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Papers by Francisca Blanca Calinescu

Annual Review of Medicine, 1998

Abdominal aortic aneurysms (AAA) may now be treated by endovascular placement of an arterial graf... more Abdominal aortic aneurysms (AAA) may now be treated by endovascular placement of an arterial graft. These grafts are inserted through the femoral artery and then secured to the aorta above and below the aneurysm. The procedure reduces the risk of many perioperative complications and reduces hospital costs and length of stay. Several FDA-approved clinical trials are currently in progress with a variety of different devices. None is available for general use at this time. Overall, more than 800 grafts have now been placed, with a primary success rate of greater than 80%. Several complications have been reported, but the incidence of complications has generally decreased as proficiency has improved. The most troublesome problem has been leak of blood around the graft with continued risk of aneurysm rupture; therefore, follow-up CT scans and clinical examinations are mandatory to allow for appropriate treatment. Future modifications of current devices and techniques for delivery can be ...

European Journal of Vascular and Endovascular Surgery, Dec 1, 2019

Abstract Abdominal aortic aneurysm (AAA) represents a major health problem affecting 2%–8% of mal... more Abstract Abdominal aortic aneurysm (AAA) represents a major health problem affecting 2%–8% of males over the age of 60 and 1% of women older than 64 years. A lot of patients with AAA remain asymptomatic until the rupture occurs. Early diagnostic and prophylactic surgical intervention (open or endovascular) is essential to prevent rupture. The open repair remains the most durable intervention but the actual approach moves to endovascular aneurysmal repair (EVAR) in most countries. EVAR is nowadays considered the technique of first choice for infrarenal AAAs with suitable aortic anatomy. There are new evolving technologies making endovascular approach suitable to almost all type of aortic morphology as well as acute or chronic pathologies. Patient selection is crucial in the successful treatment of AAA. We should carefully investigate and consider the anatomy of the abdominal aorta but also the comorbidities of the patient when we establish the treatment we propose. Medium and long-term results have improved over the years both in open and endovascular approaches due to better preoperative planning and postoperative management but also to new and refined devices for endovascular treatment.

Springer eBooks, 2016

Graft failure is an unresolved issue although there is much progress in this area. Anatomical, cl... more Graft failure is an unresolved issue although there is much progress in this area. Anatomical, clinical, and functional quantification systems of coronary lesions that require myocardial revascularization aim to establish the indication criteria and criteria for major adverse events due to this procedure. SYNTAX score (SYNergy between PCI with TAXUS™ and Cardiac Surgery), the simple additive and full logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation), global risk score, or others, have proven prediction in multiple trials and meta-analyses. Moreover, the SYNTAX score in all its variants has calculable value for interventional and surgery myocardial revascularization using clinical and functional lesion quantification based on the data from a study with 855 patients. Furthermore, EuroSCORE is used in the forecasting of major adverse events secondary to surgical myocardial revascularization with established relevance. All the other scoring systems aim to complete the most commonly utilized scores so that the most efficient myocardial revascularization procedure to be appropriate is selected. On the other hand, comparative studies between these scores demonstrate that the combination of various scores has the best prediction ability, especially when the quantification algorithm of score is based on the clinical data of patient and, nonetheless, the angiographic criterion. The significance of these scores consists in the choice of myocardial revascularization procedure with the lowest major adverse events and with the longest permeability duration.

PubMed, 2015

The approach to aortic pathology is nowadays more and more endovascular at both thoracic and abdo... more The approach to aortic pathology is nowadays more and more endovascular at both thoracic and abdominal levels. Thoracic stenting has gained worldwide acceptance as first intention to treat pathologies of the descending thoracic aorta. Indications have been extended to aortic arch aneurysms and also to diseases of the ascending aorta. The current devices in use for thoracic endovascular repair (TEVAR) are Medtronic Valiant, Gore TAG, Cook Tx2 and Jotec. The choice of the endograft depends on the thoracic aortic pathology and the anatomical suitability. The technological evolution of the abdominal aortic endografts was very rapid, arriving now at the fourth generation. We report the results of 55 elective cases of endovascular abdominal aortic repair (EVAR) performed in two vascular surgical centers in Romania and Germany. The prostheses used were 16 E-vita Abdominal XT, 12 Excluder, eight Talent, seven PowerLink, three Endurant and nine custom-made, fenestrated or branched from Jotec. The mean follow-up was 18 months with CT-scan, duplex ultrasound and contrast-enhanced ultrasound. The mortality was 2%. EVAR tends to become the gold standard for abdominal aortic aneurysm repair. Technological development of the devices with lowest profile introduction systems will permit to extend the anatomical indications to new frontiers.

Minimally Invasive Therapy & Allied Technologies, Mar 21, 2011

ABSTRACT

Abdominal aortic aneurysm (AAA) represents a major health problem affecting 2%–8% of males over t... more Abdominal aortic aneurysm (AAA) represents a major health problem affecting 2%–8% of males over the age of 60 and 1% of women older than 64 years. A lot of patients with AAA remain asymptomatic until the rupture occurs. Early diagnostic and prophylactic surgical intervention (open or endovascular) is essential to prevent rupture. The open repair remains the most durable intervention but the actual approach moves to endovascular aneurysmal repair (EVAR) in most countries. EVAR is nowadays considered the technique of first choice for infrarenal AAAs with suitable aortic anatomy. There are new evolving technologies making endovascular approach suitable to almost all type of aortic morphology as well as acute or chronic pathologies. Patient selection is crucial in the successful treatment of AAA. We should carefully investigate and consider the anatomy of the abdominal aorta but also the comorbidities of the patient when we establish the treatment we propose. Medium and long-term result...

European Journal of Vascular and Endovascular Surgery, 2019

Coronary Graft Failure, 2016

Long-term results of aorto-coronary bypass surgery (CABG) are studied in numerous trials and meta... more Long-term results of aorto-coronary bypass surgery (CABG) are studied in numerous trials and meta-analyses, still presenting several, unresolved issues related to the type of graft (venous or arterial), cardiac performance, risk factors and other preexisting comorbidities (peripheral arteritis, carotid stenosis, renal and hepatic dysfunction, stroke, etc.). Noninvasive imaging techniques such as multislice computed tomography angiography (CTA) (64-128-256 row), CT64 coronary screening, magnetic resonance angiography (MRA), single photon emission tomography (SPET), and transthoracic and transesophageal Doppler echocardiography allow periodic evaluations of graft patency with similar results when compared with data obtained by coronary angiography. Arterial grafts, especially left internal mammary artery (LIMA), ensure longer permeability compared to the venous grafts. Given that interventional cardiology made great progress in complex lesion revascularization, surgical intervention is considered mainly in case of undilatable lesions, thus resolving the “stent or surgery” problem. It is, however, acknowledged that the permeability of bypass grafts is longer than that of conventional stents. Long-term monitoring of patients with coronary lesions treated surgically is difficult because these patients are usually older than 50 years and have associated diseases that can cause death unrelated to the permeability of grafts.

Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy, 2015