Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
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Comparative Study
A comparative analysis of bench-top performance assessment of distal protection filters in transient flow conditions.
To compare the performance in vitro of 6 distal protection filters (DPFs) on the basis of filtration ability and effects on pressure gradient and vascular impedance in a flow model of the internal carotid artery (ICA). ⋯ A bench-top flow apparatus exhibiting physiologically realistic conditions was developed by combining pulsatile flow and a body temperature blood analog. Using microspheres larger than the pore size of most of the DPFs, the device-wall apposition has an important effect on the overall filter performance and the global fluid dynamics in the flow model.
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Comparative Study
Type II endoleaks after endovascular repair of abdominal aortic aneurysms: fate of the aneurysm sac and neck changes during long-term follow-up.
To evaluate the frequency of type II endoleaks after endovascular aneurysm repair (EVAR) and to compare sac diameter and neck changes in patients with type II endoleak to endoleak-free patients with at least 3-year imaging follow-up. ⋯ Persistent type II endoleaks led to significant aneurysm sac enlargement, but without increased mortality or rupture rates.
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To examine the outcomes following interventions for type II endoleaks in patients with aneurysm sac expansion after endovascular aneurysm repair (EVAR). ⋯ This study demonstrates that most patients require multiple reinterventions to treat type II endoleaks; specifically, lumbar artery embolization carries a low midterm success rate.
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To present midterm outcomes of thoracic endovascular aortic repair (TEVAR) with laser fenestration to revascularize the left subclavian artery (LSA) as an alternative to debranching. ⋯ In situ retrograde laser fenestration is a feasible and effective option for revascularizing the LSA during emergent TEVAR. Longer follow-up is necessary to determine the durability of this technique.
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Multicenter Study
Mechanisms of symptomatic spinal cord ischemia after TEVAR: insights from the European Registry of Endovascular Aortic Repair Complications (EuREC).
To test the hypothesis that simultaneous closure of at least 2 independent vascular territories supplying the spinal cord and/or prolonged hypotension may be associated with symptomatic spinal cord ischemia (SCI) after thoracic endovascular aortic repair (TEVAR). ⋯ Extensive coverage of intercostal arteries alone by a thoracic stent-graft is not associated with symptomatic SCI; however, simultaneous closure of at least 2 vascular territories supplying the spinal cord is highly relevant, especially in combination with prolonged intraoperative hypotension. As such, these results further emphasize the need to preserve the left subclavian artery during TEVAR.