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Seminars in Vascular Surgery

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https://www.readbyqxmd.com/read/27823595/status-of-branched-grafts-for-thoracic-aortic-arch-endovascular-repair
#1
REVIEW
W Anthony Lee
The aortic arch is one of the most anatomically complex segments of the thoracoabdominal aorta due the plurality of vital branch configurations, intrinsic and highly variable three-dimensional curvature, and involvement in a variety of thoracic aortic pathologies, such as aneurysmal degeneration, penetrating ulcer, and media wall dissection. Pathologies that extend the repair proximal to the left common carotid artery require more complex branch vessel management beyond a carotid-subclavian bypass. This article will review the current status of branched aortic arch endografts...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823594/off-the-shelf-fenestrated-and-branched-stent-graft-designs-for-abdominal-aortic-aneurysm-repair
#2
REVIEW
Bernardo C Mendes, Animesh Rathore, Mauricio S Ribeiro, Gustavo S Oderich
Endovascular repair of pararenal and thoracoabdominal aortic aneurysms with fenestrated and branched stent grafts has been increasingly utilized with high technical success and low morbidity and mortality. Freedom from branch-related events has been reported at 89% in 5 years, including any branch-related endoleak, stenosis, kink, disconnection, or occlusion. Patient-specific stent grafts have the advantage of fitting patients' anatomy, but require a 6- to 8-week period for customization. Off-the-shelf stent grafts have been developed based on a relative predictability of renal-mesenteric vessels...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823593/snorkel-endovascular-abdominal-aortic-aneurysm-repair-versus-fenestrated-endovascular-aneurysm-repair-is-it-a-competition
#3
REVIEW
Adam Tanious, Jason T Lee, Murray Shames
The endovascular treatment of juxtarenal abdominal aortic aneurysm (AAA) can be performed by either a standard endovascular stent graft with additional snorkle grafts to aorta branches (snorkel endovascular aneurysm repair) or implantation of a fenestrated stent graft (fenestrated endovascular aneurysm repair). While many vascular surgeons consider snorkel endovascular aneurysm repair and fenestrated endovascular aneurysm repair to be competing techniques or alternate strategies, published procedural outcomes suggest more complementary roles...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823592/secondary-interventions-after-endovascular-aneurysm-sac-sealing-endoleak-embolization-and-limb-related-interventions
#4
REVIEW
Seyed Ameli-Renani, R A Morgan
The Nellix endovascular aneurysm sealing system is a novel alternative to conventional endovascular aneurysm repair for aortic aneurysm management using paired balloon expandable endografts supported by polymer-filled endobags to achieve sealing and anatomic fixation. Part of the promise of endovascular aneurysm sealing is increased resistance to lateral and longitudinal forces and thus a potential for reduced rates of device-related failures, particularly endoleaks. Initial efficacy data on this device are encouraging, but our knowledge of its associated complications and their management is limited...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823591/nellix-endovascular-aneurysm-sealing-system-device-description-technique-of-implantation-and-literature-review
#5
REVIEW
Nayara Cioffi Batagini, David Hardy, Daniel G Clair, Lee Kirksey
Clinical outcome reports document that from 30% to 60% of endovascular aneurysm repair procedures are performed outside of US Food and Drug Administration-approved Instruction for Use, or "off label." Endovascular aneurysm repair performed outside of Instruction for Use has a significantly higher rate of device failure, potentially requiring device reintervention and even planned or emergent explant. The Nellix device has the potential to reduce the rate of aneurysm device failure through its novel design. The objective of this article was to introduce the Nellix EndoVascular Aneurysm Sealing System and indications for use and describe the technique of implantation...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823590/endovascular-aneurysm-sealing-addresses-several-limitations-of-conventional-endovascular-aneurysm-repair
#6
REVIEW
Zachary W Kostun, Edward Y Woo
Endovascular aneurysm repair has enabled a broad population of patients with infrarenal abdominal aortic aneurysm to be treated by a less-invasive technique. However, endovascular aneurysm repair has therapeutic limitations, including the need for lifelong surveillance and a higher rate of secondary interventions than open repair. These outcomes can promote patient dissatisfaction and result in increased health care costs and associated morbidity and mortality. The primary reason for secondary interventions is continued abdominal aortic aneurysm sac enlargement due to endoleaks...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823589/intervention-after-endovascular-aneurysm-repair-endosalvage-techniques-including-perigraft-arterial-sac-embolization-and-endograft-relining
#7
REVIEW
Andrew Barleben, Tazo Inui, Erik Owens, John S Lane, Dennis F Bandyk
