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Vascular, surgery, endovascular

Chaonan Zhang, Shuxiang Guo, Nan Xiao, Jiaqing Wu, Youxiang Li, Yuhua Jiang
When conducting endovascular interventional surgery, doctors usually experience high viscous resistance resulting from direct contact with blood when operating the guide wire in blood vessels, which reduces the operational efficiency. Improper operation can cause vascular injuries and greatly reduce surgical safety, sometimes leading to the death of the patient. This paper presents a new method that applies transverse microvibrations at the proximal end of a conventional passive guide wire to reduce viscous resistance...
August 9, 2018: Biomedical Microdevices
K Schürmann
CLINICAL ISSUE: Aortic bifurcation disease is a manifestation of arteriosclerosis in about 95% of cases. Stenotic disease of the aortic bifurcation is a special form of peripheral arterial occlusive disease (PAOD). Men older than 60 years are particularly affected. STANDARD TREATMENT: The potential of endovascular therapy has continued to increase. Hereby, the increased availability of hybrid operating suites which allow for a combined use of endovascular techniques and open surgery plays an important role...
August 9, 2018: Der Radiologe
M Rouer, S Godier, A Monnot, I Etienne, D Bertrand, D Guerrot, D Plissonnier
The occurrence of transplant renal artery stenosis (TRAS) ranges from 1% to 23%, and is associated with resistant hypertension, volume overload, graft dysfunction and poor long-term graft and patient survival. Enhancing graft availability with expanded criteria donors results in the transplantation of kidneys with atherosclerotic arteries, increasing the risk of vascular complications. Although endovascular management is the first line strategy in this context, in some patients surgery has to be considered...
August 6, 2018: Annals of Vascular Surgery
Jeffrey B Edwards, Mathew D Wooster, Adam Tanious, Martin R Back
OBJECTIVE: Renal artery anomalies occur at a rate of 1-2% and present a challenge to vascular surgeons performing aortic surgery. We describe adjuncts used to manage such anatomic variants. METHODS: A single surgeon registry of all abdominal aortic aneurysms repaired in an academic center was retrospectively reviewed. Patients with prior renal transplants, congenital pelvic kidneys, or horseshoe kidneys were included. Open repair was reserved for patients with no endovascular or hybrid repair options...
August 3, 2018: Annals of Vascular Surgery
Jessica M Mayor, Wilmer Valentin, Sherene Sharath, Neal R Barshes, Jayer Chung, Panos Kougias, Joseph L Mills
BACKGROUND: Despite advances in endovascular therapy, infrainguinal bypass continues to play a major role in achieving limb salvage. In this study, we sought to compare outcomes of infrainguinal bypass in patients with limb-threatening ischemia who presented with or without foot infection. METHODS: We conducted a retrospective cohort study of patients who underwent infrainguinal bypass for chronic limb-threatening ischemia at a single institution. End points of interest included long-term mortality, 45-day readmission, postoperative length of stay (LOS), major amputation, and time to wound healing...
July 28, 2018: Journal of Vascular Surgery
Evan J Ryer, Robert P Garvin, Yi Zhou, Haiyan Sun, Ahn Pham, Ksenia Orlova, James R Elmore
OBJECTIVE: Recent investigations have reported increased rates of aneurysm-related complications after endovascular aneurysm repair (EVAR) in familial abdominal aortic aneurysm (fAAA) patients. The purpose of this study was to evaluate the outcomes of open aortic repair (OAR) and EVAR in sporadic AAA (spAAA) and fAAA patients in the Society for Vascular Surgery Vascular Quality Initiative. METHODS: This was a retrospective review of all AAA repairs in the Vascular Quality Initiative from 2003 to 2017...
July 28, 2018: Journal of Vascular Surgery
Christine Espinola-Klein
Patients with peripheral artery disease are at high-risk for cardiovascular events. Anti-thrombotic treatment is very important for secondary prevention. In symptomatic patients single antiplatelet therapy with clopidogrel or Aspirin is recommended. After peripheral revascularisation transient dual antiplatelet therapy is widely used although there is only little evidence. Following peripheral bypass surgery most patients are treated with single antiplatelet therapy, in some cases (prostetic bypass grafts) dual antiplated therapy can be useful and selected patients with complex venous grafts might profit from anticoagulation with vitamin K antagonists...
