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Publications

  • Predicting Distal Aortic Remodeling After Endovascular Repair for Chronic DeBakey III Aortic Dissection

    Year: 2018

    Affiliation: University of Pennsylvania/ University of Pittsburgh

    Citation: The Annals of Thoracic Surgery

    Abstract: Chronic DeBakey III aortic dissection is typically managed with open aortic reconstruction. Thoracic endovascular aortic grafting (TEVAR) has been attempted in patients with chronic DeBakey III with improved outcomes over medical management, however with frequent failures. This study investigates factors associated with positive aortic remodeling from a large aortic center.


  • Neck diameter and inner curve seal zone predict endograft-related complications in highly angulated necks after endovascular aneurysm repair using the Aorfix endograft

    Year: 2018

    Affiliation: Elsevier User License

    Abstract: Many studies have found that preoperative aneurysm anatomy can determine the postoperative complication rates for endovascular aneurysm repair (EVAR). With continual improvement in endograft technology, patients with challenging anatomy are increasingly able to undergo successful treatment with EVAR. This study aimed to quantify the influence of proximal neck anatomy on contemporary outcomes in a cohort of abdominal aortic aneurysm patients with highly angulated aneurysm necks.


  • A case-matched validation study of anatomic severity grade score in predicting reinterventions after endovascular aortic aneurysm repair

    Year: 2013

    Affiliation: Eastern Virginia Medical School

    Citation: Journal of Vascular Surgery

    Abstract: In 2002, the Society for Vascular Surgery created the anatomic severity grading (ASG) score to classify abdominal aortic aneurysms (AAAs). Our objective was to identify the predictive capability and cutoff value of preoperative ASG score for reintervention after endovascular aneurysm repair (EVAR).


  • Anatomic severity grading score predicts technical difficulty, early outcomes, and hospital resource utilization of endovascular aortic aneurysm repair

    Year: 2011

    Affiliation: Society for Vascular Surgery

    Citation: New England Journal of Medicine

    Abstract: In 2002, a system for the grading of abdominal aortic aneurysms (AAAs) was developed by the Society for Vascular Surgery (SVS). Because the correlation of the anatomic severity grading (ASG) score to patient outcomes has yet to be validated, we provide our experience with calculating the ASG score using three-dimensional (3-D) image-rendering software and provide the practical translation of this score into early outcomes and hospital charges


  • Preoperative Relative Abdominal Aortic Aneurysm Thrombus Burden Predicts Endoleak and Sac Enlargement After Endovascular Anerysm Repair

    Year: 2011

    Affiliation: New York University Langone Medical Center

    Citation: Peripheral Vascular Society

    Abstract: Endoleak and sac growth remain unpredictable occurrences after EVAR, necessitating regular surveillance imaging, including CT angiography. This study was designed to identify preoperative CT variables that predict AAA remodeling and sac behavior post-EVAR.


  • Simulation Case Rehearsals for Carotid Artery Stenting

    Year: 2009

    Affiliation: U of Rochester Medical Center

    Citation: European Journal of Vascular and Endovascular Surgery

    Abstract: A case series of 5 patients is presented assessing the utility of simulation case rehearsals of individual patients for carotid artery stenting on an endovascular simulator. Simulated and operative device dimensions were similar. Results of subjective surveys indicated that face and content validity were excellent. The simulations predicted difficulty with vessel cannulation, however had difficulty predicting post-stent changes in bifurcation angulation. Our experience suggests that it may be feasible to use patient-specific CTA-derived data in the creation of a realistic case rehearsal simulation. The overall utility of this concept, including cost-benefit analysis, has yet to be determined.


  • A Methodology to Quantify the Geometrical Complexity of the Abdominal Aortic Aneurysm

    Year: 2019

    Affiliation: University of Strathclyde

    Citation: U.S. National Library of Medicine

    Abstract: The abdominal aortic aneurysm (AAA) anatomy influences the technical success of the endovascular aneurysm repair (EVAR), yet very few data regarding the aortic tree angles exist in the literature. This poses great limitations in the numerical analyses of endografts, constraining their design improvement as well as the identification of their operational limitations. In this study, a matrix Φ of 10 angles was constructed for the description of the pathological region and was implemented on a large dataset of anatomies. More specifically, computed tomography angiographies from 258 patients were analysed and 10 aortic angles were calculated per case, able to adequately describe the overall AAA shape. 9 dimensional variables (i.e. diameters and lengths) were also recorded. The median and extreme values of these variables were computed providing a detailed quantification of the geometrical landscape of the AAA. Moreover, statistical analysis showed that the identified angles presented no strong correlation with each other while no lateral or anterior/posterior symmetry of the AAA was identified. These findings suggest that endograft designers are free to construct any extreme case-studies with the values provided in a mix-and-match manner. This strategy can have a powerful effect in EVAR stent graft designing, as well as EVAR planning.


  • Instabilities in Aortic Length After TEVAR and Reoperation: 12 Years of Follow-Up Imaging

    Year: 2019

    Affiliation: Hospital of the University of Pennsylvania

    Citation: The Society of Thoracic Surgeons

    Abstract: Thoracic endovascular aortic repair (TEVAR) remains an important minimally invasive tool for the treatment of descending thoracic aneurysm. The long-term effects of these repairs in reduction of the aneurysmal sac size as well as stability of the stented portion require study. We report the results of 12 years of radiographic follow-up.


  • Gender Is Not an Independent Risk Factor for Long-Term Survival After Endovascular Aneurysm Repair

    Year: 2018

    Affiliation: Southern Association for Vascular Surgery Meeting

    Citation: Journal of Vascular Surgery

    Abstract: We proposed to assess the gender-based differences in age, body mass index (BMI), race, comorbidities, abdominal aortic aneurysm (AAA) diameter, aortic neck, and iliac arteries in patients undergoing endovascular aneurysm repair (EVAR) and to evaluate the impact of these variables on survival after EVAR.


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