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https://www.readbyqxmd.com/read/29148007/how-to-treat-arteriovenous-graft-infection-total-versus-partial-graft-excision
#1
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/29147169/uncomplicated-acute-type-b-aortic-dissection-selection-guidelines-for-tevar
#2
Emilia Krol, Jean M Panneton
Traditionally, the surgical management of acute type B aortic dissections was reserved for patients with signs of malperfusion, rapid expansion, retrograde dissection or rupture. The adjunct of endovascular techniques has brought a paradigm shift, leaning towards preventing long term dissection complications. Multiple risk factors have been proposed to identify patients at risk for long term aortic complications. The patients, who are offered a prophylactic endovascular therapy for uncomplicated aortic dissection, should be selected carefully, and offered intervention by an experienced team in a high-volume center...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147155/endovascular-stent-graft-repair-of-a-persistent-sciatic-artery-aneurysm
#3
Hayato Fukuda, Seiji Onitsuka, Shohei Yoshida, Yuichiro Hirata, Shinichi Hiromatsu, Hiroyuki Tanaka
Persistent sciatic artery (PSA) is a rare anomaly that may cause various symptoms, such as aneurysm, rupture, thromboembolism, and sciatica. Direct surgery can be performed to treat PSA aneurysm (PSAA), but is associated with complications; e.g., anatomical problems such as sciatic nerve injury. Herein we report a case of a 74-year-old woman with acute limb ischemia that developed from a distal embolism caused by a thrombus in the left PSAA; favorable results were obtained for her by treatment with a stent-graft after rapid anticoagulation therapy for limb salvage...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147149/endovascular-treatment-of-infrarenal-isolated-abdominal-aortic-dissection-with-application-of-the-kissing-stents-technique-a-case-report-and-review-of-the-literature
#4
Georgios Sahsamanis, Georgios Vourliotakis, Konstantinos Maltezos, Georgios Plakas, Vasileios Tzilalis
Isolated abdominal aortic dissection (IAAD) is a rare form of aortic dissection involving usually the infrarenal part of the abdominal aorta. A 45-year-old male presented with lumbar pain and claudication. Computed tomography angiography (CTA) revealed an infrarenal IAAD extending to the left external iliac artery (EIA), causing ≥90% narrowing of the lumen. An endovascular approach was decided, with deployment of an aortic stent-graft and two balloon expandable stents in both common iliac arteries (IAs), applying the kissing stents technique...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146873/mobile-interventional-stroke-teams-lead-to-faster-treatment-times-for-thrombectomy-in-large-vessel-occlusion
#5
Daniel Wei, Thomas J Oxley, Dominic A Nistal, Justin R Mascitelli, Natalie Wilson, Laura Stein, John Liang, Lena M Turkheimer, Jacob R Morey, Claire Schwegel, Ahmed J Awad, Hazem Shoirah, Christopher P Kellner, Reade A De Leacy, Stephan A Mayer, Stanley Tuhrim, Srinivasan Paramasivam, J Mocco, Johanna T Fifi
BACKGROUND AND PURPOSE: Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model...
November 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29146829/is-bridging-therapy-still-required-in-stroke-due-to-carotid-artery-terminus-occlusions
#6
Romain Bourcier, Pierre-Louis Alexandre, François Eugène, Béatrice Delasalle-Guyomarch, Benoit Guillon, Basile Kerleroux, Suzana Saleme, Gaultier Marnat, Samy Boucebci, Mahmood Mirza, Jean-Christophe Ferré, Chrysanthi Papagiannaki, Hubert Desal
INTRODUCTION: Studies comparing endovascular stroke treatment using mechanical thrombectomy (MT) with or without prior IV tissue plasminogen activator (tPa) have included only 30% of internal carotid artery terminus occlusions (ICA-O), a known predictor of recanalization failure with IV tPa. OBJECTIVE: To carry out a retrospective multicenter analysis of prospectively collected data of consecutive patients to investigate the impact of intravenous thrombolysis on ICA-O by comparing patients treated with MT alone or bridging therapy (BT)...
November 16, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29146434/cerebral-hyperperfusion-syndrome-after-endovascular-reperfusion-therapy-in-a-patient-with-acute-internal-carotid-artery-and-middle-cerebral-artery-occlusions
#7
Tetsuya Hashimoto, Shoji Matsumoto, Mitsushige Ando, Hideo Chihara, Atsushi Tsujimoto, Taketo Hatano
BACKGROUND: Cerebral hyperperfusion syndrome (CHS) is known to be a rare but devastating complication of carotid artery revascularization. Because patients with acute ischemic stroke due to acute major cerebral and/or cervical artery occlusion treated with endovascular reperfusion therapy may have impaired autoregulation in the cerebral vasculature, these patients may also develop CHS. Despite the growing number of endovascular reperfusion procedures for acute ischemic stroke, this complication has only rarely been reported...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29145350/ultrasonographic-evaluation-of-complications-related-to-transfemoral-arterial-procedures
#8
Eun Ju Chun
The transfemoral arterial approach is used to gain access for angiography, percutaneous coronary interventions, or various endovascular therapies. To decrease the risk of procedure-related vascular complications, it is recommended to puncture the common femoral artery in its middle segment. However, due to inadequate access or anatomical variability, various complications, including hematoma, pseudoaneurysm, arteriovenous fistula, thrombosis, or dissection, can occur after transfemoral arterial interventions...
