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On occasion, there is inadequate length or quality of the proximal or distal aortic neck. In these cases, a fully minimally invasive option is not possible. One solution, however, is a hybrid repair, which combines an open surgical bypass with EVAR or TEVAR. In hybrid procedures, the endograft is positioned over major aortic branches.
A hybrid cardiac surgical procedure in a narrow sense is defined as a procedure that combines a conventional, more invasive surgical part (including a skin incision) with an interventional part, using some sort of catheter-based procedure guided by fluoroscopy (or other, e.g., CT or MRI) imaging in a hybrid operating room (OR) without interruption. [1]
A thoracic aortic stent graft, seen on chest X-ray which was placed during a TEVAR procedure. Should initial medical management fail or there is the involvement of a major branch of the aorta, vascular surgery may be needed for these type B dissections.
Sorafenib, sold under the brand name Nexavar, [3] is a kinase inhibitor drug approved for the treatment of primary kidney cancer (advanced renal cell carcinoma), advanced primary liver cancer (hepatocellular carcinoma), FLT3-ITD positive AML and radioactive iodine resistant advanced thyroid carcinoma.
Indications for the surgical treatment of aortic dissection include an acute proximal aortic dissection and an acute distal aortic dissection with one or more complications. Complications include compromise of a vital organ, rupture or impending rupture of the aorta, retrograde dissection into the ascending aorta.
Graft infection from a Bentall procedure presents similarly to many infections after a major cardiac surgery, with indications in various degrees of severity. Symptoms can include fever, chills, loss of appetite, weight loss, malaise with clinical indications including septic emboli, abscess, left ventricular fistulae, transient ischemic attack.
Ticagrelor (Brilinta) is often listed with thienopyridine inhibitors and has similar indications for use but is not a thienopyridine. It is a cyclo-pentyltriazolo-pyrimidine that is distinct from the mechanism of the thienopyridines in that it reversibly (rather than irreversibly) inhibits the P2Y 12 receptor.
Tevar (transl. Attitude) is a 2015 Indian Hindi-language action film directed by debutante Amit Sharma and produced by Boney Kapoor, Sanjay Kapoor, Sunil Lulla, Naresh Agarwal and Sunil Manchanda, based on a script by Sharma and Shantanu Shrivastav.
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