R. Shahverdyan | University Hospital of Cologne (original) (raw)

Papers by R. Shahverdyan

Research paper thumbnail of Technical feasibility of endovascular aortoiliac aneurysm repair combining Anaconda fenestrated and Zenith iliac side-branched stent grafts

Journal of vascular surgery, Jan 21, 2013

We demonstrate for the first time the technical feasibility of total endovascular aneurysm repair... more We demonstrate for the first time the technical feasibility of total endovascular aneurysm repair for juxtarenal and pararenal aortoiliac aneurysms by combining the Vascutek Anaconda custom-made fenestrated stent graft with the Cook Zenith iliac side-branched stent graft. Three patients (two male and one female) presented with asymptomatic pararenal aortoiliac aneurysm in the first case and juxtarenal aorto-left iliac aneurysms in the second and third cases. We successfully deployed the Anaconda fenestrated and the iliac side-branched stent graft combined with Atrium Advanta V12 stent grafts for renal, superior mesenteric, and hypogastric arteries. Postoperative computed tomography demonstrated excluded aneurysms with patent renovisceral and hypogastric arteries and no signs of endoleak.

Research paper thumbnail of A novel technique of antegrade transapical arch and thoracic aortic endovascular repair with a triple-barrel graft

The Journal of Thoracic and Cardiovascular Surgery, 2013

The complete endovascular treatment of pathologies of the aortic arch and proximal descending tho... more The complete endovascular treatment of pathologies of the aortic arch and proximal descending thoracic aorta (TEVAR) reduces surgical trauma. The recently developed chimney technique was successfully performed in our center in limited cases as double-chimney (triple-barrel graft) technique in the aortic arch. With respect to the transapical implantation of an aortic stent-graft, various groups have described antegrade transapical TEVAR (Ta-TEVAR) of both the ascending and descending aorta. 1-3 On the basis of these limited results, we undertook for the first time the application of triple-barrel technique by antegrade implantation of an aortic stent-graft through the transapical route of a beating heart to treat a contained rupture of the aortic arch caused by a penetrating aortic ulcer.

Research paper thumbnail of F-EVAR does not Impair Renal Function more than Open Surgery for Juxtarenal Aortic Aneurysms: Single Centre Results

European Journal of Vascular and Endovascular Surgery, 2015

Research paper thumbnail of Endovascular Aneurysm Repair of Aortoiliac Aneurysms with an Iliac Side-branched Stent graft: Studying the Morphological Applicability of the Cook Device

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2015

Endovascular aneurysm (EVAR) repair of an aortic aneurysm extending to the iliac artery remains a... more Endovascular aneurysm (EVAR) repair of an aortic aneurysm extending to the iliac artery remains a challenge. Interventional occlusion of the internal iliac artery (IIA) intending to create a distal landing zone in the external iliac artery is a common approach with inherent morbidity (e.g., buttock claudication, impotence). Alternatively, iliac side-branched stent grafts can maintain pelvic blood supply, but the applicability is limited. The objective was to investigate the morphological applicability of the Cook Zenith branched graft (ZBIS) among patients with aorto-iliac or isolated iliac aneurysms. This was a retrospective single centre analysis of 66 patients (60 men; median age 74 years, range 53-90 years) undergoing repair of aorto-iliac aneurysms (open repair, IIA occlusion prior to EVAR and ZBIS) between January 2008 and December 2012. All available computed tomography angiograms with post-processing imaging were compared with the criteria for morphological applicability to ...

Research paper thumbnail of Transforming Growth Factor β1 Oppositely Regulates the Hypertrophic and Contractile Response to β-Adrenergic Stimulation in the Heart

PLoS ONE, 2011

Background: Neuroendocrine activation and local mediators such as transforming growth factor-b 1 ... more Background: Neuroendocrine activation and local mediators such as transforming growth factor-b 1 (TGF-b 1 ) contribute to the pathobiology of cardiac hypertrophy and failure, but the underlying mechanisms are incompletely understood. We aimed to characterize the functional network involving TGF-b 1 , the renin-angiotensin system, and the b-adrenergic system in the heart.

