China
Africa
Explore chapters and articles related to this topic
Case studies: urgent decisions in interventional radiology
Published in William H. Bush, Karl N. Krecke, Bernard F. King, Michael A. Bettmann, Radiology Life Support (Rad-LS), 2017
A 59-year-old man presented with worsening left leg claudication. The patient had a history of claudication for the past 2 years, progressing from approximately 300 yards to less than 50 yards. He had no history of other cardiovascular disease. His serum cholesterol had been noted to be mildly elevated, but he received no treatment for this, apart from the suggestion of a low-fat diet. He had a history of 80 pack-years of cigarette smoking. Serum creatinine, prothrombin time (PT) and partial thromboplastin time (PTT) were all within normal limits. The patient was referred for angiography, and an initial evaluation demonstrated a normal right femoral pulse with a moderately diminished left femoral pulse. The ankle-brachial artery index was 0.85 on the right and 0.55 on the left. Angiography was performed utilizing the left percutaneous femoral approach. This showed moderate atherosclerotic disease in the aorta, moderate diffuse disease in the right iliac system, a normal left common iliac artery and a 75 per cent stenosis over approximately 2 cm in the left external iliac artery. Moderate disease was seen more distally, with one vessel runoff bilaterally.
Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Figures 9.35a,b show the major branches of the thoracic and abdominal aorta. The abdominal aorta bifurcates into the right and left common iliac arteries, usually at the level of L4. Each common iliac artery further divides into the internal iliac artery, which supplies the pelvis, and the external iliac artery, which continues down the leg to become the common femoral artery (CFA) once it crosses below the inguinal ligament. A few centimetres below the inguinal ligament the CFA divides into the deep (profunda femoris, PFA) and superficial femoral (SFA) arteries.
The Altura endograft system for endovascular aneurysm repair: presentation of its unique design with clinical implications
Published in Expert Review of Medical Devices, 2022
Efstratios Georgakarakos, Konstantinos Dimitriadis, Gioultzan Memet Efenti, Georgios I Karaolanis, Christos Argyriou, George S. Georgiadis
Two interesting cases report on the Altura device were also presented in the literature recently. Kakkos et al. used the Altura stent-graft in a patient with bilateral common iliac artery aneurysms of 6.1 and 3.1 cm and a concomitant 3.2 cm infrarenal AAA [15]. The anatomy of abdominal aorta was not suitable for most commercially available bifurcated endografts, since the length from the lowest renal artery to the aortic bifurcation was only 6.7 cm, highlighting the advantage of the Altura endograft system for use in short infrarenal AAA. The Altura parts were deployed successfully with no postoperative complications. At 6-month follow-up neither endoleak nor migration was detected, while the aneurysm sacs were reduced. Another case report from Volpe et al. presents the successful deployment of the Altura in a patient with kissing stent-grafts implanted in the past for the treatment of common iliac artery aneurysms, developing afterward type Ia and IIIb endoleaks due to enlargement of the infrarenal aorta and stent fractures. Since the deployment of single-body bifurcated endografts was not an option and open surgery was excluded due to serious comorbidities, the Altura endograft was used with no complication at 1 and 6-months follow-up [16].
An update on the improvement of patient eligibility with the use of new generation endografts for the treatment of abdominal aortic aneurysms
Published in Expert Review of Medical Devices, 2020
Nikolaos Kontopodis, Nikolaos Galanakis, Ifigeneia Tzartzalou, Emmanouil Tavlas, Efstratios Georgakarakos, Ioannins Dimopoulos, Dimitrios Tsetis, Christos V Ioannou
A recent report from the ENCORE registry indicated that for a median follow up of 2.8 years and taking into account 1296 subjects, technical success was 99.7%, while freedom from type IA endoleak at 1, 3, and 5 years was 97.6%, 97.1%, and 95.8%, respectively and type I or III endoleak 96.9%, 95.7%, and 94.0%, respectively. Freedom from device-related reintervention at 1, 3, and 5 years was 96.2%, 94.4%, and 92.4%, and primary freedom from sac expansion was 97.0%, 90.3%, and 84.9% respectively. Freedom from all-cause mortality and aneurysm-related mortality at 5 years was 78.9% and 99.3%. These results were obtained even though 50% of patients presented complex aortic anatomy, (neck length <10 mm, neck diameter >28 mm, neck angle >60, reverse neck taper >10%, distal common iliac artery diameter <10 mm, or external iliac artery diameter <6 mm) [15]. These outcomes are similar to our unpublished data and indicate the favorable mid-term results with the use of Ovation iX for EVAR.
The square rod-shaped ionic polymer-metal composite and its application in interventional surgical guide device
Published in International Journal of Smart and Nano Materials, 2020
Qingsong He, Kai Huo, Xianrui Xu, Yinghao Yue, Guoxiao Yin, Min Yu
Because the position of human femoral artery is shallow, the internal diameter is relatively large and easy to operate, the current common path of cardiac interventional surgery is to use femoral artery puncture and intervention, through the external iliac artery, the common iliac artery, the abdominal aorta, the thoracic aorta, the aortic arch into the human heart, from which further angiography, stent placement and other treatment are carried out. Therefore, the branches of the common iliac artery and the human aortic arch constitute two barriers for the interventional catheter to enter the human heart. In order to better simulate the experiment of human aortic interventional surgery, a model of human aortic vascular that is close to the real size of human blood vessel was designed and the simulation experiment of interventional surgery in this model was completed. In order to simplify the difficulty of making the model and ensure that the accuracy of the intervention simulation experiment is not affected, all the inner diameter sizes of the vascular model are less than or equal to the average inner diameter sizes of the adult human vessels. The physical diagram of the vascular model is shown in Figure 11.