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https://www.readbyqxmd.com/read/28794007/the-future-of-resuscitative-endovascular-balloon-occlusion-in-combat-operations
#1
Shane A Smith, R Hilsden, A Beckett, V C McAlister
Damage control resuscitation and early thoracotomy have been used to increase survival after severe injury in combat. There has been a renewed interest in resuscitative endovascular balloon occlusion of the aorta (REBOA) in both civilian and military medical practices. REBOA may result in visceral and limb ischaemia that could be harmful if use of REBOA is premature or prolonged. The purpose of this paper is to align our experience of combat injuries with the known capability of REBOA to suggest an implementation strategy for the use of REBOA in combat care...
August 9, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28737565/use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-a-multidisciplinary-approach
#2
Carolina Nilsson, Linda Bilos, Tal Hörer, Artai Pirouzram
The usage of resuscitative endovascular balloon occlusion of the aorta, also known as aortic balloon occlusion, is an emerging method for bleeding control as a bridge to definitive treatment in trauma management. We describe a trauma case where resuscitative endovascular balloon occlusion of the aorta was used as part of the EndoVascular hybrid Trauma and bleeding Management concept to facilitate transient hemorrhage control and thereby to permit damage control surgery. The case is an illustration of the adoption of a multidisciplinary approach...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28721011/effect-of-picroside-ii-on-hind-limb-ischemia-reperfusion-injury-in-rats
#3
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28699660/binding-of-indocyanine-green-in-polycaprolactone-fibers-using-blend-electrospinning-for-in-vivo-laser-assisted-vascular-anastomosis
#4
Annemarie Schönfeld, Zacharia Mbäıdjol Kabra, Mihai Constantinescu, Dieter Bosshardt, Michael H Stoffel, Kirsten Peters, Martin Frenz
BACKGROUND AND OBJECTIVE: The clinical application of laser-assisted vascular anastomosis is afflicted by unreliable and low bonding strengths as well as tedious handling during microvascular surgery. The challenge to be met arises from the flow-off of the chromophore during soldering that changes the absorption and stains the surrounding tissue, leading to an uncontrollable thermal damage zone. In this study, we investigated the feasibility to produce an indocyanine green (ICG)-loaded patch by electrospinning and tested its applicability to both in vitro and in vivo microvascular laser soldering...
July 12, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28525553/evaluation-of-conventional-and-frozen-elephant-trunk-techniques-on-spinal-cord-blood-flow-in-an-animal-model%C3%A2
#5
Sergey Leontyev, Maja-Theresa Dieterlen, Michelle Halling, Franziska Schlegel, Alexandro Hoyer, Susann Ossmann, Kerstin Klaeske, Christian D Etz, Friedrich W Mohr
OBJECTIVES: The treatment of patients with extensive thoracic aortic disease involving the arch and descending aorta is often performed using the frozen elephant trunk technique (FET). Spinal cord blood flow (SCBF) in cervical, thoracic and lumbar sections prior, during and after aortic arch surgery were compared in conventional elephant trunk (cET) and FET technique in a pig model. METHODS: German Landrace pigs (75-85 kg) underwent aortic arch surgery using the FET ( n  = 8) or cET ( n  = 8) techniques...
May 18, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28481992/iatrogenic-subintimal-aortic-dissection-that-disappeared-without-a-trace
#6
Kazumasa Orihashi, Kazuki Kihara, Masaki Yamamoto, Hideaki Nishimori
A case of an unusual iatrogenic aortic dissection is reported. A 77-year-old male patient in shock status due to acute type A aortic dissection underwent emergency surgery. Systemic perfusion was started via the femoral artery, but another dissection appeared in the descending aorta detected by transoesophageal echocardiography. However, the flap was unusually thin, and there was no change in the pre-existing thrombosed false lumen. These findings suggested subintimal development of dissection. After systemic perfusion was promptly switched to antegrade perfusion, the new dissection could no longer be detected...
May 6, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28465982/a-detailed-study-of-multiple-vascular-variations-in-the-upper-part-of-abdomen
#7
Prakashchandra Shetty, Satheesha B Nayak
INTRODUCTION: Knowledge of vascular variations near the kidney is of importance to many clinical disciplines such as nephrologists, radiologists, gastroenterologists, and general surgeons. Variant branches of the abdominal aorta and renal arteries are the victims of iatrogenic bleeding during surgery. We found multiple vascular variations in the upper part of the abdomen during our dissection classes. METHODS: During the dissection classes of the abdomen for undergraduate medical students, we observed multiple vascular variations in the abdomen of an adult male cadaver...
