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  1. Article: External Stenting (Exostenting) to Correct Vascular Torsion and Angulation.

    Silva, Michael B / Shoaib, Muhammad / Miyara, Santiago J / Guevara, Sara / McCann-Molmenti, Alexia / Silva, H Colleen / Watt, Stacey / Zafeiropoulos, Stefanos / Hayashida, Kei / Takegawa, Ryosuke / Shinozaki, Koichiro / Choudhary, Rishabh C / Cho, Young Min / Kressel, Adam M / Alsalmay, Yaser M / Grande, Daniel A / Cicalese, Luca / Aranalde, Gabriel I / Covelli, Grace /
    Becker, Lance B / Shore-Lesserson, Linda / Molmenti, Ernesto P

    The International journal of angiology : official publication of the International College of Angiology, Inc

    2021  Volume 32, Issue 2, Page(s) 128–130

    Abstract: Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the ... ...

    Abstract Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the organ and/or body parts. On many occasions, mild angulations and torsions can be successfully addressed by repositioning the organ. In cases where the abnormal findings persist, maneuvers such as placing a fat pad to create a smoother curve, or even opening the peritoneum (in the case of kidney transplants) to allow for a better positioning of the organ, are associated with successful outcomes. When such torsions/angulations persist despite these approaches, further innovative tactics are required. In the current report, we propose a technique that involves longitudinally opening of a synthetic graft that is rigid enough to maintain its shape, such as a ringed polytetrafluoroethylene graft, and placing it as an external stent around the angulated/torsioned vessel. This maneuver will correct the underlying vascular compromise without having to perform any further invasive interventions, such as reimplanting the organ or resecting part of the involved vessel. Although primarily illustrated for application by describing an instance in which exostenting was applied during kidney transplantation, our approach could be applied to any vessel under many circumstances where angulations/twists are encountered. In this report, we describe the use of an external stent, also called exostenting, to correct a severe torsion/angulation of the external iliac artery in a kidney transplant recipient where all other measures were unsuccessful.
    Language English
    Publishing date 2021-05-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1144390-x
    ISSN 1061-1711
    ISSN 1061-1711
    DOI 10.1055/s-0041-1727132
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: External Stenting (Exostenting) to Correct Vascular Torsion and Angulation

    Silva, Michael B. / Shoaib, Muhammad / Miyara, Santiago J. / Guevara, Sara / McCann-Molmenti, Alexia / Silva, H. Colleen / Watt, Stacey / Zafeiropoulos, Stefanos / Hayashida, Kei / Takegawa, Ryosuke / Shinozaki, Koichiro / Choudhary, Rishabh C. / Cho, Young Min / Kressel, Adam M. / Alsalmay, Yaser M. / Grande, Daniel A. / Cicalese, Luca / Aranalde, Gabriel I. / Covelli, Grace /
    Becker, Lance B. / Shore-Lesserson, Linda / Molmenti, Ernesto P.

    International Journal of Angiology

    2021  Volume 32, Issue 02, Page(s) 128–130

    Abstract: Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the ... ...

