VEITH symposium is one of the most authoritative, large-scale and long-standing academic events in vascular surgery in the world. Thousands of top experts from vascular surgery, interventional radiology, interventional cardiac surgery, and other vascular surgery fields from around the world attend the VEITH symposium conference each year. Here brings together various research data updates from the world, very pioneering, prospective and controversial topic discussion, clinical technology sharing with great application value, the latest and cutting-edge medical devices and technology exploration, face-to-face communication opportunities for world-class authoritative vascular surgery experts, and so on.
On November 14, 2023, during the International Congress of Vascular and Endovascular Angiology (VEITH symposium) held at the Hilton Hotel, New York Center, USA, Professor Cha Binshan from the First Affiliated Hospital of Anhui Medical University gave a wonderful speech on the topic of "Standardizing vascular processes to improve intravascular quality - innovation of vascular access devices".
CHA Binshan
The First Affiliated Hospital of Anhui Medical University
01
How many TEVAR procedures do a young physician need to independently complete to be proficient in TEVAR? The learning curve for TEVAR treatment in TBAD patients is 46, with a time span of approximately 3 years.
Experienced in interventional procedures:
After the interventionalists completed about 28 patients with TBAD treated with TEVAR, the operation time was significantly shortened and the technical level was significantly improved.
EVAR experienced:
Studies have shown that vascular surgeons need to perform 5 to 10 TEVAR procedures to overcome the learning curve after they are already familiar with endovascular abdominal aortic aneurysm repair procedures.
No intervention experience:
Surgical time, intraoperative blood loss, fluoroscopy time, postoperative hospital stay, and perioperative complications differed significantly between learning improvement (n = 46) and proficiency (n = 70) stages. The learning curve was 46. Time span is 3 years.
02
Complications caused by TEVAR surgery remain, and standardized treatment of TEVAR remains a long way to go.
Stanford Type B aortic dissection expert consensus (2022)
·Endoleak
There are no quantitative measures to determine the number of endoleaks and surgeon experience remains to be relied upon. Adequate proximal anchorage zones are critical to avoid endoleak.
·RTAD due to other causes
Between 10% and 20% of RTADs are not caused by SINE, but by spontaneous formation of new tears in the ascending aorta at the time of disease progression, or by iatrogenic injury, such as improper arch manipulation (guidewire, catheter, balloon dilatation, etc.).
03
Perfect vascular access is an important factor in determining the success of TEVAR/EVAR.
Introducer is the core instrument for establishing in vitro and in vivo channel in endovascular interventional surgery. It can not only provide support and traction for guide wire, catheter and stent system during operation, but also effectively reduce the bleeding at puncture site, intraoperative blood loss and pain of patients. Therefore, for the performance requirements of introducer in clinical practice, in addition to meeting the thin-walled large cavity, good support and fracture resistance, it is also necessary to meet the requirements for easy puncture and blood leakage prevention. In the process of development and production of introducer, with the increasing specification and model of introducer, its performance requirements are higher, especially the blood leak resistance of hemostasis valve of large-size introducer.
APT 's Braidin ™ Pro Introducer Sheath Set, also known as Adjustable Valve Large Sheath, is sized 14F-26F and available in lengths of 15 cm, 25 cm, and 35 cm. It is currently used in the direction of TAVR, TEVAR, EVAR, retrieval of foreign bodies in the body, or filters. Patented compression hemostasis valve design, one-touch compression, adjusts hemostasis valve opening size to meet intraoperative device delivery and exchange needs, while efficient hemostasis, and can meet multi-device delivery.
Summary:
1、The learning curve of TEVAR treatment in TBAD patients was 46, with a time span of approximately 3 years;
2、Iatrogenic complications can lead to serious complications (e.g. RTAD);
3、Standardized treatment can reduce iatrogenic complications caused by inexperience;
4、One-stop vascular access solutions can reduce the difficulty of surgery, shorten aortic endoluminal learning time, and reduce iatrogenic complications.
