In this study, BMSs had significantly better patency compared with CBE stents for treatment of aortoiliac occlusive disease. A randomized trial comparing patency as well as restenosis rates with long-term follow-up is needed to determine if there is any benefit from use of covered stents in the aortoiliac segment.
Objectives
This study aimed to evaluate the effects on bone repair of different concentrations of mineral trioxide aggregate (MTA) added to AH Plus.
Materials and Methods
Bone tissue reactions were evaluated in 30 rats (
Rattus norvegicus
) after 7 and 30 days. In the AH + MTA10, AH + MTA20, and AH + MTA30 groups, defects in the tibiae were filled with AH Plus with MTA in proportions of 10%, 20% and 30%, respectively; in the MTA-FILL group, MTA Fillapex was used; and in the control group, no sealer was used. The samples were histologically analyzed to assess bone union and maturation. The Kruskal-Wallis and Mann-Whitney tests were performed for multiple pairwise comparisons (
p
≤ 0.05).
Results
At the 7-day time point, AH + MTA10 was superior to MTA-FILL with respect to bone union, and AH + MTA20 was superior to MTA-FILL with respect to bone maturity (
p
< 0.05). At the 30-day time point, both the AH + MTA10 and AH + MTA20 experimental sealers were superior not only to MTA-FILL, but also to AH + MTA30 with respect to both parameters (
p
< 0.05). The results of the AH + MTA10 and AH + MTA20 groups were superior to those of the control group for both parameters and experimental time points (
p
< 0.05).
Conclusions
The results suggest the potential benefit of using a combination of these materials in situations requiring bone repair.
CTA revealed an intact surgical repair of the ascending aorta and a stable dissection across the entire aorta extending into the left common iliac artery. There was compression of the internal lumen of the left common iliac artery by the false lumen without a re-entry site at this level.After discussing with patient, we agreed to attempt an endovascular fenestration with the objective to create a distal re-entry site and subsequent equilibration of pressure gradients.Procedure: Ultrasound guided left Common Femoral access was achieved, and a 6 french sheath secured. A 0.035'' hydrophilic floppy wire was advanced into the true lumen. IVUS was used to confirm true lumen wire placement, as well as the functional collapse at the level of the common iliac artery. The wire was exchanged for a 0.014'' support wire and the Out-backÒ re-entry catheter was advanced in a retrograde fashion to approximately 4 cm above the iliac bifurcation. Utilizing the catheter's radiopaque markers/guidance system, the hollow needle was projected forward managing to perforate across the aortic flap. At that time, the wire was advanced into the false lumen and the re-entry device removed. The wire was promptly exchanged to a 0.035''support wire and multiple balloon dilatations were accomplished uneventfully to a maximum of 18 mm (Figs 1 and 2).The next morning, we encountered a symmetrical femoral pulse exam. Repeat noninvasive stress testing demonstrated an ABI > 0.99 which did not change with exercise testing. Remarkably, the patient referred that his usual symptoms had completely resolved.
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