Congress presentation in S.PAULO 2010
DOES ANEURYSM SAC STABILIZATION DURING EVAR REDUCE THE INCIDENCE OF ENDOLEAKS?
Presentazione al congresso di S.Paulo 2010
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Phoenix 2008 Cannes Meet 2009 PREVENTION OF ENDOLEAK TYPE II WITH BIOMATERIALSSalvatore Ronsivalle
INTERNATIONAL PRESENTATIONS
ABOUT PREVENTION OF ENDOLEAK TYPE II WITH BIOMATERIALS -
PRESENTAZIONI UFFICIALI SULLA PREVENZIONE DELL'ENDOLEAK DI TIPO II MEDIANTE UTILIZZO DI BIOMATERIALI
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Endovascular repair is a safe and effective treatment for traumatic aortic transections with lower mortality and paraplegia rates compared to open surgical repair. However, endovascular repair of transections poses critical issues including appropriate timing, managing small aortic diameters, preventing endograft collapse, and avoiding left subclavian artery occlusion. Newer endografts aim to address some of these issues through features like enhanced control during deployment and ability to treat a broader range of anatomies. Overall endovascular repair shows promise as the preferred treatment but requires close follow-up and further technical improvements to devices.
A view of prevention: congress presentation at Società Italiana di Chirurgia Vascolare Milano 2009
Uno sguardo alla prevenzione: presentazione al congresso della Società Italiana di Chirurgia Vascolare Milano nel 2009
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
Gestione Multidisciplinare Integrata In Un Caso Complesso Di Piede DiabeticoSalvatore Ronsivalle
MULTISCIPLINARY MANAGEMENT OF A DIABETIC FOOT COMPLEX CASE-
GESTIONE MULTIDISCIPLINATA INTEGRATA IN UN CASO COMPLESSO DI PIEDE DIABETICO
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
This document summarizes a study on using fibrin glue to induce thrombosis of aneurysm sacs during endovascular aneurysm repair (EVAR). The study included 84 patients who underwent EVAR with additional injection of fibrin glue into the aneurysm sac. Follow-up for up to two years found thrombosis of fibrin glue-treated aneurysm sacs in 97.6% of cases. The authors conclude that intraoperative fibrin glue injection is an effective preventive strategy for type II endoleaks and may be considered for routine prevention of type II endoleaks during EVAR.
J ENDOVASC THER 2010;17:517–524-Clinical Investigation- Aneurysm Sac ‘‘Thrombization’’ and Stabilization
in EVAR: A Technique to Reduce the Risk of Type II Endoleak
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Phoenix 2008 Cannes Meet 2009 PREVENTION OF ENDOLEAK TYPE II WITH BIOMATERIALSSalvatore Ronsivalle
INTERNATIONAL PRESENTATIONS
ABOUT PREVENTION OF ENDOLEAK TYPE II WITH BIOMATERIALS -
PRESENTAZIONI UFFICIALI SULLA PREVENZIONE DELL'ENDOLEAK DI TIPO II MEDIANTE UTILIZZO DI BIOMATERIALI
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Endovascular repair is a safe and effective treatment for traumatic aortic transections with lower mortality and paraplegia rates compared to open surgical repair. However, endovascular repair of transections poses critical issues including appropriate timing, managing small aortic diameters, preventing endograft collapse, and avoiding left subclavian artery occlusion. Newer endografts aim to address some of these issues through features like enhanced control during deployment and ability to treat a broader range of anatomies. Overall endovascular repair shows promise as the preferred treatment but requires close follow-up and further technical improvements to devices.
A view of prevention: congress presentation at Società Italiana di Chirurgia Vascolare Milano 2009
Uno sguardo alla prevenzione: presentazione al congresso della Società Italiana di Chirurgia Vascolare Milano nel 2009
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
Gestione Multidisciplinare Integrata In Un Caso Complesso Di Piede DiabeticoSalvatore Ronsivalle
MULTISCIPLINARY MANAGEMENT OF A DIABETIC FOOT COMPLEX CASE-
GESTIONE MULTIDISCIPLINATA INTEGRATA IN UN CASO COMPLESSO DI PIEDE DIABETICO
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
This document summarizes a study on using fibrin glue to induce thrombosis of aneurysm sacs during endovascular aneurysm repair (EVAR). The study included 84 patients who underwent EVAR with additional injection of fibrin glue into the aneurysm sac. Follow-up for up to two years found thrombosis of fibrin glue-treated aneurysm sacs in 97.6% of cases. The authors conclude that intraoperative fibrin glue injection is an effective preventive strategy for type II endoleaks and may be considered for routine prevention of type II endoleaks during EVAR.
