European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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Eur J Vasc Endovasc Surg · Mar 2015
Comparative StudyFinite element analysis in asymptomatic, symptomatic, and ruptured abdominal aortic aneurysms: in search of new rupture risk predictors.
To compare biomechanical rupture risk parameters of asymptomatic, symptomatic and ruptured abdominal aortic aneurysms (AAA) using finite element analysis (FEA). ⋯ From different FEA derived parameters, PWRI distinguishes most precisely between asymptomatic and symptomatic AAAs. If elevated, this value may represent a negative prognostic factor for asymptomatic AAAs.
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Eur J Vasc Endovasc Surg · Mar 2015
Observational StudyUnderstanding administrative abdominal aortic aneurysm mortality data.
Administrative data in the form of Hospital Episode Statistics (HES) and the Scottish Morbidity Record (SMR) have been used to describe surgical activity. These data have also been used to compare outcomes from different hospitals and regions, and to corroborate data submitted to national audits and registries. The aim of this observational study was to examine the completeness and accuracy of administrative data relating to abdominal aortic aneurysm (AAA) repair. ⋯ The SMR-01 returns contain multiple errors. There also appears to be a systematic bias that reduces apparent 30-day mortality. Using these data alone to describe or compare activity or outcomes must be done with caution.
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Eur J Vasc Endovasc Surg · Mar 2015
Multicenter StudyThe impact of early pelvic and lower limb reperfusion and attentive peri-operative management on the incidence of spinal cord ischemia during thoracoabdominal aortic aneurysm endovascular repair.
Spinal cord ischemia (SCI) is a devastating complication following endovascular thoracoabdominal aortic aneurysm (TAAA) repair. In an attempt to reduce its incidence two peri-procedural changes were implemented by the authors in January 2010: (i) all large sheaths are withdrawn from the iliac arteries immediately after deploying the central device and before cannulation and branch extension to the visceral vessels; (ii) the peri-operative protocol has been modified in an attempt to optimize oxygen delivery to the sensitive cells of the cord (aggressive blood and platelet transfusion, median arterial pressure monitoring >85 mmHg, and systematic cerebrospinal fluid drainage). ⋯ The early restoration of arterial flow to the pelvis and lower limbs, and aggressive peri-operative management significantly reduces SCI following type I-III TAAA endovascular repair. With the use of these modified protocols, extensive TAAA endovascular repairs are associated with low rates of SCI.
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Eur J Vasc Endovasc Surg · Mar 2015
Endovascular repair with chimney technique for juxtarenal aortic aneurysm: a single center experience.
Chimney endovascular aneurysm repair (Ch-EVAR) is a cheap and immediately available method for treatment of juxtarenal aortic aneurysms (JRAAs). The aim of this study was to report experiences and results with balloon expandable stent (BES) for Ch-EVAR. ⋯ Ch-EVAR can be used to treat JRAAs with suitable anatomical conditions. However, complications of type I endoleak were not uncommon, and, therefore, further studies are required to prove its efficiency for JRAAs.
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Eur J Vasc Endovasc Surg · Mar 2015
Diameter-related variations of geometrical, mechanical, and mass fraction data in the anterior portion of abdominal aortic aneurysms.
Maximum aortic diameter is an important measure in rupture prediction of abdominal aortic aneurysms (AAAs). Analyzing the variations of geometrical, material, and biochemical properties with increased AAA diameters advances understanding of the effect of lesion enlargement on patient specific vascular properties. ⋯ Larger AAA diameters are associated with thicker ILTs, higher AAA expansion rates, and pronounced elastin loss, and may also lead to a higher propensity for tissue dissection and aneurysm rupture.