Endovascular aneurysm repair (EVAR) has revolutionized the treatment of abdominal aortic aneurysm (AAA). However, persistent AAA sac endoleak following EVAR can result in sac diameter increase requiring re-intervention in up to one-third of cases and even result in aneurysm rupture. In this case review, we summarize and detail endovascular re-interventions for each type of endoleak. We also detail specific options including stent-graft relining for indeterminate, Type III, and Type IV endoleaks and perigraft arterial sac embolization to induce thrombosis and resolve acute Type I, II, or III endoleaks...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823588/ruptured-abdominal-aortic-aneurysm-is-endovascular-aneurysm-repair-the-answer-for-everybody
#8
REVIEW
Faisal Aziz
Treatment paradigms for elective repair of asymptomatic abdominal aortic aneurysms (AAA) have evolved during the past 2 decades, with endovascular aneurysm repair as the preferred treatment modality. The patient care strategy for emergent treatment for ruptured AAA is not as straightforward, due in part to surgeon expertise and stent-graft availability at the institution. Although most reports have extrapolated elective endovascular aneurysm repair feasibility data to the ruptured AAA patient and the aneurysm anatomy, these expectations should be interpreted with caution...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823587/overview-of-aortic-aneurysm-management-in-the-endovascular-era
#9
REVIEW
Aurelia Calero, Karl A Illig
Management of aortic aneurysm disease has changed in the endovascular era, with the majority of patients opting for stent-graft repair of abdominal and thoracic aneurysms. An understanding of this vascular condition is important for primary care, emergency medicine, medicine specialists, and vascular surgeons alike. Awareness of the patient risk factors for aneurysmal degeneration, sac rupture, and medical management allows physicians to screen appropriate patient populations, which decreases aneurysm-related mortality due to rupture...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823586/infrarenal-endovascular-aneurysm-repair-new-developments-and-decision-making-in-2016
#10
REVIEW
Matthew R Smeds, Kristofer M Charlton-Ouw
New developments in infrarenal abdominal aortic aneurysm stent-graft devices have made more patients eligible for endovascular aneurysm repair (EVAR). Recent US Food and Drug Administration approval for fenestrated endograft repair and impending approval for iliac branch devices extend the proximal and distal landing zones. Better deployment systems allow for partial deployment of endografts to facilitate repositioning, and more flexible designs allow for treatment of angulated infrarenal aneurysm necks and tortuous iliac arteries...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823585/association-of-diabetes-mellitus-with-presence-expansion-and-rupture-of-abdominal-aortic-aneurysm-curiouser-and-curiouser-cried-alice
#11
REVIEW
Hisato Takagi
Both coronary artery and peripheral artery disease are representative atherosclerotic diseases that are positively associated with presence of abdominal aortic aneurysm (AAA). Diabetes mellitus, which is one of major risk factors of coronary artery and peripheral artery diseases, however, has been curiously suggested to be negatively associated with AAA, despite the positive associations of coronary artery and peripheral artery diseases with presence of AAA. In the present article, we overviewed epidemiologic evidence (meta-analyses) regarding the associations of diabetes mellitus with presence, expansion, and rupture of AAA through a systematic literature search...
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27823584/virtual-roundtable-on-endovascular-aortic-aneurysm-repair
#12
EDITORIAL
Peter R Nelson
No abstract text is available yet for this article.
March 2016: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113288/vascular-surgical-site-infection-risk-factors-and-preventive-measures
#13
REVIEW
Tazo Inui, Dennis F Bandyk
Surgical site infection (SSI) after arterial intervention is a common nosocomial vascular complication and an important cause of postoperative morbidity. Its prevention requires the vascular surgeon and the health care team to be cognizant of its epidemiology and patient-specific risk factors to apply effective measures to reduce the incidence. The majority of vascular SSIs are caused by Gram-positive bacteria with methicillin-resistant Staphylococcus aureus (MRSA) now a prevalent pathogen that is involved in more than one-third of cases...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113287/application-of-autologous-platelet-rich-plasma-to-enhance-wound-healing-after-lower-limb-revascularization-a-case-series-and-literature-review
#14
REVIEW
Mafalda Massara, David BarillĂ , Giovanni De Caridi, Raffaele Serra, Alberto Volpe, Rosangela Surace, Giovanni Foti, Daniela Marcuccio, Giulia Pucci, Pietro Volpe
Dermal tissue loss in patients affected by critical limb ischemia represents a serious wound-healing problem, with high morbidity, prolonged hospital stay, and high patient care costs. Treatment of ischemic foot lesions requires limb revascularization by endovascular or open surgical intervention and individualized patient-specific wound care, including antibiotic therapy; devitalized/infected wound debridement; and advanced wound dressing. In selected patients, spinal cord stimulation, vacuum-assisted closure therapy, and bioengineered tissue or skin substitutes and growth factors have been shown to improve wound healing...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113286/use-of-a-fluorescence-angiography-system-in-assessment-of-lower-extremity-ulcers-in-patients-with-peripheral-arterial-disease-a-review-and-a-look-forward
