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[PMID]:29384600
[Au] Autor:Kondov S; Siepe M; Beyersdorf F; von Samson-Himmelstjern P; Czerny M
[Ad] Endereço:Department of Cardiovascular Surgery, University Heart Center Freiburg, Faculty of Medicine, University of Freiburg, Germany.
[Ti] Título:Thoracoabdominal aortic replacement with a bovine pericardial tube graft for aortobronchial fistulation 10 years after TEVAR.
[So] Source:Multimed Man Cardiothorac Surg;2017, 2017 Dec 20.
[Is] ISSN:1813-9175
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Aortobronchial fistula after thoracic endovascular aortic repair is usually a late complication. It is associated with high mortality and its surgical management is technically challenging. This tutorial illustrates the steps involved in removing an infected stent graft and replacing it with a bovine pericardial tube graft.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Doenças da Aorta/cirurgia
Implante de Prótese Vascular/efeitos adversos
Fístula Brônquica/cirurgia
Infecções Relacionadas à Prótese/cirurgia
Fístula Vascular/cirurgia
[Mh] Termos MeSH secundário: Animais
Doenças da Aorta/etiologia
Bioprótese
Prótese Vascular/efeitos adversos
Fístula Brônquica/etiologia
Bovinos
Remoção de Dispositivo
Procedimentos Endovasculares/efeitos adversos
Seres Humanos
Pericárdio/transplante
Infecções Relacionadas à Prótese/etiologia
Reoperação
Stents/efeitos adversos
Fístula Vascular/etiologia
[Pt] Tipo de publicação:VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1510/mmcts.2017.027


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[PMID]:29390289
[Au] Autor:Wei XQ; Song L; Zhang XS; Wang KY; Wu J
[Ad] Endereço:Interventional Therapy Department, The Second Hospital of Dalian Medical University, Dalian, China.
[Ti] Título:Endovascular stent graft repair of aortogastric fistula caused by peptic ulcer after esophagectomy: A case report.
[So] Source:Medicine (Baltimore);96(50):e8959, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Aortogastric fistula (AGF) is a rare but devastating clinical complication after esophagectomy. In a recent report, nearly all AGF patients died of massive hemorrhage or aspiration of massive hematemesis. Therefore, timely appropriate treatment of AGF remains a challenge.Herein, we report a case of AGF that resulted from peptic ulceration after esophagectomy and was successfully treated with endovascular stent graft placement. PATIENT CONCERNS: A 59-year-old man had undergone video-assisted thoracoscopic esophagectomy for squamous cell carcinoma and esophageal reconstruction using a gastric tube 14 months previously. He suddenly experienced massive hematemesis and unstable circulatory dynamics, Infusion was performed to treat critical hemorrhagic shock but was ineffective. We informed the patient and his family members of the situation, and once written informed consent to treatment was provided, we rushed him to the operating room. DIAGNOSES: Contrast medium permeated into the gastric cavity through a fistula between the abdominal aorta and gastric tube at the 11th thoracic level, Based on this, we made a diagnosis of AGF resulting from a peptic ulcer, and this diagnosis was further confirmed by high pressure angiography combined with computed tomography (CT) imaging. INTERVENTIONS: An endovascular stent graft was placed under the guidance of digital subtraction angiography and followed by antibiotic therapy to prevent infection and proton pump inhibitor therapy to inhibit gastric acid secretion. OUTCOMES: The patient recovered uneventfully after the procedure. Four months after surgery, the patient died of organ failure caused by retroperitoneal lymph node metastasis and multiple intrahepatic metastases, with no postoperative bleeding linked to the endovascular stent graft repair. LESSONS: Our case supports the notion that endovascular stent graft repair is a feasible alternative in treatment of AGF with several advantages in addition to surgical intervention, although more such cases should be collected and analyzed in the future to corroborate our observations.
