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AORTIC ANEURYSM TREATMENT and PREVENTION

Endovascular techniques are currently accepted standard for infrarenal and upper descending uncomplicated aortic aneurysm treatment, with better than open surgery results even in older patients (1). Endovascular techniques are also possible in virtually all other aortic segments, even though may include complex and/or hybrid procedures whose safety and long term effectiveness is still to be proved.

Endovascular technique however cannot prevent paraplegia in extended descending aorta aneurysms.

Moreover recent 2 years (2006-2007) USA nationwide data review showed that only 23% of 11,669 uncomplicated, localized, non genetic, elective, descending thoracic aorta aneurysms were treated with endovascular techniques, while the other 77% (9,106) were treated by standard open aortic repair (1), wich is then by far still the principal therapeutic option.

These data suggest a possible significant clinical impact of the below two folds research approach 

1) Superior nationwide outcomes of endovascular versus open repair for isolated descending thoracic aortic aneurysm in 11,669 patients
Raja R. Gopaldas, MD,a,b Joseph Huh, MD,a,b Tam K. Dao, PhD,c Scott A. LeMaire, MD,a,b Danny Chu, MD,a,d Faisal G. Bakaeen, MD,a,d and Joseph S. Coselli, MD
J Thorac Cardiovasc Surg 2010;140:1001-10

Project 1 : easier and safer surgery for large thoracic or thoracoabdominal aneurysms:

SUTURELESS VASCULAR ANASTOMOSIS

New Devices TYPE I and II

Video 8 Jul 2009

Device TYPE III ---------------------------------------buttressed

Video 25 Nov 2009

DETAILS OF USE

Video 20 Apr 2008

LITERATURE / BIBLIOGRAPHY / REFERENCES

Main bibliography includes:

1 - Expandable prosthesis for sutureless anastomosis in thoracic aorta prosthetic substitution.

S Nazari, F Luzzana, C Banfi, Z Mourad, S Salvi, A Gaspari, F Nazari-Coerezza

Eur J Cardiothor Surg,10:1003-1009, 1996

2 - A new prosthesis for aortic arch substitution

S. Nazari, S. Salvi, A. Aluffi, E.Visconti, G.Rescigno, P.Buniva

Ann Thorac Surg, 1997; 64:1339-44

3 - Descending Aorta Substitution Using A Prosthesis With Expandable Ends. Case Report.

S. Nazari, S Salvi, E Visconti, F Caramella, C Rossi, G Rescigno, C Banfi, P Buniva

Journal Of Cardiovascular Surgery 40:417-20, 1999

4 - Improved Device for Sutureless Aortic Anastomosis Applied in a Case of Cancer

A Aluffi, P Buniva, G Rescigno, S Nazari,

Tex Heart Inst J 2002;29:56-9

5 - Expandable device type III foreasy and reliable approximation of dissection layers in sutureless aortic anastomosis. Ex vivo experimental study

S Nazari

Interact CardioVasc Thorac Surg 2010;10:161-164. doi:10.1510/icvts.2009.216291

Main meeting presentations include:

1 -Prosthetic substitution of the Aorta without blood flow interruption. Preliminary setting of a new technique.

G.Rescigno, S Nazari, A Guagliano, R Dionigi, A Zonta, M Campani.

Video, Proceedings of the 7th Annual Meeting of the European Association for Cardiothoracic Surgery, Barcelona, 20-23 Sept 1993.

2 - Prosthetic substitution of the aorta without blood flow interruption. Preliminary setting.

A Guagliano, G Rescigno, Z Mourad, V Jemos, Gs Fossati, Ap Bonoldi, U Prati, P Dionigi, S Nazari, A Zonta.

Video. Abstract, proceedings XXVIII Congress of the European Society for Surgical Research, May 23-26, 1993, Turku, Finland - Eur Surg Res 25, S1, 1993, pp51-52

3 - Prosthetic substitution of the descending aorta without blood flow interruption.

S. Nazari,Z Mourad, F. Luzzana

Abstract, Proceedings of the IV Aortic Surgery Symposium, New York, April 20-22, 1994

4 - Less than five minutes cross clamping time for descending aorta prosthetic substitution. Animal test of a new device for a new technique

C.Banfi, Z. Mourad, S.Salvi, F. Luzzana, S.Nazari.

Video, Abstract n?089, Proceedings of 8thAnnual Meeting of The European Association for Cardiothoracic Surgery, THE HAGUE, Sept 25-28, 1994

5 - Expandable prosthesis for sutureless anastomosis in thoracic aorta prosthetic substitution.

Luzzana F, Banfi C, Ticozzelli G, Barbano T, Casoni L, Nazari S

Video F104, Proceedings of the 9th Annual Meeting of The European Asssociation for Cardiothoracic Surgery, Paris, Sept 24-27, 1995

6 - Composite graft with expandable ends for total arch replacement.

S. Nazari,Z. Mourad, C. Banfi, S. Salvi, E. Visconti, A. Aluffi.

Video & Poster, Proceedings Aortic Surgery Symposium V, New York, April 23-26, 1996

7 - Sutureless expandable end prosthesis for descending aorta substitution invaded by bronchogenic cancer

P. Buniva, G. Rescigno, S. Salvi, A. Aluffi, A. Berti, F. Salsi

Video, Proceedings Aortic Surgery Symposium VIII, New York, May 2-3, 2002

8 - New device for thoracic aorta prosthetic substitution

C. Rossella, P. Buniva, A. Aluffi, I. Malusardi, G. Rescigno, S. Nazari

Video – Proceedings of 53nd International Congress of the ESCVS in Ljubljana, June 2-5, 2004

9 - Aortic Arch Substitution in less than 2 minutes.

W.Wang, S. Nazari, F. Lou, Z. Xu.

Video, Proceedings 3rd ISMICS Winter Workshop, Shanghai, RP China, December 2-4, 2005

10 - Thoracic Aorta Substitution in less than 2 minutes.

S. Nazari,

Video, Proceedings 16th  World Congress of World Society of Cardio- Thoracic Surgeons, Ottawa, August 17-20, 2006

11 - Modified Type II expandable device for ascending aorta substitution

S. Nazari,

Video, Proceedings of The 15th Annual Meeting of Asian Society for Cardiovascular Surgery, May 17-20, Beijing, R.P. China

12 - Modified expandable device for easy, quick and blood-tight sutureless anastomosis in ascending aorta.

C Rossella, MD, G. Rescigno, MD, S. Nazari, MD.

Presented as "young researcher program" at The Houston Aortic Symposium, April 2008

13 - Modified Expandable Device for Easy and Realiable Dissection Layers Approximation in Sutureless Aortic Anastomosis

S.Nazari

Video, proceedings of The Houston Aortic Symposium, Houston, March 26-28, 2009

14 - Easier, quicker and more efficient aortic-prosthesis anastomosis in total arch substitution with elephant trunk. "Ex vivo" swine experimental model

C. Rossella and S. Nazari

Video, proceedings of The Houston Aortic Symposium, Houston, March 21-23, 2013

Project 2 :

A) very early aortic wall strengthening for aneurism stabilization and prevention of rupture & dissection

B) prophylactic aortic wall strengthening for aneurysm prevention in Marfan desease and other genetic disorders

2 - ENDOVASCULAR "NET" prosthesis without obstacle to aortic branches perfusion

Authors address:

Stefano Nazari, MD

e.mail: nazari@fondazionecarrel.org

             stefano.nazari@fastwebnet.it

last modified JUN/ 9/ 2011