August 25, 2017: Ultrasonography
https://www.readbyqxmd.com/read/29145276/endovascular-stenting-of-spontaneous-isolated-dissection-of-the-superior-mesenteric-artery-a-case-report-and-literature-review
#9
Dong-Na Gao, Qing-Hui Qi, Ping Gong
RATIONALE: Spontaneous isolated dissection of the superior mesenteric artery (SID-SMA) is a rare arterial disease that is difficult to differentiate from other diseases because of lack of specific clinical manifestation and for which there is no available optimal management strategy. PATIENT CONCERNS: A 58-year-old male patient visited our emergency room with sudden onset of moderate-severe epigastric abdominal pain of uncertain cause. DIAGNOSES: Computed tomography scanning showed a characteristic "double lumen sign" of the superior mesenteric artery, and further computed tomography angiography findings revealed a dissected segment of the superior mesenteric artery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29143147/-esc-guidelines-2017-on-peripheral-arterial-diseases-summary-of-the-most-important-recommendations-and-innovations
#10
C Espinola-Klein
The current European Society of Cardiology (ESC) guidelines on peripheral arterial diseases include recommendations on diagnostics and treatment of atherosclerotic manifestations in peripheral arteries. Because of the high coincidence of atherosclerosis in different arterial territories, screening for other atherosclerotic lesions is necessary in patients with clinical symptoms in one vascular bed. Consistent treatment of cardiovascular risk factors is important in all patients with peripheral atherosclerosis...
November 15, 2017: Herz
https://www.readbyqxmd.com/read/29140184/refining-the-ischemic-penumbra-with-topography
#11
Tharani Thirugnanachandran, Henry Ma, Shaloo Singhal, Lee-Anne Slater, Stephen M Davis, Geoffrey A Donnan, Thanh Phan
It has been 40 years since the ischemic penumbra was first conceptualized through work on animal models. The topography of penumbra has been portrayed as an infarcted core surrounded by penumbral tissue and an extreme rim of oligemic tissue. This picture has been used in many review articles and textbooks before the advent of modern imaging. In this paper, we review our understanding of the topography of the ischemic penumbra from the initial experimental animal models to current developments with neuroimaging which have helped to further define the temporal and spatial evolution of the penumbra and refine our knowledge...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29137089/a-case-report-of-takayasu-arteritis-with-aortic-dissection-as-initial-presentation
#12
JiGuang Guo, GuoWu Zhang, Dan Tang, JianBin Zhang
RATIONALE: The initial symptoms and signs of Takayasu arteritis vary due to the heterogeneity of affected vessels. Moreover, the vascular lesions are difficult to detect at initial presentation, making diagnosis even more challenging. Although cases of aortic dissection with arteritis history have been reported, Takayasu arteritis in men with aortic dissection as initial presentation is very rare. PATIENT CONCERNS: A 37-year-old man presenting with persistent chest and back pain for 6 days was transferred to our hospital for further treatment...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135347/relative-cerebral-blood-volume-is-associated-with-collateral-status-and-infarct-growth-in-stroke-patients-in-swift-prime
#13
Juan F Arenillas, Elisa Cortijo, Pablo García-Bermejo, Elad I Levy, Reza Jahan, Mayank Goyal, Jeffrey L Saver, Gregory W Albers
We aimed to evaluate how predefined candidate cerebral perfusion parameters correlate with collateral circulation status and to assess their capacity to predict infarct growth in patients with acute ischemic stroke (AIS) eligible for endovascular therapy. Patients enrolled in the SWIFT PRIME trial with baseline computed tomography perfusion (CTP) scans were included. RAPID software was used to calculate mean relative cerebral blood volume (rCBV) in hypoperfused regions, and hypoperfusion index ratio (HIR). Blind assessments of collaterals were performed using CT angiography in the whole sample and cerebral angiogram in the endovascular group...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29135148/-hemorrhagic-complications-of-percutaneous-interventions-for-nephrolithiasis
#14
S V Shkodkin, Yu B Idashkin, V N Dmitriev, A V Lyubushkin, A A Nevskii
Hemorrhagic complications are one of the major problems of percutaneous urolithiasis interventions. AIM: To investigate the incidence of hemorrhagic complications after percutaneous nephrolithotripsy. MATERIAL AND METHODS: This was a comparative analysis of 146 percutaneous nephrolithotripsies. The study group comprised 81 patients with stag horn nephrolithiasis; the rest of the patients were assigned to the control group. RESULTS: Both groups were comparable in age and sex (p>0...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29129854/update-on-the-therapeutic-strategy-of-type-b-aortic-dissection
#15
Shuichiro Kaji
Stanford type B aortic dissection (TBAD) is a life-threatening disease. Current therapeutic guidelines recommend medical therapy with aggressive blood pressure lowering for patients with acute TBAD unless they have fatal complications. Although patients with uncomplicated TBAD have relatively low early mortality, aorta-related adverse events during the chronic phase worsen the long-term clinical outcome. Recent advances in thoracic endovascular aortic repair (TEVAR) can improve clinical outcomes in patients with both complicated and uncomplicated TBAD...
