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Maximo H Trujillo - One of the best experts on this subject based on the ideXlab platform.

Marek Garbowski - One of the best experts on this subject based on the ideXlab platform.

  • digital embolization due to partially uncovered Left Subclavian Artery post tevar management with amplatzer vascular plug occlusion
    Journal of Endovascular Therapy, 2007
    Co-Authors: Arindam Chaudhuri, Sanjay Nadkarni, Jonathan Tibballs, Marek Garbowski
    Abstract:

    Purpose:To describe the use of the Amplatzer vascular plug to treat a partially uncovered Left Subclavian Artery (LSA) causing digital embolism following thoracic endovascular aneurysm repair.Case Report:A 70-year-old man presented with digital ischemia of the Left index and middle fingers due to embolism from a partially covered LSA orifice during thoracic endovascular aneurysm repair for a type I thoracic aortic aneurysm. The orifice was successfully occluded using the vascular plug, supplemented by a Left carotid-Subclavian bypass to treat ongoing arm and hand claudication. The patient has had no further embolic episodes.Conclusion:A partially uncovered LSA during thoracic endovascular aneurysm repair poses a risk of thromboembolism, with resultant upper limb claudication or tissue loss. If recognized at the time of the procedure, this should be treated by proximal extension; otherwise, proximal LSA occlusion using an Amplatzer occluder may be a safe and effective option in preventing further embolic e...

  • digital embolization due to partially uncovered Left Subclavian Artery post tevar management with amplatzer vascular plug occlusion
    Journal of Endovascular Therapy, 2007
    Co-Authors: Arindam Chaudhuri, Sanjay Nadkarni, Jonathan Tibballs, Marek Garbowski
    Abstract:

    PURPOSE: To describe the use of the Amplatzer vascular plug to treat a partially uncovered Left Subclavian Artery (LSA) causing digital embolism following thoracic endovascular aneurysm repair. CASE REPORT: A 70-year-old man presented with digital ischemia of the Left index and middle fingers due to embolism from a partially covered LSA orifice during thoracic endovascular aneurysm repair for a type I thoracic aortic aneurysm. The orifice was successfully occluded using the vascular plug, supplemented by a Left carotid-Subclavian bypass to treat ongoing arm and hand claudication. The patient has had no further embolic episodes. CONCLUSION: A partially uncovered LSA during thoracic endovascular aneurysm repair poses a risk of thromboembolism, with resultant upper limb claudication or tissue loss. If recognized at the time of the procedure, this should be treated by proximal extension; otherwise, proximal LSA occlusion using an Amplatzer occluder may be a safe and effective option in preventing further embolic episodes.

Junjiro Kobayashi - One of the best experts on this subject based on the ideXlab platform.

  • balloon protection of the Left Subclavian Artery in debranching thoracic endovascular aortic repair
    The Journal of Thoracic and Cardiovascular Surgery, 2019
    Co-Authors: Yoshimasa Seike, Tetsuya Fukuda, Atsushi Omura, Kyokun Uehara, Yosuke Inoue, Hitoshi Matsuda, Junjiro Kobayashi
    Abstract:

    Abstract Objectives Since 2012, we have routinely applied balloon protection of the proximal Left Subclavian Artery to prevent embolic events through the Left vertebral Artery during debranching thoracic endovascular aortic repair. This study aimed to study the effectiveness of balloon protection of the proximal Left Subclavian Artery. Methods We reviewed the medical records of 157 patients who underwent debranching thoracic endovascular aortic repair between 2007 and 2017. Of these, 71 patients for whom balloon protection of the proximal Left Subclavian Artery was used were assigned to the balloon protection of the proximal Left Subclavian Artery group (58 men; age: 78 ± 6.7 years), and 86 patients were assigned to the control group (66 men; age: 78 ± 8.9 years). A total of 51 patients from each group were matched by their propensity scores to adjust for differences in the patients' characteristics. Results Perioperative stroke was significantly lower in the balloon protection of the proximal Left Subclavian Artery group than in the control group (0%: 0/71 vs 7.9%: 7/86, P = .014). Freedom from all causes of mortality at 2 and 4 years was significantly higher in the balloon protection of the proximal Left Subclavian Artery group compared with the control group (93%/76% vs 77%/59%, P = .015). Freedom from aortic death at 2 and 4 years was similar in both groups (97%/97% vs 91%/86%, P = .094). Propensity score matching yielded similar results of better freedom from all causes of mortality in the balloon protection of the proximal Left Subclavian Artery group (93%/93% vs 81%/63%, P = .017) and equivalent aortic death in both groups (95%/95% vs 92%/88%, P = .30). Conclusions Debranching thoracic endovascular aortic repair using balloon protection of the proximal Left Subclavian Artery demonstrated more appropriate early and late outcomes. Evaluation using propensity score matching enhanced the efficacy of balloon protection of the proximal Left Subclavian Artery.