#15
REVIEW
John H Samies, Marie Gehling, Thomas E Serena, Raphael A Yaakov
The prevalence of chronic wounds is sharply rising throughout the world due to an aging population and increases in the incidence of obesity, diabetes, and cardiovascular diseases. People with diabetes, hypertension, and hyperlipidemia are at increased risk for developing peripheral arterial disease (PAD). PAD affects 8 to 12 million people over the age of 40 years in the United States and it is a major contributing factor to the development of lower extremity ulcers. Although a number of noninvasive diagnostic tests are available to detect PAD in lower extremities, they have several clinical limitations...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113285/clinical-outcomes-of-patients-with-peripheral-artery-disease-and-lower-extremity-wounds-based-on-a-predetermined-intention-to-treat-strategy
#16
REVIEW
Isabella Possagnoli, Christian Bianchi, Jason Chiriano, Theodore Teruya, Vicki Bishop, Ahmed Abou-Zamzam, Krista Smith, Adela Valenzuela
Achieving healing in patients with peripheral artery disease and lower extremity wounds represent a significant clinical challenge. Important outcome measures that define a successful therapeutic approach include wound healing rate, time to heal, and recurrence with time. This article reviews our experience managing a peripheral artery disease patient cohort at a Veterans Affairs medical center based on the initial clinical evaluation stratification and prospective enrollment into a predetermined treatment strategy...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113284/conventional-podiatric-intervention-and-phototherapy-in-the-treatment-of-diabetic-ulcers
#17
Bahle Nteleki, Heidi Abrahamse, Nicolette N Houreld
Contemporary podiatry care involves a dynamic management plan to treat type 2 diabetes mellitus lower-limb ulcerations. Phototherapy is a noninvasive form of light therapy that has been shown to accelerate the healing rate of diabetic ulcers. This study aimed to establish whether the application of phototherapy combined with podiatric treatment improved the rate of wound healing of chronic diabetes mellitus foot ulcers. Patients with type 2 diabetes mellitus presenting with chronic lower-limb ulcers were divided into three groups: group 1 were treated with podiatric management and placebo phototherapy; group 2 were treated similarly, but with the addition of phototherapy on the ulcer(s); and group 3 were treated similarly but phototherapy was applied to the regional lymphatic nodes and ulcer(s)...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113283/impact-of-diabetic-foot-ulcer-on-health-related-quality-of-life-a-cross-sectional-study
#18
M Sonal Sekhar, Roy Raymol Thomas, M K Unnikrishnan, K Vijayanarayana, Gabriel Sunil Rodrigues
Studies have reported that health-related quality of life (HRQoL) is adversely affected by diabetic foot ulcer (DFU). There is a paucity of data on the effects of foot ulcers on HRQoL of diabetes patients in our population. Because South-Asians, especially Indians, have unique features related to diabetes and its complications, generalizing the data about their effect on HRQoL from any other part of the world is not a pragmatic approach. This study evaluated the impact of foot ulcers on HRQoL of diabetes patients...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113282/medical-and-surgical-treatment-of-chronic-venous-ulcers
#19
REVIEW
Michol A Cooper, Umair Qazi, Eric Bass, Jonathan Zenilman, Gerald Lazarus, M Frances Valle, Mahmoud B Malas
Venous ulcer of the lower extremity is a common vascular condition and is associated with decreased quality of life, reduced mobility, and social isolation. Treatment of chronic venous ulcer (CVU) includes compression therapy, debridement of the ulcer when necessary, and wound care. Collagen and antimicrobial dressings can improve the proportion of ulcers healed compared with compression alone. Acellular skin equivalents are not superior to compression, but cellular human skin equivalents can promote more rapid healing, particularly in patients with longstanding ulcers...
September 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/27113281/microenvironment-and-microbiology-of-skin-wounds-the-role-of-bacterial-biofilms-and-related-factors
#20
REVIEW
A Scalise, A Bianchi, C Tartaglione, E Bolletta, M Pierangeli, M Torresetti, M Marazzi, G Di Benedetto
Wound healing is a systemic response to injury that impacts the entire body and not just the site of tissue damage; it represents one of the most complex biological processes. Our knowledge of wound healing continues to evolve and it is now clear that the wound microenvironment plays a crucial role. The interactions between cells and the surface microenvironment, referred to as the "biofilm," contributes to skin homeostasis and healing. Understanding the functional complexity of the wound microenvironment informs how various factors such as age, ischemia, or bacterial infections can impair or arrest the normal healing processes, and it also allows for the possibility of acting therapeutically on healing defects with microenvironment manipulation...
September 2015: Seminars in Vascular Surgery
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