The Experts below are selected from a list of 1596 Experts worldwide ranked by ideXlab platform
Willem Wisselink - One of the best experts on this subject based on the ideXlab platform.
-
mid term results of robot assisted laparoscopic surgery for Aortoiliac Occlusive Disease
Vascular, 2011Co-Authors: Vincent Jongkind, J Diks, Kak K Yeung, Miguel A Cuesta, Willem WisselinkAbstract:The aim of this study was to evaluate middle-term clinical results of robot-assisted laparoscopic surgery (RALS) to treat Aortoiliac Occlusive Disease (AIOD). Between 2002 and 2007, 28 consecutive patients received robot-assisted laparoscopic aortobifemoral bypass grafting (n = 24) or Aortoiliac endarterectomy (n = 4). Patients were followed prospectively. RALS could be completed successfully in 24 patients; conversion to open surgery was necessary in four patients (14%). Median operative time was 350 min. Median aortic clamping time was 70 min. Median hospital stay was five days. One patient died within 30 days. Non-lethal complications occurred in four patients (14%). Clinical symptoms improved in all patients. Primary and secondary limb-based patencies at 36 months were 89% and 91%, respectively. In conclusion, RALS is a feasible and durable technique for patients with AIOD. Although operative times are long, RALS allows rapid postoperative recovery.
-
a systematic review of endovascular treatment of extensive Aortoiliac Occlusive Disease
Journal of Vascular Surgery, 2010Co-Authors: Vincent Jongkind, Kak K Yeung, G J Akkersdijk, Willem WisselinkAbstract:Objectives Current multidisciplinary guidelines recommend to treat extensive Aortoiliac Occlusive Disease (AIOD) by surgical revascularization. Surgery provides good long-term patency, but at the cost of substantial perioperative morbidity. Development of new technologies and techniques has led to increased use of endovascular therapy for extensive AIOD. We performed a systematic review of the literature to determine contemporary short- and long-term results of endovascular therapy for extensive AIOD. Methods The Medline, Embase, and Cochrane databases were searched to identify all studies reporting endovascular treatment of extensive AIOD (TransAtlantic Inter-Society Consensus (TASC) type C and D) from January 2000 to June 2009. Two independent observers selected studies for inclusion, assessed the methodologic quality of the included studies, and performed the data extraction. Outcomes were technical success, clinical success, mortality, complications, long-term primary, and secondary patency rates. Results Nineteen nonrandomized cohort studies reporting on 1711 patients were included. There was substantial clinical heterogeneity between the studies considering study population and interventional techniques. Technical success was achieved in 86% to 100% of the patients. Clinical symptoms improved in 83% to 100%. Mortality was described in seven studies and ranged from 1.2% to 6.7%. Complications were reported in 3% to 45% of the patients. Most common complications were distal embolization, access site hematomas, pseudoaneurysms, arterial ruptures, and arterial dissections. The majority of complications could be treated using percutaneous or noninvasive techniques. Four- or 5-year primary and secondary patency rates ranged from 60% to 86% and 80% to 98%, respectively. Conclusions Endovascular treatment of extensive AIOD can be performed successfully by experienced interventionists in selected patients. Although primary patency rates are lower than those reported for surgical revascularization, reinterventions can often be performed percutaneously, with secondary patency comparable to surgical repair.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease early clinical experience
European Journal of Vascular and Endovascular Surgery, 2005Co-Authors: D Nio, J Diks, Miguel A Cuesta, Carlos Gracia, Jan A Rauwerda, Matteus A M Linsen, Willem WisselinkAbstract:Abstract Background Robotic technology may facilitate laparoscopic aortic reconstruction. We present our early clinical experience with laparoscopic aortobifemoral bypass, aided by two different robotic surgical systems. Methods Between February 2002 and April 2004, we performed eight robot-assisted laparoscopic aorto-bifemoral bypasses for Aortoiliac Occlusive Disease. All patients were male; median age was 55 years (range: 36–64). Dissection was performed laparoscopically and the robotic system was used to construct the aortic anastomosis. Results A robot-assisted anastomosis was successfully performed in seven patients. Median operative time was 405 min (range: 260–589), with a median clamp-time of 111 min (range: 85–205). Median blood loss was 900 ml (range: 200–5800). Median anastomosis time was 74 min (range 40–110). In two patients conversion was necessary, one due to bleeding of an earlier clipped lumbar artery after completion of the anastomosis, the other because of difficulties with the laparoscopic exposure of the aorta. On post-operative day 3 one patient died unexpectedly as a result of a massive myocardial infarction. Median hospital stay was 7.5 days (range: 3–57). Conclusion Our initial experience with robotic assisted laparoscopic surgery (RALS) shows it is a feasible technique for Aortoiliac bypass surgery. However, laparoscopic Aortoiliac surgery demands considerable experience and operative times need to be reduced before this technique can be widely implemented.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease a report of two cases