J ENDOVASC THER 2010;17:517–524-Clinical Investigation- Aneurysm Sac ‘‘Thrombization’’ and Stabilization
in EVAR: A Technique to Reduce the Risk of Type II Endoleak
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Our project, our experience and our results at December 31 st 2013
Il nostro progetto, la nostra esperienza ed i nostri risultati aggiornati al 31.12.2013
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
MULTIDISCIPLINARY MANAGEMENT IN A COMPLEX CASE OF A BILATERAL TIBIAL ARTERY ANEURYSMS
GESTIONE MULTIDISCIPLINARE IN UN CASO COMPLESSO DI ANEURISMI TIBIALI BILATERALE - MARZO 2009
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
GIUV PALERMO 1999-ECOCOLORDOPPLER PER LA CHIRURGIA CAROTIDEASalvatore Ronsivalle
ECHOCOLORDOPPLER IN CAROTID SURGERY
ECOCOLORDOPPLER PER LA CHIRURGIA CAROTIDEA
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
ROUTINE USE OF CAROTID SHUNT
USO ROUTINARIO DELLO SHUNT CAROTIDEO
MINERVA CARDIOANGIOLOGICA NOVEMBRE 2000
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
Congress presentation in Cuneo 2009 about INTERNIST IN VASCULAR SURGERY
Presentazione al congresso di Cuneo 2009: L'INTERNISTA IN CHIRURGIA VASCOLARE
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
A New Management For Hypogastric Flow Exclusion In Evar Using An Extension Of...Salvatore Ronsivalle
OUR EXPERIENCE:A NEW MANAGEMENT FOR HYPOGASTRIC FLOW EXCLUSION USING AN EXTENSION OF THE SAC THROMBIZATION PROCEDURE
NOSTRA ESPERIENZA: UN NUOVO MODO DI ESCLUDERE L’ARTERIA IPOGASTRICA USANDO UN' ESTENSIONE DELLA PROCEDURA DI TROMBIZZAZIONE DELLA SACCA (Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
ECHOCOLORDOPPLER IN CAROTID SURGERY
ECOCOLORDOPPLER PER LA CHIRURGIA CAROTIDEA
MINERVA CARDIOANGIOLOGICA NOVEMBRE 2000
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
Intraoperative Intrasac Thrombin Injection to Prevent Type II Endoleak After Endovascular Abdominal Aortic
Aneurysm Repair
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
FUNNEL TECHNIQUE, J ENDOVASC THER 2006;13:775–778- Case Report-Funnel Techniq...Salvatore Ronsivalle
FUNNEL TECHNIQUE: A WAY OUT IN ABDOMINAL AORTIC ANEURYSM WITH ECTATIC PROXIMAL NECK.
TECNICA FUNNEL: UNA SOLUZIONE ALTERNATIVA IN ANEURISMA DELL'AORTA ABDOMINALE CON COLLETTO PROSSIMALE ECTASICO.
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Congress presentation in 2012 10 S.Paulo Vascular Surgery Meeting "AAA WANTED "
Presentazione al congresso 2012 10 S.Paulo Vascular Surgery Meeting "AAA CERCASI"
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
PRESENTAZIONE AL CONGRESSO DI FIRENZE 2010: DIECI ANNI DI FOLLOW UP CON ECOCO...Salvatore Ronsivalle
CONGRESS PRESENTATION IN FLORENCE EVAR 2000-2010 TEN YEAR FOLLOW UP WITH ECHOCOLORDOPPLER
PRESENTAZIONE AL CONGRESSO DI FIRENZE 2000-2010: DIECI ANNI DI FOLLOW UP CON ECOCOLORDOPPLER
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
BRACHIO-FEMORAL LOOP AND CABLE TECHNIQUE FOR EVAR: a way out which allows the device to advance with ease, consenting a more
precise releasing of the endograft main body and positioning of the prosthetic
contralateral leg
ACCESSO BRACHIO FEMORALE E TECNICA DELLA FUNIVIA: soluzione che permette all'introduttore di avanzare facilmente e consente un rilascio più preciso del corpo principale dell'endoprotesi ed il posizionamento della gambetta controlaterale
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Congress presentation in Milan SICVE 2009: ENDOLEAK TYPE II PREVENTION
Presentazione al congresso di MIlano SICVE 2009: PREVENZIONE ENDOLEAK DI TIPO II
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Our project, our experience and our results at December 31 st 2013
Il nostro progetto, la nostra esperienza ed i nostri risultati aggiornati al 31.12.2013
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
TYPE II ENDOLEAK: FROM TREATMENT OF COMPLICATION TO PREVENTIONSalvatore Ronsivalle
Congress presentation in 10°S.Paulo 2010 Vascular Surgery Meeting
Presentazione al 10 congresso di Chirurgia Vascolare di S.Paulo 2010
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Recurrent ventricular arrhythmia after cardiac surgerysalah_atta
This document discusses the management of post-cardiac surgery ventricular arrhythmias. It begins by outlining the objectives and importance of addressing ventricular arrhythmias after cardiac surgery. Some key points include that ventricular arrhythmias are seen in about 50% of patients after surgery but are generally not related to mortality if left ventricular function is good, while sustained ventricular tachycardia and fibrillation occur less commonly but are life-threatening. The document then covers the epidemiology, etiology, risk factors, diagnosis and treatment of different types of postoperative ventricular arrhythmias.
