ABSTRACT
The standard open surgical treatment of thoracic aortic aneurysms is associated with significant morbidity and mortality. Endovascular repair is less invasive and potentially less morbid for patients with multiple risk factors. The authors report their results in 9 consecutive high-risk patients treated with endovascular grafts from January 1998 through June 2000. There were 7 men and 2 women patients with an average age of 75 years. Mean aneurysm diameter was 7.1 cm. All aneurysms were repaired with Gianturco Z-stent polytetrafluoroethylene prostheses. There were no perioperative deaths. Mean length of stay was 6.3 days. Technical success was achieved in all 9 patients. Two patients had neurologic complications following repair (1 patient with transient lower extremity numbness related to spinal arthritis and 1 patient with bowel and bladder incontinence). Both patients were independent with ambulation. Mean follow-up was 15.8 months. There was no evidence of endoleak or stent migration during the follow-up period. These findings support endovascular treatment of high-risk patients with thoracic aneurysm.
Subject(s)
Angioplasty/methods , Aortic Aneurysm, Thoracic/surgery , Blood Vessel Prosthesis Implantation/methods , Aged , Aged, 80 and over , Angioplasty/standards , Aortic Aneurysm, Thoracic/classification , Aortic Aneurysm, Thoracic/diagnosis , Blood Vessel Prosthesis Implantation/standards , Comorbidity , Female , Humans , Length of Stay , Male , Middle Aged , Postoperative Complications , Prospective Studies , Treatment OutcomeABSTRACT
PURPOSE: To report the successful endovascular repair of a mycotic paravisceral aneurysm using a fenestrated stent-graft. METHODS AND RESULTS: A 55-year-old white female with a history of rheumatoid arthritis presented with an 8-cm paravisceral aneurysm secondary to pneumonia complicated by empyema. Intravascular ultrasound identified a defect in the aortic wall at the level of the celiac axis. Repair was accomplished with a fenestrated stent-graft that excluded the aneurysm and maintained flow to the celiac axis and superior mesenteric artery. Recovery was uneventful and the patient was discharged in 2 days. Six-month follow-up computed tomographic scanning confirmed aneurysm exclusion and flow to the celiac and superior mesenteric arteries. There was no evidence of graft infection. The patient died from a clinically diagnosed myocardial infarction 10 months after the stent-graft repair. CONCLUSIONS: Fenestrated stent-graft repair may evolve into a useful technique for the treatment of mycotic paravisceral aneurysms.
Subject(s)
Aneurysm, False/surgery , Aneurysm, Infected/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Escherichia coli Infections/surgery , Stents , Aneurysm, False/diagnosis , Aneurysm, False/microbiology , Aneurysm, Infected/diagnosis , Aneurysm, Infected/microbiology , Angiography , Escherichia coli/isolation & purification , Escherichia coli Infections/diagnosis , Escherichia coli Infections/microbiology , Fatal Outcome , Female , Humans , Middle Aged , Tomography, X-Ray Computed , Ultrasonography, InterventionalABSTRACT
Minimally invasive surgical therapies are popular with patients and third party payors because they offer increased safety, decreased pain, as well as shorter recovery times and hospital stays when compared to standard open surgery. Minimally invasive aortic surgery is now a practical reality. Our experience with 150 endovascular stent-graft aortic aneurysm repairs at Baptist Hospital East is detailed in the following report. In our practice, stent-grafting is now the treatment of choice for infrarenal abdominal aortic aneurysms within the context of clinical trials.
Subject(s)
Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/instrumentation , Minimally Invasive Surgical Procedures/methods , Aged , Aged, 80 and over , Aortic Aneurysm, Abdominal/diagnosis , Aortic Aneurysm, Abdominal/mortality , Aortography , Blood Vessel Prosthesis Implantation/methods , Blood Vessel Prosthesis Implantation/mortality , Female , Fluoroscopy , Graft Survival , Humans , Male , Middle Aged , Minimally Invasive Surgical Procedures/mortality , Prognosis , Prospective Studies , Stents , Survival Rate , Treatment OutcomeABSTRACT
A randomized, double blind clinical trial of the caries inhibition effects of dentifrices containing respectively monofluorophosphate and amine fluoride was performed. A third control group used a toothpaste without fluoride. A total number of 2008 schoolchildren ranging in age from 6 to 8 years and living in Strasbourg (France) participated in this study. After a baseline examination three groups were constructed with the block randomization technic. The caries inhibition effects of the three dental pastes were compared after 3 years of unsupervised use. The monofluorophosphate dentifrice showed a reduction of 7.02% for DMFT, 5.17% for DMFS and 25.26% for the df rate. The reduction of amine fluoride dentifrice caries was respectively 21.62% for DMFT, 20.94% for DMFS and 48.66% for the df rate.
