Initial single-site experience with the Ovation abdominal stent-graft system in patients with challenging aortoiliac anatomy.

BACKGROUND: Aim of the study was to evaluate the initial results of endovascular aneurysm repair with the Ovation abdominal stent-graft system in patients with challenging aortoiliac anatomy. METHODS: The Ovation stent-graft is an ultra-low profile, modular endovascular graft characterized by a 14F OD delivery system, active suprarenal fixation, and polymer-filled proximal rings that allow sealing in short (≥7 mm) proximal necks. Between November 2010 and January 2012, 14 patients with abdominal aortic aneurysms (AAA) (male: 100%, mean age: 76 years, mean AAA diameter: 54 mm) and challenging aortoiliac anatomy were treated with the Ovation endograft at a single centre. Mean patient follow-up was 5 months. RESULTS: All cases were performed under local or epidural anesthesia. No operative deaths or major complications were noted. A type I endoleak was detected on final angiogram in one case, which was successfully treated with additional ballooning and Palmaz stenting of the hooking landing zone. One patient died at 2 months due to myocardial infarction unrelated to the device or procedure. AAA-related mortality was 0%. No AAA rupture, AAA enlargement, type I or III endoleak, stent migration, access site complication, or conversion to open surgery was reported during follow-up. A type II endoleak was successfully treated with a right lumbar artery embolization at 4 months. Occlusion of an iliac axis was successfully managed with local fibrinolysis and implantation of a covered stent in the external iliac artery. CONCLUSIONS: Initial outcomes of this single-center experience suggest that the Ovation abdominal stent-graft system is a promising treatment in AAA patients with challenging aortoiliac anatomy.

Evaluation of Highly Porous Dental Implants in Postablative Oral and Maxillofacial Cancer Patients: A Prospective Pilot Clinical Case Series Report.

PURPOSE: The aim of this study was to evaluate the clinical efficacy of new porous tantalum trabecular metal (PTTM)-enhanced titanium dental implants used for the prosthodontic rehabilitation of postablative cancer patients. First-year interim results of a prospective clinical case series are presented. MATERIALS AND METHODS: A total of 25 PTTM-enhanced titanium implants were placed in both maxillas and mandibles of 6 patients, who met specific inclusion criteria. Resonance frequency analysis was conducted, and implant stability was recorded in Implant Stability Quotient (ISQ) values at implant placement and after 2, 4, 6, and 12 months of functional loading. Bone levels were calculated by digitally measuring the distance from the implant shoulder to the first bone-to-implant on periapical radiographs taken at surgery and after 2, 4, 6, and 12 months of functioning. RESULTS: Cumulative implant survival was 100% (n = 25/25). At implant placement and the 2-, 4-, 6- and 12-month monitoring appointments, mean ISQ values were 72.14 ± 5.61 (range = 50-81), 64.39 ± 8.12 (range = 44-74), 74.26 ± 7.14 (range = 44-74), 76.84 ± 7.65 (range = 60-83), and 78.13 ± 4.14 (range = 64-84), respectively, and mean crestal marginal bone loss was 0.19 ± 0.25, 0.22 ± 0.4, 0.3 ± 0.46, and 0.57 ± 0.62 mm, respectively. CONCLUSIONS: PTTM-enhanced dental implants were clinically effective in the prosthetic rehabilitation of postoncological patients. Larger long-term follow-up studies will help to evaluate clinical efficacy of PTTM dental implants.

Treatment of high-flow arteriovenous malformations (AVMs) of the head and neck with embolization and surgical resection.

AIM: Arteriovenous malformations (AVMs) with a high flow of the head and neck are quite rare compared to their low-flow counterparts, but when they do occur they are often accompanied by massive bleeding or present with significant esthetic defects. The treatment of these high-flow vascular anomalies is often highly risky. The multidisciplinary approach required for the assessment and treatment of these lesions should include angioradiology with preoperative superselective embolization, followed by surgical resection of the lesion within 24 hours and esthetic reconstruction. MATERIALS OF STUDY: We studied a series of 55 patients with AVMs of the head and neck that were treated surgically between 1999 and 2009. RESULTS: Of the 55 patients with AVMs, 7 had hemangiomas and 48 had vascular malformations, of which 28 were low-flow lesions and 20 were high-flow lesions (AVMs). The high-flow lesions were most commonly located on the lip. All 48 AVMs underwent surgical resection for concerning symptoms, diagnostic purposes, or esthetic problems. Of the 20 high-flow AVMs, 20% were classified as Schöbinger stage I, 55% as stage II, and 25% as stage III. A combined treatment of embolization and resection was used to resolve 13 of the high-flow AVMs (stages II and III), of which 4 required a flap reconstruction. CONCLUSION: Recent advances in microsurgery and interventional angioradiology have greatly improved the prognosis for patients with these malformations. Combined embolization-resection is the treatment of choice for high-flow AVMs, and esthetic reconstruction with flaps can prevent their recurrence.

A comparative study of Magnetic Resonance (MR) and Computed Tomography (CT) in the pre-implant evaluation.

AIM: A successful implant therapy is based on an accurate assessment of the anatomy of the jaws. The aim of our study was to evaluate the reliability of magnetic resonance imaging (MR) compared with computed tomography (CT) for dental implant planning in respect to bone measurements and to observe and analyze the differences. METHOD: We have studied 30 cases in which scans were performed with CT and MR. The images provided by the MR and CT examinations were delivered to three specialists in oral and maxillofacial radiology to measure the bone height at the specific sites.The measurements obtained by the specialists in MR and CT images were compared using the ANOVA test with a 0.05 significance level. RESULT: In all 30 cases examined, MR images appeared perfectly comparable to CT images. The differences between the measurements from the MR and CT exams varied from 0.04 to 1.1 mm. There were no statistically significant differences (P=0.9). CONCLUSION: The MR, when compared with CT, shown to be reliable in respect to bone measurements for dental implant planning. However, further studies are necessary to determine the technical advantages of Resonance at lower fields, compared with those of CT and MR with medium or high magnetic field.