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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
2 - A new prosthesis for aortic arch substitution
S. Nazari, S. Salvi, A. Aluffi, E.Visconti, G.Rescigno, P.Buniva
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,
5 - Expandable device type III foreasy and reliable approximation of dissection layers in sutureless aortic anastomosis. Ex vivo experimental study
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.
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
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
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
Stefano Nazari, MD