Journal of Vascular Surgery, 2002Co-Authors: Willem Wisselink, Miguel A Cuesta, Carlos Gracia, Jan A RauwerdaAbstract:This article describes the use of robotic technology in laparoscopic aortobifemoral bypass grafting. In two patients with disabling intermittent claudication on the basis of severe Aortoiliac Occlusive Disease, laparoscopic aortobifemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms that had been mounted on the operating table and were controlled from a separate console. No complications occurred. Operating times were 290 and 260 minutes, and aortic anastomosis times were 48 and 37 minutes, respectively. Blood loss was less than 200 mL in both cases. A normal diet was resumed on the second postoperative day, and the patients were discharged home on postoperative days 4 and 6. To our knowledge, this is the first report on robot-assisted laparoscopic aortobifemoral bypass in the world literature.
Michel M P J Reijnen - One of the best experts on this subject based on the ideXlab platform.
-
meta analysis of individual patient data after kissing stent treatment for Aortoiliac Occlusive Disease
Journal of Endovascular Therapy, 2019Co-Authors: Erik Groot Jebbink, Frederike A B Grimme, Suzanne Holewijn, Michel Versluis, Jan Willem Hinnen, Sebastian Sixt, John F Angle, Walter Dorigo, Michel M P J ReijnenAbstract:Purpose: To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of Aortoiliac Occlusive Disease (AIOD) based on an individual participant data (IPD) meta-ana...
-
18-0175_Supplemental_File_1 – Supplemental material for Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease
2018Co-Authors: Erik Groot Jebbink, Suzanne Holewijn, Michel Versluis, Jan Willem Hinnen, Sebastian Sixt, John F Angle, Walter Dorigo, Frederike Grimme, Michel M P J ReijnenAbstract:Supplemental material, 18-0175_Supplemental_File_1 for Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease by Erik Groot Jebbink, Suzanne Holewijn, Michel Versluis, Frederike Grimme, Jan Willem Hinnen, Sebastian Sixt, John F. Angle, Walter Dorigo and Michel M. P. J. Reijnen in Journal of Endovascular Therapy
-
systematic review of results of kissing stents in the treatment of Aortoiliac Occlusive Disease
Annals of Vascular Surgery, 2017Co-Authors: Erik Groot Jebbink, Suzanne Holewijn, Cornelis H Slump, Jan Willem Lardenoije, Michel M P J ReijnenAbstract:Background Endovascular treatment of Aortoiliac Occlusive Disease (AIOD) involving the aortic bifurcation is challenging. The gold standard is open surgery with patency rates up to 90% at 5 years, but has considerable morbidity and mortality. The kissing stent (KS) technique was introduced as an alternative. The goal of this review is to give an overview of the current results and role of the KS technique in AIOD treatment. Methods The Cochrane guidelines were used to assure a systematic method. A search query designed in the Scopus search interface was used to identify relevant studies. Abstracts from the search were screened against the inclusion and exclusion criteria. During full-text reading, methodological quality was scored using a critical review list tailored to the topic of AIOD. Thereafter, study data were extracted and pooled for further analysis. Results In total, 143 abstracts were retrieved using Scopus, 116 were rejected and 7 more were rejected after full-text screening. One study was included after cross referencing. Twenty-one studies presented 1,390 patients. Rutherford classification 1/2/3 was the indication in 76.2% of patients, and 48.4% of the lesions were classified as Trans-Atlantic Inter-Society Consensus C or D. The technical success rate was 98.7%, and the complication rate was 10.8%. Clinical improvement at 30 days was achieved in 89.9%. Primary patency at 12, 24, and 60 months was 89.3%, 78.6%, and 69.0%, respectively. Conclusions KS treatment of AIOD yields acceptable mid-term results, with high technical success rates and mostly minor complications occur. The long-term patency cannot yet match that of open surgery, underlining the need for further research that provides insight into factors related to reocclusion.