Research paper thumbnail of Five-year Patency Rates of Renal and Visceral Bypasses after Abdominal Debranching for Thoraco-abdominal Aortic Aneurysms

European Journal of Vascular and Endovascular Surgery, 2013

WHAT THIS PAPER ADDS The patency of the grafts to renal and visceral arteries is the most importa... more WHAT THIS PAPER ADDS The patency of the grafts to renal and visceral arteries is the most important aspect during a visceral hybrid procedure. In this study we report for the first time that the long-term patency of the grafts is excellent except for the right renal artery. This technique should be preferred for exclusion of thoraco-abdominal aortic aneurysms in emergency cases. The technical difficulties with the graft to the right renal artery could be avoided by careful anastomosis or by choosing an alternative technique.

Research paper thumbnail of Triple-barrel Graft as a Novel Strategy to Preserve Supra-aortic Branches in Arch-TEVAR Procedures: Clinical Study and Systematic Review

European Journal of Vascular and Endovascular Surgery, 2013

Objective: To report our early experience with total endovascular repair of aortic-arch aneurysm ... more Objective: To report our early experience with total endovascular repair of aortic-arch aneurysm using double chimney-grafts and present a literature overview. Patients and methods: The double chimney-graft technique was performed in six male patients with contained ruptured aneurysm, dissecting aneurysm, pseudoaneurysm, penetrating aortic ulcer and proximal endoleak after TEVAR. Furthermore, a systematic electronic health database search of available articles was conducted according to PRISMA Guidelines. Results: In all cases, all supra-aortic vessels had to be covered with aortic stent-graft to receive a sufficient landing and sealing zone. Chimney-grafts were introduced to the ascending aorta slightly deeper than the thoracic stent-grafts through the cut-down exposure of the common carotid arteries. We deployed aortic stent-grafts and self-expandable chimney-grafts simultaneously and successfully. The patient with contained ruptured aneurysm died due to cardiopulmonary failure on day 19, the others survived. We detected two 'gutter' endoleaks. As a result of literature search, 12 articles met the inclusion criteria. Two articles described the double-chimney technique. Conclusions: The use of double chimney-grafts is possible in high-risk patients where the proximal landing zone of endograft would be in zone 0. The available data is still limited. The long-term follow-up remains to be evaluated with the increased number of patients treated.

Research paper thumbnail of CRT-100 A Novel Total Endovascular Approach Treating Complex Aortic Arch Aneurysms In High Risk Patients

JACC: Cardiovascular Interventions, 2013

Background: Resistant hypertension is defined as uncontrolled blood pressure despite the use of o... more Background: Resistant hypertension is defined as uncontrolled blood pressure despite the use of optimal doses of three antihypertensive agents, one of which is a diuretic. recently, catheter-based renal sympathetic denervation (RSD) has been shown to be safe and effective in patients with resistant hypertension. pathophysiology of kidney function, justify the use of renal sympathetic denervation in the treatment of hypertension. the aim of the present report is to briefly summarize and discuss the outcomes of 18 patients treated with RSD in the dominican republic. Methods: Between august 2011 and may 2012, 18 patients screened for eligibility were referred to renal denervation. we used the Simplicity™ catheter and the EnligHTN™ balloon with low-power radiofrequency energy. post intervention analysis includes all patients remaining during follow-up at 6 months; only 15 were available at follow-up. we performed a paired samples t-test to compare means; two-tailed p values were statistically significant at Ͻ0.005 with 95% confidence intervals for mean bp differences. Results: Among these patients, 46.6% were female, 33.3% were diabetic, and 20% had coronary disease. baseline office blood pressure (BP) was 178.93 Ϯ 18.38/97.27 Ϯ 11.62 mmhg, despite a mean of 7Ϯ3.0 medications per patient. successful bilateral sympathetic denervation was performed in all patients. no procedural complications occurred.

