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Ultrasound angioplasty surveillance

Aleksandra Policha, Melissa Baldwin, Victoria Lee, Mark A Adelman, Caron Rockman, Todd Berland, Neal S Cayne, Thomas S Maldonado
BACKGROUND: Reversal of flow in the vertebral artery (RFVA) is an uncommon finding on cerebrovascular duplex ultrasound examination. The clinical significance of RFVA and the natural history of patients presenting with it are poorly understood. Our objective was to better characterize the symptoms and outcomes of patients presenting with RFVA. METHODS: A retrospective review was performed of all cerebrovascular duplex ultrasound studies performed at our institution between January 2010 and January 2016 (N = 2927 patients)...
February 2018: Journal of Vascular Surgery
Ravi Patel, Jeevan Mahaveer, Nasim Tahir, Sanjay Rajwal, Patricia McClean, Jai V Patel
INTRODUCTION: Percutaneous transluminal angioplasty (PTA), with or without stent placement, has become the treatment of choice for portal vein complications (PVC) following liver transplantation. We aimed to assess long-term outcomes of intervention in paediatric transplant recipients, in a single institution. MATERIALS AND METHODS: 227 children received 255 transplants between November 2000 and September 2016. 30 patients developed PVC of whom 21 had percutaneous intervention...
January 2018: Cardiovascular and Interventional Radiology
Leighton E Goldsmith, Kristy Wiebke, John Seal, Clayton Brinster, Taylor A Smith, Hernan A Bazan, W Charles Sternbergh
BACKGROUND: Hepatic artery stenosis (HAS) after liver transplantation can progress to hepatic artery thrombosis (HAT) and a subsequent 30% to 50% risk of graft loss. Although endovascular treatment of severe HAS after liver transplantation has emerged as the dominant method of treatment, the potential risks of these interventions are poorly described. METHODS: A retrospective review of all endovascular interventions for HAS after liver transplantation between August 2009 and March 2016 was performed at a single institution, which has the largest volume of liver transplants in the United States...
November 2017: Journal of Vascular Surgery
Karen J Ho, Phillip M Devlin, Arin L Madenci, Marcus E Semel, Edwin C Gravereaux, Louis L Nguyen, Michael Belkin, Matthew T Menard
OBJECTIVE: Historically, edge stenosis and late thrombosis limited the effectiveness of adjunctive endovascular brachytherapy (EVBT) for in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) and stenting. We evaluated an updated protocol of PTA and EVBT for ISR among patients with lower extremity occlusive disease. METHODS: This is a retrospective, single-center review of patients treated with PTA and EVBT for ISR in the iliac and femoropopliteal segments between 2004 and 2012...
March 2017: Journal of Vascular Surgery
Maria Guedes-Marques, Pedro A Maia, Fernando Neves, Aníbal Ferreira, João Cruz, Dulce Carvalho, Carlos Oliveira, Carlos Barreto, Telmo Carvalho, Pedro Ponce
BACKGROUND: Kidney Disease - Improving Global Outcomes (KDIGO) recommends post-percutaneous transluminal angioplasty (PTA) <30% residual stenosis (RS) and hemodynamic parameters improvement. Primary end point: how post-PTA access blood flow (ABF) improvement predicts vascular access (VA) outcome. Secondary: compare Doppler ultrasound (DU) and angiography diagnostic accuracy; determine how other factors predict outcome. METHODS: Eighty patients. DU evaluation performed pre- and post-PTA...
November 2, 2016: Journal of Vascular Access
Rukshana Shroff, Rosalie B Sterenborg, Adam Kuchta, Andrew Arnold, Nicholas Thomas, Lynsey Stronach, Soundrie Padayachee, Francis Calder
BACKGROUND: Arteriovenous fistula (AVF) formation for long-term haemodialysis in children is a niche discipline with little data for guidance. We developed a dedicated Vascular Access Clinic that is run jointly by a transplant surgeon, paediatric nephrologist, dialysis nurse and a clinical vascular scientist specialised in vascular sonography for the assessment and surveillance of AVFs. We report the experience and 2-year outcomes of this clinic. METHODS: Twelve new AVFs were formed and 11 existing AVFs were followed up for 2 years...
December 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Christopher M Faries, Rami O Tadros, Paul S Lajos, Ageliki G Vouyouka, Peter L Faries, Michael L Marin
OBJECTIVE: The purpose of this study was to report the presentation, treatment, and follow-up of isolated infrarenal aortic dissections. METHODS: A review of 37 patients with isolated infrarenal aortic dissections was performed. Computed tomography scans with intravenous administration of contrast material were examined for all patients; catheter-based angiography, magnetic resonance angiography, and duplex ultrasound were used selectively. In dissections associated with the development of abdominal aortic aneurysm (AAA), the aneurysm growth rate was determined by measuring the change in maximum aneurysm diameter over time and dividing that by the duration of observation...
