Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
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Comparative Study
Fenestrated endovascular aneurysm repair: graft complexity does not predict outcome.
To evaluate the outcomes of endografts designed with renal fenestrations alone vs. more complex designs that accommodate mesenteric arteries in a consecutive series of patients with pararenal aortic aneurysms undergoing endovascular aneurysm repair (EVAR). ⋯ In carefully selected patients with pararenal aneurysms, the inclusion of mesenteric arteries in the fenestrated graft design did not influence outcomes compared to fenestrated EVARs involving the renal arteries alone.
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Aberrant subclavian artery (ASA) is one of the most common congenital vascular anomalies of the aortic arch. The incidences of aberrant right subclavian artery (ARSA) and aberrant left subclavian artery (ALSA) are 0.4% to 2.3% and 0.05%, respectively. ⋯ Historically, open operation was the favored method to reconstruct ASA anatomy; however, novel endovascular techniques are now available. Following a brief discussion of embryonic development, symptoms, and treatment history of the ASA and Kommerell's diverticulum, the results of a literature review to collect the worldwide experience of endovascular/hybrid treatment of ASA is presented.
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Case Reports
TEVAR for ruptured mycotic aneurysm in a patient with a left ventricular assist device.
To report endovascular treatment of a ruptured mycotic aneurysm in a patient with previous cardiac surgery, a cardioverter-defibrillator, and an intrathoracic left ventricular assist device (LVAD). ⋯ Thoracic endovascular aortic repair in patients with LVAD is peculiar for several aspects: accurate planning is necessary to adequately visualize the aortic lesion despite the presence of many radiopaque devices and the femoral arteries are pulseless. Moreover, extremely slow washout of contrast from the aortic rupture prevents correct assessment of final sac exclusion with angiography; intraoperative TEE monitoring proved extremely useful.