Endovascular repair of traumatic aortic transection six years of experienceGeorge Trellopoulos
This document discusses endovascular repair as an alternative treatment for ruptured abdominal aortic aneurysms compared to open repair. Endovascular repair has the benefits of avoiding general anesthesia, clamping, and blood loss. Several studies show endovascular repair results in lower mortality and morbidity rates compared to open repair. However, patient hemodynamic status and anatomy must meet certain criteria for endovascular repair to be feasible. Key considerations for successful endovascular repair include the patient's clinical condition, CT imaging of anatomy, type of anesthesia used, stent graft configuration, and potential use of an occlusion balloon. Long-term data is still needed but endovascular repair shows promise as an additional treatment option for ruptured abdominal aortic aneurys
The document provides an overview of transcatheter aortic valve implantation (TAVI), including a brief history of its development, descriptions of the Edwards Sapien valve and delivery systems, approaches for TAVI, and complications. It also discusses patient screening and risk stratification, as well as newer valve devices that are being developed.
The Banff Classification was first developed in 1991 by pathologists, nephrologists, and transplant surgeons to standardize the interpretation of transplant biopsies. It has since evolved through biennial meetings and become the worldwide standard. The classification system aims to improve reproducibility and clinical validation of biopsy results through consensus guidelines. Future meetings will further refine the system based on research findings to best inform clinical practice.
Our project, our experience and our results at December 31 st 2013
Il nostro progetto, la nostra esperienza ed i nostri risultati aggiornati al 31.12.2013
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
MULTIDISCIPLINARY MANAGEMENT IN A COMPLEX CASE OF A BILATERAL TIBIAL ARTERY ANEURYSMS
GESTIONE MULTIDISCIPLINARE IN UN CASO COMPLESSO DI ANEURISMI TIBIALI BILATERALE - MARZO 2009
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
GIUV PALERMO 1999-ECOCOLORDOPPLER PER LA CHIRURGIA CAROTIDEASalvatore Ronsivalle
ECHOCOLORDOPPLER IN CAROTID SURGERY
ECOCOLORDOPPLER PER LA CHIRURGIA CAROTIDEA
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
ROUTINE USE OF CAROTID SHUNT
USO ROUTINARIO DELLO SHUNT CAROTIDEO
MINERVA CARDIOANGIOLOGICA NOVEMBRE 2000
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
Congress presentation in Cuneo 2009 about INTERNIST IN VASCULAR SURGERY
Presentazione al congresso di Cuneo 2009: L'INTERNISTA IN CHIRURGIA VASCOLARE
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
A New Management For Hypogastric Flow Exclusion In Evar Using An Extension Of...Salvatore Ronsivalle
OUR EXPERIENCE:A NEW MANAGEMENT FOR HYPOGASTRIC FLOW EXCLUSION USING AN EXTENSION OF THE SAC THROMBIZATION PROCEDURE
NOSTRA ESPERIENZA: UN NUOVO MODO DI ESCLUDERE L’ARTERIA IPOGASTRICA USANDO UN' ESTENSIONE DELLA PROCEDURA DI TROMBIZZAZIONE DELLA SACCA (Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
ECHOCOLORDOPPLER IN CAROTID SURGERY
ECOCOLORDOPPLER PER LA CHIRURGIA CAROTIDEA
MINERVA CARDIOANGIOLOGICA NOVEMBRE 2000
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
Intraoperative Intrasac Thrombin Injection to Prevent Type II Endoleak After Endovascular Abdominal Aortic
Aneurysm Repair
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
FUNNEL TECHNIQUE, J ENDOVASC THER 2006;13:775–778- Case Report-Funnel Techniq...Salvatore Ronsivalle
FUNNEL TECHNIQUE: A WAY OUT IN ABDOMINAL AORTIC ANEURYSM WITH ECTATIC PROXIMAL NECK.
TECNICA FUNNEL: UNA SOLUZIONE ALTERNATIVA IN ANEURISMA DELL'AORTA ABDOMINALE CON COLLETTO PROSSIMALE ECTASICO.