    Abstract Organ transplantation can be associated with vascular torsions and angulations of both recipient and donor vessels. Such kinks and/or torsions of vessels can compromise the vascular integrity, obstruct inflow and/or outflow, and result in loss of the organ and/or body parts. On many occasions, mild angulations and torsions can be successfully addressed by repositioning the organ. In cases where the abnormal findings persist, maneuvers such as placing a fat pad to create a smoother curve, or even opening the peritoneum (in the case of kidney transplants) to allow for a better positioning of the organ, are associated with successful outcomes. When such torsions/angulations persist despite these approaches, further innovative tactics are required. In the current report, we propose a technique that involves longitudinally opening of a synthetic graft that is rigid enough to maintain its shape, such as a ringed polytetrafluoroethylene graft, and placing it as an external stent around the angulated/torsioned vessel. This maneuver will correct the underlying vascular compromise without having to perform any further invasive interventions, such as reimplanting the organ or resecting part of the involved vessel. Although primarily illustrated for application by describing an instance in which exostenting was applied during kidney transplantation, our approach could be applied to any vessel under many circumstances where angulations/twists are encountered. In this report, we describe the use of an external stent, also called exostenting, to correct a severe torsion/angulation of the external iliac artery in a kidney transplant recipient where all other measures were unsuccessful.
    Keywords vascular ; torsion ; vessel ; tortuosity ; external stenting ; exostenting ; support ; organ compromise ; transplant ; kidney
    Language English
    Publishing date 2021-05-23
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1144390-x
    ISSN 1615-5939 ; 1061-1711
    ISSN (online) 1615-5939
    ISSN 1061-1711
    DOI 10.1055/s-0041-1727132
    Database Thieme publisher's database

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  3. Article: Sequential Use of Romiplostim after Eltrombopag for Refractory Thrombocytopenia in Hydrocarbon-Induced Myelodysplasia

    Morales, Luis F. / Miyara, Santiago J. / Guevara, Sara / Metz, Christine N. / Shoaib, Muhammad / Watt, Stacey / Zafeiropoulos, Stefanos / McCann-Molmenti, Alexia / Hayashida, Kei / Takegawa, Ryosuke / Shinozaki, Koichiro / Choudhary, Rishabh C. / Brindley, Elena C. / Nishikimi, Mitsuaki / Kressel, Adam M. / Alsalmay, Yaser M. / Mazzotta, Elvio A. / Cho, Young Min / Aranalde, Gabriel I. /
    Grande, Daniel A. / Zanos, Stavros / Becker, Lance B. / Molmenti, Ernesto P.

    International Journal of Angiology

    2021  

    Abstract: We describe the clinical course of a 65-year-old male patient who suffered from hydrocarbon-induced myelodysplasia and was successfully treated with the thrombopoietin receptor agonist (TPO-RA), romiplostim. Myelodysplastic syndromes (MDS) are ... ...

    Abstract We describe the clinical course of a 65-year-old male patient who suffered from hydrocarbon-induced myelodysplasia and was successfully treated with the thrombopoietin receptor agonist (TPO-RA), romiplostim. Myelodysplastic syndromes (MDS) are characterized by ineffective hematopoiesis, cytopenias, and increased risk of leukemic transformation. Here, we present a clinical vignette of MDS-associated thrombocytopenia refractory to first-line drugs as well as the TPO-RA, eltrombopag. To date, romiplostim is an U.S. Food and Drug Administration (FDA)-approved drug for idiopathic thrombocytopenic purpura and thrombocytopenia secondary to liver disease. Of note, currently the FDA advises against its use in MDS based on previous long-term safety concerns. Since the therapeutic options for thrombocytopenia in MDS patients are sparse, repurposing and reassessing romiplostim in this setting have been the focus of recent studies. At the time of writing, no published double-blind randomized clinical trials have conducted a head-to-head comparison between romiplostim and eltrombopag in thrombocytopenic MDS patients. To the best of our knowledge, for a thrombocytopenic patient in the setting of MDS, this is the first documented report of refractory clinical response after a 2-year use of eltrombopag in which replacement of treatment with romiplostim resulted in sustained physiological counts of thrombocytes within four weeks.
    Keywords romiplostim ; myelodysplastic syndromes ; thrombopoietin receptor agonist ; thrombopoiesis ; thrombocytopenia ; eltrombopag
    Language English
    Publishing date 2021-09-03
    Publisher Thieme Medical Publishers, Inc.
    Publishing place Stuttgart ; New York
    Document type Article
    ZDB-ID 1144390-x
    ISSN 1615-5939 ; 1061-1711
    ISSN (online) 1615-5939
    ISSN 1061-1711
    DOI 10.1055/s-0041-1726366
    Database Thieme publisher's database

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