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Miguel Valderrabano - One of the best experts on this subject based on the ideXlab platform.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction. Technique The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability and facilitated successful navigation of the stented site. A 16-mm-diameter Wallstent was placed through the previously placed balloon-expandable stent and postdilated. Conclusion A remote robotic catheter navigation system was able to assist stenting of an anastomotic Pulmonary Artery Stenosis following failure of conventional interventional techniques.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction.Technique:The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability ...
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical corre...
Mark G Davies - One of the best experts on this subject based on the ideXlab platform.
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endovascular management of early lung transplant related anastomotic Pulmonary Artery Stenosis
Journal of Vascular and Interventional Radiology, 2015Co-Authors: Javier E Anayaayala, Matthias Loebe, Mark G DaviesAbstract:Abstract Purpose To report the safety and short-term efficacy of endovascular interventions for symptomatic lung transplant–related anastomotic Pulmonary Artery Stenosis (PAS). Materials and Methods From February 2008 to December 2011, 354 lung transplants were performed. Pulmonary arteriography was performed in 19 patients (63% men; age, 57 y ± 21, mean ± SD; seven double-lung transplants) because of respiratory decompensation (mean 6.7 mo after transplant). Seven arteriograms were normal, and 12 showed significant PAS. One patient (5%) underwent angioplasty alone, and 11 patients (57%) underwent stent placement. Results All patients underwent general anesthesia, and femoral access was used for the intervention. Technical success was 100% in the 12 patients treated. Symptoms improved in all patients who underwent intervention, with resolution in 11 of 12 (92%). There were no major or minor complications. Three patients (16%) had recurrent symptoms after discharge secondary to chronic rejection or pneumonia. Two patients died as a result of sepsis and multiorgan failure at 2 days and 14 days, respectively, after undergoing only Pulmonary arteriography. In-stent Stenosis occurred in 1 (9%) patient who required additional stent placement. During a mean follow-up period of 11 months, the remaining stents were patent, and the patients were asymptomatic. Conclusions Endovascular stent placement provides an alternative to open repair for transplant-related anastomotic PAS. It has low mortality and morbidity rates, and it has shown excellent short-term functional and anatomic outcomes.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction. Technique The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability and facilitated successful navigation of the stented site. A 16-mm-diameter Wallstent was placed through the previously placed balloon-expandable stent and postdilated. Conclusion A remote robotic catheter navigation system was able to assist stenting of an anastomotic Pulmonary Artery Stenosis following failure of conventional interventional techniques.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction.Technique:The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability ...
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical corre...
Lee N Benson - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Artery Stenosis in hybrid single-ventricle palliation: High incidence of left Pulmonary Artery intervention
The Journal of Thoracic and Cardiovascular Surgery, 2014Co-Authors: Otto Rahkonen, Osami Honjo, Rajiv Chaturvedi, Lee N Benson, Christopher A. CaldaroneAbstract:Objective Pulmonary Artery growth is an important determinant of outcome in single-ventricle strategies. Higher rates of Pulmonary Artery intervention have been reported with hybrid-based palliation when compared with Norwood palliation. Methods We performed a retrospective review of Pulmonary Artery growth and clinical outcomes in patients undergoing hybrid-based single-ventricle palliation. Results The stage I hybrid procedure was performed in 72 patients between 2004 and 2012, of whom 54 were on a Fontan palliative pathway. Thirty-four infants completed stage II, and 20 infants underwent the Fontan operation. The mean diameters of the right Pulmonary Artery (5.6 ± 1.9 mm) and left Pulmonary Artery (5.6 ± 2.1 mm) were similar before stage II. After stage II, the right and left Pulmonary Artery diameters were 8.5 ± 2.1 mm and 5.8 ± 1.3 mm, respectively ( P P = .002). The mean right Pulmonary Artery z score was normal throughout, but the left Pulmonary Artery did not maintain a normal size. The cumulative Pulmonary Artery intervention rate was 50% at any time after stage II. Fifteen interventions (88%) were performed after stage II (35% during the same hospitalization, 71% Conclusions There is significant risk of left Pulmonary Artery compromise after the second stage of hybrid palliation associated with a high intervention rate.
