The Experts below are selected from a list of 1254 Experts worldwide ranked by ideXlab platform
Scott R Schell - One of the best experts on this subject based on the ideXlab platform.
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duodenal perforation with an inferior vena cava filter an unusual cause of abdominal pain
Journal of Vascular Surgery, 2002Co-Authors: Robert J Feezor, Thomas S Huber, Burress M Welborn, Scott R SchellAbstract:Abstract The insertion of inferior vena cava (IVC) filters results in Device Migration at rates that exceed 50% in some studies, although the clinical significance of Migration remains in question. These filters can also erode or penetrate the IVC wall, injuring adjacent retroperitoneal and abdominal structures. The risk of erosion or perforation is estimated to be as much as 25%, although clinical symptoms are observed far less frequently in patients with these complications. We describe the presentation, evaluation, and treatment of a patient with an IVC strut protruding into the duodenum. This case report discusses complications, presenting symptoms, and treatment of patients with IVC filters complications. (J Vasc Surg 2002;35:1010-2.)
Samuel R Money - One of the best experts on this subject based on the ideXlab platform.
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mid and long term Device Migration after endovascular abdominal aortic aneurysm repair a comparison of aneurx and zenith endografts
Journal of Vascular Surgery, 2005Co-Authors: Britt H Tonnessen, Charles W Sternbergh, Samuel R MoneyAbstract:Background Freedom from Migration is key to the durability of endovascular aneurysm repair (EVAR). This study evaluates the mid- and long-term incidence of Migration with two different endografts. Methods Between September 1997 and June 2004, 235 patients were scheduled for EVAR with an AneuRx (Medtronic/AVE Inc.) or Zenith (Cook) endograft. Patients with fusiform, infrarenal aneurysms and a minimum 12 months of follow-up were analyzed, for a final cohort of 130 patients. Migration was assessed on axial computed tomography (CT) (2.5 to 3 mm cuts) as the distance from the most caudal renal artery to the first slice containing endograft (AneuRx) or to the top of the bare suprarenal stent (Zenith). Aortic neck diameters were measured at the most caudal renal artery. The initial postoperative CT scan was the baseline. Migration was defined by caudal movement of the endograft at two thresholds, ≥5 mm and ≥10 mm, or a ny Migration with a related clinical event. Results Life-table analysis demonstrated AneuRx freedom from Migration (≥10 mm or clinical event) was 96.1%, 89.5%, 78.0%, and 72.0% at 1, 2, 3, and 4 years, respectively. Zenith freedom from Migration was 100%, 97.6%, 97.6%, and 97.6% at 1, 2, 3, and 4 years, respectively ( P = .01, log-rank test). The stricter 5-mm Migration threshold found 67.4% of AneuRx and 90.1% of Zenith patients free from Migration at 4 years of follow-up. Twelve out of 14 (85.7%) AneuRx patients (12/14) with Migration (≥10 mm or clinical event) underwent 14 related secondary procedures (13 endovascular, 1 open conversion). The single Zenith patient with Migration (≥10 mm) has not required adjuvant treatment. Mean follow-up was 39.0 ± 2.3 months (AneuRx) and 30.8 ± 1.9 months (Zenith, P = .01). Patients with and without Migration did not differ in age, gender ratio, aneurysm diameter, and neck diameter. However, initial neck length was shorter in patients with Migration (22.1 ± 2.1 mm vs 31.2 ± 1.2 mm, P = .02). A subset of patients (21.6%) experienced significant (defined as ≥3 mm) maximum aortic neck dilation. Of the AneuRx patients, ≥3 mm aortic neck dilation affected 30.8% of migrators vs 13.0% of nonmigrators ( P = .20). Conclusions Endograft Migration is a time-dependent phenomenon affected by both Device choice and aortic neck length. A great majority of patients (85.7%) with Migration of the AneuRx Device ultimately required treatment. A minority of patients experienced aortic neck dilation that could be considered clinically significant. Careful surveillance for Migration is an essential component of long-term follow-up after EVAR.