[Mh] Termos MeSH primário: Doenças da Aorta/terapia
Procedimentos Endovasculares
Esofagectomia
Fístula Gástrica/terapia
Úlcera Péptica/cirurgia
Complicações Pós-Operatórias/terapia
Stents
Fístula Vascular/terapia
[Mh] Termos MeSH secundário: Doenças da Aorta/diagnóstico por imagem
Prótese Vascular
Implante de Prótese Vascular
Extravasamento de Materiais Terapêuticos e Diagnósticos
Evolução Fatal
Fístula Gástrica/diagnóstico por imagem
Seres Humanos
Masculino
Meia-Idade
Complicações Pós-Operatórias/diagnóstico por imagem
Cirurgia Torácica Vídeoassistida
Tomografia Computadorizada por Raios X
Fístula Vascular/diagnóstico por imagem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008959


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[PMID]:29320978
[Au] Autor:Lim CS; Dhutia A; Riga C; Dharmadasa A; Gibbs RGJ; Hamady MS
[Ad] Endereço:1 Regional Vascular Unit, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
[Ti] Título:Two-Vessel Branched Stent Graft for Severely Angulated Aortic Arch Aneurysm in a Jehovah's Witness.
[So] Source:Vasc Endovascular Surg;52(2):154-158, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Aneurysmal disease involving the origins of supra aortic vessels often requires complex open and/or endovascular repair that is not only associated with significant risk of mortality and morbidity but also often with perioperative blood loss requiring transfusion. We report a successful repair of a large thoracic aortic aneurysm (TAA) involving the aortic arch with a custom-made Bolton Relay 2-vessel branched thoracic aortic endograft in a 42-year-old Jehovah's Witness who would otherwise be very unlikely to survive an open repair. Branched thoracic aortic endografting offers a potentially safe, minimally invasive, and effective alternative for TAA disease involving the supra-aortic arteries, especially in patients who are at high risk of open surgery.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Perda Sanguínea Cirúrgica/prevenção & controle
Implante de Prótese Vascular/instrumentação
Prótese Vascular
Procedimentos Endovasculares/instrumentação
Testemunhas de Jeová
Religião e Medicina
Stents
[Mh] Termos MeSH secundário: Adulto
Angiografia Digital
Aneurisma da Aorta Torácica/diagnóstico por imagem
Aortografia/métodos
Transfusão de Sangue
Angiografia por Tomografia Computadorizada
Seres Humanos
Masculino
Desenho de Prótese
Resultado do Tratamento
Recusa do Paciente ao Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180112
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417747426


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[PMID]:29246081
[Au] Autor:Garriboli L; Jannello AM
[Ad] Endereço:1 Department of Vascular Surgery, H. Sacro Cuore Don Calabria, Negrar VR, Italy.
[Ti] Título:Uncovered Chimney Stent Graft for Renal Arteries With the Nellix Endovascular Aneurysm Sealing Technique.
[So] Source:Vasc Endovascular Surg;52(2):148-153, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To describe the application of uncovered chimney stent grafts with the Nellix endovascular aneurysm sealing technique (ChEVAS) for juxtarenal abdominal aortic aneurysms (JAAAs). CASE REPORT: Two patients with JAAA and multiple comorbidities were considered unfit for open surgery and were selected for an endovascular approach. Fenestrated and branched endografts were too expensive, and a chimney endovascular approach was considered inappropriate for the relatively high incidence of proximal type I endoleak and graft migration. ChEVAS was performed successfully with the novel addition of uncovered chimney stents to further reduce costs and possibly improve target vessel patency. JAAA exclusion and visceral vessel patency was confirmed at 18-month follow-up. CONCLUSION: ChEVAS with bare chimney stents is technically less complex, potentially reduces access complications and procedural costs, and may improve long-term patency compared to alternative techniques. Results at 18 months seem promising, but strict follow-up is necessary as the long-term durability is unknown.
