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Vascular and Endovascular Surgery

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https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#1
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27881699/multicenter-experience-of-surgical-explantation-of-carotid-stents-for-recurrent-stenosis
#2
Jesse A Columbo, John C McCallum, Philip P Goodney, Thomas C Bower, Marc L Schermerhorn, Richard J Powell, Randall R DeMartino
OBJECTIVE: A significant cohort of patients who have undergone carotid artery stenting (CAS) will have in-stent restenosis (ISR). The optimal management of symptomatic or severe ISR remains poorly defined. The purpose of this study was to describe the indications, treatment, and mid- to long-term outcomes of patients undergoing CAS explantation for ISR. METHODS: All patients undergoing internal carotid artery stent explantation with carotid artery reconstruction at Mayo Clinic Rochester, Dartmouth-Hitchcock Medical Center, and Beth-Israel Deaconess Medical Center from 2003 to 2013 were retrospectively reviewed...
November 22, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27852881/treatment-of-angio-seal-related-femoral-artery-occlusion-using-directional-atherectomy-primary-results-and-midterm-follow-up
#3
Anvar Babaev, Rohit Gokhale, Susanna Zavlunova, Michael Attubato
OBJECTIVE: We describe a novel approach for the endovascular treatment of femoral artery occlusion as a result of Angio-Seal closure device deployment. BACKGROUND: Angio-Seal is the most commonly used vascular closure device following percutaneous coronary and peripheral catheterizations worldwide. A rare complication of Angio-Seal deployment is an occlusion of the femoral artery leading to limb ischemia requiring revascularization. Given its unique ability to cut both atherosclerotic plaque and the Angio-Seal anchor with a collagen plug at operator-directed planes, TurboHawk/HawkOne atherectomy device can be a fast and effective approach to treat Angio-Seal-associated femoral artery occlusions...
November 16, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27852880/endovascular-treatment-of-complex-carotid-jugular-fistula-case-report-of-an-alternative-technique-using-the-superficial-temporal-artery
#4
Gonzalo Alonso-Argüeso, Alejandro Rodriguez-Morata, Blanca Vera-Arroyo, Maria Jesus Lara-Villoslada, Rafael Gomez-Medialdea
Inadvertent complications of jugular vein catheterization are not uncommon, however, a persistent symptomatic carotid-jugular fistula has been rarely reported. A 72-year-old male with infected surgical wound after coxofemoral disarticulation for sarcoma presented with symptoms of acute right heart failure. A fistula between the right common carotid artery (CCA) and the internal jugular vein was demonstrated on Doppler ultrasound and confirmed on computed tomography angiogram. Catheterization of the right CCA seemed not possible using a conventional femoral approach due to the tortuosity and elongation of the brachiocephalic artery...
November 16, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27837181/results-of-ultrasound-guided-foam-sclerotherapy-of-the-great-saphenous-vein-with-new-parameters-of-the-technique
#5
A Baeshko, N Shestak, S Korytko
AIM: To report the outcome of a series of patients with chronic venous disease due to incompetence of the great saphenous vein (GSV) managed by ultrasound-guided foam sclerotherapy (USGFS). DESIGN: Controlled clinical trial with maximum 5-year follow-up of results of USGFS of the GSV with new parameters of the procedure. MATERIALS AND METHODS: This research analyzes the results of USGFS of the GSV (395 GSV) and its tributaries in 326 patients with varicose veins of the lower extremities over the period from January 2009 to January 2014 with the following parameters of the procedure: 60° limb elevation, calf bandage, and cooled foam injection...
November 11, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27770082/endovascular-reconstruction-of-extrahepatic-portal-vein-in-noncirrhotic-and-nonmalignant-chronic-portal-vein-thrombosis-secondary-to-an-iatrogenic-stenotic-lesion
#6
Manuel Guerrero-Hernandez, Carlos A Hinojosa, Javier E Anaya-Ayala, Erika Elenes, Aldo Torre
Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV...
October 20, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27770081/thoracic-outlet-syndrome-in-a-volleyball-player-due-to-nonunion-of-the-first-rib-fracture
#7
Kathleen T Puttmann, Bhagwan Satiani, Patrick Vaccaro
Fracture of the first rib with ensuing callus formation is a rare cause of thoracic outlet syndrome. We report a case of a 17-year-old female volleyball player who presented with months of chronic arm pain. Radiographic imaging demonstrated nonunion fracture of the first rib. Physical therapy had been unsuccessful in relieving the pain, and surgical management was performed with resection of the first rib through a transaxillary approach with complete resolution of symptoms. Inflammation surrounding such fractures may destroy tissue planes, making dissection more technically difficult...
