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  1. Article: The AneuRx modular endograft device for the treatment of abdominal aortic aneurysms. Overview of 7 years of clinical use.

    Schmittling, Z C / McLafferty, R B / Danetz, J S / Ramsey, D E / Hodgson, K J

    The Journal of cardiovascular surgery

    2004  Volume 45, Issue 4, Page(s) 301–306

    Abstract: Open surgical repair of abdominal aortic aneurysms (AAAs) has been performed for over 40 years now with good results. However, the procedure continues to be high-risk with numerous potential complications. The AneuRx modular bifurcated endograft was one ... ...

    Abstract Open surgical repair of abdominal aortic aneurysms (AAAs) has been performed for over 40 years now with good results. However, the procedure continues to be high-risk with numerous potential complications. The AneuRx modular bifurcated endograft was one of the first to be tested to exclude AAAs via an endovascular approach. Data from multiple clinical trials show that treatment of AAAs with the AneuRx device is comparable to open repair with regards to mortality and may have improved short-term and long-term morbidities rates. The following review discusses clinical use of the AneuRx stent graft system from the initial clinical trial in 1996 to its current commercial use.
    MeSH term(s) Aorta, Abdominal/surgery ; Aortic Aneurysm, Abdominal/surgery ; Blood Vessel Prosthesis/adverse effects ; Blood Vessel Prosthesis Implantation ; Humans ; Minimally Invasive Surgical Procedures ; Postoperative Complications ; Prosthesis Design ; Stents/adverse effects
    Language English
    Publishing date 2004-08
    Publishing country Italy
    Document type Journal Article ; Review
    ZDB-ID 80143-4
    ISSN 1827-191X ; 0021-9509
    ISSN (online) 1827-191X
    ISSN 0021-9509
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 469: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article: Cerebrospinal fluid drainage in thoracoabdominal aortic surgery.

    Coselli, J S / LeMaire, S A / Schmittling, Z C / Köksoy, C

    Seminars in vascular surgery

    2000  Volume 13, Issue 4, Page(s) 308–314

    Abstract: Paraplegia caused by spinal cord ischemia remains a devastating complication after surgical repair of thoracoabdominal aortic aneurysms. Cerebrospinal fluid (CSF) drainage has been advocated as a protective adjunct to reduce the incidence of ... ...

    Abstract Paraplegia caused by spinal cord ischemia remains a devastating complication after surgical repair of thoracoabdominal aortic aneurysms. Cerebrospinal fluid (CSF) drainage has been advocated as a protective adjunct to reduce the incidence of postoperative neurologic deficits. Studies in animals have shown that CSF drainage during thoracic aortic clamping reduces CSF pressure, improves spinal cord blood flow, and prevents paraplegia. Previous retrospective and randomized clinical studies, however, have been inconclusive because of confounding factors and other limitations. A recent prospective randomized trial focusing solely on CSF drainage during repair of extent I and II thoracoabdominal aortic aneurysms indicated an 80% reduction in the relative risk of paraplegia and paraparesis in patients who received this adjunct. Consequently, CSF drainage has emerged as an important addition to the multimodality strategy for preventing postoperative spinal cord deficits.
    MeSH term(s) Animals ; Aorta, Abdominal/surgery ; Aorta, Thoracic/surgery ; Aortic Aneurysm/surgery ; Cerebrospinal Fluid ; Drainage ; Humans ; Intraoperative Care ; Randomized Controlled Trials as Topic ; Retrospective Studies
    Language English
    Publishing date 2000-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645131-7
    ISSN 1558-4518 ; 0895-7967
    ISSN (online) 1558-4518
    ISSN 0895-7967
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2503: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article: Mortality and paraplegia after thoracoabdominal aortic aneurysm repair: a risk factor analysis.

    Coselli, J S / LeMaire, S A / Miller, C C / Schmittling, Z C / Köksoy, C / Pagan, J / Curling, P E

    The Annals of thoracic surgery

    2000  Volume 69, Issue 2, Page(s) 409–414

    Abstract: Background: Recent recommendations regarding thoracoabdominal aortic aneurysm (TAAA) management have emphasized individualized treatment based on balancing a patient's calculated risk of rupture with their anticipated risk of postoperative death or ... ...

    Abstract Background: Recent recommendations regarding thoracoabdominal aortic aneurysm (TAAA) management have emphasized individualized treatment based on balancing a patient's calculated risk of rupture with their anticipated risk of postoperative death or paraplegia. The purpose of this study was to enhance this risk-benefit decision by providing contemporary results and determining which preoperative risk factors currently predict mortality and paraplegia after TAAA surgery.
    Methods: Risk factor analyses based on data regarding 1,220 consecutive patients undergoing TAAA repair from 1986 through 1998 were performed using multiple logistic regression with step-wise model selection.
    Results: The 30-day mortality rate was 4.8% (58 of 1,220) and the incidence of paraplegia was 4.6% (56 of 1,206). For elective cases, predictors of operative mortality included renal insufficiency (p = 0.0001), increasing age (p = 0.0005), symptomatic aneurysms (p = 0.0059), and extent II aneurysms (p = 0.0054). Extent II aneurysms (p = 0.0023) and diabetes (p = 0.0402) were predictors of paraplegia.
    Conclusions: These risk models may assist in decisions regarding elective TAAA operations. For patients who are acceptable candidates, contemporary surgical management provides favorable results.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/mortality ; Aortic Aneurysm, Thoracic/mortality ; Cardiac Surgical Procedures/mortality ; Female ; Humans ; Male ; Middle Aged ; Paraplegia/etiology ; Postoperative Complications ; Risk Assessment ; Risk Factors ; Survival Analysis
    Language English
    Publishing date 2000-02
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/s0003-4975(99)01478-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: A new predictive model for adverse outcomes after elective thoracoabdominal aortic aneurysm repair.