[Mh] Termos MeSH primário: Aorta Abdominal/cirurgia
Aneurisma da Aorta Abdominal/cirurgia
Implante de Prótese Vascular/instrumentação
Prótese Vascular
Procedimentos Endovasculares/instrumentação
Artéria Renal/cirurgia
Stents
[Mh] Termos MeSH secundário: Idoso de 80 Anos ou mais
Aorta Abdominal/diagnóstico por imagem
Aneurisma da Aorta Abdominal/diagnóstico por imagem
Aortografia/métodos
Angiografia por Tomografia Computadorizada
Seres Humanos
Masculino
Meia-Idade
Desenho de Prótese
Artéria Renal/diagnóstico por imagem
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417747175


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[PMID]:29350897
[Au] Autor:Tomic A; Milovic N; Marjanovic I; Lekovic; Bjelanovic Z; Sarac M; Vavic N; Ignjatovic L; Stamenkovic D; Mickovic S
[Ti] Título:Aortobifemoral reconstruction and renal transplantation in a patient with abdominal aortic aneurysm and occlusion of iliac arteries: A case report.
[So] Source:Vojnosanit Pregl;74(1):81-4, 2017 Jan.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Aortoiliac occlusive disease and abdominal aortic aneurysm in patients with renal insufficiency on hemodialysis can significantly influence the success of renal transplantation. In the recent past, advanced atherosclerosis was considered as contraindication for renal transplantation. Complicated creation of vascular anastomoses and progression of occlusive or aneurysmal disease were the main reasons. Case report: We presented a 52-year-old man with a 5-year history of end-stage renal disease on haemodialysis. The patient was previously excluded from renal transplantation program because of severe aortoiliac atherosclerosis and abdominal aortic aneurysm. Resection of abdominal aortic aneurysm with occlusion of the iliac arteries and reconstruction with aortobifemoral synthetic grafts was performed and followed by cadaveric renal transplantation. Conclusion: Advanced atherosclerotic disease in aortoiliac segment requires elective vascular surgical reconstruction, as part of preparation for renal transplantation in patients with end-stage renal disease.
[Mh] Termos MeSH primário: Aneurisma da Aorta Abdominal/cirurgia
Arteriopatias Oclusivas/cirurgia
Implante de Prótese Vascular/métodos
Artéria Femoral/cirurgia
Artéria Ilíaca/cirurgia
Falência Renal Crônica/cirurgia
Transplante de Rim
[Mh] Termos MeSH secundário: Aneurisma da Aorta Abdominal/complicações
Aneurisma da Aorta Abdominal/diagnóstico por imagem
Aortografia/métodos
Arteriopatias Oclusivas/complicações
Arteriopatias Oclusivas/diagnóstico por imagem
Prótese Vascular
Implante de Prótese Vascular/instrumentação
Angiografia por Tomografia Computadorizada
Artéria Femoral/diagnóstico por imagem
Seres Humanos
Artéria Ilíaca/diagnóstico por imagem
Falência Renal Crônica/complicações
Falência Renal Crônica/diagnóstico
Masculino
Meia-Idade
Polietilenotereftalatos
Desenho de Prótese
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Polyethylene Terephthalates)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.2298/VSP140609139T


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[PMID]:29328558
[Au] Autor:Marjanovic I; Tomic A; Maric N; Pecarski D; Sarac M; Paunovic D; Rusovic S
[Ti] Título:Endovascular treatment of the subclavian artery aneurysm in high-risk patient - a single-center experience.
[So] Source:Vojnosanit Pregl;73(10):941-4, 2016 Oct.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:We present our first experience with endovascular treatment of 6 subclavian artery aneurysms (SAA) occurring in five male and one female patient. All patients, in our studies, according to ASA classification were high risk for open repair of SAA. The etiology of the all aneurysms was atherosclerosis degeneration of the artery. Two aneurysms were of intrathoracic location, then the other were extrathoracic. Symptoms related to subclavian artery aneurysms were present in two patients, compression and chest pain in one, and hemorrhage shock in second, while the remaining patients were asymptomatic. We preferred the Viabhan endoprosthesis for endovascular repair in 5 cases. In one patient with ruptured of subclavian artery aneurysm who was high-risk for open repair we made combined endovascular procedure. First at all, we covered the origin of left subclavian artery with thoracic stent graft and after that we put two coils in proximal part of subclavian artery. There was no operative mortality, and the early patency rate was 100%. The follow-up period was from 3 months to 3 years. During this period, one patient died of heart failure and one patient required endovascular reoperation due to endoleak type I. Endovascular treatment is recommended for all patients with subclavian artery aneurysm whenever this is possible due to anatomical reasons especially in high-risk patient with intrathoracic localization of aneurysm, to prevent potential complications.
