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Journal of Cardiovascular Surgery

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https://www.readbyqxmd.com/read/28206725/the-tibiopedal-retrograde-vascular-access-for-challenging-popliteal-and-below-the-knee-chronic-total-occlusions-literature-review-and-description-of-the-technique
#1
Andrej Schmidt, Olaf J Bakker, Yvonne Bausback, Dierk Scheinert
In recent years, the retrograde tibiopedal approach is increasingly being used for revascularization of complex chronic total occlusions of infrainguinal arteries to bailout those cases where a guidewire was not possible to pass through the lesion from antegrade and therefore the treatment would have failed. The present popularity of this technique is in contrast to the paucity of data published so far. Nevertheless, from the reports that are available and from the authors' experience we conclude that it is not only a successful but also a safe technique...
February 15, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28183175/carotid-endarterectomy-has-significantly-lower-risk-in-the-last-two-decades-should-the-guidelines-now-be-updated
#2
Djordje Radak, Djurre de Waard, Alison Halliday, Mihailo Neskovic, Slobodan Tanaskovic
Carotid endarterectomy (CEA) carries a significant risk of procedural stroke and death Guidelines recommend keeping this risk below 6% and below 3% for symptomatic and asymptomatic patients respectively. After analysing our Institute's CEA results during the past 25 years, we found the rate of postoperative complications was now well below Guideline thresholds. Accordingly, we studied temporal changes in procedural risks in randomized controlled trials (RCTs) and in large observational studies in order to compare these against Guidelines...
February 9, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28183174/the-petticoat-concept-for-endovascular-treatment-of-type-b-aortic-dissection
#3
Luca Bertoglio, Enrico Rinaldi, Germano Melissano, Roberto Chiesa
INTRODUCTION: A systematic literature search on outcomes of the PETTICOAT technique was aimed at verifying the feasibility and safety of the procedure, comparing clinical outcomes with standard stent-grafting of the proximal entry tear as well as describing the possible benefits in terms of aortic remodeling. EVIDENCE ACQUISITION: Potentially eligible papers were sought through a computerized search of MEDLINE and SCOPUS databases between January 2006 and June 2016...
February 9, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28155264/surgical-and-endovascular-venous-arterialization-ready-to-take-on-the-desert-by-storm
#4
Michiel A Schreve, Çağdaş Ünlü, Steven Kum, Yih K Tan
Patients with critical limb ischemia have a poor life expectancy, and aggressive revascularization is accepted to maintain their independence in the end stage of life. Bypass surgery and, more recently, endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and resolve rest pain. Up to 20% of patients with critical limb ischemia are not suitable candidates for a vascular intervention because of extensive occlusions of the outflow in the crural and pedal vessels...
February 2, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28128542/management-of-ambulatory-day-case-endovascular-procedures-for-peripheral-arterial-disease
#5
Alexandra Hauguel, Blandine Maurel, Nicolas Bague, Flora Vulcain-Gouailler, Alain Costargent, Philippe Chaillou, Yann Gouëffic
BACKGROUND: Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature. METHODS: We used PRISMA guidelines and Medline to conduct this systematic review...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28128541/fenestrated-and-chimney-endovascular-aneurysm-repair-versus-open-surgery-for-complex-abdominal-aortic-aneurysms
#6
Vicente A Sala-Almonacil, José M Zaragozá-García, Mauricio Ramírez-Montoya, Vicente Molina-Nácher, Inmaculada Martínez-Perelló, Francisco J Gómez-Palonés
BACKGROUND: Many patients with complex abdominal aortic aneurysms are unfit for open repair. New endovascular technologies and bailout techniques are being used for managing those complex anatomies. The purpose of this study is to compare the results obtained with advanced endovascular aneurysm repair techniques (fenestrated and chimney endografts) to those obtained with open repair for the treatment of complex abdominal aortic aneurysms not anatomically suitable for standard endovascular exclusion (infrarenal neck <10 mm, juxtarenal, suprarenal and Crawford's type IV thoracoabdominal aneurysms)...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28128540/determinants-of-aortic-regurgitation-after-transcatheter-aortic-valve-implantation-an-observational-study-using-multi-slice-computed-tomography-msct-guided-sizing
#7
Zouhair Rahhab, Nahid El Faquir, Ramón Rodríguez-Olivares, Claire Ren, Nicolas VAN Mieghem, Marcel L Geleijnse, Carl Schultz, Ron VAN Domburg, Peter P DE Jaegere
BACKGROUND: To explore the determinants of aortic regurgitation (AR) after transcatheter aortic valve implantation (TAVI) using Multi Slice Computed Tomography (MSCT) instead of echocardiography-guided sizing. METHODS: Determinants of AR were assessed in 313 consecutive patients who underwent TAVI with the Medtronic(MCS, n=259) or Edwards Sapien or XT(ESV, n=54) using MSCT- guided sizing. AR was assessed by angiography immediately after TAVI (n=313, Sellers) and by echocardiography at discharge (n=285, VARC-2)...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28124516/overview-of-the-current-knowledge-on-etiology-natural-history-and-treatment-of-aortic-dissection
#8
Swapnil Parve, Bulat A Ziganshin, John A Elefteriades
In this manuscript, we review the etiology, classification, clinical manifestation, behavior, management and outcomes of aortic dissection. We emphasize the importance of genetics in the development of aortic dissection, discuss the role of size in clinical decision-making, and review the mechanism of aortic dissection development as well as the maturation of dissection aorta.
