T Holzenbein

Medical University of Vienna, Wien, Vienna, Austria

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Publications (5)8.81 Total impact

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    ABSTRACT: We report on the case of a 35-year-old male who underwent emergency stent-graft placement in March 2007 due to a complicated type B dissection. One week after this procedure the patient developed critical visceral malperfusion. Subsequently, autologous iliaco-mesenteric as well as iliaco-hepatic bypass grafting was performed. At 6-month follow-up, aortic remodelling has occurred and visceral perfusion is regular.
    The Thoracic and Cardiovascular Surgeon 04/2009; 57(2):110-1. DOI:10.1055/s-2008-1038666 · 1.08 Impact Factor
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    ABSTRACT: Endovascular stent-graft placement is an accepted treatment for various diseases of the thoracic aorta. However, visceral rerouting, in order to gain sufficient distal length to safely deploy the stent-graft in patients with distal aneurysm extension, has not been reported often in the literature.We report on the case of an 82-year-old patient with two aneurysms of the descending aorta and involvement of the celiac trunk. The patient was treated by an autologous renal to hepatic artery bypass and consecutive stent-graft placement.In selected patients, extraanatomic visceral bypass and consecutive stent-graft placement can be a less invasive alternative to conventional approaches.
    EJVES Extra 03/2006; 31(5):564-564. DOI:10.1016/j.ejvs.2005.11.019
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    ABSTRACT: Endovascular stent-graft placement has become a safe and effective treatment modality for various diseases of the distal aortic arch as well as of the descending aorta. However, its effectiveness may be limited by various kinds of endoleaks resulting in persistent or recurrent perfusion of the aneurysm sac. Subsequently, systemic pressurization leads to expansion of the aneurysm sac, exposing the patient to a recurrent risk of aneurysm rupture. We report on the case of a 57-year-old male who underwent emergency stent-graft placement in March 2001 due to a contained rupture of a distal aortic arch aneurysm involving the origin of the left subclavian artery. Due to the emergency condition, a subclavian-to-carotid artery transposition had not been performed prior to stent-graft placement. During follow-up the patient developed a type II endoleak originating from the left subclavian artery with consecutive enlargement of the aneurysm sac. The endoleak was successfully treated by subclavian-to-carotid artery transposition.
    The Thoracic and Cardiovascular Surgeon 11/2005; 53(5):322-4. DOI:10.1055/s-2005-865630 · 1.08 Impact Factor
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    ABSTRACT: To evaluate the feasibility and long-term outcome of distal arterial reconstruction combined with free muscle flap transfer for patients who would otherwise have undergone major amputation. Between 1996 and 2001, 27 reconstructions using autologous vein were performed in 25 patients. Seventeen of these patients had diabetes mellitus. Gracilis, rectus abdominis and latissimus dorsi muscles were used as free flaps, covered with split-thickness skin grafts. Eighty-five percent of patients had a patent graft and viable muscle flap after 1-month. Mean follow-up was 51 months (4-72 months). At the time of follow-up 77% of reconstructions were patent and 70% of patients regained full functional capacity of their lower extremities. Limb-salvage by distal arterial reconstruction and free muscle flap transfer, is feasible with low mortality and morbidity and provides excellent long-term results with regard to graft patency and functional status.
    European Journal of Vascular and Endovascular Surgery 07/2004; 27(6):635-9. DOI:10.1016/j.ejvs.2004.02.028 · 3.07 Impact Factor
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    ABSTRACT: To determine midterm durability and need for reinterventions after stent-graft placement in atherosclerotic descending thoracic aortic aneurysms. Fifty-four patients (38 men; mean age 68 years, range 33-87) underwent stent-graft repair of chronic atherosclerotic aneurysms of the descending thoracic aorta between November 1996 and December 2002. Acute aortic syndromes (type B aortic dissections, perforating ulcers, and traumatic dissections) were excluded from analysis. Two types of commercially available stent-grafts were used (Talent and Excluder). The primary technical success rate was 94.4%. In-hospital mortality was 3.7% (2/54). No adverse neurological events were encountered. Of 3 (5.6%) early type I endoleaks, 2 (3.7%) required reintervention; the other type I endoleak closed spontaneously. Mean follow-up was 38 months (range 1-72) in the 52 surviving patients. Four (7.7%) type I, 7 (13.5%) type II, and 4 (7.7%) type III endoleaks were seen. Three 3 patients had additional treatment for endoleaks (proximal stenting [type Ia], open thoracoabdominal repair [type Ib], and embolization [type II]). Two of the 3 reinterventions were performed in the first year of follow-up. One additional patient with a type Ia endoleak not suitable for reintervention is under close observation. There were no differences in the number of endoleaks between the 2 types of stent-grafts. Three-year event-free survival was 63%. Midterm durability of endovascular stent-graft placement in atherosclerotic descending aortic aneurysms seems promising, as the rate of endoleaks requiring reintervention is acceptably low. In our series, endoleak formation occurred during the first year after stent-graft placement, so close follow-up of patients after aortic aneurysm repair is crucial. Further studies are warranted to evaluate long-term durability of this new treatment modality.
    Journal of Endovascular Therapy 03/2004; 11(1):26-32. DOI:10.1583/1545-1550(2004)011<0026:SPIADT>2.0.CO;2 · 3.59 Impact Factor