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 · Oct 2014
Multicenter Study Clinical TrialMid-term outcomes and aortic remodelling after thoracic endovascular repair for acute, subacute, and chronic aortic dissection: the VIRTUE Registry.
The VIRTUE Registry describes the mid-term clinical and morphological results of thoracic endovascular repair (TEVR) in patients with type B aortic dissection. ⋯ The principle clinical findings suggest that TEVR is able to provide good protection from aortic-related death in the mid-term, but with a high rate of aortic reintervention. Analysis of aortic morphology suggested that aortic remodelling in subacute patients is similar to the acute group. Retention of aortic plasticity in the subacute group lengthens the therapeutic window for the treatment of uncomplicated type B dissection.
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Eur J Vasc Endovasc Surg · Oct 2014
Hybrid approach to emergent and urgent treatment of complex thoracoabdominal aortic pathology.
The aim was to report a single center experience with hybrid procedures in the emergency treatment of patients with thoracoabdominal aortic pathology. Thoracoabdominal aortic aneurysm (TAAA) repair is primarily conducted by conventional surgery in the urgent and emergency setting. The role of hybrid procedures with stent graft coverage of the aorta and extra-anatomical debranching of the renovisceral arteries has so far not been defined in this context. ⋯ Hybrid procedures have the potential to be an alternative treatment option for complex thoracoabdominal pathology in the urgent and emergency setting. The procedure is readily available and enables adequate surgical repair with enduring results. Nevertheless it is still associated with significant mortality and morbidity.
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Eur J Vasc Endovasc Surg · Sep 2014
Randomized Controlled Trial Multicenter Study Comparative StudyA decision aid regarding treatment options for patients with an asymptomatic abdominal aortic aneurysm: a randomised clinical trial.
Abdominal aortic aneurysm patients tend to be informed inconsistently and incompletely about their disorder and the treatment options open to them. The objective of this trial was to evaluate whether these patients are better informed and experience less decisional conflict regarding their treatment options after viewing a decision aid. ⋯ In addition to regular patient-surgeon communication, a decision aid helps to share treatment decisions with abdominal aortic aneurysm patients by increasing their knowledge about the disorder and available treatment options without raising anxiety levels; however, it does not reduce decisional conflict, nor does it improve satisfaction.
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Eur J Vasc Endovasc Surg · Aug 2014
ReviewBenefits of remote ischaemic preconditioning in vascular surgery.
Remote ischaemic preconditioning (RIPC) is a physiological mechanism to protect against ischaemia-reperfusion injury. It is a technique in which short pre-emptive periods of ischaemia and reperfusion are thought to protect against ischaemia-reperfusion injury during procedures requiring longer periods of ischaemia. Discovered in the 1980s, its clinical application has been investigated heavily since the first human study in 2006. The aim of this paper was to provide a review of this rapidly expanding subject. ⋯ Current trials and therefore meta-analyses are generally underpowered. The technique is physiologically sound but remains lacking in clear clinical benefit.