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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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Related Experiment Video

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Use of steerable sheaths for complex aortic procedures.

Ben Harrison1, Richard Bond1

  • 1Department of Vascular Surgery, Fiona Stanley Hospital, Perth, WA, Australia.

Vascular
|May 30, 2023
PubMed
Summary
This summary is machine-generated.

Cardiac steerable sheaths (HSS) offer a versatile solution for complex endovascular treatments. This study shows their effectiveness in challenging aortic procedures, improving patient outcomes where standard methods fail.

Keywords:
Endovascular aortic repairbranched endovascular aortic repaircannulationsteerable catheter

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Area of Science:

  • Vascular Surgery
  • Endovascular Interventions
  • Medical Device Innovation

Background:

  • Standard catheters often face challenges in accessing complex vascular pathologies.
  • Branched and fenestrated aortic grafts require precise target vessel cannulation.
  • Cardiac electrophysiology devices may offer novel solutions for non-cardiac interventions.

Purpose of the Study:

  • To evaluate the utility of cardiac-designed steerable sheaths for non-cardiac endovascular treatments.
  • To assess the ease of use and effectiveness in target vessel cannulation for aortic grafts.
  • To demonstrate the application of the HeartSpan Steerable Sheath (HSS) in complex vascular disease.

Main Methods:

  • Retrospective review of 15 patients (2019-2022) utilizing the HeartSpan Steerable Sheath (HSS).
  • Analysis of cases involving complex vascular pathology and challenging target vessel cannulation.
  • Case presentation focusing on branch graft insertion via distal access and sheath characteristics.

Main Results:

  • Successful cannulation and stenting in 21 out of 23 target vessels where standard approaches failed.
  • HSS facilitated fenestrated endovascular graft deployment in 5 cases and full t-Branch graft deployment in 4 cases.
  • Demonstrated utility in superior mesenteric artery cannulation for ischemia, iliac artery cannulation, and branched device access.

Conclusions:

  • Cardiac steerable sheaths, such as the HSS, are effective for cannulating challenging vessels in aortic endovascular procedures.
  • This modified approach can salvage cases otherwise deemed inoperable, especially where specialized aortic sheaths are unavailable.
  • The HSS provides a viable alternative for complex endovascular interventions, enhancing treatment accessibility.