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Anesthesia for vascular surgery

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https://www.readbyqxmd.com/read/28899835/successful-treatment-by-microvascular-decompression-surgery-of-a-patient-with-hemiparesis-due-to-vertebral-artery-compression-of-the-medulla-oblongata-a-case-report-and-literature-review
#1
Jibin Ren, Hongtao Sun, Yunfeng Diao, Xuegang Niu, Hang Wang, Zhengjun Wei, Fei Yuan
Little literature is available on hemiparesis caused by vascular medullary compression, which may occur as a result of dolichoectasia of the vertebrobasilar arterial system. In this paper, we report a case of vertebral artery compression of the medulla oblongata in a 67-year old woman. The patient was hypertensive and developed hemiparesis and intermittent spasms for five years, which became worsened for one year. Cranial nerve MRI showed compression of the medulla oblongata by the left vertebral artery. Motor evoked potential (MEP) examination showed abnormal conduction of MEPs of bilateral toe abductors...
September 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#2
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890063/the-value-of-carotid-endarterectomy-as-a-learning-tool-for-trainees
#3
L M Cacioppa, R Pini, M Longhi, A Vacirca, E Gallitto, G L Faggioli, M Gargiulo, A Stella
INTRODUCTION: Carotid endarterectomy (CEA) intervention needs a specific training and a sufficient learning curve to obtain optimal results in terms of outcome. A formative program was settled up in a single academic center in order to optimize training of standard CEA procedures. This study aims to evaluate the 11-year results of the teaching CEA program. METHODS: The trainees CEA teaching program is carried on during the 5-year vascular surgery residency period and it is stratified as follows: learning theory and intervention assistance (minimum 50 procedures per-year) in the first and second residency-year; performing CEA as second operator in the third and fourth residency-year (minimum 50 procedures per-year); CEA execution as first operator with attending supervision in the last residency-year...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28887248/positive-impact-of-an-aortic-center-designation
#4
Adam Tanious, Mathew Wooster, Marcelo Giarelli, Paul A Armstrong, Brad Johnson, Karl A Illig, Bruce Zwiebel, Lawrence S Grundy, Robert Hooker, Christiano Caldeira, Martin A Back, Murray L Shames
BACKGROUND: In January 2015 we created a multidisciplinary Aortic Center with the collaboration of Vascular Surgery, Cardiac Surgery, Interventional Radiology, Anesthesia and Hospital Administration. We report the initial success of creating a Comprehensive Aortic Center. METHODS: All aortic procedures performed from January 1, 2015 until December 31, 2016 were entered into a prospectively collected database and compared with available data for 2014. Primary outcomes included the number of all aortic related procedures, transfer acceptance rate, transfer time and proportion of elective/emergent referrals...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28883778/examination-of-risk-factors-for-the-development-of-surgical-site-infections
#5
Slobodan Stanic, Janja Bojanic, Predrag Grubor, Biljana Mijovic, Veljko Maric
INTRODUCTION: Hospital-acquired infections (HAI) and surgical site infections (SSI) are a global public health problem. The aim of the study was to determine the incidence of SSIs at the Surgical Clinics of the University Clinical Centre Banja Luka and to identify risk factors for the development of SSIs. METHODS: In order to determine the frequency of SSIs through the incidence compared to the patients operated at the Surgical Clinics of the University Clinical Centre Banja Luka, we conducted a prospective cohort study which encompassed 11...
June 2017: Materia Socio-medica
https://www.readbyqxmd.com/read/28872504/chondrocutaneous-preauricular-free-flap-for-reconstruction-of-nasal-defects-aided-by-interposition-vascular-graft
#6
Sangjun Yim, Seok-Chan Eun
INTRODUCTION: Reconstruction of a nose deformity with a full-thickness defect is not an easy procedure because the nose is highly noticeable, being located at the center of the face, and plays an important role in breathing. Esthetics and functionality are equally important. Local flap reconstruction is an option but it has limitations for reconstruction of large defects because of the following the scar and the deformity at the recipient site. Chondrocutaneous preauricular free flaps can be used to provide grafts with satisfactory esthetics...
