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Vascular, surgery, endovascular

Natzi Sakalihasan, Jean-Baptiste Michel, Athanasios Katsargyris, Helena Kuivaniemi, Jean-Olivier Defraigne, Alain Nchimi, Janet T Powell, Koichi Yoshimura, Rebecka Hultgren
An abdominal aortic aneurysm (AAA) is a localized dilatation of the infrarenal aorta. AAA is a multifactorial disease, and genetic and environmental factors play a part; smoking, male sex and a positive family history are the most important risk factors, and AAA is most common in men >65 years of age. AAA results from changes in the aortic wall structure, including thinning of the media and adventitia due to the loss of vascular smooth muscle cells and degradation of the extracellular matrix. If the mechanical stress of the blood pressure acting on the wall exceeds the wall strength, the AAA ruptures, causing life-threatening intra-abdominal haemorrhage - the mortality for patients with ruptured AAA is 65-85%...
October 18, 2018: Nature Reviews. Disease Primers
Sharon C Kiang, Khwaja A Ahmed, Victoria J Cha, Donald V Farley, Udochukwu E Oyoyo, Ahmed M Abou-Zamzam, Roger T Tomihama
Objectives There is paucity in the literature reporting radiation usage analysis in vascular surgery. In the era of endovascular surgeries, analyzing the surgeons' use of radiation in vascular procedures can help establish quality improvement initiatives. Methods A retrospective review was undertaken of intraoperative fluoroscopic-guided vascular surgery procedures at a single institution from 2010 to 2017. Mobile C-arms were utilized to gather the six radiation usage metrics and cases were categorized into 6 anatomic surgical fields and 10 surgical procedure types...
October 18, 2018: Vascular
Jan Sobstyl, Maryla Kuczyńska, Ewa Kuklik, Łukasz Światłowski, Maria Tsitskari, Tomasz Jargiełło
External injuries are one of the common reasons for reporting to hospital emergency departments. Peripheral vascular injuries occur in up to about 25% of upper and lower extremity injury cases. Arteriovenous fistula is a type of arterial injury. Doppler ultrasound is currently the primary diagnostic method for vascular injuries as it allows for the implementation of appropriately targeted treatment, indicating the potential need for extended diagnosis or patient qualification for endovascular or classical surgery...
2018: Journal of Ultrasonography
Jun Takei, Satoru Tochigi, Masami Arai, Toshihide Tanaka, Ikki Kajiwara, Keisuke Hatano, Daisuke Ichinose, Hiroki Sakamoto, Yuzuru Hasegawa, Toshihiro Ishibashi, Satoshi Tani, Yuichi Murayama
We report the case of a patient with a spinal extradural arteriovenous fistula (AVF) associated with Cowden syndrome (CS) that was successfully treated by endovascular surgery. CS is an autosomal dominant disorder associated with diverse symptoms caused by a deleterious mutation in the phosphatase and tensin homolog ( PTEN ) gene. A 67-year-old woman was diagnosed with CS based on her medical history of multiple cancers for which she underwent abdominal surgery, macrocephaly, Lhermitte-Duclos disease, and facial papules...
October 2018: NMC Case Report Journal
Uwe Wahl, Ingmar Kaden, Andreas Köhler, Tobias Hirsch
Hypothenar or thenar hammer syndrome (HHS) and hand-arm vibration syndrome (HAVS) are diseases caused by acute or chronic trauma to the upper extremities. Since both diseases are generally related to occupation and are recognised as occupational diseases in most countries, vascular physicians need to be able to distinguish between the two entities and differentiate them from other diagnoses. A total of 867 articles were identified as part of an Internet search on PubMed and in non-listed occupational journals...
October 16, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Melissa Anne Wright, Daniel Steffens, Ravi Lee Huilgol
BACKGROUND: The prevalence of peripheral arterial disease (PAD) in Australia is currently poorly characterized. The risk factor profile for PAD is changing with the population ageing, diabetes increasing and smoking rates declining. The management of PAD is also evolving, with advances in medical management and endovascular technique. The trends in PAD prevalence and surgical management have implications for preventative medicine, the Australian health system and vascular surgery. We report and analyse trends in PAD surgical intervention performed between 2001 and 2015...