    LeMaire, S A / Miller, C C / Conklin, L D / Schmittling, Z C / Köksoy, C / Coselli, J S

    The Annals of thoracic surgery

    2000  Volume 71, Issue 4, Page(s) 1233–1238

    Abstract: Background: Recent recommendations have emphasized individualized treatment based on balancing a patient's risk of thoracoabdominal aortic aneurysm rupture with the risk of an adverse outcome after surgical repair. The purpose of this study was to ... ...

    Abstract Background: Recent recommendations have emphasized individualized treatment based on balancing a patient's risk of thoracoabdominal aortic aneurysm rupture with the risk of an adverse outcome after surgical repair. The purpose of this study was to determine which preoperative risk factors currently predict an adverse outcome after elective thoracoabdominal aortic aneurysm repair.
    Methods: A single, composite end point termed adverse outcome was defined as the occurrence of any of the following: death within 30 days, death before discharge from the hospital, paraplegia, paraparesis, stroke, or acute renal failure requiring dialysis. A risk factor analysis was performed using data from 1,108 consecutive elective thoracoabdominal aortic aneurysm repairs.
    Results: The incidence of an adverse outcome was 13.0% (144 of 1,108 patients); predictors included preoperative renal insufficiency (p = 0.0001), increasing age (p = 0.0035), symptomatic aneurysms (p = 0.020), and extent II aneurysms (p = 0.0001). These risk factors were used to construct an equation that estimates the probability of an adverse outcome for an individual patient.
    Conclusions: This new predictive model may assist in decisions regarding elective thoracoabdominal aortic aneurysm operations. For patients who are acceptable candidates, contemporary surgical management provides favorable results.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analysis of Variance ; Aneurysm, Dissecting/mortality ; Aneurysm, Dissecting/surgery ; Aneurysm, Ruptured/mortality ; Aneurysm, Ruptured/surgery ; Aortic Aneurysm, Abdominal/mortality ; Aortic Aneurysm, Abdominal/surgery ; Aortic Aneurysm, Thoracic/mortality ; Aortic Aneurysm, Thoracic/surgery ; Elective Surgical Procedures ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Middle Aged ; Predictive Value of Tests ; Probability ; Risk Assessment ; Survival Analysis ; Treatment Outcome ; Vascular Surgical Procedures/methods ; Vascular Surgical Procedures/mortality
    Language English
    Publishing date 2000-12-20
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/s0003-4975(00)02678-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  5. Article: S100beta correlates with neurologic complications after aortic operation using circulatory arrest.

    LeMaire, S A / Bhama, J K / Schmittling, Z C / Oberwalder, P J / Köksoy, C / Raskin, S A / Curling, P E / Coselli, J S

    The Annals of thoracic surgery

    2001  Volume 71, Issue 6, Page(s) 1913–8; discussion 1918–9

    Abstract: Background: Astrocyte protein S100beta is a potential serum marker for neurologic injury. The goals of this study were to determine whether elevated serum S100beta correlates with neurologic complications in patients requiring hypothermic circulatory ... ...

    Abstract Background: Astrocyte protein S100beta is a potential serum marker for neurologic injury. The goals of this study were to determine whether elevated serum S100beta correlates with neurologic complications in patients requiring hypothermic circulatory arrest (HCA) during thoracic aortic repair, and to determine the impact of retrograde cerebral perfusion (RCP) on S100beta release in this setting.
    Methods: Thirty-nine consecutive patients underwent thoracic aortic repairs during HCA; RCP was used in 25 patients. Serum S100beta was measured preoperatively, after cardiopulmonary bypass, and 24 hours postoperatively.
    Results: Neurologic complications occurred in 3 patients (8%). These patients had higher postbypass S100beta levels (7.17 +/- 1.01 microg/L) than those without neurologic complications (3.63 +/- 2.31 microg/L, p = 0.013). Patients with S100beta levels of 6.0 microg/L or more had a higher incidence of neurologic complications (3 of 7, 43%) compared with those who had levels less than 6.0 microg/L (0 of 30, p = 0.005). Retrograde cerebral perfusion did not affect S100beta release.
    Conclusions: Serum S100beta levels of 6.0 microg/L or higher after HCA correlates with postoperative neurologic complications. Using serum S100beta as a marker for brain injury, RCP does not provide improved cerebral protection over HCA alone.
    MeSH term(s) Aged ; Aorta, Thoracic/surgery ; Brain/blood supply ; Brain Damage, Chronic/blood ; Brain Damage, Chronic/diagnosis ; Cardiopulmonary Bypass ; Female ; Heart Arrest, Induced ; Humans ; Male ; Middle Aged ; Postoperative Complications/blood ; Postoperative Complications/diagnosis ; Predictive Value of Tests ; Regional Blood Flow/physiology ; S100 Proteins/blood
    Chemical Substances S100 Proteins ; S100A1 protein
    Language English
    Publishing date 2001-06-08
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 211007-6
    ISSN 1552-6259 ; 0003-4975
    ISSN (online) 1552-6259
    ISSN 0003-4975
    DOI 10.1016/s0003-4975(01)02536-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 252: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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