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- Kölbel, Tilo, et al.
(författare)
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The Chimney Technique
- 2009
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Ingår i: Gefässchirurgie. - : Springer Science and Business Media LLC. - 1434-3932 .- 0948-7034. ; 14:3, s. 206-212
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Tidskriftsartikel (refereegranskat)abstract
- A thoracic chimney graft is a stent or stent graft that is deployed in a supraaortic branch vessel, protruding somewhat proximally into the free aortic lumen like a chimney parallel to the main aortic stent graft. The chimney graft is used to preserve flow to vital aortic side branches covered by the main aortic stent graft. Standard off-the-shelf stent grafts can be used to instantly treat lesions with inadequate fixation zones. The chimney graft offers an alternative to fenestrated stent grafts in urgent cases, in aneurysms with challenging neck anatomy, and in thoracic endovascular aortic repair for reconstituting an unintentionally covered aortic side branch. We describe our experience with this technique and review the current literature. More data and further technical improvements are necessary before the chimney graft can be widely advocated.
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| 3. |
- Ohrlander, T, et al.
(författare)
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Emergency intervention for thrombosed popliteal artery aneurysm: can the limb be salvaged?
- 2007
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Ingår i: Journal of Cardiovascular Surgery. - 0021-9509. ; 48:3, s. 289-297
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Tidskriftsartikel (refereegranskat)abstract
- We present a review and our own experience of the demographic aspects of popliteal artery aneurysms (PAAs), their clinical presentation, the treatment alternatives and associated outcome. The incidence of PAAs varies between 0,1-1%. 95% of the patients are male. 50% are asymptomatic at the time of diagnosis. Annually, 5-24% of PAAs develop symptoms. The clinical presentation varies widely with an amputation rate of up to 78% in acute ischemic cases. The main indication for PAA repair is prevention of embolisation but acute revascularisation is the primary task in die emergency setting. Open surgery and endovascular techniques are described and can be combined with intraarterial thrombolysis as pre- or intraoperative treatment. The literature proves often inconclusive due to small numbers of heterogenous cases. Each case, therefore, needs to be assessed individually and offered the most suitable treatment.
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| 4. |
- Ohrlander, T., et al.
(författare)
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Influence of preoperative medical assessment prior to elective endovascular aneurysm repair for abdominal aortic aneurysm
- 2012
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Ingår i: International Angiology. - 1827-1839. ; 31:4, s. 368-375
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Tidskriftsartikel (refereegranskat)abstract
- Aim. The aim of this study was to compare preoperative patient evaluation by a vascular physician with a standardized workup protocol prior to elective endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA), in terms of differences in patient medication and mortality. Methods. Consecutive patients with infrarenal AAA treated with standard EVAR from 1998 to 2006 (group 2) and 2007 to 2011 (group 1) were compared. Patients in group 1 (N.=201) were investigated preoperatively by a vascular physician, evaluating comorbidities and medication. Patients in group 2 (N.=304) underwent a standardized preoperative work-up including spirometry and echocardiography. Median time of follow-up was 23 months in group 1 and 71 months in group 2. Results. The proportion of patients who had on-going medication with anti-platelet and lipid lowering medication at admission was higher in group 1 compared to group 2 (62% versus 51%; P=0.013 and 68% versus 35%; P<0.001). In group 1, the proportion of newly instituted or increased dosage of anti-hypertensive, anti-platelet or lipid lowering medication at preoperative evaluation was 40%, 24% and 31%, respectively. The total cost for preoperative assessment per patient was 272 (sic) in group 1 and 293 (sic) in group 2 (P<0.001). There was no difference in 30-day (P=0.29) or long-term (P.0.24) mortality between the two groups. Conclusion. Preoperative assessment by a vascular physician resulted in lower costs and improvement of medication against atherosclerosis, uncontrolled hypertension and perioperative ischemic cardiac events, but mortality was unaffected. [Int Angiol 2012;31:368-75]
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