October 15, 2018: ANZ Journal of Surgery
Chih-Chen Kao, Tzu-Hao Huang, Chien-Wei Chen, Yao-Kuang Huang
Blunt abdominal aortic injury is an extremely rare condition. In the past, when blunt abdominal aortic injury was managed with open surgery, intra-abdominal injury was identified more easily, while in the era of endovascular surgery, intra-abdominal injury might potentially be found after vascular reconstruction. We present a case of blunt abdominal aortic injury treated using a parallel graft-stent and simultaneous laparoscopy which revealed an occult bowel perforation.
October 13, 2018: Interactive Cardiovascular and Thoracic Surgery
Ding Yuan, Jun Wen, Liqing Peng, Jichun Zhao, Tinghui Zheng
Hybrid visceral-renal debranching procedures with endovascular repair have been proposed as a less invasive alternative to conventional thoracoabdominal aortic aneurysm or dissection (TAAA or TAAD) surgery. Up to now, there has been no information about the hemodynamic effects of retrograde visceral reconstruction (RVR) for Crawford type II/III/IV TAAA patients undergoing hybrid treatment. The aim is to provide insights in the abnormal hemodynamics of RVR from unilateral or bilateral common iliac arteries (CIAs)...
2018: PloS One
I V Kuchin, T É Imaev, P M Lepilin, A S Kolegaev, I S Medvedeva, A E Komlev, S K Ternovoĭ, R S Akchurin
The problem concerning diagnosis and treatment of abdominal aortic aneurysms (AAA) is important today because of a high proportion of this pathology within the structure of population morbidity and mortality, with a tendency of these indices to increase, as well as high lethality rates in development of complications. Endovascular treatment of aortic aneurysms is one of the most rapidly developing methods of treatment in vascular surgery. Over the last two decades this type of treatment has been playing an important part in the armamentarium of the vascular surgeon and is often considered as primary treatment of patients with AAA of infrarenal localization...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Łukasz Przepiórka, Przemysław Kunert, Paulina Juszyńska, Michał Zawadzki, Bogdan Ciszek, Mariusz Głowacki, Andrzej Marchel
Spinal dural arteriovenous fistula (SDAVF) is the most common vascular malformation of the spine in adults. However, the coincidence of tethered cord syndrome, lipoma, and SDAVF on the sacral level is exceptionally rare. We describe two patients, probably the fifth and sixth ever reported. The first was a 33 year-old female who underwent surgical cord de-tethering. Surprisingly, a sacral SDAVF was discovered intraoperatively, despite negative digital subtraction angiography (DSA). The second patient was a 30 year-old male with similar pathologies...
2018: Frontiers in Neurology
Ryosuke Kowatari, Yasuyuki Suzuki, Kazuyuki Daitoku, Satoshi Taniguchi, Shinya Kakehata, Ikuo Fukuda
We report a simple endovascular repair for symptomatic aberrant right subclavian artery (ARSA) in an 11-year-old girl. She had undergone tracheostomy due to hypoxic encephalopathy after cardiac surgery and suffered from dyspnea. Computed tomography revealed tracheal stenosis caused by a vascular ring made with an ARSA and the right common carotid artery. Transcatheter ARSA embolization using an Amplatzer vascular plug and coils was performed. Symptoms improved within a few days after this intervention and no complications such as upper extremity ischemia were encountered...
October 10, 2018: Vascular and Endovascular Surgery
Viviana Manuel, Ryan Gouveia E Melo, Ruy Fernandes E Fernandes, Ana Rita Santos, Luís Silvestre, Emanuel Silva, Tony Soares, Luís Mendes Pedro
Introduction: There is much debate in the literature regarding the management of blunt cervical carotid injuries. This report describes a case of bilateral carotid artery dissection in the very uncommon case of a near hanging victim and the treatment controversies regarding its management. Report: A 50 year old male patient was admitted after attempted suicide through hanging, having been swiftly rescued by a bystander. On admission, six hours after the event there was no neurological deficit...
2018: EJVES Short Reports
Sam C Tyagi, Keith D Calligaro, Shinichi Fukuhara, Jacques Greenberg, Danielle M Pineda, Hong Zheng, Matthew J Dougherty, Douglas A Troutman
OBJECTIVE: Although lifelong surveillance is recommended by the Society for Vascular Surgery for patients undergoing endovascular aneurysm repair (EVAR) reported that compliance with long-term follow-up has been poor. We sought to identify factors that predict compliance with EVAR surveillance through analysis of patient variables and post-EVAR questionnaire results. METHODS: We analyzed 28 patient variables gathered from our computerized registry, patient charts, and phone questionnaires of patients who underwent EVAR between January 1, 2010, and December 31, 2014...
