysm formation in a patient with idiopathic multiple aneurysms Yu Lun, MD, Han Jiang, MD, PhD, Yuchen Jing, MD, Shijie Xin,

Midterm results from a physician-sponsored investigational device exemption clinical trial evaluating physician-modified endovascular grafts for the treatment.

Restrictive bare stent for prevention of stent graft-induced distal redissection after thoracic endovascular aortic repair for type B aortic dissection

Staged hybrid approach using proximal thoracic endovascular aneurysm repair and distal open repair for the treatment of extensive thoracoabdominal aortic.

Efficacy and durability of the chimney graft technique in urgent and complex thoracic endovascular aortic repair Adel Bin Jabr, MD, Bengt Lindblad, MD,

Management of acute type B aortic dissection

Thoracic endovascular aortic repair with branched Inoue Stent Graft for arch aortic aneurysms Junichi Tazaki, MD, Kanji Inoue, MD, Hirooki Higami, MD,

Paraplegia after coronary artery bypass surgery: An uncommon complication in a patient with history of thoracic endovascular aortic repair Aurélien Vallée,

Use and durability of femoral vein for autologous reconstruction with infection of the aortoiliofemoral axis Bernhard Dorweiler, MD, PhD, Achim Neufang,

Saphenous vein graft aneurysm formation in a patient with idiopathic multiple aneurysms Yu Lun, MD, Han Jiang, MD, PhD, Yuchen Jing, MD, Shijie Xin,

Treatment of an early type II endoleak causing hemorrhage after endovascular aneurysm repair for ruptured abdominal aortic aneurysm Olivier Hartung,

Dissection of the abdominal aorta in blunt trauma: endovascular or conventional surgical management? Jean-Philippe Berthet, MD, Charles-Henri Marty-Ané,

Late neurological recovery of paraplegia after endovascular repair of an infected thoracic aortic aneurysm Barend M.E. Mees, MD, PhD, Frederico Bastos.

Aortic remodeling after endovascular repair with stainless steel-based stent graft in acute and chronic type B aortic dissection Chih-Pei Ou Yang, MD,

Endovascular treatment of traumatic thoracic aortic injury—should this be the new standard of treatment? Peter H. Lin, MD, Ruth L. Bush, MD, Wei Zhou,

Pregnancy-Associated Type B Aortic Dissection Treated With Thoracic Endovascular Aneurysm Repair Chang Shu, MD, PhD, Kun Fang, MD, Alan Dardik, MD, PhD,

G. Chad Hughes, MD, Asvin M. Ganapathi, MD, Jeffrey E

Sukgu M. Han, MD, Warren J. Gasper, MD, Timothy A.M. Chuter, MD

Hybrid Repair of an Aortic Arch Aneurysm Using Double Parallel Grafts Perfused by Retrograde Flow in Endovascular Repair Combined With Left Subclavian.

Massachusetts General Hospital

Endovascular Treatment of Late Anastomotic Aneurysm Following Bypass Surgery for Atypical Aortic Coarctation due to Takayasu Arteritis Y. Obitsu, N.

Phlegmasia cerulea dolens secondary to an aortoiliac aneurysm

Presentation transcript:

Endovascular Treatment of Acute Aortic Emergencies: Early Results Badr Aljabri, MD, FRCSC King Khalid University Hospital Riyadh, Saudi Arabia

EVAR and Aortic Emergency To evaluate early results of EVAR used in different Aortic Emergencies King Khalid University Hospital, Riyadh

Methods From prospective collected data of consecutive patients with Acute Aortic Emergencies (AAE) treated with EVAR February January 2008

Methods Preoperative multi-planer enhanced computed tomography with 2.5 mm cuts. All done under GA. Stent grafts were introduced through a common femoral artery cut down.

Methods Back-up meier wire Angiography cath through right brachial artery

22 EVAR February January Thoracic 4 Abdominal 1 Hybrid

10 AAE 5 Blunt traumatic thoracic aorta ruptures 4 Ruptured true thoracic aortic aneurysms 1 Ruptured proximal anastomotic aortic psudoaneurysm

Results 13 stent grafts implanted 9 Males : 1 Female mean age of 45 years (22– 73 years) Stent graft diameter mm

Number of patients Number of stents Technical success rate % Left SCA Coverage 30-day mortality rate (%) Complications Blunt Thoracic Rupture Ruptured true thoracic aortic aneurysms (50)1MI Ruptured proximal anastomotic aortic psudoaneurysm 11100NA00 Total (20)1 MI

Results No paraplegia or stoke 1 Access related complication

Case review

Ruptured true thoracic aortic aneurysm 65 year old male patient, HTN Sever back pain No history of trauma Referred with TAA for further management

Ruptured proximal anastomotic aortic psudoaneurysm 52 year old male patient HTN, NIDDM,ESRD on hemodialysis Aorto-bifemoral bypass 6 years ago ACS with left ventricular aneurysm Abdominal pain + pulsatile tender mass Cardiac cath

Blunt traumatic thoracic aorta rupture 23 year old male patient Head-on collusion MVA Multiple fractures both upper and lower limbs and small liver laceration CXR Enhanced CT

17 series 1109 patients 538 (48.5%) TEVAR Significant reduction in Mortality Neurological injury Subgroup analysis

Retrospective review 74 patients 35 open VS 39 TEVAR 30 day mortality 20% surgical group 7.7% TEVAR

30 patients 2 (6.6%) 30-day mortality 1 stroke No paraplegia

Conclusion Endovascular stent graft is an effective treatment option for an acute aortic emergencies particularly those who present with traumatic ruptures. Long-term follow-up is required to confirm its durability

Thank You