5 results on '"Drucker C"'
Search Results
2. The Caged Knickerbocker: A Novel Modification to Targeted False Lumen Management in Complex Aortic Dissection.
- Author
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Blitzer DN, Pereira GA, Drucker C, Rolle N, Nagarsheth K, Karwowski J, Hall M, Taylor B, Ghoreishi M, and Toursavadkohi S
- Subjects
- Humans, Retrospective Studies, Aortography methods, Treatment Outcome, Time Factors, Stents, Aortic Aneurysm, Thoracic surgery, Blood Vessel Prosthesis Implantation adverse effects, Endovascular Procedures adverse effects, Aortic Dissection
- Abstract
Introduction: Targeted false lumen management has been described for complex presentations of aortic dissection. The "Knickerbocker" technique is often referenced and includes dilating a focal portion of an oversized endograft in the true lumen to purposefully rupture the false lumen septum, but at the expense of increased risk for visceral propagation and malperfusion. This case series describes a novel modification of the Knickerbocker technique by caging the distal end of the endograft prior to focal dilation., Methods: A retrospective chart review was conducted at a tertiary academic center from 2018-2020. Patients were included if they had a history or current presentation of aortic dissection and underwent a Caged Knickerbocker (CKB) repair. Data were collected to include demographics, indications for repair, technical success, perioperative outcomes, hospital course, mortality, and further aortic interventions., Results: Five patients were included in our evaluation. Four patients (80%) presented with chronic Type B aortic dissection (cTBAD) and concomitant aneurysmal degeneration of the thoracic aorta; 1 patient (20%) presented with an acute rupture secondary to cTBAD. Three patients (60%) had previous aortic repairs, 2 of which were for Type A Aortic Dissection that additionally required redo sternotomy and total arch replacement prior to CKB. CKB was technically successful in all cases with no peri-operative complications. Two (40%) patients required further aortic intervention due to aneurysmal degeneration., Conclusion: Achieving complete false lumen thrombosis is a considerable challenge when managing complex aortic dissections. Our data demonstrate the technical feasibly and early successful outcomes with the CKB approach. Importantly, CKB facilitates future distal extension into the para-visceral aorta in cases of complex thoracoabdominal aortic aneurysms. Further research should focus on discerning individual patients who will benefit from targeted false lumen management and compare outcomes between different approaches.
- Published
- 2023
- Full Text
- View/download PDF
3. Endovascular Thrombectomy of Septic Thrombophlebitis of the Inferior Vena Cava: Case Report and Review of the Literature.
- Author
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Talaie T, Drucker C, Aicher B, Khalifeh A, Lal B, Sarkar R, and Toursavadkohi S
- Subjects
- Aged, Computed Tomography Angiography, Female, Humans, Magnetic Resonance Angiography, Male, Middle Aged, Phlebography methods, Sepsis diagnosis, Sepsis microbiology, Thrombophlebitis diagnostic imaging, Thrombophlebitis microbiology, Treatment Outcome, Vena Cava, Inferior diagnostic imaging, Vena Cava, Inferior microbiology, Endovascular Procedures, Sepsis surgery, Thrombectomy methods, Thrombophlebitis surgery, Vena Cava, Inferior surgery
- Abstract
We describe the cases of 2 patients who had septic thrombophlebitis and were successfully managed with endovascular thrombectomy. Patient A developed septic thrombophlebitis of the inferior vena cava after several retroperitoneal resections for metastatic renal cell carcinoma. The thrombus was successfully removed via endovascular mechanical balloon thrombectomy. Patient B was a patient with pancreatic adenocarcinoma involving the portal vein who developed a septic inferior vena cava thrombus extending from the level and beyond the renal veins, for which she underwent endovascular thrombectomy. We argue that this approach is safe and feasible. It should be considered as a supplemental treatment modality for select decompensating patients who require lifesaving interventions and have contraindications to traditional management of surgical thrombectomy or excision of the involved venous segment.
- Published
- 2018
- Full Text
- View/download PDF
4. Laser Fenestration for Treatment of a Complicated Chronic Type B Aortic Dissection.
- Author
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Talaie T, Werter C, Drucker C, Aicher BO, Crawford R, and Toursavadkohi S
- Subjects
- Aged, Aortic Dissection complications, Aortic Dissection diagnostic imaging, Aortic Dissection physiopathology, Aortic Aneurysm, Thoracic complications, Aortic Aneurysm, Thoracic diagnostic imaging, Aortic Aneurysm, Thoracic physiopathology, Aortography methods, Chronic Disease, Computed Tomography Angiography, Endovascular Procedures instrumentation, Humans, Laser Therapy instrumentation, Male, Regional Blood Flow, Treatment Outcome, Ultrasonography, Interventional, Vascular Patency, Aortic Dissection surgery, Aortic Aneurysm, Thoracic surgery, Endovascular Procedures methods, Laser Therapy methods
- Abstract
We report a case of a complex chronic type B aortic dissection treated by thoracic endovascular aortic repair and laser fenestration of the false septum to preserve flow to branch vessels originating from both the true and false lumen. Dissections complicated by thoracoabdominal aneurysmal degeneration with critical organs being perfused by branches arising from both true and false lumens are rare and leave limited options for repair. Despite advancements in endovascular techniques, fenestration remains one of the only means of preserving flow to both the true and false lumens and thus was necessary in the management of our patient. This novel procedure allows complex aortic dissections to be addressed endovascularly, which increases the flexibility and management of this challenging problem that previously required an open repair with significant morbidity.
- Published
- 2018
- Full Text
- View/download PDF
5. Chondrosarcoma of the sphenoethmoid complex.
- Author
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Drucker C, Sanders AD, Bowes AK, and Maddalozzo J
- Subjects
- Child, Chondrosarcoma secondary, Chondrosarcoma surgery, Ethmoid Sinus surgery, Humans, Male, Nasal Cavity, Nose Neoplasms diagnosis, Nose Neoplasms surgery, Orbital Neoplasms complications, Orbital Neoplasms diagnosis, Orbital Neoplasms surgery, Paranasal Sinus Neoplasms secondary, Paranasal Sinus Neoplasms surgery, Sphenoid Sinus surgery, Vision, Low etiology, Chondrosarcoma pathology, Ethmoid Sinus pathology, Nose Neoplasms secondary, Orbital Neoplasms secondary, Paranasal Sinus Neoplasms pathology, Sphenoid Sinus pathology
- Abstract
Chondrosarcoma of the nose and paranasal sinuses is extremely rare. We report a case of a child with a massive chondrosarcoma of the sphenoethmoid complex who presented with a change of visual acuity. Clinical and histologic characteristics of this lesion are discussed, along with treatment options and factors affecting prognosis.
- Published
- 1990
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