January 25, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28124515/anatomic-criteria-determining-high-risk-carotid-surgery-patients
#9
Pavlos Tsantilas, Andreas Kuehnl, Erich Brenner, Hans H Eckstein
BACKGROUND: Based on randomized trials, carotid endarterectomy (CEA) is the standard procedure for patients with a 50-99% symptomatic carotid stenosis and carefully selected patients with an asymptomatic high-grade carotid stenosis. Carotid artery stenting (CAS) is a technical alternative for patients with a high surgical risk or difficult anatomic conditions (e.g., recurrent stenosis). This study aims to provide an overview of anatomic factors associated with a higher risk of CEA complications...
January 25, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28124514/effect-of-remote-ischemic-preconditioning-on-the-melatonin-and-antioxidative-status-a-pilot-study-in-patients-undergoing-cardiac-surgery
#10
Rafael Struck, Maria Wittmann, Thomas Recht, Georg Baumgarten, Patrick Meybohm, Andreas Müller, Soyhan Bagci
BACKGROUND: Remote ischemic preconditioning (RIPC), a phenomenon in which a transient ischemia applied to a nonvital tissue protects another organ or tissue from subsequent lethal ischemic injury, is reported to protect the myocardium to withstand a subsequent prolonged ischemic event in patients undergoing cardiac surgery with cardiopulmonary bypass. It remains unclear whether oxidative stress and endogenous antioxidant enzymes play a role in the mechanistic pathways of RIPC. The aim of the present study was to evaluate the effects of RIPC on oxidative stress and extracellular concentrations of melatonin, extracellular superoxide dismutase (eSOD) and extracellular glutathione peroxidase (eGPx) in patients undergoing cardiac surgery with cardiopulmonary bypass...
January 25, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28124513/a-systematic-review-and-meta-analysis-of-chordal-replacement-versus-leaflet-resection-for-isolated-posterior-mitral-valve-prolapse
#11
Christos G Mihos, Evin Yucel, Orlando Santana
INTRODUCTION: Chordal replacement (Chord MVr) for isolated posterior mitral valve prolapse allows for preservation of the native mitral valve apparatus. The potential benefits of this approach, as compared with leaflet resection (Resection), are not clearly defined. EVIDENCE ACQUISITION: A systematic review and meta-analysis was conducted on operative, clinical, and echocardiographic outcomes. Risk ratios (RR) were calculated by the Mantel-Haenszel method under a fixed or random effects model, as appropriate...
January 25, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28051291/biobanking-in-carotid-artery-disease-translation-to-clinical-practice
#12
Ian D VAN Koeverden, Joyce E Vrijenhoek, Gert J DE Borst, Hester M DEN Ruijter, Gerard Pasterkamp
Biobanking of atherosclerotic tissue samples has contributed to our understanding of vascular occlusive disease. The careful examination of atherosclerotic plaques derived during vascular surgery or autopsies helped shape our minds in understanding the underlying substrate of arterial thrombosis. This review will outline concepts of progression of atherosclerotic disease that have been based on descriptions of human plaque pathology. In addition, we will discuss the current shift in clinical presentation and underlying pathology of acute cerebral and coronary events that asks for a careful consideration of the currently widely applied description of the "vulnerable plaque"...
January 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28051290/arterial-pathologies-in-athletes
#13
George Peach, Sidhartha Sinha, Robert J Hinchliffe
Identification and treatment of arterial pathologies in athletes can present a significant challenge because symptoms may be nonspecific and standard examination is often unremarkable. Sportspeople frequently experience long delays to diagnosis, during which time their ability to exercise and their quality of life may be severely impacted. Though the conditions that affect this young patient group may not be widely seen in the general population, knowledge of their existence and recognition of the need for specialist referral can aid early identification and appropriate management...