[Mh] Termos MeSH primário: Aneurisma/cirurgia
Implante de Prótese Vascular
Embolização Terapêutica
Procedimentos Endovasculares
Artéria Subclávia/cirurgia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Aneurisma/diagnóstico por imagem
Aneurisma/fisiopatologia
Prótese Vascular
Implante de Prótese Vascular/efeitos adversos
Implante de Prótese Vascular/instrumentação
Angiografia por Tomografia Computadorizada
Embolização Terapêutica/efeitos adversos
Embolização Terapêutica/instrumentação
Procedimentos Endovasculares/efeitos adversos
Procedimentos Endovasculares/instrumentação
Feminino
Seres Humanos
Masculino
Desenho de Prótese
Sérvia
Stents
Artéria Subclávia/diagnóstico por imagem
Artéria Subclávia/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Grau de Desobstrução Vascular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150420091M


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[PMID]:29320620
[Au] Autor:Koncar IB; Dragas M; Sabljak P; Pesko P; Markovic M; Davidovic L
[Ti] Título:Aortoesophageal and aortobronchial fistula caused by Candida albicans after thoracic endovascular aortic repair.
[So] Source:Vojnosanit Pregl;73(9):684-7, 2016 Sep.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Endovascular stent-graft placement has emerged as a minimally invasive alternative to open surgery for the treatment of aortic aneurysms and dissections. There are few reports of stent graft infections and aortoenteric fistula after endovascular thoracic aortic aneurysm repair, and the first multicentric study (Italian survey) showed the incidence of about 2%. Case report: We presented a 69-year-old male patient admitted to our hospital 9 months after thoracic endovascular aortic repair, due to severe chest pain in the left hemithorax and arm refractory to analgesic therapy. Multislice computed tomography (MSCT) showed a collection between the stent graft and the esophagus with thin layers of gas while gastroendoscopy showed visible blood jet 28 cm from incisive teeth. Surgical treatment was performed in collaboration of two teams (esophageal and vascular surgical team). After explantation of the stent graft and in situ reconstruction by using Dacron graft subsequent esophagectomy and graft omentoplasty were made. After almost four weeks patient developed hemoptisia as a sign of aorto bronchial fistula. Treatment with implantation of another aortic cuff of 26 mm was performed. The patient was discharged to the regional center with negative blood culture, normal inflammatory parameters and respiratory function. Three months later the patient suffered deterioration with the severe weight loss and pneumonia caused by Candida albicans and unfortunately died. The survival time from the surgical treatment of aortoesophageal fistula was 4 months Conclusion: Even if endovascular repair of thoracic aortic diseases improves early results, risk of infection should not be forgotten. Postoperative respiratory deterioration and finally hemoptisia could be the symptoms of another fistula.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/efeitos adversos
Prótese Vascular/efeitos adversos
Fístula Brônquica/microbiologia
Candida albicans/isolamento & purificação
Candidíase/microbiologia
Procedimentos Endovasculares/efeitos adversos
Fístula Esofágica/microbiologia
Infecções Relacionadas à Prótese/microbiologia
Stents/efeitos adversos
Fístula Vascular/microbiologia
[Mh] Termos MeSH secundário: Idoso
Aortografia/métodos
Implante de Prótese Vascular/instrumentação
Fístula Brônquica/diagnóstico por imagem
Fístula Brônquica/cirurgia
Candidíase/diagnóstico
Candidíase/cirurgia
Angiografia por Tomografia Computadorizada
Remoção de Dispositivo
Procedimentos Endovasculares/instrumentação
Fístula Esofágica/diagnóstico por imagem
Fístula Esofágica/cirurgia
Esofagectomia
Evolução Fatal
Seres Humanos
Masculino
Tomografia Computadorizada Multidetectores
Infecções Relacionadas à Prótese/diagnóstico por imagem
Infecções Relacionadas à Prótese/cirurgia
Fatores de Tempo
Resultado do Tratamento
Fístula Vascular/diagnóstico por imagem
Fístula Vascular/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180111
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141209074K


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[PMID]:29390556
[Au] Autor:Si D; Yang H; Liu G; Tong Y; He Y
[Ad] Endereço:Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China.
