MyMedR

Displaying all 6 publications

Abstract:

Sort:

Fulltext Hybrid procedure in pseudoaneurysm of the descending thoracic aorta in Hospital Kuala Lumpur

Kumaraguru P, Mazri YM, Yaacob AF, Hanif H, Zainal AA, Lau JH

Med J Malaysia, 2011 Oct;66(4):381-2.
PMID: 22299568 MyJurnal

Conventional open repair for Thoracoabdominal aortic aneurysm (TAA) is associated with high morbidity and mortality. Spinal cord ischemia (SCI), renal failure, bowel ischemia and mortality are established complications following this procedure. With the advent of endovascular stent technology, various novel approaches have been described to reduce these complications, namely fenestrated stent graft and hybrid procedure. We present a case of hybrid procedure in a pseudoaneurysm of descending thoracic aorta done in Kuala Lumpur Hospital.

Matched MeSH terms: Blood Vessel Prosthesis Implantation/methods*
Importance of kissing balloon inflation in bifurcation stenting

Choo GH

J Interv Cardiol, 2009 Apr;22(2):117-20.
PMID: 19379469 DOI: 10.1111/j.1540-8183.2009.00443.x

Percutaneous bifurcation intervention is usually sufficient with a single-stent strategy. When the double-stent strategy is employed, higher restenosis and target lesion revascularization (TLR) rates are observed, especially at the side-branch ostium. The results may be improved, however, with refinement in techniques, for example, final kissing balloon inflation and double kissing balloon inflation.

Matched MeSH terms: Blood Vessel Prosthesis Implantation/methods*
Superior vena cava obstruction bypass - an alternative technique using bovine pericardial conduit: a case report

Abdullah F, Adeeb S

Heart Surg Forum, 2003;6(3):E50-1.
PMID: 12821439

An alternative technique of superior vena cava obstruction bypass using bovine pericardial conduit is described. The patient in this case had recurrent bilateral thrombophlebitis and thrombosed saphenous veins. Most of the surgical techniques reported in the literature so far have described the use of polyethylene terephthalate (Dacron) graft, polytetrafluoroethylene graft, autologous pericardial patch, and spiral vein graft. The use of synthetic grafts has been plagued with high rates of thrombosis. The pathology, clinical presentation, surgical technique, and outcome are discussed.

Matched MeSH terms: Blood Vessel Prosthesis Implantation/methods*
Single stage treatment of complex aortic pathology (mega-aortic syndrome) using frozen elephant trunk technique

Krishna Moorthy PS, Saat SA, Sakijan AS

Med J Malaysia, 2019 02;74(1):94-96.
PMID: 30846673

This is a case report of single-stage total thoracic aortic repair by the frozen elephant trunk technique for a 75-yearold female with a complex aortic pathology of mega-aorta extending from the ascending aorta to the descending aorta. We used a Thora flex™ Hybrid device, a frozen elephant trunk device with four branched grafts and the distal stent graft. The distal stent graft was inserted into the downstream descending aorta via an aortic arch and positioned 15 cm beyond the left subclavian artery after total arch replacement had been performed using a four-branch graft. The postoperative course was unremarkable with no complications. A post procedural computed tomography scan demonstrated complete exclusion of the descending thoracic aneurysm without endoleak. Therefore, fixing the whole mega-aorta in a single stage using the frozen elephant trunk was effective and safe.

Matched MeSH terms: Blood Vessel Prosthesis Implantation/methods
Effect of implantation site on outcome of tissue-engineered vascular grafts

Sologashvili T, Saat SA, Tille JC, De Valence S, Mugnai D, Giliberto JP, et al.

Eur J Pharm Biopharm, 2019 Jun;139:272-278.
PMID: 31004790 DOI: 10.1016/j.ejpb.2019.04.012

OBJECTIVE: Vascular prostheses for small caliber bypass grafts in cardiac and vascular diseases or for access surgery are still missing. Poly (Ɛ-caprolactone) (PCL) has been previously investigated by our group and showed good biocompatibility and mechanical properties in vitro and rapid endothelialisation, cellular infiltration and vascularisation in vivo yielding optimal patency in the abdominal aortic position. The aim of the present study is to evaluate our PCL graft in the carotid position and to compare its outcome to the grafts implanted in the abdominal aortic position.
METHODS: PCL grafts (1 mm ID/10 mm long) were implanted into the left common carotid artery in 20 Sprague-Dawley rats and compared to our previously published series of abdominal aortic implants. The animals were followed up to 3, 6, 12 and 24 weeks. At each time point, in vivo compliance, angiography and histological examination with morphology were performed.
RESULTS: PCL grafts showed good mechanical properties and ease of handling. The average graft compliance was 14.5 ± 1.7%/ mmHg compared to 7.8 ± 0.9% for the abdominal position and 45.1 ± 3.2%/ mmHg for the native carotid artery. The overall patency for the carotid position was 65% as compared to 100% in the abdominal position. Complete endothelialisation was achieved at 3 weeks and cell invasion was more rapid than in the aortic position. In contrast, intimal hyperplasia (IH) and vascular density were less pronounced than in the aortic position.
CONCLUSION: Our PCL grafts in the carotid position were well endothelialised with early cellular infiltration, higher compliance, lower IH and calcification compared to the similar grafts implanted in the aortic position. However, there was a higher occlusion rate compared to our abdominal aorta series. Anatomical position, compliance mismatch, flow conditions may answer the difference in patency seen.

Matched MeSH terms: Blood Vessel Prosthesis Implantation/methods*
Fulltext Unrestricted use of polymer-free sirolimus eluting stents in routine clinical practice

Krackhardt F, Kočka V, Waliszewski M, Toušek P, Janek B, Trenčan M, et al.

Medicine (Baltimore), 2020 Feb;99(8):e19119.
PMID: 32080086 DOI: 10.1097/MD.0000000000019119

Stent designs with ultrathin struts may further increase the procedural success of challenging lesion subsets. The objective of this study was to assess the safety and efficacy of ultrathin strut, polymer-free sirolimus eluting stent (PF-SES) implantations in a large scale, unselected patient population.Adult patients underwent percutaneous coronary interventions (PCI) with a thin-strut PF-SES. Data from two all-comers observational studies having the same protocol (ClinicalTrials.gov Identifiers: NCT02629575 and NCT02905214) were pooled. The accumulated target lesion revascularization (TLR) rate at 9-12 months was the primary endpoint. All dual antiplatelet therapy strategies according to the applicable guidelines were permissible.In total, 7243 patients were prospectively enrolled for PCI with PF-SES in stable coronary artery disease or acute coronary syndrome (ACS). Major risk factors in the overall cohort were diabetes (37.3%), ST elevation myocardial infarction (18.1%) and non-ST myocardial infarction (24.6%). The follow-up rate was 88.6% in the overall population. The TLR rate in the overall cohort was 2.2% whereas definite/probable stent thrombosis (ST) occurred in 0.7%. In patients with in-stent restenosis lesions, the major adverse cardiac events rate was 6.4% whereas the corresponding rate for isolated left main coronary artery (LMCA) disease was highest with 6.7% followed by patients with culprit lesions in vein bypasses (VB, 7.1%). The mortality rate in patients treated in VB lesions was highest with 5.4%, followed by the isolated LMCA subgroup (3.4%) and ACS (2.6%).PCI with PF-SES in an unselected patient population, is associated with low clinical event and ST rates. Furthermore, PF-SES angioplasty in niche indications demonstrated favorable safety and efficacy outcomes with high procedural success rates.

Matched MeSH terms: Blood Vessel Prosthesis Implantation/methods