January 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28051289/failure-modes-and-secondary-endovascular-interventions-after-endovascular-aortic-repair
#14
Timothy Resch
Endovascular repair has a firmly established role in the treatment of aortic disease. The development of endovascular devices to treat even complex aortic disease has broadened the panorama of repair significantly but has also introduced new forms of repair failure. Standard devices for EVAR and TEVAR have also been enhanced, providing better adaptation to the anatomy treated, smaller delivery systems, more intuitive delivery designs as well as improved features to facilitate precise delivery of the device...
January 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28045242/evidence-for-periprocedural-antiplatelet-therapy-heparinization-and-bridging-of-coumarin-therapy-in-carotid-revascularization
#15
Art Brand, Gert J DE Borst
Thromboembolism prevention is a crucial factor determining both the natural outcome and outcome of intervention of stenotic atherosclerotic carotid artery pathology. Roughly 80% of all natural course cerebral ischemic events are caused by thromboembolism, versus 20% due to hemodynamic insufficiency. The risk of periprocedural cerebral (micro) thromboembolization during carotid revascularization is considered to be even higher, with a higher rate in carotid artery stenting (CAS) as compared to carotid endarterectomy (CEA)...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28045241/evidence-for-and-risks-of-endovascular-treatment-of-asymptomatic-acute-type-b-aortic-dissection
#16
Rachel E Clough, Christoph A Nienaber
Acute aortic dissection is a challenging disease to manage. Type B aortic dissection has traditionally been divided temporally into acute and chronic cases but more recently this classification has been modified to include a sub-acute phase. Computed tomography is the imaging technique used most frequently in diagnosis and management. Active management of blood pressure is essential and should include beta-blockade unless contra-indicated. In-hospital outcomes are generally acceptable in patients with medically managed acute uncomplicated type B aortic dissection, with up to 90% of patients surviving to hospital discharge but by 5-years up to 50% of patients are dead with a significant proportion dying from aortic rupture...
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28045240/what-should-we-expect-from-the-hybrid-room
#17
Adrien Hertault, Jonathan Sobocinski, Rafaëlle Spear, Richard Azzaoui, Matthieu Delloye, Dominique Fabre, Stephan Haulon
The concept of hybrid room was defined as an optimized surgical theater, offering the best compromise between asepsis criteria from standard surgical rooms and high quality imaging equipment from fixed radiological suites. This review aimed at summarizing what vascular surgeons should expect from hybrid rooms in daily practice and in the near future.
January 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28004900/current-management-of-inguinal-false-aneurysms
#18
Kim Houlind, Jørn M Jepsen, Cristian Saicu, Sten Vammen, Johnny K Christensen, Hans Ravn
False aneurysms are formed as a result of bleeding causing a hematoma to compress the surrounding tissue. The majority of false aneurysms presenting to the vascular surgeon are caused by iatrogenic injury to an artery. Although anastomotic failure occurs, a much higher number is caused by bleeding from puncture sites after percutaeous intervention. Anticoagulative medication, low patelet counts and severely calcified vessels increase the risk of forming a false aneurysm. Experienced specialists may make the diagnosis from physical examination, but ultrasound imaging is almost always needed in order to decide for a treatment strategy...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28004899/evidence-overview-benefit-of-cerebral-protection-devices-during-carotid-artery-stenting
#19
Jan A Vos
Embolic Protection Devices (EPD's) are often used during Carotid Angioplasty and Stenting (CAS) to reduce procedural cerebral emboli. This manuscript seeks to present an overview of evidence on EPD's during CAS. There are three categories of EPD's: Distal Occlusion (DO-EPD), Filter (F-EPD) and Proximal Occlusion (PO-EPD). DO and F-EPD's have the disadvantage that the device has to be advanced through the stenosis, without protection and that the device may damage the distal internal carotid artery (ICA). F-EPD's have the advantage of maintaining antegrade flow throughout the procedure...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28004898/tips-and-tricks-in-vascular-access-for-t-evar
#20
Beatrice Fiorucci, Nikolaos Tsilimparis, Fiona Rohlffs, Franziska Heidemann, Sebastian E Debus, Tilo Kölbel
Endovascular repair has become the treatment of choice for thoracic and abdominal aortic pathologies in the last decades, and is associated with excellent results in terms of perioperative, mid- and long-term morbidity and mortality. Access vessels play a central role in these procedures since access-related issues can increase the rates of technical failures and determine clinical complications for the patient. Therefore, accurate preoperative clinical evaluation and review of the preoperative images are mandatory...
December 22, 2016: Journal of Cardiovascular Surgery
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