Total aortic arch stenting--hemodynamical impact of carotid artery perfusion.

Details

Serval ID
serval:BIB_47D2AB854F71
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Total aortic arch stenting--hemodynamical impact of carotid artery perfusion.
Journal
Interactive cardiovascular and thoracic surgery
Author(s)
Niclauss L., von Segesser L.K.
ISSN
1569-9285 (Electronic)
ISSN-L
1569-9285
Publication state
Published
Issued date
10/2009
Peer-reviewed
Oui
Volume
9
Number
4
Pages
562-564
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Abstract
The aim of this experimental study is to evaluate the feasibility and the outcome of total endovascular stent implantation in the aortic arch. Indications for this operation-technique would be acute or chronic dissection of the aortic arch (non-A-non-B dissection) or type B dissection with retrograde extension. Four pigs were canulated via the distal abdominal aorta and a retrograde placement of a Djumbodis arch stent (4-9 cm) was controlled by using intravascular ultrasound and intracardiac ultrasound by the inferior cava vein and under radioscopic control. Cerebral perfusion, by using a flow meter placed on one prepared carotid artery, were controlled before, immediate post-procedural (<1 min), and in the early follow-up after aortic arch stent implantation. During the implantation process, especially during balloon inflation and deflation, mean carotid perfusion decreases slightly. A reactive increase of carotid perfusion after stent placements indicates transitory cerebral hypo-perfusion. Non-covered aortic arch stent implantation is technically feasible and could be a potential treatment option in otherwise inoperable arch dissections. The time required for balloon inflation and deflation causes an important risk of cerebral ischemia. The latter can be reduced by transaxillary perfusion.

Keywords
Animals, Aorta, Thoracic/diagnostic imaging, Aorta, Thoracic/physiopathology, Blood Pressure, Brain Ischemia/etiology, Brain Ischemia/physiopathology, Brain Ischemia/prevention & control, Carotid Arteries/physiopathology, Catheterization/adverse effects, Catheterization/instrumentation, Cerebrovascular Circulation, Echocardiography, Feasibility Studies, Hemodynamics, Perfusion, Regional Blood Flow, Stents, Swine, Time Factors, Ultrasonography, Interventional
Pubmed
Open Access
Yes
Create date
14/01/2010 13:53
Last modification date
20/08/2019 13:54
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