[Ti] Título:Treatment of longitudinal stent compression under intravenous ultrasound guidance: A case report.
[So] Source:Medicine (Baltimore);96(51):e9405, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Longitudinal stent compression is a rare phenomenon, which has been increasingly reported in recent years. PATIENT CONCERNS: Following 2 stents implanted into the middle and proximal segments of the left anterior descending (LAD) artery, longitudinal stent compression occurred when a post-dilation balloon was introduced into the proximal stent opening. DIAGNOSE: The intravenous ultrasound (IVUS) examination revealed overlapping at the opening of the proximal stent and poor stent adherence. INTERVENTIONS: Another balloon was carefully inserted into the opening for post-dilation, followed by angiography and IVUS examination. OUTCOMES: The IVUS examination indicated that the overlapping at the opening of the proximal stent was improved and the stents were well adhered. LESSONS: Such compression may be prevented by gentle and careful balloon maneuverability and improved with the use of additional balloon angioplasty or stent implantation.
[Mh] Termos MeSH primário: Angioplastia Coronária com Balão
Prótese Vascular/efeitos adversos
Estenose Coronária/etiologia
Stents/efeitos adversos
Ultrassonografia de Intervenção/métodos
[Mh] Termos MeSH secundário: Angioplastia Coronária com Balão/métodos
Estenose Coronária/diagnóstico por imagem
Estenose Coronária/terapia
Vasos Coronários/diagnóstico por imagem
Feminino
Seres Humanos
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009405


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[PMID]:29178903
[Au] Autor:Ma X; He Z; Li L; Liu G; Li Q; Yang D; Zhang Y; Li N
[Ad] Endereço:Department of Plastic Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang, 150086, China.
[Ti] Título:Development and in vivo validation of tissue-engineered, small-diameter vascular grafts from decellularized aortae of fetal pigs and canine vascular endothelial cells.
[So] Source:J Cardiothorac Surg;12(1):101, 2017 Nov 25.
[Is] ISSN:1749-8090
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Tissue engineering has emerged as a promising alternative for small-diameter vascular grafts. The aim of this study was to determine the feasibility of using decellularized aortae of fetal pigs (DAFPs) to construct tissue-engineered, small-diameter vascular grafts and to test the performance and application of DAFPs as vascular tissue-engineered scaffolds in the canine arterial system. METHODS: DAFPs were prepared by continuous enzymatic digestion. Canine vascular endothelial cells (ECs) were seeded onto DAFPs in vitro and then the vascular grafts were cultured in a custom-designed vascular bioreactor system for 7 days of dynamic culture following 3 days of static culture. The grafts were then transplanted into the common carotid artery of the same seven dogs from which ECs had been derived (two grafts were prepared for each dog with one as a backup; therefore, a total of 14 tissue-engineered blood vessels were prepared). At 1, 3, and 6 months post-transplantation, ultrasonography and contrast-enhanced computed tomography (CT) were used to check the patency of the grafts. Additionally, vascular grafts were sampled for histological and electron microscopic examination. RESULTS: Tissue-engineered, small-diameter vascular grafts can be successfully constructed using DAFPs and canine vascular ECs. Ultrasonographic and CT test results confirmed that implanted vascular grafts displayed good patency with no obvious thrombi. Six months after implantation, the grafts had been remodeled and exhibited a similar structure to normal arteries. Immunohistochemical staining showed that cells had evenly infiltrated the tunica media and were identified as muscular fibroblasts. Scanning electron microscopy showed that the graft possessed a complete cell layer, and the internal cells of the graft were confirmed to be ECs by transmission electron microscopy. CONCLUSIONS: Tissue-engineered, small-diameter vascular grafts constructed using DAFPs and canine vascular ECs can be successfully transplanted to replace the canine common carotid artery. This investigation potentially paves the way for solving a problem of considerable clinical need, i.e., the requirement for small-diameter vascular grafts.