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bladed balloon angioplasty for peripheral Pulmonary Artery Stenosis
Catheterization and Cardiovascular Interventions, 2004Co-Authors: Hisashi Sugiyama, Rajiv Chaturvedi, Gruchen R Veldtman, Gunnar Norgard, Kyongjin Lee, Lee N BensonAbstract:Treatment for peripheral Pulmonary Artery Stenosis is challenging, and conventional balloon angioplasty has not proved to be universally effective. Evaluated was the efficacy of bladed balloon (BB) dilation to address vessels resistant to conventional high-pressure (10–15 atm) balloon angioplasty (BA). Thirty-one procedures were performed on 14 children with age range 1 month to 15 years. The diameter of the BB ranged from 3 to 8 mm. After BB dilation, all children had subsequent conventional BA (balloon size range, 3–10 mm). The minimal lumen diameter (MLD) before and after the procedure, whether there was a waist at initial BA, and BB diameter-to-MLD ratio before the procedure were measured. A > 50% increase in MLD was considered successful. Four children had Williams syndrome, two children Alagille syndrome, five children Fallot's tetralogy, and three miscellaneous lesions. The resistant Stenosis was located in the right central Pulmonary Artery in 6, right branch Pulmonary Artery in 7, left central Pulmonary Artery in 6, and left branch Pulmonary Artery in 12 lesions. Median BB diameter was 253% (117–440%) of the MLD and increased from 2.0 ± 0.7 to 3.2 ± 0.8 mm (P < 0.0001), with a mean increase of 73% ± 62%. There was an inverse relationship between the MLD before and increase after the procedure (r = 0.75; P < 0.001). The BB diameter-to-MLD ratio before procedure was significantly associated with the increase in MLD (r = 0.70; P < 0.001). After the procedure, 18 of the 31 procedures were considered successful. In all successful procedures, the BB diameter was greater than twice the MLD before the procedure. Comparing children with Williams and Alagille syndrome with the remaining eight children, there were no significant differences in the increase in MLD. A small aneurysm and thrombus were noticed in two and three children, respectively, but no fatal complications were reported. BB angioplasty is effective for resistant peripheral Pulmonary Artery Stenosis when conventional BA fails. The diameter of the BB should be larger than twice the minimal luminal diameter of the stenotic lesion. Catheter Cardiovasc Interv 2004;62:71–77. © 2004 Wiley-Liss, Inc.
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Interventional Strategies in the Management of Peripheral Pulmonary Artery Stenosis
Journal of interventional cardiology, 2003Co-Authors: Kalyani R. Trivedi, Lee N BensonAbstract:Abstract Peripheral Pulmonary Artery Stenosis challenges therapeutic algorithms for the management of congenital heart malformations. Surgical repair of the proximal Pulmonary Artery lesion remains with a high recurrence rate while the distal lesions are difficult to access. With the development of transcatheter interventional strategies in the early 1980s, a number of transcatheter treatment options became available. In this review, we summarize the current state of the art for interventional strategies in the management of peripheral Pulmonary Artery Stenosis.
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experimental branch Pulmonary Artery Stenosis angioplasty using a novel cutting balloon
Canadian Journal of Cardiology, 1998Co-Authors: Alan G Magee, David F Wax, Yoshikatsu Saiki, Ivan Rebekya, Lee N BensonAbstract:To determined the safety and efficacy of a bladed balloon in the treatment of branch Pulmonary Artery Stenosis, a model of left Pulmonary Artery Stenosis was surgically created in two-week-old pigs. Seven pigs underwent angioplasty, five with the bladed balloon and two with conventional balloons. Overall, acute results showed a fall in the peak systolic pressure gradients from 8.3 +/- 2.3 mmHg to 3.2 +/- 3.1 mmHg and an increase in the minimum stenotic diameters from 4.5 +/- 2mm to 5.6 +/- mm. Acute pathological examination after cutting angioplasty showed regular luminal cuts that healed completely by four to six weeks in chronically surviving animals. Two of three surviving animals had persistent vessel enlargement at follow-up with one showing little overall change. Cutting balloons are effective in branch Pulmonary Artery angioplasty and may have clinical applications.
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percutaneous implantation of a balloon expandable endoprosthesis for Pulmonary Artery Stenosis an experimental study
Journal of the American College of Cardiology, 1991Co-Authors: Lee N Benson, Frank Hamilton, Himansu K Dasmahapatra, Marlene Rabinowitch, John C Coles, Robert M FreedomAbstract:Abstract Conventional therapy to treat peripheral Pulmonary Artery Stenosis (surgery or balloon angioplasty) has been frustrating. Recently a variety of peripheral vascular stenoses, in which conventional approaches are disappointing, have become amenable to therapy with the use of a balloon-expandable endovascular stent. This experimental study was designed to assess the application of such a prosthesis in artificially created Pulmonary Artery stenoses. In 9 of 12 2-week old pigs, left Pulmonary Artery Stenosis was surgically created (3.9 ± 1.1 mm diameter and 7 ± 1 mm Hg mean gradient). At 6.8 ± 1 weeks of age (13 ± 4 kg), percutaneous (femoral venous) implantation of a 3-cm long balloon-expandable (maximal diameter 18 mm) stent (three placed into normal Pulmonary Artery branches) using a 3-cm × 10-mm balloon dilating catheter was achieved without technical difficulties. Stenoses were enlarged to 8.3 ± 1.4 mm with a decrease in mean gradient to 1 ± 1 mm Hg that was maintained through 3.5 months of follow-up. Histologic and electron micrographic studies identified normalappearing neoendothelial layering over stent struts without intraluminal or peripheral thrombus formation and nonobstructed side branching to lung subsegments. These findings support the application of this approach in the treatment of Pulmonary Stenosis that is not amenable to conventional therapy.
