Objective To present our experience using fenestrated and branched endoluminal grafts for Para-anastomotic aneurysms (PAA) following prior open aneurysm surgery, and after previous endovascular ...aneurysm repair (EVAR) complicated by proximal type I endoleak. Methods Fenestrated and/or branched EVAR was performed on eleven patients. Indications included proximal type I endoleak after EVAR and short infrarenal neck ( n = 4), suprarenal aneurysm after open AAA ( n = 4), distal type I endoleak after endovascular TAA ( n = 1), proximal anastomotic aneurysm after open AAA ( n = 1), and an aborted open AAA repair due to bleeding around a short infrarenal neck. Results The operative target vessel success rate was 100% (28/28) with aneurysm exclusion in all patients. Mean hospital stay was 6.0 days (range 2–12 days, SD 3.5 days). Thirty day mortality was 0%. All cause mortality during 18 months mean follow-up (range 5–44 months, SD 16.7 months) was 18% (2/11) with no deaths from aneurysm rupture. Cumulative visceral branch patency was 96% (27/28) at 42 months. Average renal function remained unchanged during the follow-up period. Conclusions Our report highlights the potential of fenestrated and branched technology to improve re-operative aortic surgical outcomes. The unique difficulties of increased graft on graft friction hindering placement, short working distance, and increased patient co-morbidities should be recognized.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
This study provides a descriptive account of differential object marking (DOM) in the (endangered) Tver Karelian variety of the Karelian language. DOM in Tver Karelian is primarily based on the ...referential boundedness of a verb phrase, which in turn is determined according to the divisibility and cumulativity of the referents of the verbal and nominal predicates of the verb phrase in question. In addition to boundedness, DOM in Tver Karelian is also affected by the word class of a given object (noun or pronoun), as well as verbal morphology and semantics.
This study provides a descriptive account of the adessive case in the endangered and scarcely documented Tver Karelian variety of the Karelian language. Te investigation provides not only an overview ...of the many functional uses of the case in question, but also comparisons to Finnish and Estonian, as well as Russian. Te adessive case is historically associated with external location but has acquired a wide range of other uses not directly related to location, including temporal, instrumental, possessive, dative, and experiential functions. Te case is even used to mark direct and oblique objects of certain verbs. Some of these functions are shared by the adessive case in other Finnic languages, including Finnish and Estonian, while other functions that set Tver Karelian apart from these relatives appear to have developed under the influence of Russian with which the language has a long history of contact.
This study provides a descriptive account of differential object marking (DOM) in the (endangered) Tver Karelian variety of the Karelian language. DOM in Tver Karelian is primarily based on the ...referential boundedness of a verb phrase, which in turn is determined according to the divisibility and cumulativity of the referents of the verbal and nominal predicates of the verb phrase in question. In addition to boundedness, DOM in Tver Karelian is also affected by the word class of a given object (noun or pronoun), as well as verbal morphology and semantics.
Fenestrated stent-grafts aim at treating short-necked aneurysms. As a result of customized fenestrations, patency of vital side branches such as the renal arteries and the superior mesenteric artery ...can be maintained, whilst positioning the graft over these aortic side branches. Over the years, the technique has been refined. Results in a few experienced centers are good, with excellent patency rates of targeted side branches.
Suprarenal and thoraco-abdominal aneurysms can only be treated by endovascular means with branched grafts. This can be achieved with fenestrated grafts, but with the use of covered stents through the fenestrations, or by fully branched grafts. Both options are feasible and present with specific advantages and disadvantages.
This report gives an overview of our 5-years experience with fenestrated and branched grafts, and discusses the following aspects of the technique: indications, technical principles, results, and limitations.
The Cook Zenith endovascular graft Verhoeven, E L G; Bos, W T G J; Tielliu, I G J ...
Journal of cardiovascular surgery
47, Issue:
3
Journal Article
Peer reviewed
From its early release in 1994, the Zenith endovascular graft presented with a more complex but very controlled deployment mechanism. It was loaded into small and flexible introduction systems. The ...main difference with most early grafts was the intended suprarenal fixation with a bare stent including hooks and barbs. This suprarenal fixation proved to be both safe and efficient. Several improvements were made over the years, resulting in the Zenith Tri-Fab stent-graft. Major advantages of the Tri-Fab include availability of stock products and the versatility with regard to distal diameter and lengths. Finally, the Zenith graft acted as the platform in the development of fenestrated and branched grafts.
Orthopnea: not always of cardiac origin Oranen, B I; Meinesz, A F; van der Hoeven, J H ...
Nederlands tijdschrift voor geneeskunde,
1999-May-01, 19990501, Volume:
143, Issue:
18
Journal Article
Respiratory insufficiency developed in a man aged 68 after cardiac surgery and in a man aged 60 with COPD and a history of cigarette smoking after an attack of 'flu', while in a woman aged 70 with ...non insulin-dependent diabetes mellitus it had been present for years. All three had bilateral diaphragmatic paralysis. The diagnosis is based on the triad orthopnoea, paradoxical abdominal movements during respiration in the recumbent position and a decrease of the vital capacity in the horizontal as compared with the sitting position. The patients' physical condition could be improved with the aid of (noninvasive) ventilatory support.
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