September 1, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28836154/randomized-controlled-trial-of-moderate-hypothermia-versus-deep-hypothermia-anesthesia-on-brain-injury-during-stanford-a-aortic-dissection-surgery
#7
Xufang Sun, Hua Yang, Xinyu Li, Yue Wang, Chuncheng Zhang, Zhimin Song, Zhenxiang Pan
This study aimed to compare the effects of moderate versus deep hypothermia anesthesia for Stanford A aortic dissection surgery on brain injury. A total of 82 patients who would undergo Stanford A aortic dissection surgery were randomized into two groups: moderate hypothermia group (MH, n = 40, nasopharyngeal temperature 25 °C, and rectal temperature 28 °C) and deep hypothermia group (DH, n = 42, nasopharyngeal temperature 20 °C, and rectal temperature 25 °C). Different vascular replacement techniques including aortic root replacement, Bentall, and Wheat were used...
August 23, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28802790/vascular-air-embolism-a-silent-hazard-to-patient-safety
#8
REVIEW
Sorin J Brull, Richard C Prielipp
PURPOSE: To narratively review published information on prevention, detection, pathophysiology, and appropriate treatment of vascular air embolism (VAE). MATERIALS AND METHODS: MEDLINE, SCOPUS, Cochrane Central Register and Google Scholar databases were searched for data published through October 2016. The Manufacturer and User Facility Device Experience (MAUDE) database was queried for "air embolism" reports (years 2011-2016). RESULTS: VAE may be introduced through disruption in the integrity of the venous circulation that occurs during insertion, maintenance, or removal of intravenous or central venous catheters...
August 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28777716/research-priorities-in-subspecialty-palliative-care-policy-initiatives
#9
Lynn F Reinke, Diane E Meier
Palliative care demonstrably improves quality of life for the seriously ill in a manner that averts preventable health crises and their associated costs. Because of these outcomes, palliative care is now broadening its reach beyond hospitals, and hospice care for those near death, to patients and their families living in the community with chronic multimorbidities that have uncertain or long expected survival. In this article, we address research needed to enable policies supportive of palliative care access and quality, including changes in regulatory, accreditation, financing, and training approaches in the purview of policy makers...
August 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28738862/impact-of-ischemic-preconditioning-on-surgical-treatment-of-brain-tumors-a-single-center-randomized-double-blind-controlled-trial
#10
Arthur H A Sales, Melanie Barz, Stefanie Bette, Benedikt Wiestler, Yu-Mi Ryang, Bernhard Meyer, Martin Bretschneider, Florian Ringel, Jens Gempt
BACKGROUND: Postoperative ischemia is a frequent phenomenon in patients with brain tumors and is associated with postoperative neurological deficits and impaired overall survival. Particularly in the field of cardiac and vascular surgery, the application of a brief ischemic stimulus not only in the target organ but also in remote tissues can prevent subsequent ischemic damage. We hypothesized that remote ischemic preconditioning (rIPC) in patients with brain tumors undergoing elective surgical resection reduces the incidence of postoperative ischemic tissue damage and its consequences...
July 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28673782/percutaneous-closure-of-periprosthetic-paravalvular-leaks-a-viable-alternative-to-surgery
#11
Ana Isabel Azevedo, Pedro Braga, Alberto Rodrigues, Lino Santos, Bruno Melica, José Ribeiro, Francisco Sampaio, Ricardo Fontes-Carvalho, Marlene Fonseca, Adelaide Dias, Vasco Gama Ribeiro
INTRODUCTION AND OBJECTIVES: Paravalvular leak (PVL) is a possible complication after prosthetic valve implantation. PVL can cause significant symptoms of congestive heart failure and/or hemolysis. Medical therapy is palliative and reoperation has a high mortality rate. Percutaneous transcatheter closure is a promising alternative for symptomatic patients at high surgical risk. We aim to review the efficacy and safety of percutaneous PVL closure in a consecutive series of patients referred to our center...
July 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28671280/impact-of-obstructive-sleep-apnea-in-transsphenoidal-pituitary-surgery-an-analysis-of-inpatient-data
#12
Sei Y Chung, Michael J Sylvester, Varesh R Patel, Michael Zaki, Soly Baredes, James K Liu, Jean Anderson Eloy
OBJECTIVES/HYPOTHESIS: Although previous studies have reported increased perioperative complications among obstructive sleep apnea (OSA) patients undergoing any surgery requiring general anesthesia, there is a paucity of literature addressing the impact of OSA on postoperative transsphenoidal surgery (TSS) complications. The aim of this study was to analyze postoperative outcomes in transsphenoidal pituitary surgery patients with OSA. Secondarily, we examined patient characteristics and comorbidities...
