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Micheal Murphy

Publications and source records attributed to Micheal Murphy.

5 recordsLinked to original sources
PubMed2004

In situ stent-graft fenestration to preserve the left subclavian artery.

PURPOSE: To report our first clinical application of a new technique for in situ fenestration of a thoracic stent-graft. CASE REPORT: After completing a series of in vitro and in vivo experiments, in situ stent-graft fenestration was employed during endograft repair of a saccular thoracic aortic aneurysm in a 77-year-old woman. Because the stent-graft would have covered the left subclavian artery ostium, a modified Zenith TX1 thoracic stent-graft was deployed then fenestrated transluminally using a guidewire followed by serial cutting balloons, which created a fenestration over the LSA sufficiently large to accommodate a Jomed covered stent on an 8-mm balloon. Completion angiography showed exclusion of the aneurysm and brisk flow into the LSA. Following the procedure, the arm pressures were nearly equal. The 6-month CT scan showed no endoleak and a patent subclavian artery stent. CONCLUSIONS: In situ graft fenestration to preserve the left subclavian artery after deliberate coverage during endovascular repair of a thoracic aortic aneurysm appears feasible in this initial clinical application. There are uncertainties regarding the long-term stability of the fabric tears that are an inherent part of this technique.

Aged↗
PubMed2003

Plain radiographic surveillance of abdominal aortic stent-grafts: the Liverpool/Perth protocol.

PURPOSE: To present a protocol for plain radiographic surveillance of abdominal aortic stent-grafts that addresses the main variables in need of standardization: (1) patient position, (2) radiographic centering point, and (3) focus-to-film distance. TECHNIQUE: Our policy is to perform baseline anteroposterior and lateral films following endoluminal grafting and repeat the studies annually. These are the most important films to assess migration and component separation; supplementary right and left posterior oblique radiographs may help identify wireform fractures. It is best to perform radiography before computed tomography if both tests are scheduled for the same day, as excretion of intravenous contrast opacifies the renal collecting systems and interferes with radiographic analysis. CONCLUSIONS: Evaluation of the radiographs depends on the design of the stent-graft, so it is important to understand graft construction and the position of the radiopaque markers to best assess changes on follow-up films.

Aortic Aneurysm, Abdominal↗