-
treatment of Aortoiliac Occlusive Disease with the endologix afx unibody endograft
European Journal of Vascular and Endovascular Surgery, 2016Co-Authors: Thomas S Maldonado, Michel M P J Reijnen, Gregory G Westin, Omid Jazaeri, Mark W Mewissen, Amit J Dwivedi, H E Garrett, Dias A Perera, T Shimshak, Vito A ManteseAbstract:Objective/Background Aorto-bifemoral bypass remains the gold standard for treatment of Aortoiliac Occlusive Disease (AIOD) in patients with advanced (TASC D) lesions, but has significant associated morbidity and mortality. Treatment with a unibody stent-graft positioned at the aortic bifurcation is a potential endovascular option for the treatment of AIOD. The current study examines the safety, efficacy, and early patency rates of the Endologix AFX unibody stent-graft for treatment of AIOD. Methods A multicenter retrospective review was conducted of patients treated exclusively for AIOD with the AFX device. Primary, assisted primary, and secondary patency rates were noted. Clinical improvement was assessed using Rutherford classification and ankle brachial index. Mean duration of follow-up was 22.2 ± 11.2 months. Ninety-one patients (56 males [62%]) were studied. Results Sixty-seven patients (74%) presented with lifestyle-limiting intermittent claudication and the remaining 24 (26%) had critical limb ischemia. Technical success was 100%. Complications included groin infection ( n = 4 [4%]), groin hematoma ( n = 4 [4%]), common iliac rupture ( n = 4 [4%]), iliac dissection ( n = 4 [4%]), and thromboembolic event ( n = 3 [3%]; one femoral, one internal iliac artery, and one internal iliac with bilateral popliteal/tibial thromboemboli). Thirty-day mortality was 1% (1/91) resulting from a case of extensive pelvic thromboembolism. At 1 year, 73% of patients experienced improvement in Rutherford stage of −3 or greater compared with baseline. Nine patients (10%) required 16 secondary interventions. At all time points, primary patency rates were > 90%, assisted patency rates were > 98%, and secondary patency rates were 100%. Conclusion This is the largest study to examine the use of the Endologix AFX unibody stent-graft for the treatment of AIOD. Use of the AFX stent-graft appears to be a safe and effective endovascular treatment for complex AIOD.
-
editor s choice first results of the covered endovascular reconstruction of the aortic bifurcation cerab technique for Aortoiliac Occlusive Disease
European Journal of Vascular and Endovascular Surgery, 2015Co-Authors: Frederike A B Grimme, Peter Goverde, P J E M Verbruggen, Clark J Zeebregts, Michel M P J ReijnenAbstract:Objective In this study the first results are presented of a new endovascular technique using covered stents to reconstruct the aortic bifurcation in patients with Aortoiliac Occlusive Disease. With the "Covered Endovascular Reconstruction of the Aortic Bifurcation" (CERAB) technique, the anatomy and physiology of the aortic bifurcation is mimicked. Material and methods Between 2009 and March 2014, 103 patients (51 male, 52 female) suffering from obstructive lesions at the level of the aortic bifurcation were treated with CERAB in two clinics. The median age was 61 years (range 36–85 years). Lesion morphology was evaluated by CT angiography. Six TASC-II B lesions, nine TASC-II C lesions, and 88 TASC-II D lesions were treated. Follow up was a median 12 months (range 0–49 months) and consisted of clinical examination, ankle brachial indices, and duplex ultrasound examination. Results Technical success was obtained in 98 procedures (95.1%). In five cases lesions could not be recanalized. Primary patency was 87.3% at 1 year and 82.3% at 2 years, while secondary patency was 95.0% at 1 year and 95.0% at 2 years. Mean ankle brachial indices improved significantly from 0.64 ± 0.21 before to 0.91 ± 014, after the procedure ( p Conclusions The CERAB technique appears to be a safe and feasible alternative to open surgical reconstruction of the aortic bifurcation in complex Occlusive Disease. Comparative studies with the current gold standards are indicated.