October 20, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27770080/lower-extremity-revascularization-in-end-stage-renal-disease-which-patients-benefit
#8
Douglas W Jones, Kirsten Dansey, Allen D Hamdan
Patients with end-stage renal disease (ESRD) who present with critical limb ischemia (CLI) have become an increasingly common and complex treatment problem for vascular surgeons. Dialysis patients have high short-term mortality rates regardless of whether revascularization is pursued. ESRD patients with CLI can be managed with: local wound care, endovascular or surgical revascularization, or amputation. Some patients may heal small foot wounds with local wound care alone, even if distal perfusion is marginal, as long as any infectious process has been controlled...
October 20, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27733701/arterioenteric-fistulae-due-to-pseudoaneurysms-of-the-right-common-iliac-and-splanchnic-vessels-presenting-as-upper-gi-bleed
#9
Prashant R Rao, Bhushan D Thombre, Ajit Patel, Anurag Dandekar, Rajinder Singh, Rajeev M Joshi
Arterial pseudoaneurysms are relatively rare complications of the vascular system. Many cases may remain asymptomatic for a lifetime only to be discovered incidentally, whereas others may cause fatal hemorrhage. Majority of cases present with local compressive symptoms. Rarely, it has been implicated as an etiology for gastrointestinal (GI) bleed by eroding into an adjacent bowel, with splanchnic pseudoaneurysm being more commonly responsible as compared to peripheral ones. Although rare, they are an important consideration because of the high mortality rate...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27681173/inhibitory-effect-of-tlr4-gene-silencing-on-intimal-hyperplasia-of-vein-grafting
#10
Zhicheng Zhu, Rihao Xu, Xiaomei Zheng, Tiance Wang, Dan Li, Yong Wang, Kexiang Liu
PURPOSE: The present study aimed to explore the regulating effect of Toll-like receptor 4 (TLR4) on intimal hyperplasia in rat vein grafts. METHODS: Rat models of external jugular vein carotid artery bypass grafting were established. Afterward, TLR4 small interfering RNA (siRNA) recombinant plasmids were constructed, which were transfected into rat vein graft bypass to study the effect of TLR4 silencing on intimal hyperplasia and to explore the underlying mechanisms...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27681172/surgical-revascularization-of-symptomatic-kinking-of-the-internal-carotid-artery
#11
Ji-Heng Hao, Li-Yong Zhang, Kai Lin, Wei-Dong Liu, Shi-Gang Zhang, Ji-Yue Wang, Gang Li, Le-Xin Wang
OBJECTIVE: To evaluate the safety and outcomes of surgical revascularization for patients with symptomatic kinking of the internal carotid artery (ICA). METHODS: Twenty-five consecutive patients presented with symptomatic kinking of the ICA and a history of transient ischemic attack (TIA) or stroke were prospectively enrolled in this study. All patients were treated with ICA transection and end-to-side reimplantation at the level of the carotid bulb. Patients were followed up for a median of 32 months...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27681171/complications-and-failure-of-endovenous-laser-ablation-and-radiofrequency-ablation-procedures-in-patients-with-lower-extremity-varicose-veins-in-a-5-year-follow-up
#12
Witold Woźniak, R Krzysztof Mlosek, Piotr Ciostek
INTRODUCTION: Thermal ablation techniques have gradually replaced Babcock procedure in varicose vein treatment. AIM: A comparative quantitative-qualitative analysis of complications and failure of endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) in a 5-year follow-up. MATERIALS AND METHODS: One hundred ten adult participants with varicose veins clinical grade C2 to C6, treated for isolated great saphenous vein (GSV) or small saphenous vein (SSV) insufficiency in a single lower extremity in 2009 to 2010, were enrolled and subdivided into EVLA (n = 56) and RFA (n = 54) groups...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27651428/clinical-and-functional-impact-of-hypogastric-artery-exclusion-during-evar
#13
Wassim Mansour, Laura Capoccia, Pasqualino Sirignano, Nunzio Montelione, Chiara Pranteda, Martina Formiconi, Enrico Sbarigia, Francesco Speziale
PURPOSE: Hypogastric artery (HA) revascularization during endovascular aneurysm repair (EVAR) is still open to debate. Moreover, exclusion-related complication rates reported in literature are not negligible. The aim of this study is to present and analyze the outcomes in patients undergoing EVAR with exclusion of 1 or both HAs at our academic center. METHODS: We retrospectively reviewed our results in patients submitted to EVAR and needing HA exclusion, in terms of perioperative (30-day) and follow-up rates of intestinal and spinal cord ischemia, buttock claudication, buttock skin necrosis, and sexual dysfunction...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27645027/acute-carotid-stent-thrombosis-a-comprehensive-review
#14
Konstantinos G Moulakakis, Spyridon N Mylonas, Andreas Lazaris, Georgios Tsivgoulis, John Kakisis, Giorgos S Sfyroeras, Constantine N Antonopoulos, Elias N Brountzos, Spyridon N Vasdekis
