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aortoiliac occlusive disease

Juliet J Ray, Sarah A Eidelson, Charles A Karcutskie, Jonathan P Meizoso, Hilene DeAmorim, Lee J Goldstein, John Karwowski, Arash Bornak
INTRODUCTION: This study examines the outcome of hybrid revascularization combining iliofemoral endartectomy and iliac artery stenting using covered stents in TASC C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS: A retrospective review was conducted of patients with TASC C and D AIOD involving the CFA and undergoing hybrid revascularization. Covered stents were used primarily. Demographics, indications for surgery, lesion classification, hospital length-of-stay (LOS), 30-day morbidity/mortality, hemodynamic and clinical success, as well as patency were assessed...
February 23, 2018: Annals of Vascular Surgery
Ayşe Keven, Mehmet Sedat Durmaz
Background: Peripheral arterial disease is an atherosclerotic disease characterized by an increase in morbidity and mortality. For these reasons early diagnosis of peripheral arterial disease is important. Ankle-brachial systolic pressure index measurement is frequently used in screening studies. Evaluating waveforms of distal lower extremities with Doppler ultrasound can be used as a screening program and provides more accurate information on peripheral arterial disease. Aim: We investigate the prevalence of peripheral arterial disease, compare the efficacy of Doppler ultrasound evaluation of distal lower extremity waveforms and ankle-brachial systolic pressure index measurement in screening programs, and discuss the importance of early diagnosis of asymptomatic cases...
December 2017: Journal of Ultrasonography
Luigi Pascarella, Maen Aboul Hosn
BACKGROUND: Peripheral arterial disease (PAD) is a complex and highly prevalent pathology. It has been estimated that ∼8.5 million people in the United States are affected by PAD, of which 12%-20% are older than age 60. The TransAtlantic Inter-Society Consensus (TASC) guidelines classified aortoiliac atherosclerotic disease based on morphology and level of lesions. TASC II guidelines recommend bilateral surgical bypass to the femoral arteries for TASC II C and D lesions. The aortobifemoral bypass (ABF) has been considered the gold standard in the treatment of aortoiliac occlusive disease (AIOD)...
January 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Anthony H Kashou, Nabil Braiteh, Ali Zgheib, Hisham E Kashou
BACKGROUND: Aortoiliac occlusive disease, which is also referred to as Leriche syndrome, is a chronic atherosclerotic occlusive disease that occurs at the level of the aortic bifurcation. It is often thought to present with a triad of clinical symptoms: (1) intermittent lower extremity vascular claudication, (2) impotence, and (3) weak/absent femoral pulses. CASE PRESENTATION: We report a case of a 47-year-old Caucasian woman who presented with an acute inferior ST-elevation myocardial infarction...
January 11, 2018: Journal of Medical Case Reports
Ahmet Yuksel, Mustafa Cagdas Cayir, Gencehan Kumtepe, Yusuf Velioglu, Fahri Hayri Atli, Ayhan Muduroglu, Orcun Gurbuz
Femorofemoral crossover bypass is a surgical arterial revascularization modality which is commonly performed for unilateral aortoiliac occlusive disease. It is primarily applied to patients with intermittent claudication or critical limb ischemia in whom underlying anatomic constraints rule out endovascular means of restoring in-line flow and those who do not qualify for anatomic reconstruction due to the comorbid conditions that preclude a more invasive open surgical approach. This surgical procedure may be also used as a complementary component of endovascular repair of abdominal aortic aneurysms when one aortoiliac arterial system is occluded to ensure exclusion of the aortic aneurysm...
December 31, 2017: Thoracic and Cardiovascular Surgeon
Junior Univers, Chandler Long, Stephen A Tonks, Michael B Freeman
Endovascular intervention has become the mainstay for treatment of most patients suffering from peripheral vascular disease. We describe a patient with a known nickel allergy who underwent placement of a stainless steel stent for aortoiliac occlusive disease. Despite our attempt to avoid a nickel-containing stent, the patient developed a diffuse rash consistent with a nickel or metal allergy. A review of stainless steel metallurgy revealed that nickel, cobalt, and titanium are frequently used to provide anticorrosive properties to stainless steel...
December 13, 2017: Journal of Vascular Surgery
Kim Taeymans, Erik Groot Jebbink, Suzanne Holewijn, Jasper M Martens, Michel Versluis, Peter C J M Goverde, Michel M P J Reijnen
OBJECTIVE: The objective of this study was to demonstrate the 3-year outcome of the covered endovascular reconstruction of the aortic bifurcation (CERAB) technique for the treatment of extensive aortoiliac occlusive disease (AIOD). METHODS: Between February 2009 and July 2016, all patients treated with the CERAB technique for AIOD were identified in the local databases of two centers and analyzed. Demographics and lesion characteristics were scored. Follow-up consisted of clinical assessment, duplex ultrasound, and ankle-brachial indices...
