Identifying (high) risk patients for endovascular treatment – unfavorable medical comorbidities

2007 ◽  
pp. 13-19
Keyword(s):  
High Risk ◽  
Endovascular Treatment ◽  
Medical Comorbidities ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals A ruptured penetrating atherosclerotic ulcer of the ascending aorta: a case report of an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Josephine Chenesseau ◽  
Pierre-Antoine Barral ◽  
Philippe Piquet ◽  
Marine Gaudry
Keyword(s):  
Cardiac Surgery ◽  
High Risk ◽  
Endovascular Treatment ◽  
Endovascular Repair ◽  
Innominate Artery ◽  
Ascending Aorta ◽  
Stent Grafts ◽  
Penetrating Atherosclerotic Ulcer ◽  
High Risk Patients ◽  
Risk Patients

Abstract Background An endovascular approach to the management of a ruptured plaque in the ascending aorta may be an alternative to open surgery in high-risk patients. This option may become inevitable due to the number of elderly patients unfit for open cardiac surgery. There are very few stent grafts able to fit the ascending aorta and in emergency cases, most medical teams have been limited to current thoracic aortic endografts, the shortest of which measure 10 cm. Case summary We report a case of an endovascular repair of a ruptured penetrating atherosclerotic ulcer of the ascending aorta. The patient was considered for open cardiac surgery but was evaluated at a high mortality risk based on his age, his medical history, and significant calcifications on his aorta. Our vascular surgical team decided then to perform an endovascular repair with extending the length of the aortic coverage by debranching the innominate artery. Discussion Endovascular treatment of an acute ruptured aorta is feasible in high-risk patients with thoracic endovascular stent grafts and coverage of the innominate artery. Endovascular treatment of the ascending aorta is at its infancy and in need of further research. New stent grafts designed for the ascending aorta are in progress and should increase the numbers of interventions in the years to come.

Is the Endovascular Treatment of Carotid Stenosis in High-Risk Patients Really Safer than Carotid Endarterectomy?

2004 ◽  
Vol 17 (4) ◽  
pp. 332-338 ◽  
Author(s):  
F.M. McKevitt ◽  
S. Macdonald ◽  
G.S. Venables ◽  
T.J. Cleveland ◽  
P.A. Gaines
Keyword(s):  
High Risk ◽  
Endovascular Treatment ◽  
Carotid Endarterectomy ◽  
Carotid Stenosis ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Substance use disorders and medical comorbidities among high-need, high-risk patients with diabetes

2018 ◽  
Vol 186 ◽  
pp. 86-93 ◽  
Author(s):  
Li-Tzy Wu ◽  
Udi E. Ghitza ◽  
He Zhu ◽  
Susan Spratt ◽  
Marvin Swartz ◽  
...  
Keyword(s):  
Substance Use ◽  
High Risk ◽  
Substance Use Disorders ◽  
Medical Comorbidities ◽  
High Risk Patients ◽  
Patients With Diabetes ◽  
Risk Patients

Catheter-based treatment of the dissected ascending aorta: a systematic review

2020 ◽  
Vol 59 (1) ◽  
pp. 80-91
Author(s):  
Changtian Wang ◽  
Ludwig Karl von Segesser ◽  
Francesco Maisano ◽  
Enrico Ferrari
Keyword(s):  
High Risk ◽  
Aortic Dissection ◽  
Endovascular Treatment ◽  
Open Surgery ◽  
Type A ◽  
Ascending Aorta ◽  
Type A Aortic Dissection ◽  
High Risk Patients ◽  
Risk Patients

Summary OBJECTIVES Type A aortic dissection requires immediate surgical repair. Despite improvements in surgery and anaesthesia, there is still a considerable risk when high-risk patients are concerned. Less invasive endovascular treatments are under evaluation. We investigated the current status of catheter-based treatment for type A aortic dissection with the entry tear located in the ascending aorta. METHODS A PubMed search was supplemented by searching through bibliographies and key articles. Demographics, risk score, stent graft detail, access route, mortality, cause of death, complications, reinterventions and follow-up data were extracted and analysed. RESULTS Thirty-one articles (7 retrospective reports; 24 case reports/series) were included in the study. In total, 104 patients (mean age 71 ± 14 years) received endovascular treatment for acute (63) or chronic (41) type A dissection. A history of a major cardiac or aortic operation was present in 29 patients. The mean EuroSCORE II was 30 ± 20 in 4 reports. A total of 114 stent grafts were implanted: ‘off-the-shelf’, 65/114; custom made, 12/114; and modified, 7/114. Hospital complications included intraprocedural conversion to open surgery (2/104), stroke (2/104), coronary stenting (2/104), early endoleak (9/104) and repeat aortic endovascular treatment for endoleak (5/104). Hospital mortality was 10% (intraoperative death 2/104). Mean duration of follow-up time was 21 ± 21 months (range 1–81 months); follow-up data were available for 86 patients: 10 patients died of non-aortic-related causes; reintervention for aortic disease (endovascular repair or open surgery) was performed in 8 patients. CONCLUSIONS Catheter-based ascending aorta repair for type A aortic dissection with the entry tear in the ascending aorta can be considered in carefully selected high-risk patients. Further analysis and specifically designed devices are required.

Combination of norfloxacin and cisapride in prevention of SBP in high risk patients: A new approach

2001 ◽  
Vol 120 (5) ◽  
pp. A376-A376
Author(s):  
B JEETSANDHU ◽  
R JAIN ◽  
J SINGH ◽  
M JAIN ◽  
J SHARMA ◽  
...  
Keyword(s):  
High Risk ◽  
New Approach ◽  
High Risk Patients ◽  
Risk Patients
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