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influence of endograft oversizing on Device Migration endoleak aneurysm shrinkage and aortic neck dilation results from the zenith multicenter trial
Journal of Vascular Surgery, 2004Co-Authors: Charles W Sternbergh, Samuel R Money, Roy K Greenberg, Timothy A M ChuterAbstract:Abstract Background Generous endograft oversizing has been associated with propensity for aortic neck dilation and subsequent Device Migration in endografts without suprarenal fixation. Effects of variable oversizing of endografts with suprarenal fixation have been poorly studied. Methods Three hundred fifty-one patients underwent endovascular AAA repair (EVAR) in a prospective multicenter trial using the Zenith AAA Endovascular Graft, a fully supported bifurcated 3-piece endograft with barb-enhanced suprarenal stent fixation. Blinded core-laboratory measurement of variables was prospectively recorded at predischarge and at 1, 6, 12, and 24 months after the procedure. Potential influence of endograft oversizing on subsequent aortic neck dilation (minor axis), aneurysm shrinkage (major axis), Device Migration, endoleak, rupture, open conversion, and death were retrospectively studied. Data are given as mean ± SEM. Results Risk of endograft Migration (>5mm) at 12 months was 2.3% (6/261). However, patients with endograft oversizing of >30% had a 14% (4/29) Migration risk compared with those oversized ≤30% (0.9%, 2/232), P 10 mm or clinical event). Device oversizing >30% was associated with decreased AAA sac shrinkage (48% vs 77%) and with increased sac enlargement (9.5% vs 0.6%) at 24 months when compared with oversizing of ≤30%, respectively ( P = .001). Incidence rate of any endoleak at 12 and 24 months was 8.2% (21/256) and 7.1% (12/169), respectively. Oversizing of endografts by >30% was associated with an increased type II endoleak rate (11 vs 4.7%) that failed to reach statistical significance ( P = .27). Aortic neck diameters increased significantly by 6 months ( P P = .86) or 24 months ( P = .64). Conclusions Device Migration and endoleaks were very infrequent after treatment with the Zenith AAA Endovascular Graft. However, endograft oversizing of >30% was associated with an ∼14-fold increase in Device Migration (>5 mm) at 12 months and with a ∼16-fold increased risk of AAA expansion at 24 months. Although further follow-up will be essential to assess whether these early associations continue, avoidance of excessive endograft oversizing is recommended.
John O F Roehm - One of the best experts on this subject based on the ideXlab platform.
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use of the bird s nest filter in oversized inferior venae cavae
Journal of Vascular and Interventional Radiology, 1991Co-Authors: Richard A Reed, George P Teitelbaum, Frank C Taylor, Michael J Pentecost, John O F RoehmAbstract:An inferior vena cava (IVC) diameter of greater than 28 mm has been considered a contraindication to the intracaval placement of Greenfield, LG-Medical (LGM), and Simon nitinol filters, necessitating biiliac placement of these Devices. With the Bird's Nest filter (BNF), the maximum span of the struts, which immobilize the Device, is 60 mm; this allows the placement of the BNF in an oversized IVC having a diameter of greater than 28 mm. Over a 44-month period, 799 IVC filters (547 BNF, 136 Greenfield filters, and 116 LGM filters) were inserted. BNFs were placed in 18 patients (2.3%) with an oversized IVC (diameter range, 29–42 mm); all filters were placed via the femoral route. Patient records were reviewed to determine if problems were associated with filter insertion (including insertion site femoral vein thrombosis) and to determine the prevalence of filter Migration, caval thrombosis, and new or recurrent pulmonary emboli (PE) after insertion. No difficulties were encountered during insertion. There was no documented case of Device Migration, caval thrombosis, or clinically apparent new or recurrent PE. The data suggest that the BNF is the filtering Device of choice in patients with an oversized IVC.
Mark W Wilson - One of the best experts on this subject based on the ideXlab platform.
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intraprocedural safety and technical success of the mvp micro vascular plug for embolization of pulmonary arteriovenous malformations
Journal of Vascular and Interventional Radiology, 2015Co-Authors: Miles B Conrad, Brandon M Ishaque, Andrew M Surman, Robert K Kerlan, Michael D Hope, Melissa A Dickey, Steven W Hetts, Mark W WilsonAbstract:This case series describes early experience, intraprocedural safety, and technical success of the MVP Micro Vascular Plug (MVP; Covidien, Irvine, California) for embolization of 20 pulmonary arteriovenous malformations (PAVMs) using 23 plugs in seven patients with hereditary hemorrhagic telangiectasia. There was no Device Migration, and all Devices were successfully detached electrolytically. Immediate cessation of flow through the feeding artery was achieved in 21 of 23 (91%) deployments. There was one minor complication. This series demonstrates the MVP to be safe and technically successful in the treatment of PAVMs.
Robert J Feezor - One of the best experts on this subject based on the ideXlab platform.
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duodenal perforation with an inferior vena cava filter an unusual cause of abdominal pain
Journal of Vascular Surgery, 2002Co-Authors: Robert J Feezor, Thomas S Huber, Burress M Welborn, Scott R SchellAbstract:Abstract The insertion of inferior vena cava (IVC) filters results in Device Migration at rates that exceed 50% in some studies, although the clinical significance of Migration remains in question. These filters can also erode or penetrate the IVC wall, injuring adjacent retroperitoneal and abdominal structures. The risk of erosion or perforation is estimated to be as much as 25%, although clinical symptoms are observed far less frequently in patients with these complications. We describe the presentation, evaluation, and treatment of a patient with an IVC strut protruding into the duodenum. This case report discusses complications, presenting symptoms, and treatment of patients with IVC filters complications. (J Vasc Surg 2002;35:1010-2.)