Acute carotid stent thrombosis (ACST) is a rare complication that can lead to dramatic and catastrophic consequences. A rapid diagnosis and prompt recanalization of the internal carotid artery are needed to minimize the ischemic insult and the reperfusion injury. We reviewed the current literature on this devastating complication of CAS with the intention of investigating the potential causative factors and to define the appropriate management. According to our study discontinuation of antiplatelet therapy, resistance to antiplatelet agents and inherent or acquired thrombotic disorders are the main causes of thrombosis...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27630223/massive-hemorrhage-from-multiple-hepatic-artery-aneurysms
#15
S Lowell Kahn, Jonathan McClain, Jeffrey L Kaufman
A 66-year-old man, with an abnormal porta hepatis, consistent with tumor or inflammation, developed massive bleeding from one of numerous hepatic artery aneurysms, and coil embolization achieved control of bleeding. He died of subsequent multisystem organ failure, and the most likely diagnosis was either polyarteritis nodosa or segmental arterial mediolysis. Although the dual hepatic blood supply allows a degree of arterial embolization, this case demonstrates the risks associated with large territory hepatic arterial embolization in the presence of hemodynamic instability...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27625002/free-esophageal-perforation-following-hybrid-visceral-debranching-and-distal-endograft-extension-to-repair-a-ruptured-thoracoabdominal-aortic-aneurysm
#16
Hussam Abou-Al-Shaar, Khaled Juan Zaza, Muhammad Anees Sharif, Samer Koussayer
Free esophageal perforation following a hybrid visceral debranching and distal endograft extension to repair a ruptured thoracoabdominal aortic aneurysm (TAAA) is a rare complication. The authors report a 56-year-old male who underwent elective thoracic endovascular aortic repair of a thoracic aneurysm. Four and a half years later, he presented with a new aneurysm extending from the distal end of the thoracic stent graft to the aortic bifurcation involving all the visceral arterial branches. The TAAA ruptured while he was awaiting an elective repair, and as a result, he underwent an emergency hybrid procedure...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27609737/hybrid-repair-of-thoracoabdominal-aortic-aneurysms-is-a-durable-option-for-high-risk-patients-in-the-endovascular-era
#17
Suvi Väärämäki, Velipekka Suominen, Georg Pimenoff, Jukka Saarinen, Ilkka Uurto, Juha Salenius
OBJECTIVE: To report our long-term experience in using the hybrid technique in complex thoracoabdominal aortic aneurysms (TAAAs). METHODS: Between March 2005 and September 2013, 10 patients with TAAA underwent hybrid procedures with open renovisceral revascularization and thoracoabdominal aortic endografting. Patients were analyzed retrospectively. RESULTS: Six men and 4 women with a mean age of 66 years (range 54-81 years) were treated electively during the study period...
October 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27630269/aneurysm-formation-after-endovascular-treatment-of-acute-type-a-dissection
#18
Lai Yang, Jiaping Wang
Recently, reports have described successful endovascular stent graft (ESG) treatment of patients with acute type A aortic dissection. We report 1 ESG treatment for this condition and the complication of a new aneurysm formation during a 6-month follow-up.
August 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27630268/celiac-artery-stenting-in-the-treatment-of-intestinal-ischemia-due-to-the-sacrifice-of-the-dominant-inferior-mesenteric-artery-during-endovascular-aortic-repair
#19
Zijie Su, Tianyue Pan, Weishuai Lian, Daqiao Guo, Zhihui Dong, Weiguo Fu
A 42-year-old man had intestinal ischemia 7 weeks after endovascular abdominal aortic aneurysm repair due to sacrifice of the inferior mesenteric artery, which had compensated for the intestinal blood supply because of the total occlusion of the superior mesenteric artery (SMA) and severe stenosis of the celiac artery (CA). He was diagnosed in the active phase of Takayasu arteritis, and an emergency endovascular treatment was performed. After the SMA failed to be recanalized, a stent was successfully placed into the CA; this choice was made based on the preexisting collaterals between them...
August 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27630267/comparative-outcomes-of-ultrasound-assisted-thrombolysis-and-standard-catheter-directed-thrombolysis-in-the-treatment-of-acute-pulmonary-embolism
#20
Nathan L Liang, Efthymios D Avgerinos, Luke K Marone, Michael J Singh, Michel S Makaroun, Rabih A Chaer
OBJECTIVES: The objective of this study was to compare the outcomes of patients undergoing ultrasound-accelerated thrombolysis (USAT) and standard catheter-directed thrombolysis (CDT) for the treatment of acute pulmonary embolism (PE). METHODS: The records of all patients in our institution having undergone CDT or USAT for massive or submassive PE from 2009 to 2014 were retrospectively reviewed. Standard statistical methods were used to compare characteristics and to assess for longitudinal change in outcomes...
August 2016: Vascular and Endovascular Surgery
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