Jan A Rauwerda - One of the best experts on this subject based on the ideXlab platform.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease early clinical experience
European Journal of Vascular and Endovascular Surgery, 2005Co-Authors: D Nio, J Diks, Miguel A Cuesta, Carlos Gracia, Jan A Rauwerda, Matteus A M Linsen, Willem WisselinkAbstract:Abstract Background Robotic technology may facilitate laparoscopic aortic reconstruction. We present our early clinical experience with laparoscopic aortobifemoral bypass, aided by two different robotic surgical systems. Methods Between February 2002 and April 2004, we performed eight robot-assisted laparoscopic aorto-bifemoral bypasses for Aortoiliac Occlusive Disease. All patients were male; median age was 55 years (range: 36–64). Dissection was performed laparoscopically and the robotic system was used to construct the aortic anastomosis. Results A robot-assisted anastomosis was successfully performed in seven patients. Median operative time was 405 min (range: 260–589), with a median clamp-time of 111 min (range: 85–205). Median blood loss was 900 ml (range: 200–5800). Median anastomosis time was 74 min (range 40–110). In two patients conversion was necessary, one due to bleeding of an earlier clipped lumbar artery after completion of the anastomosis, the other because of difficulties with the laparoscopic exposure of the aorta. On post-operative day 3 one patient died unexpectedly as a result of a massive myocardial infarction. Median hospital stay was 7.5 days (range: 3–57). Conclusion Our initial experience with robotic assisted laparoscopic surgery (RALS) shows it is a feasible technique for Aortoiliac bypass surgery. However, laparoscopic Aortoiliac surgery demands considerable experience and operative times need to be reduced before this technique can be widely implemented.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease a report of two cases
Journal of Vascular Surgery, 2002Co-Authors: Willem Wisselink, Miguel A Cuesta, Carlos Gracia, Jan A RauwerdaAbstract:This article describes the use of robotic technology in laparoscopic aortobifemoral bypass grafting. In two patients with disabling intermittent claudication on the basis of severe Aortoiliac Occlusive Disease, laparoscopic aortobifemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms that had been mounted on the operating table and were controlled from a separate console. No complications occurred. Operating times were 290 and 260 minutes, and aortic anastomosis times were 48 and 37 minutes, respectively. Blood loss was less than 200 mL in both cases. A normal diet was resumed on the second postoperative day, and the patients were discharged home on postoperative days 4 and 6. To our knowledge, this is the first report on robot-assisted laparoscopic aortobifemoral bypass in the world literature.
Carlos Gracia - One of the best experts on this subject based on the ideXlab platform.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease early clinical experience
European Journal of Vascular and Endovascular Surgery, 2005Co-Authors: D Nio, J Diks, Miguel A Cuesta, Carlos Gracia, Jan A Rauwerda, Matteus A M Linsen, Willem WisselinkAbstract:Abstract Background Robotic technology may facilitate laparoscopic aortic reconstruction. We present our early clinical experience with laparoscopic aortobifemoral bypass, aided by two different robotic surgical systems. Methods Between February 2002 and April 2004, we performed eight robot-assisted laparoscopic aorto-bifemoral bypasses for Aortoiliac Occlusive Disease. All patients were male; median age was 55 years (range: 36–64). Dissection was performed laparoscopically and the robotic system was used to construct the aortic anastomosis. Results A robot-assisted anastomosis was successfully performed in seven patients. Median operative time was 405 min (range: 260–589), with a median clamp-time of 111 min (range: 85–205). Median blood loss was 900 ml (range: 200–5800). Median anastomosis time was 74 min (range 40–110). In two patients conversion was necessary, one due to bleeding of an earlier clipped lumbar artery after completion of the anastomosis, the other because of difficulties with the laparoscopic exposure of the aorta. On post-operative day 3 one patient died unexpectedly as a result of a massive myocardial infarction. Median hospital stay was 7.5 days (range: 3–57). Conclusion Our initial experience with robotic assisted laparoscopic surgery (RALS) shows it is a feasible technique for Aortoiliac bypass surgery. However, laparoscopic Aortoiliac surgery demands considerable experience and operative times need to be reduced before this technique can be widely implemented.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease a report of two cases
Journal of Vascular Surgery, 2002Co-Authors: Willem Wisselink, Miguel A Cuesta, Carlos Gracia, Jan A RauwerdaAbstract:This article describes the use of robotic technology in laparoscopic aortobifemoral bypass grafting. In two patients with disabling intermittent claudication on the basis of severe Aortoiliac Occlusive Disease, laparoscopic aortobifemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms that had been mounted on the operating table and were controlled from a separate console. No complications occurred. Operating times were 290 and 260 minutes, and aortic anastomosis times were 48 and 37 minutes, respectively. Blood loss was less than 200 mL in both cases. A normal diet was resumed on the second postoperative day, and the patients were discharged home on postoperative days 4 and 6. To our knowledge, this is the first report on robot-assisted laparoscopic aortobifemoral bypass in the world literature.
