Acute complicated type B aortic dissection (TBAD) is a potentially catastrophic, life-threatening condition. If left untreated, there is a high risk of aortic rupture, irreversible organ or limb damage, or death. Several risk factors have been associated with acute complicated TBAD, including age and refractory hypertension. In the acute phase, even uncomplicated patients are more prone to develop complications if hypertension and pain are left medically untreated. Innovations in stent graft technologies have incrementally improved outcomes since their first use for this condition in 1999, though improvement is needed in mitigating periprocedural complications, adverse events, and mortality. In the past decade, endovascular repair has become the preferred treatment because of its superior outcomes to open repair and medical therapy. The Valiant Captivia Thoracic Stent Graft System is a third-generation endovascular stent graft with advancements in minimally invasive delivery, conformability to the anatomy, and the minimization of adverse sequelae. Herein, this stent graft is briefly reviewed and its 3-year outcomes are presented. Freedom from all-cause and dissection-related mortality was 79.1% and 90.0%, respectively. The Valiant Captivia Stent Graft represents a safe, effective intervention for acute complicated TBAD. Continued surveillance is needed to verify its longer-term durability.
Aortic Aneurysm, Thoracic ; Aortic Rupture ; Blood Vessel Prosthesis ; Endovascular Procedures ; Extremities ; Freedom ; Humans ; Hypertension ; Mortality ; Risk Factors ; Self Expandable Metallic Stents

The search for a nonthrombogenic material with the potential for use in small diameter vascular graft applications continues to be a field of extensive investigation. This article describes the choice of biomaterials used as vascular prosthesis, the innovation of construction of tissue-engineered blood vessels, the indispensability, methods and the effect produced by surface modification of vascular prosthesis. The article also points out that research achievements of vascular prosthesis must be made with the exploitation of new nonthrombogenic biomaterial and the development of tissue engineering.
Biocompatible Materials ; Bioprosthesis ; Blood Vessel Prosthesis ; Prosthesis Design ; Surface Properties ; Tissue Engineering

Nitinol self expandable metal stents are increasingly utilised for malignant obstruction in the proximal gastrointestinal tract. We describe a case in which repeated fracture of proximal duodenal stents with dissolution of the nitinol wire skeleton and covering membranes occurred in a long term cancer survivor. This necessitated placement of 4 stents for symptom control and to allow oral feeding until the patient's death 20 months after the initial stent was inserted. Fracture of gastric and duodenal stents has rarely been described previously, some incidences of which were considered due to mechanical causes. Dissolution of stent metal skeletons has not previously been recognised in gastroduodenal stents but has been described in an oesophageal stent subject to reflux of gastric content and a biochemical mechanism has been proposed. With modern oncological treatment the prospect of patients outliving their stents is increasing and the need for repeat procedures should form part of the consent process.
Gastric Outlet Obstruction ; Gastrointestinal Tract ; Humans ; Incidence ; Membranes ; Prosthesis Failure ; Radiology, Interventional ; Self Expandable Metallic Stents ; Skeleton ; Stents ; Survivors

Arteries ; surgery ; Arteriosclerosis Obliterans ; surgery ; Bioprosthesis ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; instrumentation ; Humans ; Lower Extremity ; blood supply ; surgery

No abstract available.
Blood Vessel Prosthesis* ; Stents*

BACKGROUND: Current vascular prostheses are considered still inadequate for reconstruction of small-diameter vessels. To evaluate the potential use of xenograft vessels as small diameter arterial grafts, we implanted porcine vessels in goats. The grafts were treated with two different processes, freezing and acellularization, before implantation, and gross inspection as well as microscopic examination followed after a predetermined period. MATERIAL AND METHOD: Bilateral porcine carotid arteries were harvested and immediately stored at -70 degrees C within tissue preservation solution. One of them was designated as frozen xenograft vessel. The other one was put on acellularization process using NaCl-SDS solution and stored frozen until further use. Grafts were implanted in the place of carotid arteries of the same goat. The grafts have remained implanted for 1, 3, and 6 months in three animals, respectively. Periodic ultrasonographic examinations were performed during the observation period. After explantation, the grafts were analyzed grossly and histologically under light microscope. RESULT: All animals survived the experimental procedure without problems. Ultrasonographic examinations showed excellent patency of all the grafts during the observation period. Gross examination revealed nonthrombotic, patent lumens with smooth surfaces. Microscopic examinations of the explanted grafts showed cellular reconstruction at the 6-month stage in both grafts. Although more inflammatory responses were observed in the early phase of frozen xenografts, there was no evidence of significant rejection. CONCLUSION: These findings suggest that porcine xenograft vessels, regardless of pre-implantation processes of acelluarization or freezing, can be acceptably implanted in goats, although short duration of observation in a small number of animals may limit this study.
Animals ; Bioprosthesis ; Blood Vessel Prosthesis ; Carotid Arteries ; Freezing ; Goats* ; Heterografts ; Tissue Preservation ; Transplantation, Heterologous* ; Transplants*

Vascular tissue engineering is a novel approach by which an ideal vascualr graft constructed in vitro that will not be obstructed for a long time without immunological reaction after implantation. This article reviewed the definition of the tissue engineering blood vessel (TEBV), cellular resourses, the selection of biocompatible materials, the devising methods and the research achievements. Furthermore, it also discussed the current problems of TEBV and looked forward to future clinical application.
Biocompatible Materials ; Bioprosthesis ; Blood Vessel Prosthesis ; Cell Culture Techniques ; Tissue Engineering ; methods

No abstract available.
*Cholangiopancreatography, Endoscopic Retrograde ; Cholestasis, Extrahepatic/*therapy ; Common Bile Duct/*surgery ; Duodenum/*surgery ; *Endosonography ; Female ; Humans ; Male ; Neoplasms/*complications ; Prosthesis Implantation/*methods ; *Self Expandable Metallic Stents

Artificial prosthesis is an important tool to help amputees to gain or partially obtain abled human limb functions. Compared with traditional prosthesis which is only for decoration or merely has feedforward control channel, the perception and feedback function of prosthesis is an important guarantee for its normal use and self-safety. And this includes the information of position, force, texture, roughness, temperature and so on. This paper mainly summarizes the development and current status of artificial prostheses in the field of perception and feedback technology in recent years, which is derived from two aspects: the recognition way of perception signals and the feedback way of perception signals. Among the part of recognition way of perception signals, the current commonly adopted sensors related to perception information acquisition and their application status in prosthesis are overviewed. Additionally, from the aspects of force feedback stimulation, invasive/non-invasive electrical stimulation, and vibration stimulation, the feedback methods of perception signals are summarized and analyzed. Finally, some problems existing in the perception and feedback technology of artificial prosthesis are proposed, and their development trends are also prospected.
Amputees ; Artificial Limbs ; Feedback, Sensory ; Humans ; Prosthesis Design ; Prosthesis Implantation

Blood Vessel Prosthesis ; Humans ; Stents