August 2018: Deutsche Medizinische Wochenschrift
Piotr Kaźmierski, Mirosław Wąsiewicz, Jarosław Chrząstek, Michał Pająk
BACKGROUND: Iatrogenic vascular injuries, due to the particular nature of such pathology, are associated with high morbidity and mortality in the postoperative period. OBJECTIVES: The objective of this study was to present a case of non-classic approach to the therapy of iatrogenic arteriovenous fistula. MATERIAL AND METHODS: We present a case of a 17-year old female patient admitted to the Department of Vascular, General and Oncologic Surgery (Copernicus Memorial Hospital, Łódź, Poland) due to an iatrogenic injury to the common iliac vein and artery, following neurosurgical intervention on the spine...
July 30, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Sachin S Saboo, Murthy Chamarthy, Sanjeev Bhalla, Harold Park, Patrick Sutphin, Fernando Kay, John Battaile, Sanjeeva P Kalva
Pulmonary arteriovenous malformations (PAVMs) are rare, abnormal low resistance vascular structures that connect a pulmonary artery to a pulmonary vein, thereby bypassing the normal pulmonary capillary bed and resulting in an intrapulmonary right-to-left shunt. The spectrum of PAVMs extends from microscopic lesions causing profound hypoxemia and ground glass appearance on computed tomography (CT) but with normal catheter angiographic findings to classic pulmonary aneurysmal connections that abnormally connect pulmonary veins and arteries...
June 2018: Cardiovascular Diagnosis and Therapy
Andrea Cervi, James Demetrios Douketis
Recent years have witnessed an onslaught of large, multicenter, randomized controlled trials evaluating the prevention and management of thrombotic vascular diseases. While these trials have applied rigorous methodology to pragmatic and clinically relevant questions, several important gaps in knowledge remain. In this review, we critically appraise landmark studies in thrombosis published between 2016 and 2017 that address several ongoing areas of clinical uncertainty. Specifically, we review the role of endovascular therapy in the prevention of post-thrombotic syndrome following acute lower limb deep vein thrombosis (DVT) (ATTRACT trial), the efficacy of edoxaban as the first direct oral anticoagulant used for the treatment of cancer-associated thrombosis (HOKUSAI VTE-Cancer study), whether aspirin can be considered for thromboprophylaxis post-major orthopedic surgery (EPCAT-2 trial), and the need for anticoagulant therapy for treatment of isolated distal DVT (CACTUS trial)...
July 27, 2018: Internal and Emergency Medicine
Zhi-Yuan Wu, Zuo-Guan Chen, Yong-Peng Diao, Rui Sun, Chang-Wei Liu, Yue-Xin Chen, Yue-Hong Zheng, Bao Liu, Yong-Jun Li
AIM: This study aimed to evaluate the safety and efficiency of the sandwich technique in endovascular repair of complex aortoiliac aneurysm. METHODS: Sixteen patients (mean 69.6 years old, ranging from 58 to 78 years old) with complex aortoiliac aneurysm were studied retrospectively from October 2013 to September 2017 in two vascular centers of teaching hospitals. Computed tomography angiography (CTA) was performed to make individual therapy. They were all performed endovascular repair with sandwich technique, including one with the sandwich, chimney and fenestrated technique during the same procedure...
July 24, 2018: Annals of Vascular Surgery
C H Tam, Y C Chan, Y Law, S W Cheng
BACKGROUND: Three-dimensional (3D) printing, also known as rapid prototyping or additive manufacturing, is a novel adjunct in the medical field. The aim of this systematic review is to evaluate the role of 3D printing technology in the field of contemporary vascular surgery in terms of its technical aspect, practicability and clinical outcome. METHODS: A systematic search of literatures published from 1st January 1980 to 15th July 2017 were identified from the EMBASE, MEDLINE and Cochrane library database with reference to the PRISMA guideline...
July 24, 2018: Annals of Vascular Surgery
E Álvarez-Fuente, A Fadrique Fuentes, R Poves-Álvarez, E Gómez-Pesquera, A Hernández Lozano
Median arcuate ligament syndrome, also known as celiac artery compression syndrome, is a rare and unusual clinical disorder. Its symptoms are non-specific, which complicates its diagnosis, and a multidisciplinary approach is required to treat the disorder. The ligament is circumferentially cleared by laparoscopy. Selective angiography and endovascular techniques may be used after laparoscopy. Vital organs and important vascular structures can be injured during the surgery. The combination of different procedures, as well as the high risk of damage, make this process a significant challenge for the anaesthetist...