  • balloon protection of the Left Subclavian Artery in debranching thoracic endovascular aortic repair
    The Journal of Thoracic and Cardiovascular Surgery, 2019
    Co-Authors: Yoshimasa Seike, Tetsuya Fukuda, Atsushi Omura, Kyokun Uehara, Yosuke Inoue, Hitoshi Matsuda, Junjiro Kobayashi
    Abstract:

    Abstract Objectives Since 2012, we have routinely applied balloon protection of the proximal Left Subclavian Artery to prevent embolic events through the Left vertebral Artery during debranching thoracic endovascular aortic repair. This study aimed to study the effectiveness of balloon protection of the proximal Left Subclavian Artery. Methods We reviewed the medical records of 157 patients who underwent debranching thoracic endovascular aortic repair between 2007 and 2017. Of these, 71 patients for whom balloon protection of the proximal Left Subclavian Artery was used were assigned to the balloon protection of the proximal Left Subclavian Artery group (58 men; age: 78 ± 6.7 years), and 86 patients were assigned to the control group (66 men; age: 78 ± 8.9 years). A total of 51 patients from each group were matched by their propensity scores to adjust for differences in the patients' characteristics. Results Perioperative stroke was significantly lower in the balloon protection of the proximal Left Subclavian Artery group than in the control group (0%: 0/71 vs 7.9%: 7/86, P = .014). Freedom from all causes of mortality at 2 and 4 years was significantly higher in the balloon protection of the proximal Left Subclavian Artery group compared with the control group (93%/76% vs 77%/59%, P = .015). Freedom from aortic death at 2 and 4 years was similar in both groups (97%/97% vs 91%/86%, P = .094). Propensity score matching yielded similar results of better freedom from all causes of mortality in the balloon protection of the proximal Left Subclavian Artery group (93%/93% vs 81%/63%, P = .017) and equivalent aortic death in both groups (95%/95% vs 92%/88%, P = .30). Conclusions Debranching thoracic endovascular aortic repair using balloon protection of the proximal Left Subclavian Artery demonstrated more appropriate early and late outcomes. Evaluation using propensity score matching enhanced the efficacy of balloon protection of the proximal Left Subclavian Artery.

Runlin Gao - One of the best experts on this subject based on the ideXlab platform.

  • stenting for Left Subclavian Artery stenosis in patients scheduled for Left internal mammary Artery coronary Artery bypass grafting
    Catheterization and Cardiovascular Interventions, 2016
    Co-Authors: Wuqiang Che, Hui Dong, Xiongjing Jiang, Meng Peng, Yubao Zou, Haiyan Qian, Huimin Zhang, Yuejin Yang, Runlin Gao
    Abstract:

    Objectives To evaluate the early and long-term outcomes of stent placement for Left Subclavian Artery stenosis (LSAS) in patients scheduled for Left internal mammary Artery-coronary Artery bypass grafting (LIMA-CABG). Background Few studies have demonstrated the safety and effectiveness of endovascular therapy for the treatment of LSAS before LIMA-CABG; therefore, use of this therapy requires further exploration and evaluation. Methods Between February 2000 and April 2014, the clinical data of 167 consecutive patients (mean age 64  ± 9 years, 141 males) scheduled for LIMA-CABG with LSAS who were treated by stenting at the Fuwai Hospital were collected and analyzed retrospectively. Results The technical success rate of the procedure was 97.6% (163/167). The mean stenosis of target lesions decreased from 86.5 ± 9.9% to 7.6 ± 4.6% (P < 0.001). The incidences of death, stroke, and myocardial infarction, as well as the combined incidence of death, stroke, and myocardial infarction from the time of stenting to 30 days after the stenting procedure were 0.6% (n = 1), 1.8% (n = 3), 0% (n = 0), and 1.8% (n = 3), respectively. The 10-year rate of follow-up was 94.6%. The overall survival rate was 98.8% at 1 year, 97.5% at 2 years, 93.9% at 5 years, and 86.2% at 10 years. A total of 14.1% (23/163) of patients developed in-stent restenosis. Stent restenosis-related angina and myocardial infarction were observed in 13 and 3 patients, respectively. The patency rates of the Left Subclavian Artery were 95.7, 93.8, 86.5, and 75.2% at 1, 2, 5, and 10 years, respectively. The target vessel reconstruction rate was 8.0% (13/163). Conclusions Stenting of LSAS at experienced medical centers for patients scheduled for LIMA-CABG was safe and effective with a low incidence of complication and in-stent restenosis. © 2016 Wiley Periodicals, Inc.

Francisco Tortoledo - One of the best experts on this subject based on the ideXlab platform.