Research paper thumbnail of Technical feasibility of endovascular aortoiliac aneurysm repair combining Anaconda fenestrated and Zenith iliac side-branched stent grafts

Journal of vascular surgery, Jan 21, 2013

We demonstrate for the first time the technical feasibility of total endovascular aneurysm repair... more We demonstrate for the first time the technical feasibility of total endovascular aneurysm repair for juxtarenal and pararenal aortoiliac aneurysms by combining the Vascutek Anaconda custom-made fenestrated stent graft with the Cook Zenith iliac side-branched stent graft. Three patients (two male and one female) presented with asymptomatic pararenal aortoiliac aneurysm in the first case and juxtarenal aorto-left iliac aneurysms in the second and third cases. We successfully deployed the Anaconda fenestrated and the iliac side-branched stent graft combined with Atrium Advanta V12 stent grafts for renal, superior mesenteric, and hypogastric arteries. Postoperative computed tomography demonstrated excluded aneurysms with patent renovisceral and hypogastric arteries and no signs of endoleak.

Research paper thumbnail of A novel technique of antegrade transapical arch and thoracic aortic endovascular repair with a triple-barrel graft

The Journal of Thoracic and Cardiovascular Surgery, 2013

The complete endovascular treatment of pathologies of the aortic arch and proximal descending tho... more The complete endovascular treatment of pathologies of the aortic arch and proximal descending thoracic aorta (TEVAR) reduces surgical trauma. The recently developed chimney technique was successfully performed in our center in limited cases as double-chimney (triple-barrel graft) technique in the aortic arch. With respect to the transapical implantation of an aortic stent-graft, various groups have described antegrade transapical TEVAR (Ta-TEVAR) of both the ascending and descending aorta. 1-3 On the basis of these limited results, we undertook for the first time the application of triple-barrel technique by antegrade implantation of an aortic stent-graft through the transapical route of a beating heart to treat a contained rupture of the aortic arch caused by a penetrating aortic ulcer.

Research paper thumbnail of F-EVAR does not Impair Renal Function more than Open Surgery for Juxtarenal Aortic Aneurysms: Single Centre Results

European Journal of Vascular and Endovascular Surgery, 2015

Research paper thumbnail of Endovascular Aneurysm Repair of Aortoiliac Aneurysms with an Iliac Side-branched Stent graft: Studying the Morphological Applicability of the Cook Device

European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery, 2015

Endovascular aneurysm (EVAR) repair of an aortic aneurysm extending to the iliac artery remains a... more Endovascular aneurysm (EVAR) repair of an aortic aneurysm extending to the iliac artery remains a challenge. Interventional occlusion of the internal iliac artery (IIA) intending to create a distal landing zone in the external iliac artery is a common approach with inherent morbidity (e.g., buttock claudication, impotence). Alternatively, iliac side-branched stent grafts can maintain pelvic blood supply, but the applicability is limited. The objective was to investigate the morphological applicability of the Cook Zenith branched graft (ZBIS) among patients with aorto-iliac or isolated iliac aneurysms. This was a retrospective single centre analysis of 66 patients (60 men; median age 74 years, range 53-90 years) undergoing repair of aorto-iliac aneurysms (open repair, IIA occlusion prior to EVAR and ZBIS) between January 2008 and December 2012. All available computed tomography angiograms with post-processing imaging were compared with the criteria for morphological applicability to ...

Research paper thumbnail of Transforming Growth Factor β1 Oppositely Regulates the Hypertrophic and Contractile Response to β-Adrenergic Stimulation in the Heart

PLoS ONE, 2011

Background: Neuroendocrine activation and local mediators such as transforming growth factor-b 1 ... more Background: Neuroendocrine activation and local mediators such as transforming growth factor-b 1 (TGF-b 1 ) contribute to the pathobiology of cardiac hypertrophy and failure, but the underlying mechanisms are incompletely understood. We aimed to characterize the functional network involving TGF-b 1 , the renin-angiotensin system, and the b-adrenergic system in the heart.