January 2017: Journal of Cardiovascular Echography
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#8
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28185953/a-novel-smad3-mutation-caused-multiple-aneurysms-in-a-patient-without-osteoarthritis-symptoms
#9
Audrey Courtois, Wouter Coppieters, Vincent Bours, Jean-Olivier Defraigne, Alain Colige, Natzi Sakalihasan
Heterozygous mutations in the SMAD3 gene were recently described as the cause of a form of non-syndromic familial aortic thoracic aneurysm and dissection (FTAAD) transmitted as an autosomal dominant disorder and often associated with early-onset osteoarthritis. This new clinical entity, called aneurysms-osteoarthritis syndrome (AOS) or Loeys-Dietz syndrome 3 (LDS3), is characterized by aggressive arterial damages such as aneurysms, dissections and tortuosity throughout the arterial tree. We report, here, the case of a 45 year-old man presenting multiple visceral arteries and abdominal aortic aneurysms but without dissection of the thoracic aorta and without any sign of osteoarthritis...
April 2017: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/28166165/automated-variable-aortic-control-versus-complete-aortic-occlusion-in-a-swine-model-of-hemorrhage
#10
Timothy K Williams, Lucas P Neff, Michael Austin Johnson, Rachel M Russo, Sarah-Ashley Ferencz, Anders J Davidson, Nathan F Clement, John Kevin Grayson, Todd E Rasmussen
BACKGROUND: Future endovascular hemorrhage control devices will require features that mitigate the adverse effects of vessel occlusion. Permissive regional hypoperfusion (PRH) with variable aortic control (VAC) is a novel strategy to minimize hemorrhage and reduce the ischemic burden of complete aortic occlusion (AO). The objective of this study was to compare PRH with VAC to AO in a lethal model of hemorrhage. METHODS: Twenty-five swine underwent cannulation of the supraceliac aorta, with diversion of aortic flow through an automated extracorporeal circuit...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28123428/key-genes-expressed-in-different-stages-of-spinal-cord-ischemia-reperfusion-injury
#11
Jian-An Li, Chun-Fang Zan, Peng Xia, Chang-Jun Zheng, Zhi-Ping Qi, Chun-Xu Li, Zhi-Gang Liu, Ting-Ting Hou, Xiao-Yu Yang
The temporal expression of microRNA after spinal cord ischemia/reperfusion injury is not yet fully understood. In the present study, we established a model of spinal cord ischemia in Sprague-Dawley rats by clamping the abdominal aorta for 90 minutes, before allowing reperfusion for 24 or 48 hours. A sham-operated group underwent surgery but the aorta was not clamped. The damaged spinal cord was removed for hematoxylin-eosin staining and RNA extraction. Neuronal degeneration and tissue edema were the most severe in the 24-hour reperfusion group, and milder in the 48-hour reperfusion group...
November 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/27918332/isoflurane-impairs-motor-function-recovery-by-increasing-neuroapoptosis-and-degeneration-during-spinal-ischemia-reperfusion-injury-in-rats
#12
Shih-Yuan Fang, Jung-Shun Lee, Jun-Neng Roan, Yu-Chuan Tsai, Chen-Fuh Lam
BACKGROUND: Spinal cord ischemia (SCI) leads to variable degrees of neurologic deficit in patients undergoing major cardiovascular surgery. The effect of intraoperative neuroprotection against SCI and the subsequent ischemia-reperfusion injury is still limited. Because isoflurane is a commonly used anesthetic agent during major operation, and its neuroprotective and neurotoxicity effects have both been discussed, this study aimed to investigate the effect of isoflurane on the spinal cord's functional recovery in a rat model of cord ischemia...
January 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27913135/mycophenolate-mofetil-attenuates-uterine-ischaemia-reperfusion-injury-in-a-rat-model
#13
Gulcin Sahin Ersoy, Meryem Kurek Eken, Ozge Cevik, Ozlem T Cilingir, Reshef Tal
This study evaluated the effect of mycophenolate mofetil (MMF) on uterine tissue preservation following ischaemia/reperfusion (I/R) injury. Uterine I/R injury was induced in rats by clamping the lower abdominal aorta and ovarian arteries for 30 min. Group I/R + V (n = 7) received vehicle alone while Group I/R + M (n = 7) received 20 mg/kg/day MMF. Control groups underwent sham surgery and received vehicle (Group C) or 20 mg/kg/day MMF (Group M) (n = 7 for both). Four hours after detorsion, uterine tissue 8-hydroxy-2'-deoxyguanosine (8-OHdG), glutathione, malondialdehyde (MDA), myeloperoxidase (MPO), superoxide dismutase (SOD) and serum ischaemia modified albumin (IMA) concentrations were measured...
February 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/27887010/technical-note-rapid-large-volume-resuscitation-at-resuscitative-thoracotomy-by-intra-cardiac-catheterization
#14
Shamir O Cawich, Vijay Naraynsingh
An emergency thoracotomy may be life-saving by achieving four goals: (i) releasing cardiac tamponade, (ii) controlling haemorrhage, (iii) allowing access for internal cardiac massage and (iv) clamping the descending aorta to isolate circulation to the upper torso in damage control surgery. We theorize that a new goal should be achieving rapid, large-volume fluid resuscitation and we describe a technique to achieve this.