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Congress presentation in 2012 10 S.Paulo Vascular Surgery Meeting "AAA WANTED "
Presentazione al congresso 2012 10 S.Paulo Vascular Surgery Meeting "AAA CERCASI"
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
PRESENTAZIONE AL CONGRESSO DI FIRENZE 2010: DIECI ANNI DI FOLLOW UP CON ECOCO...Salvatore Ronsivalle
CONGRESS PRESENTATION IN FLORENCE EVAR 2000-2010 TEN YEAR FOLLOW UP WITH ECHOCOLORDOPPLER
PRESENTAZIONE AL CONGRESSO DI FIRENZE 2000-2010: DIECI ANNI DI FOLLOW UP CON ECOCOLORDOPPLER
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
BRACHIO-FEMORAL LOOP AND CABLE TECHNIQUE FOR EVAR: a way out which allows the device to advance with ease, consenting a more
precise releasing of the endograft main body and positioning of the prosthetic
contralateral leg
ACCESSO BRACHIO FEMORALE E TECNICA DELLA FUNIVIA: soluzione che permette all'introduttore di avanzare facilmente e consente un rilascio più preciso del corpo principale dell'endoprotesi ed il posizionamento della gambetta controlaterale
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Congress presentation in Milan SICVE 2009: ENDOLEAK TYPE II PREVENTION
Presentazione al congresso di MIlano SICVE 2009: PREVENZIONE ENDOLEAK DI TIPO II
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Our project, our experience and our results at December 31 st 2013
Il nostro progetto, la nostra esperienza ed i nostri risultati aggiornati al 31.12.2013
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
TYPE II ENDOLEAK: FROM TREATMENT OF COMPLICATION TO PREVENTIONSalvatore Ronsivalle
Congress presentation in 10°S.Paulo 2010 Vascular Surgery Meeting
Presentazione al 10 congresso di Chirurgia Vascolare di S.Paulo 2010
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Recurrent ventricular arrhythmia after cardiac surgerysalah_atta
This document discusses the management of post-cardiac surgery ventricular arrhythmias. It begins by outlining the objectives and importance of addressing ventricular arrhythmias after cardiac surgery. Some key points include that ventricular arrhythmias are seen in about 50% of patients after surgery but are generally not related to mortality if left ventricular function is good, while sustained ventricular tachycardia and fibrillation occur less commonly but are life-threatening. The document then covers the epidemiology, etiology, risk factors, diagnosis and treatment of different types of postoperative ventricular arrhythmias.
Endovascular repair of traumatic aortic transection six years of experienceGeorge Trellopoulos
This document discusses endovascular repair as an alternative treatment for ruptured abdominal aortic aneurysms compared to open repair. Endovascular repair has the benefits of avoiding general anesthesia, clamping, and blood loss. Several studies show endovascular repair results in lower mortality and morbidity rates compared to open repair. However, patient hemodynamic status and anatomy must meet certain criteria for endovascular repair to be feasible. Key considerations for successful endovascular repair include the patient's clinical condition, CT imaging of anatomy, type of anesthesia used, stent graft configuration, and potential use of an occlusion balloon. Long-term data is still needed but endovascular repair shows promise as an additional treatment option for ruptured abdominal aortic aneurys
The document provides an overview of transcatheter aortic valve implantation (TAVI), including a brief history of its development, descriptions of the Edwards Sapien valve and delivery systems, approaches for TAVI, and complications. It also discusses patient screening and risk stratification, as well as newer valve devices that are being developed.
The Banff Classification was first developed in 1991 by pathologists, nephrologists, and transplant surgeons to standardize the interpretation of transplant biopsies. It has since evolved through biennial meetings and become the worldwide standard. The classification system aims to improve reproducibility and clinical validation of biopsy results through consensus guidelines. Future meetings will further refine the system based on research findings to best inform clinical practice.
This document discusses acute abdomen in pediatric patients. It defines acute abdomen and provides the main etiologies as inflammatory, traumatic, obstructive, and vascular conditions. It then discusses specific acute abdominal conditions that present at different ages, including neonatal causes like necrotizing enterocolitis, meconium plugs and atresia. Other causes mentioned include gastroenteritis, intussusceptions, malrotation and tumors. Signs and symptoms as well as approaches to specific conditions like appendicitis, meconium ileus and hypertrophic pyloric stenosis are summarized. Radiological images are also included to illustrate various pathologies.
This document classifies and discusses various types of ocular traumatic damages. It describes traumatic damages by etiology, traumatic agent, mechanism of trauma, and localization. The types of injuries include contusions, penetrating injuries, burns, and more. Statistics on epidemiology of eye injuries are provided, such as most being industrial or affecting younger males. Treatment outcomes and various conditions resulting from different types of injuries are explained, such as hyphema, retinal tears, and endophthalmitis. Surgical and medical management of injuries including foreign bodies, lacerations, and infections are outlined.
Role of embolic protection device in coronary and carotid interventionRamachandra Barik
This document discusses various catheter-based approaches for treating thrombus-rich lesions, including embolic protection devices. It describes proximal occlusion devices that block flow into the vessel using a balloon. Filter wires and occlusion balloons are distal protection devices that trap embolic debris downstream of the lesion. Thrombectomy devices like the Angiojet and Hydrolyzer use saline jets to dissolve and aspirate thrombi. Experience shows these technologies may help reduce complications during PCI of thrombus-rich lesions.
Role of embolic protection device in coronary and carotid interventionDrRajkumar Nune
This document discusses various catheter-based approaches for treating thrombus-rich lesions, including embolic protection devices and thrombectomy catheters. It describes trials comparing different embolic protection devices for use in stent grafting, as well as thrombectomy catheters such as the Angiojet and Hydrolyser that use aspiration or rheolytic technologies to remove thrombus. Novel devices are being developed and tested in clinical trials to debulk thrombus prior to interventions like PCI in order to reduce embolization risks.