Research paper thumbnail of Five-year Patency Rates of Renal and Visceral Bypasses after Abdominal Debranching for Thoraco-abdominal Aortic Aneurysms

European Journal of Vascular and Endovascular Surgery, 2013

WHAT THIS PAPER ADDS The patency of the grafts to renal and visceral arteries is the most importa... more WHAT THIS PAPER ADDS The patency of the grafts to renal and visceral arteries is the most important aspect during a visceral hybrid procedure. In this study we report for the first time that the long-term patency of the grafts is excellent except for the right renal artery. This technique should be preferred for exclusion of thoraco-abdominal aortic aneurysms in emergency cases. The technical difficulties with the graft to the right renal artery could be avoided by careful anastomosis or by choosing an alternative technique.

Research paper thumbnail of Triple-barrel Graft as a Novel Strategy to Preserve Supra-aortic Branches in Arch-TEVAR Procedures: Clinical Study and Systematic Review

European Journal of Vascular and Endovascular Surgery, 2013

Objective: To report our early experience with total endovascular repair of aortic-arch aneurysm ... more Objective: To report our early experience with total endovascular repair of aortic-arch aneurysm using double chimney-grafts and present a literature overview. Patients and methods: The double chimney-graft technique was performed in six male patients with contained ruptured aneurysm, dissecting aneurysm, pseudoaneurysm, penetrating aortic ulcer and proximal endoleak after TEVAR. Furthermore, a systematic electronic health database search of available articles was conducted according to PRISMA Guidelines. Results: In all cases, all supra-aortic vessels had to be covered with aortic stent-graft to receive a sufficient landing and sealing zone. Chimney-grafts were introduced to the ascending aorta slightly deeper than the thoracic stent-grafts through the cut-down exposure of the common carotid arteries. We deployed aortic stent-grafts and self-expandable chimney-grafts simultaneously and successfully. The patient with contained ruptured aneurysm died due to cardiopulmonary failure on day 19, the others survived. We detected two 'gutter' endoleaks. As a result of literature search, 12 articles met the inclusion criteria. Two articles described the double-chimney technique. Conclusions: The use of double chimney-grafts is possible in high-risk patients where the proximal landing zone of endograft would be in zone 0. The available data is still limited. The long-term follow-up remains to be evaluated with the increased number of patients treated.

Research paper thumbnail of CRT-100 A Novel Total Endovascular Approach Treating Complex Aortic Arch Aneurysms In High Risk Patients

JACC: Cardiovascular Interventions, 2013

Background: Resistant hypertension is defined as uncontrolled blood pressure despite the use of o... more Background: Resistant hypertension is defined as uncontrolled blood pressure despite the use of optimal doses of three antihypertensive agents, one of which is a diuretic. recently, catheter-based renal sympathetic denervation (RSD) has been shown to be safe and effective in patients with resistant hypertension. pathophysiology of kidney function, justify the use of renal sympathetic denervation in the treatment of hypertension. the aim of the present report is to briefly summarize and discuss the outcomes of 18 patients treated with RSD in the dominican republic. Methods: Between august 2011 and may 2012, 18 patients screened for eligibility were referred to renal denervation. we used the Simplicity™ catheter and the EnligHTN™ balloon with low-power radiofrequency energy. post intervention analysis includes all patients remaining during follow-up at 6 months; only 15 were available at follow-up. we performed a paired samples t-test to compare means; two-tailed p values were statistically significant at Ͻ0.005 with 95% confidence intervals for mean bp differences. Results: Among these patients, 46.6% were female, 33.3% were diabetic, and 20% had coronary disease. baseline office blood pressure (BP) was 178.93 Ϯ 18.38/97.27 Ϯ 11.62 mmhg, despite a mean of 7Ϯ3.0 medications per patient. successful bilateral sympathetic denervation was performed in all patients. no procedural complications occurred.