Externalized transapical guidewire technique after artificial aortic valve replacement during complete endovascular aortic arch repair.

Jędrzejczak, Tomasz; Rynio, Paweł; Lewandowski, Maciej; Kazimierczak, Arkadiusz

doi:10.5114/wiitm.2020.93987

Cited by 4 publications

(4 citation statements)

References 14 publications

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“…In the group of patients treated endovascularly, the Aortic Team used the following novel techniques: it was the first in the world to successfully use the modified ETAG technique in a patient with an artificial aortic valve ( n = 4) [ 2 ]. It was one of the first in the world to use 3D printing and holography to prepare and perform PMEG procedures in both the aortic arch and thoracoabdominal segments [ 3 – 5 ].…”

Section: Resultsmentioning

confidence: 99%

Multidisciplinary aortic arch procedures within the “Aortic Team”

Jędrzejczak¹,

Rynio²,

Lewandowski³

et al. 2022

kitp

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Introduction and aim The European societies EACTS (European Association for Cardio-Thoracic Surgery) and ESVS (European Society for Vascular Surgery) recommend the establishment of “Aortic Teams” from 2019. In Poland, the first such team was officially established in Specialist University Hospital no. 2 in Szczecin in 2021. Material and methods Sixty-four patients were treated for aortic arch pathology using frozen elephant trunk ( n = 3), branch custom made devices ( n = 12), physician-modified endo-grafts (PMEG; n = 30) and the thoracic endovascular aortic repair “plus” technique ( n = 19). Results Among thoracic endovascular aortic repair (TEVAR) plus (chimneys/periscopes, n = 7, extra-anatomical bypasses, n = 12) there was 100% technical success and 4% bad outcomes (stroke or death). Among “customized” stent grafts there were Bolton Relay ( n = 8), Brail Endo-Branch ( n = 1) and Castor branched stent graft ( n = 3) with 91% technical success and 18% bad outcomes. In the group of PMEG there were 14 cases with one fenestration, 5 cases with two fenestrations and 11 cases with triple fenestration to all vessels of the aortic arch. In this group, technical success was achieved in 91% and poor outcome ended treatment in 11%. In total we noted a 91% technical success rate and a good treatment outcome was achieved in 89%. The cooperation of cardiac surgeons and vascular surgeons in one team brought competence benefits for both specialties. It allowed for good clinical and economic results despite new logistical complexities and fits into the currently changing perspective of cardiac surgery development worldwide. Conclusions Implementation of the recommendation to create aortic teams within cardiac surgery departments is possible and may be cost-effective in Polish conditions.

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Section: Resultsmentioning

confidence: 99%

Multidisciplinary aortic arch procedures within the “Aortic Team”

Jędrzejczak¹,

Rynio²,

Lewandowski³

et al. 2022

kitp

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“…3D models can also help in the development of novel treatment procedures or the implementation of new treatment techniques. [ 13 , 14 ] The usefulness of 3D printing in educating and training surgeons with little practical experience has been demonstrated. [ 8 , 15 ] FFF was the chosen method of 3D printing due to the availability of the method, the possible simplicity of its implementation in everyday practice, and the relatively simple and clean technological process for the user.…”

Section: Discussionmentioning

confidence: 99%

3D printing in the endovascular treatment of visceral artery aneurysms

Soliński,

Celer,

Dyś

et al. 2023

Medicine

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Visceral artery aneurysms (VAAs) are vascular pathologies that are difficult to treat. The variable geometry of the vessels and the location of aneurysms render difficult their evaluation in radiological imaging studies. Less invasive endovascular procedures are increasingly used in common practice. Our aim was to test the feasibility of using 3D printing technology in the preparation of preoperative spatial models of visceral artery aneurysms and their impact on interventional treatment. In our observational study, we examined a group of patients with true aneurysms of the visceral arteries who were followed and who underwent endovascular procedures with the use of 3D prints for better imaging of vascular lesions. We analyzed the fused filament fabrication method of 3D printing and printable materials in the preparation of spatial vascular models. We confirmed that more accurate visualization and analysis of vascular anatomy could assist operators in attempting minimally invasive treatment with good results. Extending imaging studies using 3D printing models that allow for the assessment of the position, morphology and geometry of the aneurysm sac, particularly of vessel branches, could encourage surgeons to perform endovascular procedures.

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“…Additionally, in the present case a common departure from the innominate artery and left carotid artery would trigger a competition between the radial force of the two parallel stent grafts going through the narrow area, with difficult-to-predict consequences. Despite risks related to some heparinization (in a lower dose, but still ACT extension) and technical difficulties (modification of the stent graft requires experience, just as inside arch implantation requires an understanding of the graft’s behavior when passing through its curvature), the procedure was safely performed [ 3 – 5 ]. It shows that it is feasible in urgent cases.…”

Section: Discussionmentioning

confidence: 99%

Physician-modified endograft in ruptured aortic arch

Jędrzejczak¹,

Żołnierczuk²,

Molski³

et al. 2022

pwki

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We present the case of a 27-year-old motorcyclist after a multi-organ trauma. He suffered a rupture of the aortic arch located in zone 2 and was disqualified from surgical replacement of the aortic arch due to active bleeding from parenchymal organs. Instead, he was provided with a physician-modified endograft (PMEG) to complete fenestrated thoracic endovascular aortic repair as a damage control procedure. No reports in the world literature are found regarding the use of PMEG technology in truly ruptured post-traumatic pseudo-aneurysm on the border of zone 1 and 2 of the aortic arch in emergency settings. The surgery provided temporary supply of the aorta and allowed all of the other surgical and orthopedic procedures to be completed. Endovascular treatment of aortic arch damage with PMEG is possible and can be effectively used for urgent indications when an open operation is not possible.

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Externalized transapical guidewire technique after artificial aortic valve replacement during complete endovascular aortic arch repair.

Cited by 4 publications

References 14 publications

Multidisciplinary aortic arch procedures within the “Aortic Team”

Multidisciplinary aortic arch procedures within the “Aortic Team”

3D printing in the endovascular treatment of visceral artery aneurysms

Physician-modified endograft in ruptured aortic arch

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