[Mh] Termos MeSH primário: Aorta Torácica/ultraestrutura
Bioprótese
Prótese Vascular
Prenhez
Engenharia Tecidual/métodos
Tecidos Suporte
[Mh] Termos MeSH secundário: Animais
Artéria Carótida Primitiva
Modelos Animais de Doenças
Cães/embriologia
Células Endoteliais/citologia
Feminino
Fibroblastos/ultraestrutura
Microscopia Eletrônica de Varredura
Gravidez
Sus scrofa/embriologia
Suínos/embriologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180202
[Lr] Data última revisão:
180202
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1186/s13019-017-0661-x


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[PMID]:27776939
[Au] Autor:Fukui S; Tanaka H; Kobayashi K; Kajiyama T; Mitsuno M; Yamamura M; Ryomoto M; Miyamoto Y
[Ad] Endereço:Department of Cardiovascular Surgery, Hyogo College of Medicine, Nishinomiya, Japan. Electronic address: fukui0104@yahoo.co.jp.
[Ti] Título:Development of Collaterals to the Spinal Cord after Endovascular Stent Graft Repair of Thoracic Aneurysms.
[So] Source:Eur J Vasc Endovasc Surg;52(6):801-807, 2016 12.
[Is] ISSN:1532-2165
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: In thoracic and thoraco-abdominal aortic aneurysm repair, spinal cord injury (SCI) is devastating. Detection of the Adamkiewicz artery might be important for preventing SCI. Although thoracic endovascular stent grafts often occlude the segmental artery, the incidence of SCI in thoracic endovascular aortic repair is thought to be low compared with open repair. This study aimed to evaluate how the Adamkiewicz artery is supplied after segmental arteries are occluded by stent grafts. METHODS: From March 2007 to August 2015, 32 patients were enrolled whose segmental arteries that were connected to the Adamkiewicz arteries were occluded by stent grafts. Segmental arteries, Adamkiewicz arteries, collateral circulation into the Adamkiewicz arteries, and anterior spinal arteries were pre- and post-operatively evaluated by computed tomography angiography. RESULTS: Post-operatively, Adamkiewicz arteries were detected in 24 (75%) patients, except for two patients with paraplegia and six without paraplegia. Post-operative Adamkiewicz arteries were the same as pre-operative Adamkiewicz arteries, except for one Adamkiewicz artery that was located at two vertebral levels below the pre-operative level. SCI occurred in two (6.3%) patients. The distribution of feeding arteries into the Adamkiewicz artery post-operatively was divided into three patterns as follows: a segmental artery below the distal landing zone of the stent graft (53%), branches of the left subclavian artery (33%), and a branch of the left external iliac artery (13%). CONCLUSIONS: The length of the stent graft should be as short as possible. Blood supply to the left subclavian artery should be maintained because segmental arteries below the segmental artery occluded by the stent graft and branches of the left subclavian artery can become collaterals post-operatively.
[Mh] Termos MeSH primário: Aneurisma da Aorta Torácica/cirurgia
Implante de Prótese Vascular/instrumentação
Prótese Vascular
Circulação Colateral
Procedimentos Endovasculares/instrumentação
Medula Espinal/irrigação sanguínea
Stents
Artéria Subclávia/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Aneurisma da Aorta Torácica/diagnóstico por imagem
Aneurisma da Aorta Torácica/fisiopatologia
Aortografia/métodos
Implante de Prótese Vascular/efeitos adversos
Angiografia por Tomografia Computadorizada
Procedimentos Endovasculares/efeitos adversos
Feminino
Seres Humanos
Masculino
Meia-Idade
Tomografia Computadorizada Multidetectores
Desenho de Prótese
Fluxo Sanguíneo Regional
Estudos Retrospectivos
Fatores de Risco
Isquemia do Cordão Espinal/diagnóstico por imagem
Isquemia do Cordão Espinal/etiologia
Isquemia do Cordão Espinal/fisiopatologia
Artéria Subclávia/diagnóstico por imagem
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE



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