July 3, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28604090/anesthetic-management-of-a-patient-with-multiple-sclerosis
#13
Naohiro Ohshita, Shoko Gamoh, Masahiko Kanazumi, Masahiro Nakajima, Yoshihiro Momota, Yasuo M Tsutsumi
A 54-year-old woman diagnosed with multiple sclerosis (MS) at the age of 19 years was scheduled to undergo temporomandibular joint mobilization. She was currently in a remission phase from her MS but with persistent sequelae, including impaired eyesight and muscle weakness of the limbs. In addition, the blood vessels in her upper limbs were compromised by the formation of internal shunts secondary to vascular prosthesis replacements for plasma exchange therapy in MS. After a previous joint mobilization surgery, her temporomandibular joint developed adhesions with resultant trismus...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28587389/comparison-of-the-hemodynamics-and-dynamics-of-fluid-shift-of-ringer-s-solution-before-surgery-in-children-and-adults
#14
Guizhou Zhu, Yuhong Li, Guomei Ru, Qiannan Ding
The present study investigated the hemodynamics, vascular and extravascular volume expansion induced by infusion of lactated Ringer's solution in children and adults before surgery. This was a prospective randomized double-blind study. A total of 28 patients (14 children and 14 adult patients; American Society of Anesthesiology status I) scheduled for similar minor pelvic, anal rectal or lower limb surgery were recruited for the present study. All patients were administered with 10 ml/kg of lactated Ringer's solution at a constant rate over 20 min...
June 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28583731/risk-factors-for-postoperative-delirium-in-patients-undergoing-vascular-surgery
#15
REVIEW
George C Galyfos, Georgios E Geropapas, Argiri Sianou, Fragiska Sigala, Konstantinos Filis
OBJECTIVE: Postoperative delirium (PODE) remains a common complication after vascular surgery procedures although the exact pathogenesis remains unclear, mainly because of its multifactorial character. The aim of this systematic review was to evaluate pooled data on potential risk factors for PODE in patients undergoing vascular surgery procedures. METHODS: A systematic literature review was conducted conforming to established criteria to identify eligible articles published from 1990 to 2016...
September 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#16
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28468198/capillary-hemangioma-of-the-tympanic-membrane-and-external-auditory-canal
#17
Seo Bin Kim, Hwan-Ho Lee
Hemangiomas are very common tumors characterized by large numbers of vessels filled with blood. Capillary hemangioma is the most common type of hemangioma, whereas capillary hemangiomas of the tympanic membrane and external auditory canal are extremely rare vascular tumors. The authors present capillary hemangioma of the tympanic membrane and external auditory canal in a 54-year-old woman with right-sided aural fullness for 3 months. Under local anesthesia, the mass was resected by transcanal microscopic surgery...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#18
MULTICENTER STUDY
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28384676/microscope-integrated-optical-coherence-tomography-angiography-in-the-operating-room-in-young-children-with-retinal-vascular-disease
#19
Xi Chen, Christian Viehland, Oscar M Carrasco-Zevallos, Brenton Keller, Lejla Vajzovic, Joseph A Izatt, Cynthia A Toth
Importance: Intraoperative optical coherence tomography (OCT) has gained traction as an important adjunct for clinical decision making during vitreoretinal surgery, and OCT angiography (OCTA) has provided novel insights in clinical evaluation of retinal diseases. To date, these two technologies have not been applied in combination to evaluate retinal vascular disease in the operating suite. Objective: To conduct microscope-integrated, swept-source OCTA (MIOCTA) in children with retinal vascular disease...
May 1, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28341606/safety-and-efficacy-of-sequential-intracorneal-ring-segment-implantation-and-cross-linking-in-pediatric-keratoconus
#20
Youssef Abdelmassih, Sylvain El-Khoury, Ali Dirani, Rafic Antonios, Ali Fadlallah, Carole G Cherfan, Elias Chelala, Elias F Jarade
PURPOSE: To evaluate the safety and visual outcome of intracorneal ring segment (ICRS) implantation followed by cross-linking in pediatric keratoconus patients. DESIGN: Retrospective interventional case series. METHODS: This retrospective study included pediatric patients (aged ≤14 years) with keratoconus and poor corrected distance visual acuity (CDVA) that underwent ICRS implantation and cross-linking (CXL). ICRS were inserted under topical anesthesia after creating a corneal tunnel with a femtosecond laser...
June 2017: American Journal of Ophthalmology
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