Publications (3)2.86 Total impact
-
Article: Treatment of residual type A aortic dissection with implantation of the Djumbodis system: is purely endovascular treatment becoming a reality?
[show abstract] [hide abstract]
ABSTRACT: To evaluate the usefulness of a new transfemoral device to avoid major complications related to residual type A aortic dissection following ascending aortic replacement. Three men (aged 60, 61, and 72 years, respectively) with a residual type A aortic dissection following replacement of the ascending aorta 1, 4, and 5 years prior, respectively, were treated with the Djumbodis Dissection System. The residual dissection developed at the distal anastomosis of the aortic graft and involved all the aortic arch. The Djumbodis Dissection System is an uncovered steel stent, available in 3 lengths (40, 90, 140 mm), pre-mounted on a low pressure (0.3 bars) balloon catheter. The mesh of the device is sufficiently large to bring together the dissected layers without occluding main vital branches. The device was implanted through the femoral artery over a stiff guidewire to exclude the residual false lumen. Satisfactory aortic remodeling was documented in all cases at 1 year. The Djumbodis Dissection System might be a purely endovascular treatment to replace open surgery for residual type A aortic dissection. More cases and longer follow-up are required.Journal of Endovascular Therapy 06/2011; 18(3):368-73. · 2.86 Impact Factor -
Article: Impact of blood coagulation and fibrinolytic system changes on early and mid term clinical outcome in patients undergoing stent endografting surgery.
[show abstract] [hide abstract]
ABSTRACT: Blood coagulation and fibrinolytic system changes after endovascular repair (EVAR) of aortic pathologies are of great interest. We have examined the risk for consumption coagulopathy and its clinical implications early, and at a mid-term follow-up, in a prospective study. From June 2002 to June 2004, 41 patients for abdominal aortic aneurysm (AAA), 16 for thoracic aortic aneurysm (TAA) and 13 for acute type-B dissection underwent EVAR. Plasminogen, fibrin degradation products (FDP) and D-dimer were monitored as markers of fibrinolysis. Platelet count, fibrinogen, antithrombin III and prothrombin were assayed as markers of coagulation. The aortic diameters were assessed by computed tomography (CT) scan. FDP and D-Dimer levels significantly increased, while plasminogen values significantly decreased, on postoperative day 1 and 5, coagulation parameters significantly decreased on postoperative day 1 and 5. All parameters recovered on the 1st month of follow-up, except fibrinogen levels that showed a significant increase on month 1 and 6. We did not observe clinical complications related to coagulative disorders. There was no correlation between the preoperative diameter and the coagulative and fibrinolysis variations in the AAA and TAA group. Type-B dissection patients showed a significant correlation between the preoperative presence of a large false lumen and a high level of fibrinolysis. EVAR leads to changes in coagulation and fibrinolysis, with characteristic developments. These latter have no clinical relevance and have no effect on early outcome and on mid-term follow-up.Interactive cardiovascular and thoracic surgery 01/2007; 5(6):724-8. -
Article: ESCVS article - Aortic and aneurysmal Impact of blood coagulation and fibrinolytic system changes on early and mid term clinical outcome in patients undergoing stent endografting surgery
[show abstract] [hide abstract]
ABSTRACT: Objective: Blood coagulation and fibrinolytic system changes after endovascular repair (EVAR) of aortic pathologies are of great interest. We have examined the risk for consumption coagulopathy and its clinical implications early, and at a mid-term follow-up, in a prospective study. Methods: From June 2002 to June 2004, 41 patients for abdominal aortic aneurysm (AAA), 16 for thoracic aortic aneurysm (TAA) and 13 for acute type-B dissection underwent EVAR. Plasminogen, fibrin degradation products (FDP) and D-dimer were monitored as markers of fibrinolysis. Platelet count, fibrinogen, antithrombin III and prothrombin were assayed as markers of coagulation. The aortic diameters were assessed by computed tomography (CT) scan. Results: FDP and D-Dimer levels significantly increased, while plasminogen values significantly decreased, on postoperative day 1 and 5, coagulation parameters significantly decreased on postoperative day 1 and 5. All parameters recovered on the 1st month of follow-up, except fibrinogen levels that showed a significant increase on month 1 and 6. We did not observe clinical complications related to coagulative disorders. There was no correlation between the preoperative diameter and the coagulative and fibrinolysis variations in the AAA and TAA group. Type-B dissection patients showed a significant correlation between the preoperative presence of a large false lumen and a high level of fibrinolysis. Conclusion: EVAR leads to changes in coagulation and fibrinolysis, with characteristic developments. These latter have no clinical relevance and have no effect on early outcome and on mid- term follow-up. 2006 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.
