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Journal of Cardiovascular Surgery

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https://www.readbyqxmd.com/read/28051291/biobanking-in-carotid-artery-disease-translation-to-clinical-practice
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28004897/management-of-acute-aortic-thrombosis
#10
Mark Kaschwich, Christian A Behrendt, Nikolaos Tsilimparis, Tilo Kölbel, Sabine H Wipper, Eike S Debus
Acute aortic thrombosis (AAT) is a rare life threatening event that leads to a sudden occlusion of the aorta. The mortality and morbidity of AAT is still high despite modern surgical techniques. Usually it is the result of a large saddle embolus to the aortic bifurcation, in situ thrombosis of an atherosclerotic aorta or acute occlusion of an abdominal aortic aneurysm. Clinical symptoms depend on the level of the aortic occlusion and can be mistaken for a stroke or similar neurological disease. The combination of age and advanced cardiac disease seems to be significant risks factors for AAT...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28004896/treatment-of-acute-thoracoabdominal-aortic-aneurysms
#11
Germano Melissano, Daniele Mascia, Sthefano G Atique, Luca Bertoglio, Roberto Chiesa
INTRODUCTION: Acute thoracoabdominal aortic aneurysms (aTAAA) are an uncommon and lethal condition associated with an extremely high mortality and morbidity rates. Both endovascular and open repair may be offered in emergency. aim of this study is to report our results and present a literature review regarding endovascular and open surgical repair of aTAAA. EVIDENCE ACQUISITION: MEDLINE, EMBASE, and the Cochrane Library CENTRAL databases were searched from 1991 to 2016...
December 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998051/follow-up-and-surveillance-of-vein-grafts-when-and-how-to-intervene-to-prevent-complications
#12
Olivia M McBride, Roderick T Chalmers
Despite advances in endovascular strategies, surgical infrainguinal lower limb revascularization remains the gold standard treatment for critical lower limb ischemia and disabling claudication.1 Maintaining patency of infrainguinal vein bypass grafts has been a challenging task for vascular surgeons as they are prone to developing stenosis which may precipitate failure of the bypass.2,3 Duplex ultrasound scanning has evolved as the investigation of choice to identify vein graft lesions but graft surveillance programs using this technique remain controversial...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998050/evidence-overview-anatomical-criteria-determining-patients-at-high-risk-for-carotid-stenting
#13
Jos C VAN DEN Berg
Carotid artery stenting is a complex endovascular procedure that may be an alternative for carotid endarterectomy in selected patients. This paper gives an overview of the anatomical and lesion characteristics that are related to an increase in complications with CAS procedures, in order to provide criteria to select patients that will benefit most from CAS.
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998049/long-term-results-of-outside-instructions-for-use-evar
#14
José Oliveira-Pinto, Nelson Oliveira, Frederico Bastos-Gonçalves, Sanne Hoeks, Marie J VAN Rijn, Sander Ten Raa, Armando Mansilha, Hence J Verhagen
BACKGROUNG: Endovascular aneurysm repair (EVAR) has progressively expanded to more complex anatomies, frequently outside manufacturer's instructions for use (IFU). However, the long term results of off-label use of EVAR remains largely undocumented. The aim of this paper is to examine the long term results of outside IFU EVAR. METHODS: English literature was searched to identify publications on long term results for outside IFU EVAR. A follow-up extending for at least 5 years was the minimum required as inclusion criteria...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998048/chronic-mesenteric-ischemia-when-and-how-to-intervene-on-patients-with-celiac-sma-stenosis
#15
Juliëtte Blauw, Tomas Bulut, Paul Eenhoorn, Roland J Beuk, Marjolein Brusse-Keizer, Jeroen Kolkman, Robert H Geelkerken
Studies that compared open surgical mesenteric artery repair (OSMAR) with percutaneous mesenteric artery stenting (PMAS) in patients with chronic mesenteric ischemia (CMI) are based on merely older studies in which only a minority of patients received PMAS. This does not reflect the current PMAS-first choice treatment paradigm. This article focused on the present opinions and changes in outcomes of OSMAR for CMI in the era of preferred use of PMAS. Patients who received OSMAR for CMI from 1997 until 2014 in a tertiary referral centre for chronic mesenteric ischemia were included in this report...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998047/how-to-manage-hypertension-with-atherosclerotic-renal-artery-stenosis