This document discusses pelvic reconstructive surgery and highlights related to surgical mesh. It notes that over 1,000 complications have been reported with transvaginal mesh including erosion, infection, pain and other issues. Mesh may not improve outcomes over traditional non-mesh repairs for pelvic organ prolapse. The FDA recommends registries to track outcomes, standardized training, improved informed consent processes and clarifying mesh indications. Specific mesh properties like pore size, weight, material and surgical techniques can impact complications. Alternative native tissue repairs and hybrid meshes are also discussed.
This document discusses bile duct injuries that can occur during cholecystectomy. It provides background on the history and burden of bile duct injuries. The incidence varies from 0.1-0.6% depending on the type of procedure (open vs laparoscopic). Bile duct injuries can have devastating consequences for both patients and surgeons, including significant morbidity, mortality, economic costs, litigation, and loss of confidence or job for surgeons. Various patient factors, anatomical variants, pathology, misinterpretation of structures, and failures during surgery can all contribute to the mechanism of bile duct injuries. Achieving the critical view of safety during surgery and understanding dangerous anatomy are emphasized as ways to help prevent such injuries.
This document discusses endoleaks, which occur when blood flows outside the endoluminal graft used to treat an aneurysm but remains within the aneurysm sac. It classifies endoleaks into types 1-4 based on their cause. Type 1 endoleaks are graft-related due to issues at fixation sites, while type 2 is due to retrograde branch vessel flow. Type 3 results from graft integrity issues. The document outlines diagnosis and management strategies for different endoleak types, noting that types 1 and 3 can often be treated endovascularly. It also presents statistics on endoleak incidence and risk factors like proximal neck length, diameter and angulation.
This document summarizes a seminar presentation on deep venous thrombosis (DVT). It defines DVT, discusses its incidence in India compared to Western populations, and outlines Virchow's triad of factors that can lead to DVT - venous stasis, endothelial damage, and hypercoagulability. Diagnostic tests like Doppler ultrasound, MRI, and D-dimer are covered. Treatment options include anticoagulation with heparin or warfarin, thrombolytic therapy, and surgery in some cases. Compression stockings and duration of treatment are also discussed.
TUBE ILEOSTOMY PAPER PRESENTATION ASICON.pptxAjilAntony10
This document presents a study comparing tube ileostomy to loop ileostomy. The study included 44 patients in each group undergoing ileostomy for fecal diversion, mainly for large bowel malignancies. Outcomes such as time for ileostomy function, time to oral intake, ileostomy output, number of stoma bags used, complications, and length of hospital stay were compared. Tube ileostomy was found to have fewer complications like skin excoriation, electrolyte imbalance, and require fewer stoma bags. It also had a shorter time to stoma closure compared to loop ileostomy. The document concludes that tube ileostomy may be a better alternative to loop ileostomy for fecal diversion.
Endovascular repair of traumatic aortic transection six years of experienceGeorge Trellopoulos
The document discusses endovascular repair of traumatic aortic transections based on the experiences of treating 12 patients. It finds that endovascular stent grafting securely excluded the traumatic transections with no mortality or paraplegia, though one patient experienced late stent graft collapse requiring reintervention. The results suggest endovascular repair may be superior to open surgery for traumatic aortic transections given its lower mortality, paraplegia, and stroke rates.
Endovascular Repair of Thoracoabdominal AneurysmPAIRS WEB
This document discusses total endovascular repair of thoracoabdominal aortic aneurysms (TAAAs) using fenestrated and branched endovascular aneurysm repair (F-EVAR/B-EVAR) techniques. It summarizes outcomes from 86 high-risk patients treated with F-EVAR/B-EVAR for TAAA between 2007-2014, finding a 30-day mortality of 2.3%, 1-year survival of 91%, and 3-year survival of 88%. The use of staged procedures was associated with reducing spinal cord ischemia from 10% to 0%. The conclusion is that F-EVAR/B-EVAR provides good outcomes for high-risk TAAA patients when
Misadventures in endoscopic surgery dr rabiRabi Satpathy
This document discusses complications that can occur during endoscopic and hysteroscopic surgeries. It notes that reported complication rates for endoscopic surgery are around 3-5 cases per 1000, and have decreased by around 50% since the 1970s. Common complications include injuries from trocars or the Veress needle, organ perforation, and hemorrhage. The document provides tips for minimizing complications, such as using cauterization and identifying tissue planes before dissection. It also discusses specific complications for hysteroscopic procedures like trauma, hemorrhage, and thermal damage. Overall, the document outlines various complications and best practices for reducing risks during minimally invasive gynecological surgeries.