Javier E Anayaayala - One of the best experts on this subject based on the ideXlab platform.
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endovascular management of early lung transplant related anastomotic Pulmonary Artery Stenosis
Journal of Vascular and Interventional Radiology, 2015Co-Authors: Javier E Anayaayala, Matthias Loebe, Mark G DaviesAbstract:Abstract Purpose To report the safety and short-term efficacy of endovascular interventions for symptomatic lung transplant–related anastomotic Pulmonary Artery Stenosis (PAS). Materials and Methods From February 2008 to December 2011, 354 lung transplants were performed. Pulmonary arteriography was performed in 19 patients (63% men; age, 57 y ± 21, mean ± SD; seven double-lung transplants) because of respiratory decompensation (mean 6.7 mo after transplant). Seven arteriograms were normal, and 12 showed significant PAS. One patient (5%) underwent angioplasty alone, and 11 patients (57%) underwent stent placement. Results All patients underwent general anesthesia, and femoral access was used for the intervention. Technical success was 100% in the 12 patients treated. Symptoms improved in all patients who underwent intervention, with resolution in 11 of 12 (92%). There were no major or minor complications. Three patients (16%) had recurrent symptoms after discharge secondary to chronic rejection or pneumonia. Two patients died as a result of sepsis and multiorgan failure at 2 days and 14 days, respectively, after undergoing only Pulmonary arteriography. In-stent Stenosis occurred in 1 (9%) patient who required additional stent placement. During a mean follow-up period of 11 months, the remaining stents were patent, and the patients were asymptomatic. Conclusions Endovascular stent placement provides an alternative to open repair for transplant-related anastomotic PAS. It has low mortality and morbidity rates, and it has shown excellent short-term functional and anatomic outcomes.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction. Technique The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability and facilitated successful navigation of the stented site. A 16-mm-diameter Wallstent was placed through the previously placed balloon-expandable stent and postdilated. Conclusion A remote robotic catheter navigation system was able to assist stenting of an anastomotic Pulmonary Artery Stenosis following failure of conventional interventional techniques.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction.Technique:The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability ...
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical corre...
Alan B Lumsden - One of the best experts on this subject based on the ideXlab platform.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction. Technique The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability and facilitated successful navigation of the stented site. A 16-mm-diameter Wallstent was placed through the previously placed balloon-expandable stent and postdilated. Conclusion A remote robotic catheter navigation system was able to assist stenting of an anastomotic Pulmonary Artery Stenosis following failure of conventional interventional techniques.
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical correction.Technique:The technique is illustrated in a 72-year-old man with end-stage lung disease who received a left single lung transplant. On postoperative day 54, he was evaluated for recurrent dyspnea on exertion that was due to a severe Stenosis at the site of the Pulmonary Artery anastomosis. Balloon angioplasty was performed, and a 10-mm stent was deployed, with marked clinical improvement. Fourteen months later, he presented with recurrent symptoms due to in-stent reStenosis. Multiple attempts at catheterization and balloon angioplasty of the stent failed. Due to the technical difficulty involved in maneuvering the balloon while maintaining stability, it was decided to repeat the angioplasty with the assistance of a Hansen Sensei remote robotic navigation system. The robotic arm markedly enhanced stability ...
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robot assisted stenting of a high grade anastomotic Pulmonary Artery Stenosis following single lung transplantation
Journal of Endovascular Therapy, 2010Co-Authors: Alan B Lumsden, Javier E Anayaayala, Matthias Loebe, Mark G Davies, Itamar Birnbaum, Jean Bismuth, Zulfiqar F Cheema, Hossam El F Sayed, Harish Seethamraju, Miguel ValderrabanoAbstract:Purpose:To report robot-assisted stenting of a Stenosis at the Pulmonary Artery anastomosis following lung transplantation, a rare complication that conveys poor prognosis even after surgical corre...