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27847799/clinical-importance-of-congenital-anomalies-of-the-inferior-vena-cava-in-organ-procurement-surgery-from-a-deceased-donor-two-case-reports
#15
Mi-Hyeong Kim, Kang-Woong Jun, In-Sung Moon, Ji-Il Kim
Congenital anomalies of the inferior vena cava (IVC) are rare but important problems in living donors for kidney transplantation, especially in cases of a short left renal vein and accompanying vascular and urological anatomic variations. However, the clinical impacts of IVC anomalies in deceased donors have yet to be reported. The unexpected presence of an IVC in an unusual position poses challenges to surgeons and increases the risk of bleeding during organ removal. Accompanying vascular variations can cause unexpected bleeding and injury and therefore technical complications in procurement and subsequent implantation...
November 2016: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/27602083/protective-effect-of-shenfu-injection-preconditioning-on-lung-ischemia-reperfusion-injury
#16
Hong Zhang, Zhanhai Wan, Xiang Yan, De-Gui Wang, Yufang Leng, Yongqiang Liu, Yan Zhang, Haijun Zhang, Xuena Han
Lung ischemia-reperfusion injury remains a problem in thoracic surgery, as minimal progress has been made concerning its prevention and control. In the present study, the protective effects and the underlying mechanism of Shenfu injection preconditioning on a rat lung ischemia-reperfusion model was investigated. Shenfu injection is a well-known Chinese traditional medicine, which is composed of Red Radix Ginseng and Radix Aconitum carmichaelii, with ginseng saponin and aconitum alkaloids as the active ingredients...
September 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27581114/gluteal-compartment-syndrome-following-abdominal-aortic-aneurysm-treatment-case-report-and-review-of-the-literature
#17
Emanuela Viviani, Anna Maria Giribono, Donatella Narese, Doriana Ferrara, Giuseppe Servillo, Luca Del Guercio, Umberto Marcello Bracale
Compartment syndrome (CS) is a pathological increase of the interstitial pressure within the closed osseous fascial compartments. Trauma is the most common cause, followed by embolization, burns, and iatrogenic injuries; it usually involves the limbs. The major issue when dealing with CS is the possibility to do an early diagnosis in order to intervene precociously, through a fasciotomy, reducing the risk of tissue, vascular and nervous damage. Although it is an infrequent condition, it is potentially life threatening...
December 2016: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/27440162/aortic-dissection
#18
REVIEW
Christoph A Nienaber, Rachel E Clough, Natzi Sakalihasan, Toru Suzuki, Richard Gibbs, Firas Mussa, Michael T Jenkins, Matt M Thompson, Arturo Evangelista, James S M Yeh, Nicholas Cheshire, Ulrich Rosendahl, John Pepper
Aortic dissection is a life-threatening condition caused by a tear in the intimal layer of the aorta or bleeding within the aortic wall, resulting in the separation (dissection) of the layers of the aortic wall. Aortic dissection is most common in those 65-75 years of age, with an incidence of 35 cases per 100,000 people per year in this population. Other risk factors include hypertension, dyslipidaemia and genetic disorders that involve the connective tissue, such as Marfan syndrome. Swift diagnostic confirmation and adequate treatment are crucial in managing affected patients...
July 21, 2016: Nature Reviews. Disease Primers
https://www.readbyqxmd.com/read/27179206/circulating-endothelial-microparticles-are-elevated-in-bicuspid-aortic-valve-disease-and-related-to-aortic-dilation
#19
Josep M Alegret, Neus Martínez-Micaelo, Gerard Aragonès, Raúl Beltrán-Debón
BACKGROUND/OBJECTIVES: The mechanisms underlying aortic dilation in bicuspid aortic valve (BAV) disease are unknown. Circulating endothelial microparticles (EMPs) have emerged as biomarkers of endothelial damage. We sought to evaluate the relationships among EMPs, BAV disease, and aortic dilation. METHODS: Four evaluations were used. Circulating EMPs (PECAM(+), E-selectin(+)) were compared between BAV patients and tricuspid aortic valve (TAV) control subjects. The variables related to circulating EMPs were investigated in BAV patients...
August 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27070441/extending-resuscitative-endovascular-balloon-occlusion-of-the-aorta-endovascular-variable-aortic-control-in-a-lethal-model-of-hemorrhagic-shock
#20
Timothy Keith Williams, Lucas P Neff, Michael Austin Johnson, Sarah-Ashley Ferencz, Anders J Davidson, Rachel M Russo, Todd E Rasmussen
BACKGROUND: The duration of use and efficacy of resuscitative endovascular balloon occlusion of the aorta (REBOA) is limited by distal ischemia. We developed a hybrid endovascular-extracorporeal circuit variable aortic control (VAC) device to extend REBOA duration in a lethal model of hemorrhagic shock to serve as an experimental surrogate to further the development of endovascular VAC (EVAC) technologies. METHODS: Nine Yorkshire-cross swine were anesthetized, instrumented, splenectomized, and subjected to 30% liver amputation...
August 2016: Journal of Trauma and Acute Care Surgery
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