Adhesions are an important yet often neglected cause of impaired fertility
The use of adhesion prevention agents should be considered in laparoscopic surgeries as well as Open Surgeries, where adhesion formation is expected
Similar to S.PAULO 2010, ENDOLEAK'S PREVENTION (20)
ALISEO Treatment Of Iatrogenic Artery Pseudoaneurysm By Ultrasound Guided Fib...Salvatore Ronsivalle
Treatment Of Iatrogenic Artery Pseudoaneurysm By Ultrasound Guided Fibrin Glue Injection
Trattamento dello pseudoaneurisma iatrogeno mediante iniezione coguidata di colla di fibrina-
XXXIII° Congresso Nazionale della Società Italiana di Cardiologia Invasiva Porto Antico di Genova, Centro Congressi-3 ottobre 2012 Treatment of iatrogenic artery pseudoaneurysm by ultrasound guided fibrin glue injection: a single center experience Francesca Faresin; Francesca Franz; Marco Zennaro; Enrico Favaretto; Luigi Pedon; Salvatore Ronsivalle; Division of Vascular Surgery,Division of Cardiology, Cittadella Hospital, Padua, Italy-
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
PERIPHERAL ARTERIOPATY AND DIABETES: EPIDEMIOLOGY, DIAGNOSIS AND THERAPEUTIC PATH
ARTERIOPATIA PERIFERICA E DIABETE: EPIDEMIOLOGIA, EZIOPATOGENESI, DIAGNOSI E PERCORSO TERAPEUTICO
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology-Vascular Surgery-ULSS 15 Alta Padovana)
ACUTE STROKE CAUSED BY CARDIAC EMBOLISM- CASO DI STROKE ACUTO DA EMBOLIA CARDIACA
(Angiologia-Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Angiology- Vascular Surgery -ULSS 15 Alta Padovana)
CHIMNEY TECHNIQUE IN ABDOMINAL AORTIC ANEURYSM WITH RENAL ARTERIES INVOLVEMENT
TECNICA CHIMNEY IN ANEURISMA DELL’AORTA ADDOMINALE CON COINVOLGIMENTO DELLE ARTERIE RENALI
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
J ENDOVASC THER 2012;19:128–130-Letters to he Editors-Type II Endoleak: From Treatment of a Complication to Prevention
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
Ann Vasc Surg 2012; 26: 141-148-Selected technique- Funnel Technique for EVAR: ‘‘A Way Out’’ for Abdominal Aortic Aneurisms With Ectatic Proximal Necks
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
IMAGES OF A COMPLEX CASE OF MULTIPLE ANEURYSMAL DISEASE IN A 58 YEAR OLD MAN
IMMAGINI DI UN CASO COMPLESSO DI MALATTIA POLINEURISMATICA
(Chirurgia Vascolare-ULSS 15 Alta Padovana)
(Vascular Surgery -ULSS 15 Alta Padovana)
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1. DOES ANEURYSM SAC STABILIZATION DURING EVARDOES ANEURYSM SAC STABILIZATION DURING EVAR
REDUCE THE INCIDENCE OF ENDOLEAKS?REDUCE THE INCIDENCE OF ENDOLEAKS?
SEVEN YEARS EXPERIENCESEVEN YEARS EXPERIENCE
DEPARTMENT OF CARDIOVASCULAR DISEASES
DIVISION OF VASCULAR AND ENDOVASCULAR SURGERY
Chief: Salvatore Ronsivalle, MD
S.Paulo April 20-24
CICE2010CICE2010
2. BACKGROUNDBACKGROUND
EVAREVAR (endovascular aneurysm repair) is an increasingly used method of(endovascular aneurysm repair) is an increasingly used method of
repairing aortic abdominal aneurysmrepairing aortic abdominal aneurysm
TYPE II ENDOLEAK isTYPE II ENDOLEAK is
the most common form of complication (20-30%), due to partial andthe most common form of complication (20-30%), due to partial and
incomplete spontaneously early or late “ thrombization” of the aneurysmincomplete spontaneously early or late “ thrombization” of the aneurysm
sac after EVAR; it is joined by its retrograde perfusion from aortic collateralsac after EVAR; it is joined by its retrograde perfusion from aortic collateral
branchesbranches
Its management is still debatedIts management is still debated
3. TREATMENTTREATMENT TYPE II ENDOLEAKTYPE II ENDOLEAK
Preoperative embolization (IMA, LA)Preoperative embolization (IMA, LA)
Embolization therapy (transarterial, translumbar)Embolization therapy (transarterial, translumbar)
Laparoscopic retroperitoneal lumbar branches ligationLaparoscopic retroperitoneal lumbar branches ligation
Open traditional surgeryOpen traditional surgery
4. PRESENT AND FUTUREPRESENT AND FUTURE
Prevention is the best strategy to use in managing this complicationPrevention is the best strategy to use in managing this complication
The stimulation and acceleration of a complete aneurysmThe stimulation and acceleration of a complete aneurysm
sac “ thrombization “ with the introduction of biocompatiblesac “ thrombization “ with the introduction of biocompatible
materialsmaterials
in the aneurysm sac performed during EVAR seems to be promisingin the aneurysm sac performed during EVAR seems to be promising
5. BIOMATERIALSBIOMATERIALS
FIBRIN SEALANTFIBRIN SEALANT is a fully absorbable biologic adhesive matrixis a fully absorbable biologic adhesive matrix
made of two main components 1)made of two main components 1) fibrinogen solutionfibrinogen solution containingcontaining
plasma coagulation proteins and 2)plasma coagulation proteins and 2) thrombin solutionthrombin solution containingcontaining