November 20, 2017: Journal of Vascular Surgery
Mahek Shah, Soumya Patnaik, Rahul Sinha, Issac Opoku-Asare, Khalid Chaudhry, Sean Janzer
Surgical management of advance aortoiliac occlusive disease is time-tested and a widely practiced strategy, particularly when there is significant coronary artery disease associated with aortoiliac occlusive disease. The technological advances in the field of percutaneous techniques have facilitated the use of nonsurgical endovascular alternatives for peripheral arterial disease in patients with significant comorbidities at high surgical risk, as illustrated in our case report. We report a case of chronic total occlusion of the aorta that was treated percutaneously with endovascular stenting...
2017: Case Reports in Cardiology
Takuya Tsujimura, Osamu Iida, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Shota Okuno, Yasuhiro Matsuda, Masahiko Fujihara, Yoshiaki Yokoi, Toshiaki Mano
AIM: We investigated 2-year clinical outcomes after implantaton of Epic(TM) self-expanding nitinol stents for patients with peripheral artery disease (PAD) due to the aortoiliac occlusive disease (AIOD). METHODS: This study was a multicenter and retrospective study. From February 2013 through October 2014, 292 lesions (chronic total occlusion, 21%; TASC Ⅱ C/D, 35%) in 217 consecutive patients (74±8 years; male, 81%; diabetes mellitus, 47%; dialysis, 21%; critical limb ischemia, 29%) who had undergone endovascular therapy (EVT) with Epic(TM) self-expanding nitinol stents for PAD with AIOD were analyzed...
October 5, 2017: Journal of Atherosclerosis and Thrombosis
Erik Groot Jebbink, Stefan Engelhard, Guillaume Lajoinie, Jean-Paul P M de Vries, Michel Versluis, Michel M P J Reijnen
PURPOSE: To investigate the effect of distal stenotic lesions on flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) configuration used in the treatment of aortoiliac occlusive disease. METHOD: Laser particle image velocimetry measurements were performed using in vitro models of the aortic bifurcation with and without a CERAB configuration in place. A hemodynamically nonsignificant stenosis (ΔP: 9 mm Hg), a hemodynamically significant (ΔP: 26 mm Hg) stenosis, and a total occlusion were simulated in the left iliac arteries...
December 2017: Journal of Endovascular Therapy
Joost A Bekken, Hidde Jongsma, Bram Fioole
BACKGROUND: During the past decade, endovascular treatment has become the treatment of choice for all types of aortoiliac occlusive disease, including TASC C and D lesions. Patency rates, however, are still below those of open surgical techniques. One propagated technique to improve patency rates is the use of covered stents. This review assessed the available literature on covered stents for aortoiliac occlusive disease. METHODS: An extensive search was performed of the MEDLINE, Embase, and Cochrane databases...
September 20, 2017: Journal of Cardiovascular Surgery
Roy Miler, Jeanwan Kang, Patrick Sowa, Matthew Eagleton, F Ezequiel Parodi
INTRODUCTION/OBJECTIVES: Endovascular repair of a proximal anastomotic pseudoaneurysm of an end-to-side aortobifemoral bypass (ABF) can lead to pelvic ischemia. We present a novel application of branched aortic endograft to repair such pseudoaneurysm while preserving flow into the ABF and native aortoiliac system. METHODS: A 71 year old male with history of aortoiliac occlusive disease resulting in lifestyle limiting claudication was treated with an aortobifemoral bypass in 1999...
September 8, 2017: Annals of Vascular Surgery
Pasqualino Sirignano, Wassim Mansour, Laura Capoccia, Chiara Pranteda, Nunzio Montelione, Francesco Speziale
PURPOSE: To describe results of AFX unibody stent-graft treatment for TransAtlantic Inter-Society Consensus (TASC) D aortoiliac occlusive disease (AIOD) with coexistent abdominal aortic aneurysm (AAA). METHODS: A retrospective analysis was conducted of 21 consecutive patients (mean age 73.6±6.4 years; 17 men) with TASC D AIOD plus AAA (diameter >3.5 cm) treated electively using the AFX stent-graft. Common iliac artery (CIA) and external iliac artery (EIA) stenosis or occlusion was reported...
