The Experts below are selected from a list of 11562 Experts worldwide ranked by ideXlab platform
Alan B. Lumsden - One of the best experts on this subject based on the ideXlab platform.
-
Transluminal stent graft repair with Wallgraft endoprosthesis in a porcine arteriovenous graft Pseudoaneurysm model
Journal of vascular surgery, 2003Co-Authors: Peter H. Lin, Chris K. Johnson, Jennifer K. Pullium, Alan J. Koffron, Brian S. Conklin, Thomas T. Terramani, Ruth L. Bush, Changyi Chen, Alan B. LumsdenAbstract:Abstract Purpose: Pseudoaneurysm is a known complication of arteriovenous grafts in chronic hemodialysis and can result in graft disruption or thrombosis if left untreated. This study evaluated the safety and efficacy of endovascular repair with Wallgraft endoprosthesis (Boston Scientific, Inc, Watertown, Mass) in a porcine arteriovenous graft (AVG) Pseudoaneurysm model. Materials and Methods: Bilateral groin AVG Pseudoaneurysms (n = 18) were created with an oversized Dacron interposition graft within a polytetrafluoroethylene femoral AVG in nine domestic swine and allowed to mature 28 ± 4 days (standard deviation). Transluminal placement of Wallgraft was performed to exclude the Pseudoaneurysm from the AVG circulation. Hemodialysis was performed (400 mL/min × 1 hour, with intravenous heparin 30 units/kg) every 4 days for a total of 6 weeks via 15-gauge needles in the treated AVG Pseudoaneurysm site. Arteriography and duplex ultrasound scan were performed to determine AVG patency and Pseudoaneurysm flow. Histologic evaluation was performed to determine Wallgraft morphology. In vitro pulsatile flow chamber was used to determine maximal flow volume without peri-Wallgraft endoleak. Results: All AVG Pseudoaneurysms were successfully excluded with the Wallgrafts. Twelve AVG (67%) remained patent at the completion of the study. No Wallgraft migration occurred from hemodialysis. Transient peri-Wallgraft endoleak ( Conclusion: Endoluminal placement of Wallgraft endoprosthesis provides adequate structural support for continuous hemodialysis after AVG Pseudoaneurysm exclusion. Transient blood flow in the Pseudoaneurysm cavity may occur immediately after the hemodialysis, which may represent the effect of heparin used during hemodialysis. This study suggests Wallgraft is a safe and effective treatment for AVG Pseudoaneurysm and permits continuous hemodialysis. (J Vasc Surg 2003;37:175-81.)
-
endoluminal stent placement and coil embolization for the management of carotid artery Pseudoaneurysms
Journal of Endovascular Therapy, 2001Co-Authors: Ruth L. Bush, Peter H. Lin, Thomas F Dodson, Jacques E Dion, Alan B. LumsdenAbstract:Purpose:To present a series of carotid artery Pseudoaneurysms treated successfully using an endovascular approach.Methods:From April 1995 to November 1999, 5 patients with neurological symptoms not explained by computed tomography of the head were identified by carotid angiography as having internal carotid artery (ICA) Pseudoaneurysms. Three patients had sustained blunt trauma, and 2 had previous elective carotid endarterectomies for atherosclerotic disease. The time between injury and treatment ranged from 3 days to 10 years. The patients were treated with endovascular stent placement for exclusion of the Pseudoaneurysm, followed by filling of the cavity with multiple detachable coils. Patients were maintained on oral antiplatelet agents or anticoagulant therapy after the procedure.Results:Primary technical success was 100%. No patient suffered permanent neurological sequelae. Postprocedure angiography demonstrated a patent ICA in all cases, with complete obliteration of the Pseudoaneurysm. At a mean 8....
Y. Shibamoto - One of the best experts on this subject based on the ideXlab platform.
-
Superior Mesenteric Artery Stent-graft Placement in a Patient with Pseudoaneurysm Developing from a Pancreatic Pseudocyst
CardioVascular and Interventional Radiology, 2004Co-Authors: H. Ogino, T. Banno, Y. Sato, M. Hara, Y. ShibamotoAbstract:Pseudoaneurysm is a relatively rare but serious complication of pancreatitis which is often fatal. We report successful stent-graft placement in the superior mesenteric artery in a 45-year-old man with a pancreatic pseudocyst that grew during therapy for chronic pancreatitis and developed into a Pseudoaneurysm. After a stent graft was inserted in the superior mesenteric artery, the Pseudoaneurysm disappeared and no further complications developed. Stent-graft placement was considered to be a useful therapy for Pseudoaneurysms in the superior mesenteric arterial region.
Mingfong Chen - One of the best experts on this subject based on the ideXlab platform.