aprotinin (antifibrino-litic agent)aprotinin (antifibrino-litic agent)
INCONELINCONEL (nickel and cobalt alloy)(nickel and cobalt alloy) COILSCOILS are radiopaque, alloware radiopaque, allow
MRI scanning, CT and CDU imagingMRI scanning, CT and CDU imaging
7. ANGIOGRAPHY DURING EVARANGIOGRAPHY DURING EVAR
Final angiography performed to verify sac thrombization and root occlusion
of lumbar and inferioir mesenteric arteries
8. September 1999September 1999
December 2009December 2009
545 patients545 patients
underwent EVARunderwent EVAR
September 1999September 1999
May 2003May 2003
228 pts: EVAR standard procedure228 pts: EVAR standard procedure
June 2003June 2003
December 2006December 2006
131 pts: EVAR plus fibrin glue131 pts: EVAR plus fibrin glue
January 2007January 2007
December 2009December 2009
186 pts: EVAR186 pts: EVAR
plus inconel coils and fibrin glueplus inconel coils and fibrin glue
POPULATIONPOPULATION
12. INCIDENCE RATEINCIDENCE RATE
cohort
person-time
(months)
failures
(num)
rates (x 1000
person-months)
EVAR alone 15770 34 2,16
EVAR plus sac thrombization 8539 7 0,82
total 24309 41 1,69
Incidence rate was 2.16 rates * 1000 person-month for EVAR alone group and 0.82 rates * 1000 person-months
for EVAR plus thrombization
Armando Olivieri MD, Department of Prevention - Epidemiology Unit
13. KAPLAN MAYER SURVIVING CURVEKAPLAN MAYER SURVIVING CURVE
Armando Olivieri MD, Department of Prevention - Epidemiology Unit
0.000.250.500.751.00
cumulativeprobability
253 230 152 95 74 43 12 0 0 0 0EVAR plus thrombization
227 188 174 167 162 154 148 119 61 44 20EVAR alone
Number at risk
0 12 24 36 48 60 72 84 96 108 120
follow up in months
EVAR alone EVAR plus sac thrombization
log-rank test p=0.0000
Kaplan–Meier Curves for the Primary End Point (endoleak type II)
14. RISK (HAZARD RATIO) FOR TYPE II ELRISK (HAZARD RATIO) FOR TYPE II EL
ADJUSTED FOR SURGICAL TECHNIQUE,GENDER AND OBESITYADJUSTED FOR SURGICAL TECHNIQUE,GENDER AND OBESITY
Armando Olivieri MD, Department of Prevention - Epidemiology Unit
Hazard
Ratio p
I.C. 95%
surgical technique
EVAR alone 1,00
EVAR plus sac thrombization 0,13 0,000 0,05 0,36
gender
male 1,00
female 0,32 0,007 0,14 0,74
obesity
normal/overweight 1,00
BMI>30 0,10 0,023 0,01 0,73
15. SEPT 1999-MAY 2003
228 pts
JUNE 2003-DEC 2008
254 pts
TYPE II ENDOLEAK
TOTAL
34 7
STABLE IN FOLLOW UP 6 (18 %) 3 (43 %)
SPONTANEUSLY
RESOLVED
11 (32 %) 3 (43 %)
SPONTANEUSLY RETIRED
5 (15 %) 1 (14 %)
TREATED WITH SURGERY
(CONVERTION)
3 (9%) -
TREATED WITH SURGERY
(PARTIAL CONVERTION) 1 (3%) -
DIED 8 (23%)
-
TYPE II ENDOLEAKTYPE II ENDOLEAK
September 1999 – December 2008
16. DISCUSSIONDISCUSSION
Biomaterials used for intrasac thrombization are inserted between main stentgraftBiomaterials used for intrasac thrombization are inserted between main stentgraft
and aneurysmal wall as a means or method to form an enclosureand aneurysmal wall as a means or method to form an enclosure
Due to a fibrin sealant injection, the coils form a structure that accelerates andDue to a fibrin sealant injection, the coils form a structure that accelerates and
consolidates the clot formation process forming a “concrete” compound, resultingconsolidates the clot formation process forming a “concrete” compound, resulting
in manifesting a durable, long lasting, sturdy stabilization of the whole complexin manifesting a durable, long lasting, sturdy stabilization of the whole complex
fixed en blocfixed en bloc
Fibrin glue injection did not cause microembolization or any allergic orFibrin glue injection did not cause microembolization or any allergic or
anaphilactic reactionsanaphilactic reactions
17. TREATMENT VERSUS PREVENTIONTREATMENT VERSUS PREVENTION
Previous studies have demonstrated a high rate of success (92% Baum et al JPrevious studies have demonstrated a high rate of success (92% Baum et al J
Vasc Interv Radiol 2001; 12:111-6 and 71 % Timaran et al J Vasc Surg 2004;Vasc Interv Radiol 2001; 12:111-6 and 71 % Timaran et al J Vasc Surg 2004;
39:1157-62) using translumbar embolization in the treatment of persistent EL39:1157-62) using translumbar embolization in the treatment of persistent EL
type II with sac enlargementtype II with sac enlargement
After the introduction of our preventive technique we had a significantly lowerAfter the introduction of our preventive technique we had a significantly lower
incidence of EL II which accords with the high percentage of success rate inincidence of EL II which accords with the high percentage of success rate in
translumbar embolizationtranslumbar embolization
We prevent complications in almost all treated patients as translumbarWe prevent complications in almost all treated patients as translumbar
embolization resolves EL II in a high percentage of treated casesembolization resolves EL II in a high percentage of treated cases