Miguel A Cuesta - One of the best experts on this subject based on the ideXlab platform.
-
mid term results of robot assisted laparoscopic surgery for Aortoiliac Occlusive Disease
Vascular, 2011Co-Authors: Vincent Jongkind, J Diks, Kak K Yeung, Miguel A Cuesta, Willem WisselinkAbstract:The aim of this study was to evaluate middle-term clinical results of robot-assisted laparoscopic surgery (RALS) to treat Aortoiliac Occlusive Disease (AIOD). Between 2002 and 2007, 28 consecutive patients received robot-assisted laparoscopic aortobifemoral bypass grafting (n = 24) or Aortoiliac endarterectomy (n = 4). Patients were followed prospectively. RALS could be completed successfully in 24 patients; conversion to open surgery was necessary in four patients (14%). Median operative time was 350 min. Median aortic clamping time was 70 min. Median hospital stay was five days. One patient died within 30 days. Non-lethal complications occurred in four patients (14%). Clinical symptoms improved in all patients. Primary and secondary limb-based patencies at 36 months were 89% and 91%, respectively. In conclusion, RALS is a feasible and durable technique for patients with AIOD. Although operative times are long, RALS allows rapid postoperative recovery.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease early clinical experience
European Journal of Vascular and Endovascular Surgery, 2005Co-Authors: D Nio, J Diks, Miguel A Cuesta, Carlos Gracia, Jan A Rauwerda, Matteus A M Linsen, Willem WisselinkAbstract:Abstract Background Robotic technology may facilitate laparoscopic aortic reconstruction. We present our early clinical experience with laparoscopic aortobifemoral bypass, aided by two different robotic surgical systems. Methods Between February 2002 and April 2004, we performed eight robot-assisted laparoscopic aorto-bifemoral bypasses for Aortoiliac Occlusive Disease. All patients were male; median age was 55 years (range: 36–64). Dissection was performed laparoscopically and the robotic system was used to construct the aortic anastomosis. Results A robot-assisted anastomosis was successfully performed in seven patients. Median operative time was 405 min (range: 260–589), with a median clamp-time of 111 min (range: 85–205). Median blood loss was 900 ml (range: 200–5800). Median anastomosis time was 74 min (range 40–110). In two patients conversion was necessary, one due to bleeding of an earlier clipped lumbar artery after completion of the anastomosis, the other because of difficulties with the laparoscopic exposure of the aorta. On post-operative day 3 one patient died unexpectedly as a result of a massive myocardial infarction. Median hospital stay was 7.5 days (range: 3–57). Conclusion Our initial experience with robotic assisted laparoscopic surgery (RALS) shows it is a feasible technique for Aortoiliac bypass surgery. However, laparoscopic Aortoiliac surgery demands considerable experience and operative times need to be reduced before this technique can be widely implemented.
-
robot assisted laparoscopic aortobifemoral bypass for Aortoiliac Occlusive Disease a report of two cases
Journal of Vascular Surgery, 2002Co-Authors: Willem Wisselink, Miguel A Cuesta, Carlos Gracia, Jan A RauwerdaAbstract:This article describes the use of robotic technology in laparoscopic aortobifemoral bypass grafting. In two patients with disabling intermittent claudication on the basis of severe Aortoiliac Occlusive Disease, laparoscopic aortobifemoral bypass grafting was performed with a proximal end-to-side anastomosis constructed with robotic arms that had been mounted on the operating table and were controlled from a separate console. No complications occurred. Operating times were 290 and 260 minutes, and aortic anastomosis times were 48 and 37 minutes, respectively. Blood loss was less than 200 mL in both cases. A normal diet was resumed on the second postoperative day, and the patients were discharged home on postoperative days 4 and 6. To our knowledge, this is the first report on robot-assisted laparoscopic aortobifemoral bypass in the world literature.