July 23, 2018: Revista Española de Anestesiología y Reanimación
Anthony N Hage, Ravi N Srinivasa, Jacob J Bundy, Joseph J Gemmete, Evan J Johnson, Rajiv N Srinivasa, Nishant Patel, Mamdouh Khayat, Dawn Coleman, Steven D Abramowitz, Jeffrey Forris Beecham Chick
BACKGROUND: To characterize the vascular surgery Twitter network. METHODS: A total of 20,841 consecutive tweets by 8,282 unique Twitter accounts regarding vascular surgery from October 23, 2014 to January 15, 2018 were analyzed. Twitter analytics, including activity metrics, content analysis, user characteristics, engagement, and network analysis were performed using Symplur Signals, a health care social media analytics platform. RESULTS: Vascular surgery tweets, the number of users tweeting about vascular surgery, and vascular surgery tweet impressions have increased by an annual average of 77...
July 23, 2018: Annals of Vascular Surgery
John R Potts, R James Valentine
OBJECTIVE: The objective of this study was to document trends in the performance of open arterial vascular surgery procedures (OAVP) by general surgery residents (GSR). BACKGROUND: The ACGME Review Committee for Surgery considers vascular surgery (VS) to be an "essential content area." However, the operative experience in VS for GSRs is threatened by 1) increasing numbers of GSRs, 2) increasing numbers of VS trainees, and 3) the proliferation of endovascular surgery...
July 24, 2018: Annals of Surgery
O Grip, A Wanhainen, K Michaëlsson, L Lindhagen, M Björck
BACKGROUND: Consensus is lacking regarding intervention for patients with acute lower limb ischaemia (ALI). The aim was to study amputation-free survival in patients treated for ALI by either primary open or endovascular revascularization. METHODS: The Swedish Vascular Registry (Swedvasc) was combined with the Population Registry and National Patient Registry to determine follow-up on mortality and amputation rates. Revascularization techniques were compared by propensity score matching 1 : 1...
July 25, 2018: British Journal of Surgery
Patrick C Bonasso, Melvin S Dassinger, Matthew R Smeds, Mohammed M Moursi
INTRODUCTION: Vascular surgeons infrequently care for pediatric patients. As such, variability in operative management and available hospital resources at free-standing children's hospitals may exist. The study aims were: 1) determine vascular surgeon comfort level with pediatric vascular surgery, and 2) determine variations in pediatric vascular surgery practice patterns. MATERIAL AND METHODS: A survey composed of clinical vignettes emailed to all members of Vascular and Endovascular Surgery Society was designed to assess operative management of pediatric vascular conditions and hospital resources...
July 19, 2018: Annals of Vascular Surgery
Desislava D Kostova-Lefterova, Nadelin N Nikolov, Stefan S Stanev, Boyka B Stoyanova
OBJECTIVE: Hybrid surgical methods such as remote endarterectomy and endovascular revascularization are fluoroscopy-guided procedures successfully replacing conventional open surgery for treatment of peripheral artery disease (PAD). The aim of this study was to: (1) evaluate the dose parameters describing exposure of patients undergoing endovascular or hybrid revascularization of the lower limb (below the inguinal ligament); (2) compare the data available in the literature with the evaluations of patients' dose values and related factors for patients undergoing such procedures; (3) examine the correlation of doses with certain parameters; (4) estimate the peak skin dose and assess the potential for radiation induced skin injuries during the procedures...
July 20, 2018: British Journal of Radiology
Nitin Agarwal, Michael D White, Jonathan Cohen, L Dade Lunsford, D Kojo Hamilton
OBJECTIVE The purpose of this study was to analyze national trends in adult cranial cases performed by neurological surgery residents as logged into the Accreditation Council for Graduate Medical Education (ACGME) system. METHODS The ACGME resident case logs were retrospectively reviewed for the years 2009-2017. In these reports, the national average of cases performed by graduating residents is organized by year, type of procedure, and level of resident. These logs were analyzed in order to evaluate trends in residency experience with adult cranial procedures...
July 13, 2018: Journal of Neurosurgery
Hyejin Mo, Sungsin Cho, Hwan Jun Jae, Seung-Kee Min
A 57-year-old woman presented to vascular surgery clinic with visceral artery aneurysms that were incidentally detected during regular check-up. Imaging studies revealed occlusion of the celiac axis and severe stenosis of the superior mesenteric artery and 3 aneurysms along the posterior and inferior pancreaticoduodenal arteries, as well as the right gastroepiploic artery. Endovascular embolization of all aneurysms was rejected because of the risk of hepatic ischemia. These complicated lesion caused by polyarteritis nodosa were successfully treated using a hybrid operation with coil embolization, aneurysm resection, and antegrade aorto-celiac-superior mesentery artery bypass...
June 2018: Vascular Specialist International
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