-
treatment of iatrogenic femoral artery Pseudoaneurysm with percutaneous thrombin injection
Journal of Vascular Surgery, 1997Co-Authors: Chiausuong Liau, Fengming Ho, Mingfong ChenAbstract:Abstract Purpose: Local compression has been advocated for the treatment of femoral artery Pseudoaneurysms. Although it is effective and has a high success rate, this method bears some limitations; among them are prolonged procedure time, discomfort for patients, and recurrence. As a potent thrombosis-inducing agent, thrombin has been used topically, and occasionally intravascularly, for hemostasis. Pseudoaneurysms with a narrow connecting tract to the native artery may be suitable for treatment with thrombin injection to induce intracavitary coagulation. Methods: Patients with Pseudoaneurysms of the femoral artery were evaluated by ultrasonography. Under ultrasound guidance, an intravenous catheter was introduced percutaneously into the Pseudoaneurysm, with the catheter position confirmed by contrast ultrasonography. One thousand units of thrombin dissolved in normal saline solution was then injected slowly into the Pseudoaneurysm through the catheter to induce thrombosis. The patients were monitored closely for any adverse effects after thrombin injection. Results: A total of five patients with femoral artery Pseudoaneurysms were treated with direct percutaneous thrombin injection under ultrasound guidance. Within seconds of thrombin injection thrombus formation was evident, and blood flow in the Pseudoaneurysm soon ceased when the thrombosis extended to the connecting tract. All procedures were uneventful and successful. No recurrence was noted during follow-up periods of 1 to 28 months. Conclusion: Our initial experience with the small number of patients demonstrates the simplicity, lack of morbidity, and high success rate for ultrasound-guided percutaneous thrombin injection for the treatment of femoral artery Pseudoaneurysms. (J Vasc Surg 1997;26:18-23.)
W C Wei - One of the best experts on this subject based on the ideXlab platform.
-
endovascular stent graft repair is an effective and safe alternative therapy for arteriovenous graft Pseudoaneurysms
European Journal of Vascular and Endovascular Surgery, 2016Co-Authors: Weng Kin Wong, W L Cheng, Hsuantzu Yang, W C WeiAbstract:Objective/Background Pseudoaneurysm formation occurs in 2–10% of hemodialysis arteriovenous grafts (AVGs). Surgical repair often requires Pseudoaneurysm resection, interposition graft placement, and insertion of a catheter as a bridge. Endovascular stent graft repair is a controversial alternative therapy. This study was performed to examine the effectiveness and mid-term outcomes of stent graft repair for AVG Pseudoaneurysms. Methods All patients who had undergone stent graft repair for AVG Pseudoaneurysms between December 2012 and July 2015 were identified from hospital medical records for retrospective analysis. Outcome measures were technical success, early and late complications, and primary and secondary patency rates. Results A total of 37 stent graft repairs of AVG Pseudoaneurysms were performed in 35 patients (42.9% men; mean age 66.9 years). The mean time from AVG creation to Pseudoaneurysm repair was 69 months. The indications of treatment (as per the institutional policy) were large Pseudoaneurysm (56.7%), impending rupture (27.1%), and bleeding (16.2%). Mean Pseudoaneurysm diameter was 23.0 mm. The most common diameter and length of stent graft used were 7 mm (67.6%) and 50 mm (48.6%), respectively. Technical success was 100%. Only one early complication occurred after stent graft repair, which was due to recurrence of the Pseudoaneurysm as a result of a short landing zone. Late complications included infection (17.1%) and thrombosis (37.1%). The 1, 6, and 12 month primary patency rates were 89.2%, 55.5%, and 22.0%, respectively. The 1, 6, and 12 month secondary patency rates were 100%, 88.6%, and 78.6%, respectively. The median follow up was 12.3 months. Conclusions The study demonstrates that endovascular stent graft repair is an effective and safe alternative therapy for AVG Pseudoaneurysms. However, the rate of thrombosis and infection was high and needs to be balanced against open surgery in future studies.
Jeffrey L Ballard - One of the best experts on this subject based on the ideXlab platform.
-
treatment of radial and ulnar artery Pseudoaneurysms using percutaneous thrombin injection
Journal of Hand Surgery (European Volume), 2004Co-Authors: Ewa Komorowskatimek, Theodore H Teruya, Ahmed M Abouzamzam, Diane Papa, Jeffrey L BallardAbstract:Pseudoaneurysm formation is a recognized complication of arterial catheterization or traumatic arterial disruption, which may lead to considerable morbidity. Ultrasound-guided thrombin injection has been shown to be effective in the treatment of peripheral Pseudoaneurysms; however, its application in the management of radial or ulnar artery Pseudoaneurysms has not been well established. Arterial thrombosis and distal embolization are concerns when treating a Pseudoaneurysm involving a small vessel. We performed successful ultrasound-guided thrombin injection of a 3-cm radial artery and a 2.5-cm ulnar artery Pseudoaneurysm resulting from arterial catheterization and missed arterial trauma, respectively. Radial artery recannalization occurred 28 days after the procedure whereas the ulnar artery remained patent throughout the observation period.