December 2017: Journal of Endovascular Therapy
Enrico Gallitto, Mauro Gargiulo, Gianluca Faggioli, Rodolfo Pini, Chiara Mascoli, Antonio Freyrie, Stefano Ancetti, Andrea Stella
OBJECTIVE: Fenestrated and branched endovascular aneurysm repair (FB-EVAR) is a valid option to treat juxtarenal and pararenal abdominal aortic aneurysms and thoracoabdominal aortic aneurysms. Because successful deployment depends on complex maneuvers, hostile iliac artery anatomy (HIA) can prejudice the FB-EVAR outcome. The aim of the study was to evaluate the impact of HIA on FB-EVAR outcome. METHODS: Between 2010 and 2015, all patients undergoing FB-EVAR were prospectively categorized according to iliac anatomy (friendly iliac artery anatomy [FIA] or HIA)...
December 2017: Journal of Vascular Surgery
Akiko Tanaka, Alexa Perlick, Charles C Miller, Harleen K Sandhu, Shaikh Afaq, Hazim J Safi, Ali Azizzadeh, Kristofer M Charlton-Ouw
OBJECTIVE: Although the incident risk of peripheral artery disease increases in patients with metabolic syndrome, several authors report favorable outcomes in obese patients after arterial bypass surgery. We examine the effect of the so-called "obesity paradox" and metabolic syndrome on outcomes after open aortoiliac bypass surgery. METHODS: We identified patients between 2004 and 2015 who had open surgical bypass for aortoiliac occlusive disease. We excluded patients with endovascular repair and those treated primarily for aneurysmal disease...
September 5, 2017: Annals of Vascular Surgery
Bogna Gryszczyńska, Dorota Formanowicz, Magdalena Budzyń, Maria Wanic-Kossowska, Elżbieta Pawliczak, Piotr Formanowicz, Wacław Majewski, Krzysztof Wojciech Strzyżewski, Magdalena P Kasprzak, Maria Iskra
OBJECTIVES: The main question of this study was to evaluate the intensity of oxidative protein modification shown as advanced oxidation protein products (AOPP) and carbonylated proteins, expressed as protein carbonyl content (C=O) in abdominal aortic aneurysms (AAA), aortoiliac occlusive disease (AIOD), and chronic kidney disease (CKD). DESIGN AND METHODS: The study was carried out in a group of 35 AAA patients and 13 AIOD patients. However, CKD patients were divided into two groups: predialysis (PRE) included 50 patients or hemodialysis (HD) consisted of 34 patients...
2017: BioMed Research International
S Cheddie, C Manneh, H Zulu
BACKGROUND: Guillotine amputation for diabetic foot sepsis followed by an elective refashioning of the stump is regarded as standard practice. Primary amputation is associated with higher reamputation rates. METHOD: A prospective cohort study of 85 patients who underwent surgery for diabetic foot sepsis from 2014 to 2016 at Madadeni Provincial Hospital, KwaZulu-Natal was done. Ethical approval was granted. The Wagner classification (Wag) was used to classify disease severity...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
M J Motsumi, N G Naidoo
BACKGROUND: This study investigated the pattern and distribution of peripheral arterial disease in diabetic patients with critical limb ischaemia (CLI) and to stratify the findings according to the patients' risk factor profile, gender and age group. METHOD: We conducted a one-year prospective descriptive study (January 2014 to December 2014) at Groote Schuur Hospital, University of Cape Town. The research protocol and the informed consent were approved by the Institutional Review Board, and all subjects included in this study gave an informed consent...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
Keiichi Hishikari, Hiroyuki Hikita, Shun Nakamura, Shun Nakagama, Masafumi Mizusawa, Tasuku Yamamoto, Junichi Doi, Yuya Utsugi, Yuta Sudo, Shigeki Kimura, Takashi Ashikaga, Atsushi Takahashi, Mitsuaki Isobe
PURPOSE: To evaluate the usefulness of serum lipoprotein(a) as a biomarker of clinical outcomes after endovascular therapy (EVT) for atherosclerotic aortoiliac lesions. METHODS: Serum lipoprotein(a) concentrations were measured at admission in 189 consecutive patients (median age 72 years; 160 men) with peripheral artery disease who underwent EVT for aortoiliac occlusive disease. The patients were dichotomized into 2 groups based on serum lipoprotein(a) levels ≤40 mg/dL (LOW; n=135) or >40 mg/dL (HIGH; n=54)...
August 1, 2017: Journal of Endovascular Therapy
Marco Zavatta, Matthew W Mell
OBJECTIVE: We sought to analyze the outcomes of revascularization for aortoiliac-femoral occlusive disease by comparing hybrid repair by endovascular revascularization and open common femoral endarterectomy (ER-CFE) with open aortoiliac reconstruction and CFE (OR-CFE). METHODS: Using the national Society for Vascular Surgery Vascular Quality Initiative database from 2009 to 2015, we identified all patients receiving open or endovascular revascularization of the aortoiliac system and who additionally underwent CFE...
August 16, 2017: Journal of Vascular Surgery
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