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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Modified Octopus Technique for Thoracoabdominal Aortic Aneurysm
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Developing a complex endovascular fenestrated and branched aortic program.

Andres Schanzer1, Donald Baril2, William P Robinson1

  • 1Division of Vascular Surgery, University of Massachusetts Medical School, Worcester, Mass.

Journal of Vascular Surgery
|January 18, 2015
PubMed
Summary
This summary is machine-generated.

Developing a specialized endovascular aortic repair program requires strategic planning, team integration, and data collection. This approach successfully established a center of excellence for complex aortic aneurysms.

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Area of Science:

  • Vascular Surgery
  • Endovascular Repair
  • Aortic Pathology

Background:

  • The strategic priority was to establish an internationally recognized center for endovascular treatment of complex aortic pathology.
  • Five critical components were identified: specialized training, industry partnerships, integrated team approach, data collection, and physician-sponsored investigational device exemptions.

Purpose of the Study:

  • To describe the development and outcomes of a complex endovascular aortic program.
  • To evaluate the effectiveness of a strategic planning approach in building expertise and ensuring patient outcomes.

Main Methods:

  • Performed 49 complex endovascular aortic repairs (juxtarenal, pararenal, thoracoabdominal aneurysms) using commercially manufactured and physician-modified devices.
  • Utilized 142 fenestrations, branches, and scallops in repairs.
  • Collected prospective data with 30-day and 1-year follow-up, employing Kaplan-Meier analysis.

Main Results:

  • Successfully developed a complex endovascular aortic program within 5 years.
  • The program treated a range of complex aortic aneurysms, including juxtarenal, pararenal, and thoracoabdominal types.
  • Achieved acceptable patient outcomes through a focused, team-based strategic planning approach.

Conclusions:

  • A strategic, team-based approach is effective for developing complex endovascular aortic programs.
  • This model facilitates gaining expertise with new technologies while maintaining patient safety.
  • The program demonstrated success in treating complex aortic pathology from the aortic valve to the iliac artery.