November 2016: Journal of Vascular Surgery
K Mathur, R K Vohra, J Hodson, S Kuyumdzhiev, M J Duddy, J D Hopkins
OBJECTIVE: Graft angioplasty combines the durability and ability of surgical bypasses to treat long arterial occlusions with the minimally invasive nature of endovascular procedures. The purpose of this study was to evaluate the efficacy of single and repeated graft angioplasty in revising failing infrainguinal vein bypass grafts and to determine predictors of medium- and long-term freedom from revision after graft angioplasty. METHOD: This was a retrospective analysis from a prospectively maintained database...
August 2016: European Journal of Vascular and Endovascular Surgery
Raffaella Mauro, Rodolfo Pini, Gianluca Faggioli, Gabriele Donati, Maria Grazia Facchini, Rosalinda D'Amico, Antonio Freyrie, Mauro Gargiulo, Andrea Stella
BACKGROUND: Arteriovenous prosthetic graft (AVG) is an alternative hemodialysis vascular access choice; however, its performance is limited by a high rate of thrombosis. The aim of the study was to compare the long-term secondary patency of AVG in patients undergoing a surveillance program and the long-term secondary patency of AVG in patients with clinical assessment of AVG malfunction. METHODS: From 2009 to 2012, all patients with AVG entered in a duplex ultrasound (DUS) surveillance program (at 3 months and then every 6 months postoperatively) to assess AVG malfunction and/or stenosis (stenosis >50% and blood flow decrease [<600 mL/min]) and eventually treated by endovascular revascularization...
August 2015: Annals of Vascular Surgery
Michael Allon
Arteriovenous grafts (AVGs) are prone to frequent thrombosis that is superimposed on underlying hemodynamically significant stenosis, most commonly at the graft-vein anastomosis. There has been great interest in detecting AVG stenosis in a timely fashion and performing preemptive angioplasty, in the belief that this will prevent AVG thrombosis. Three surveillance methods (static dialysis venous pressure, flow monitoring, and duplex ultrasound) can detect AVG stenosis. Whereas observational studies have reported that surveillance with preemptive angioplasty substantially reduces AVG thrombosis, randomized clinical trials have failed to confirm such a benefit...
December 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Ramon L Varcoe, Olaf Schouten, Shannon D Thomas, Andrew F Lennox
PURPOSE: To investigate a new bioresorbable vascular scaffold for the treatment of focal tibial and distal popliteal lesions. METHODS: Tibial and distal popliteal angioplasty was performed in 15 limbs of 14 patients (9 men; median age 82 years) with critical limb ischemia (CLI, n=7) or severe claudication. The 18 lesions (mean length 22.2±14.0 mm) were implanted with 22 everolimus-eluting bioresorbable scaffolds (Absorb). Clinical and ultrasound follow-up was performed at 1, 3, 6, and 12 months to detect restenosis and evaluate safety, midterm restenosis rate, and clinical improvement...
April 2015: Journal of Endovascular Therapy
Haitham Ali, Ahmed Elbadawy, Mahmoud Saleh, Ayman Hasaballah
OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of balloon angioplasty as the primary method of intervention in patients with color duplex ultrasound documented failing bypass grafts and to determine factors that may affect the patency of lower extremity bypass grafts revised by percutaneous transluminal angioplasty (PTA). METHODS: All consecutive patients who underwent lower extremity bypass grafts from January 2009 to December 2013 were enrolled in a graft surveillance program...
July 2015: Journal of Vascular Surgery
Lee Lian Chew, Bien Soo Tan, Krishna Kumar, Maung Myint Htoo, Kok Seng Wong, Christopher W S Cheng, Terence K B Teo, Farah Gillani Irani, Hui Lin Choong, Kiang Hiong Tay
INTRODUCTION: This study aimed to assess the outcome of percutaneous transluminal angioplasty (PTA) as the primary treatment for transplant renal artery stenosis (TxRAS). MATERIALS AND METHODS: A retrospective review of PTA of TxRAS from April 1999 to December 2008 was performed. Twenty-seven patients (17 males (M):10 females (F)) with the mean age of 49.5 years underwent PTA of TxRAS in the review period. Indications for PTA were suboptimal control of hypertension (n=12), impaired renal function (n=6) and both suboptimal control of hypertension and impaired renal function (n=9)...