18. WHY PREVENTION ?WHY PREVENTION ?
EVAR plus a preventive aneurysm sac “ thrombization “ costs about 630EVAR plus a preventive aneurysm sac “ thrombization “ costs about 630
dollars more than EVAR alone, but EL type II reduction saves moneydollars more than EVAR alone, but EL type II reduction saves money
and time becauseand time because
we have primary clinical successwe have primary clinical success
we do not have to treat the complicationswe do not have to treat the complications
we can modify the terms of follow upwe can modify the terms of follow up
19. Prevention of type II endoleak with biomaterals isPrevention of type II endoleak with biomaterals is
●● SimpleSimple
●● SafeSafe
●● Low costLow cost
●● Independent of stent graft usedIndependent of stent graft used
●● Reduces frequency ofReduces frequency of
follow-upfollow-up
●● Increases EVAR successIncreases EVAR success
CONCLUSIONCONCLUSION
20. DRASTICDRASTIC
TYPE II ENDOLEAKTYPE II ENDOLEAK
REDUCTIONREDUCTION
Manifesting, durable, long lasting, sturdy stabilization ofManifesting, durable, long lasting, sturdy stabilization of
whole complex fixed en bloc could probably also reduce thewhole complex fixed en bloc could probably also reduce the
incidence of type IA and III endoleaksincidence of type IA and III endoleaks
Editor's Notes
EVAR is an increasingly used method of repairing abdominal aortic aneurysm in patients with a suitable anatomy. Principal among these adverse events is the presence of a type II endoleak, which occurs at some interval after EVAR in 20% to 30 % of patients.
On the other hand, when there is an aneurysm sac enlargement within 6 to12 months this indicates that we should use more aggressive modern day techniques such as, early to late percutaneous trans-arterial and direct trans-lumbar embolization with microcoils and liquid embolic agents or surgical approaches such as laparoscopic retroperitoneal branch ligation or endoscopic aneurysm sac fenestration seldom resolve the problem and the best results are achieved with open surgery, being therefore, in most cases, the most appropriate choice.
The Natural history of a type II endoleak leads us to believe that prevention is the best strategy to use in managing this complication “thrombization” with the introduction of biocompatible materials performed during EVAR seems to be promising.
The study population of our observational study included all patients who underwent endovascular abdominal aortic aneurysm (AAA) repair at our institution.
All these consecutive patients were characterized by temporally sequential surgical techniques
Table 1 presents baseline characteristics of the cohort study. Our cohort study therefore included 462 patients divided into two groups. Group 1 consisting of 228 patients who underwent standard EVAR, 213 male and 15 female, (mean age 71.8 ± 8.5 years, range 25-88). Group 2 consisting of 254 patients who underwent EVAR combined with aneurysm sac “ thrombization “, (fibrin glue injection with or without coils insertion) 232 male and 22 female, (mean age 72.1 ± 8 years, range 25-89).
All groups considered were homogeneous for all anatomic parameters assessed (sac and neck size, diameter of iliac arteries, number of sacral and/or renal accessory arteries).
The groups of patients with supra-renal fixation of main stent graft (Talent, Endurant) and infra-renal fixation of main stent graft (AneuRx, Excluder, Anaconda) were homogeneous for all anatomic parameters assessed
Incidence rate was 2.16 rates * 1000 person – month for EVAR alone group and 0.82 rates * 1000 person – months for EVAR plus thrombization
The Kaplan-Meier survival curve showed a clear difference between the two groups with a log rank test p = 0.0000
Final proportional hazards survival model: patients with preventive sac thrombization showed a highly significant protection against the development of type II endoleak (hazard ratio 0.13 , 95% confidence interval 0.05-0.36).
In group I among the 34 cases of type II endoleak detected, 11 (32%) resolved spontaneously, 3 (9%) were treated with open surgery (complete conversion) , 1 (3 %) underwent surgical ligation of one lumbar artery (semi conversion) , 5 (15 %) were unavailable for follow-up and 6 (18 %) were stable at follow-up. In group II within the 7 cases of type II endoleaks detected, 3 (43%) resolved spontaneously, 1 (43%) was unavailable for follow-up and 3 (43%) were stable at follow up