#16
Jean B Ricco, Romain Belmonte, Guilio Illuminati, Xavier Barral, Fabrice Schneider, Bertrand Chavent
The management of atherosclerotic renal artery stenosis (ARAS) in patients with hypertension has been the topic of great controversy. Major contemporary clinical trials such as the Cardiovascular Outcomes for Renal Artery lesions (CORAL) and Angioplasty and Stenting for Renal Atherosclerotic lesions (ASTRAL) have failed to show significant benefit of revascularization over medical management in controlling blood pressure and preserving renal function. We present here the implications and limitations of these trials and formulate recommendations for management of ARAS...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998046/supervised-exercise-therapy-it-does-work-but-how-to-set-up-a-program
#17
David Hageman, Marijn M VAN DEN Houten, Steffie Spruijt, Lindy N Gommans, Marc R Scheltinga, Joep A Teijink
Intermittent claudication (IC) is a manifestation of peripheral arterial disease. IC has a high prevalence in the older population, is closely associated with other expressions of atherosclerotic disease and often co-exists in multimorbid patients. Treatment of IC should address reduction of cardiovascular risk and improvement of functional capacity and health-related quality of life (QoL). As recommended by contemporary international guidelines, the first-line treatment includes supervised exercise therapy (SET)...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27998045/how-can-a-vascular-surgeon-help-in-kidney-transplantation
#18
Anne Lejay, Fabien Thaveau, Sophie Caillard, Yannick Georg, Bruno Moulin, Philippe Wolf, Bernard Geny, Nabil Chakfe
Kidney transplantation is a surgical procedure involving both vascular and ureteric anastomoses. As a matter of fact, it can be performed either by urologists or vascular surgeons. However, vascular surgeon's expertise can be helpful at different times. In the present paper we describe how can vascular surgeons help at the different stages of kidney transplantation process in modern care: 1) before kidney transplantation for recipient preparation in order to allow subsequent graft implantation, either by performing percutaneous embolization of renal arteries in the setting of polycystic kidney disease or treatment of aneurysmal or occlusive lesions that would contra-indicate graft implantation; 2) at the time of surgery graft back table preparation and repair; and 3) after surgery for long- term follow-up, including transplant renal artery stenosis treatment or transplant nephrectomy...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27922253/imaging-modalities-of-carotid-artery-stenting
#19
Tomoyuki Umemoto, Andrea Pacchioni, Bernhard Reimers
Compared with conventional angiogram-guided procedure, intravascular imaging modalities give us a lot of useful information to make the procedure better. Intravascular imaging modalities give us the information about lesion characters, reference vessel diameter and the interaction between the stent strut and the plaque such as stent strut malapposition or plaquqe prolapse in real time during the procedure. We can change our strategy according to these information. Intravascular ultrasound (IVUS) is a most common intravasculr imaging modality during CAS in these days...
December 6, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27922252/update-on-new-stents-and-protection-devices-for-carotid-artery-stenting-what-we-know-what-we-learnt-recently-and-what-we-need-to-know
#20
Dimitrios N Nikas, Xenofon Makos, Tomoyuki Umemoto, George Liappas, Andrea Pacchioni, Narek Zakarian, Bernhard Reimers
Carotid artery stenting (CAS) is considered an alternative option to carotid endarterectomy (CEA) for significant carotid stenosis, in both symptomatic and asymptomatic patients. Comparing to CEA, CAS offers significant advantages. The most important arise from the minimally invasive nature of the procedure, which reduces the surgical complications and adds significant comfort to the patient, without compromising the efficacy. Nowadays, CAS can achieve acute and long-term outcome results comparable to CEA, maintaining low rates of periprocedural embolic events...
December 6, 2016: Journal of Cardiovascular Surgery
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