January 2014: Annals of the Academy of Medicine, Singapore
Vimalraj Boganashanmugam, Peter J Psaltis, Paul Antonis
Management of acute thrombotic occlusion of coronary artery aneurysms is challenging with a lack of randomized trial evidence. We report an unusual case of a 30-year-old Indian Australian male who presented with an extensive anterior STEMI because of very large thrombus burden in a dilated proximal left anterior descending artery. A relatively conservative treatment approach comprising emergency aspiration thrombectomy and ongoing infusion of glycoprotein IIb/IIIa inhibitor, guided by surveillant inpatient angiography and intravascular ultrasound, helped achieve a satisfactory outcome in a complex setting in which percutaneous coronary angioplasty and stenting were not desirable...
November 15, 2016: Catheterization and Cardiovascular Interventions
Patrick E Casey, Charles J Miranda, Haytham Al-Khaffaf, Peter M Woodhead
PURPOSE: A surveillance duplex scan detected a stenosis within a left groin hemodialysis loop graft in a 57-year-old woman who was allergic to both iohexol and gadolinium contrast agents. This precluded the use of standard angioplasty treatment techniques. Intravascular ultrasound (IVUS) uses a catheter mounted with a miniaturized ultrasound probe to produce detailed cross-sectional vessel images. Clinically, it has been used in the assessment of coronary artery disease but has also supplemented standard angiography techniques in the assessment of peripheral vascular and hemodialysis access lesions...
September 2014: Journal of Vascular Access
Blake A Hamby, Daniel E Ramirez, George E Loss, Hernan A Bazan, Taylor A Smith, Edward Bluth, W Charles Sternbergh
BACKGROUND: Hepatic artery stenosis (HAS) after orthotopic liver transplantation is a significant risk factor for subsequent hepatic artery thrombosis (HAT). HAT is associated with a 30%-50% risk of liver failure culminating in retransplantation or death. Traditional treatment of hepatic artery complications has been surgical, with hepatic artery revision or retransplantation. Endovascular therapy of HAS, described primarily in the interventional radiology literature, may provide a less-invasive treatment option...
April 2013: Journal of Vascular Surgery
Donald T Baril, Luke K Marone
Surveillance following lower extremity bypass, carotid endarterectomy, and endovascular aortic aneurysm repair has become the standard of care at most institutions. Conversely, surveillance following lower extremity endovascular interventions is performed somewhat sporadically in part because the duplex criteria for recurrent stenoses have been ill defined. It appears that duplex surveillance after peripheral endovascular interventions, as with conventional bypass, is beneficial in identifying recurrent lesions which may preclude failure and occlusion...
July 2012: Vascular and Endovascular Surgery
Jaroslav Kudlicka, Jan Kavan, Vladimir Tuka, Jan Malik
PURPOSE: Patency of mature vascular access for hemodialysis is mostly limited by the growing stenoses leading to acute access thrombosis. The therapy of choice is usually percutaneous balloon angioplasty (PTA). However, PTA injures the vessel wall and subsequent re-stenosis develops faster than de novo stenosis. Therefore, the key is in appropriate timing of PTA procedures--as late as possible but before access thrombosis develops. Ultrasonography combines the morphologic and functional access assessment, but the former is less precise than angiography...
July 2012: Journal of Vascular Access
Trung D Bui, Joseph L Mills, Daniel M Ihnat, Angelika C Gruessner, Kaoru R Goshima, John D Hughes
OBJECTIVE: Duplex ultrasound (DU) surveillance (DUS) criteria for vein graft stenosis and thresholds for reintervention are well established. The natural history of DU-detected stenosis and the threshold criteria for reintervention in patients undergoing endovascular therapy (EVT) of the femoropopliteal system have yet to be determined. We report an analysis of routine DUS after infrainguinal EVT. METHODS: Consecutive patients undergoing EVT of the superficial femoral artery (SFA) or popliteal artery were prospectively enrolled in a DUS protocol (≤1 week after intervention, then at 3, 6, and 12 months thereafter)...
February 2012: Journal of Vascular Surgery
Gautam V Shrikhande, Ashley R Graham, Ritu Aparajita, Kathy A Gallagher, Nicholas J Morrissey, James F McKinsey, Rajeev Dayal
BACKGROUND: Studies examining duplex surveillance of lower extremity bypass grafts have defined a role for guiding graft re-intervention. The goal of this study is to determine the utility of duplex scanning to detect angiographic restenosis after endovascular therapy in patients with infrainguinal arterial disease. METHODS: A prospective registry including all patients treated for lower extremity atherosclerotic disease between February 2004 and September 2008 was established...
May 2011: Annals of Vascular Surgery
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