October 6, 2018: Journal of Vascular Surgery
Daniel M Heiferman, Hasan R Syed, Daphne Li, Brian D Rothstein, Ali Shaibani, Tadanori Tomita
Cirsoid aneurysms, also known as scalp arteriovenous malformations (AVM), are rare congenital extracranial vascular anomalies that often present as an enlarging pulsatile scalp mass. A 14-yr-old male presented with a pulsatile scalp lesion that was first noticed 3 yr prior and had progressively enlarged. No history of trauma was reported. MRI demonstrated a 4 cm wide and 2 cm tall nidus and catheter angiography was performed to further define the vascular supply and drainage. The patient underwent transvenous endovascular embolization followed by surgical excision via a bicoronal incision, as shown in this operative video...
October 5, 2018: Operative Neurosurgery (Hagerstown, Md.)
S Keisin Wang, Natalie A Drucker, Jodi L Raymond, Thomas M Rouse, Andres Fajardo, Gary W Lemmon, Michael C Dalsing, Brian W Gray
OBJECTIVE: The purpose of this investigation was to determine our limb-related contemporary pediatric revascularization perioperative and follow-up outcomes after major blunt and penetrating trauma. METHODS: A retrospective review was performed of a prospectively maintained pediatric trauma database spanning January 2010 to December 2017 to capture all level I trauma activations that resulted in a peripheral arterial revascularization procedure. All preoperative, intraoperative, and postoperative continuous variables are reported as a mean ± standard deviation; categorical variables are reported as a percentage of the population of interest...
October 3, 2018: Journal of Vascular Surgery
Chiara Lomazzi, Viviana Grassi, Sara Segreti, Marta Cova, Daniele Bissacco, Ruth L Bush, Santi Trimarchi
No abstract text is available yet for this article.
October 3, 2018: European Journal of Vascular and Endovascular Surgery
Alexander Zimmermann, Stefanie Balk, Andreas Kuehnl, Hans-Henning Eckstein
BACKGROUND: Based on prospective vein bypass trials for lower leg ischemia, objective performance goals (OPG) were established by the Society for Vascular Surgery (SVS) and are used as a benchmark tool for open and endovascular treatments. This study aims to analyze OPG of all patients with critical leg ischemia (CLI) treated by open revascularization techniques at a tertiary care facility in routine practice. METHODS: From 01/2005 to 03/2013, 315 patients (mean age 72 years) with CLI were retrospectively included in this study...
October 1, 2018: Annals of Vascular Surgery
Roberto Sansone, Lucas Busch, Ralf Langhoff
The updated ESC guidelines on PAD were developed, for the first time, as a collaboration between cardiologists and vascular surgeons and unveiled at the European Society of Cardiology (ESC) 2017 congress. Although awareness has improved, PAD is still associated with significant morbidity, mortality, and quality of life impairment. Primarily, the guidelines emphasize the need for a multidisciplinary management of these patients and propose "a vascular team". A new chapter on antithrombotic therapies is provided...
October 2018: Deutsche Medizinische Wochenschrift
Yosuke Hata, Osamu Iida, Mitsuyoshi Asai, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura, Shota Okuno, Yasuhiro Matsuda, Toshiaki Mano
Enlargement due to residual dissection after surgical ascending aortic replacement is technically challenging to treat. Endovascular entry closure using an Amplatzer vascular plug 2 (AVP2) in the sub-acute phase has not been reported. A 75-year-old female underwent emergent ascending aorta replacement for Stanford type A aortic dissection. Postoperative computed tomography angiography (CTA) showed a distal aortic arch diameter of 41 mm and a patent false lumen. CTA one month after the operation revealed distal aortic arch enlargement to 52 mm, which is considered high-risk for rupture...
April 2018: Journal of Cardiology Cases
Matthew Scott-Young, Laurence McEntee, James Furness, Ben Schram, Wayne Hing, David Grosser, Mario Zotti
Background: Treatment options for aortic-iliac pathology may include endovascular repair and open surgical repair. Treatment options for degenerative disc disease (DDD) are varied but commonly include anterior reconstruction. When both the aortic-iliac and spinal pathologies are significant and surgical intervention is indicated for each pathology, the opportunity exists for concurrent treatment of both the aortic-iliac pathology and DDD in the same operation. The purpose of this case series was to document the safety and feasibility of a surgical strategy whereby a combined elective reconstructive procedure was performed for aortic and anterior lumbar spinal pathologies...
June 2018: International Journal of Spine Surgery
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