November 10, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29129420/surgical-strategy-for-the-treatment-of-aortoesophageal-fistula
#16
Takahiro Yamazato, Tetsu Nakamura, Noriyuki Abe, Koki Yokawa, Yuki Ikeno, Yojiro Koda, Soichiro Henmi, Hidekazu Nakai, Yasuko Gotake, Takashi Matsueda, Takeshi Inoue, Hiroshi Tanaka, Yoshihiro Kakeji, Yutaka Okita
OBJECTIVE: To present a surgical strategy for aortoesophageal fistula (AEF). METHODS: From October 1999 to May 2017, 27 patients with AEF were treated at Kobe University Hospital. After 9 patients with malignancies or fish bone penetration were excluded, 18 patients who had AEF secondary to aortic lesions were investigated. The mean age was 67.2 ± 10.4 years, and the male/female ratio was 16:2. Twelve patients had a nondissection thoracic aneurysm, and 6 patients had a chronic aortic dissection...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29128156/utility-of-a-power-aspiration-based-extraction-technique-as-an-initial-and-secondary-approach-in-the-treatment-of-peripheral-arterial-thromboembolism-results-of-the-multicenter-prism-trial
#17
Richard R Saxon, James F Benenati, Corey Teigen, George L Adams, Luke E Sewall
PURPOSE: To investigate the safety and initial efficacy of XTRACT, a power aspiration-based extraction technique for treatment of peripheral arterial thromboembolism with the use of the Penumbra/Indigo system. MATERIALS AND METHODS: A total of 79 patients were enrolled: 39 (49.4%) underwent XTRACT as the initial therapy and 40 (50.6%) underwent XTRACT after failed catheter-directed thrombolysis or other mechanical intervention or for removal of distal emboli that occurred during an intervention...
November 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29125410/hemorrhage-associated-with-ventriculoperitoneal-shunt-placement-in-aneurysmal-subarachnoid-hemorrhage-patients-on-a-regimen-of-dual-antiplatelet-therapy-a-retrospective-analysis
#18
Joseph S Hudson, Yasunori Nagahama, Daichi Nakagawa, Robert M Starke, Brian J Dlouhy, James C Torner, Pascal Jabbour, Lauren Allan, Colin P Derdeyn, Jeremy D W Greenlee, David Hasan
OBJECTIVE Intracranial stenting and flow diversion require the use of dual antiplatelet therapy (DAPT) to prevent in-stent thrombosis. DAPT may significantly increase the risk of hemorrhagic complications in patients who require subsequent surgical interventions. In this study, the authors sought to investigate whether DAPT is a risk factor for hemorrhagic complications associated with ventriculoperitoneal (VP) shunt placement in patients with aneurysmal subarachnoid hemorrhage (aSAH). Moreover, the authors sought to compare VP shunt complication rates with respect to the shunt's location from the initial external ventricular drain (EVD) site...
November 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29125027/thromboembolic-complications-during-endovascular-treatment-of-ruptured-cerebral-aneurysms
#19
Motohiro Nomura, Kentaro Mori, Akira Tamase, Tomoya Kamide, Syunsuke Seki, Yu Iida, Kazutaka Shirokane, Eiichi Baba, Atsushi Tsuchiya, Hiroshi Shima
Background In cases of subarachnoid hemorrhage due to aneurysm rupture, the administration of an anticoagulant or antiplatelet agent involves the risk of rebleeding from the aneurysm. There is a possibility of inducing thromboembolic events during the endovascular embolization of ruptured cerebral aneurysms. Patients and methods From April 2006 to March 2017, we treated a total of 70 patients with ruptured cerebral aneurysms with an endovascular technique. Among them, five patients (7.1%) showed intra-arterial thrombus formation...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29125024/wingspan-stent-delivery-catheter-fracture-and-the-trap-technique-for-endovascular-salvage
#20
Manoj Jagani, Huy M Do, Jeremy J Heit
Background Intracranial atherosclerotic disease may result in ischemic infarction and has a high rate of recurrent ischemic strokes despite medical therapy. Patients who fail medical therapy may undergo endovascular treatment with cerebral artery angioplasty and possible Wingspan stent placement. We present a unique case of Wingspan delivery microcatheter fracture that resulted in a retained foreign body and an endovascular salvage maneuver. Case description An elderly patient presented with an acute ischemic stroke due to a severe stenosis in the proximal left middle cerebral artery (MCA)...
January 1, 2017: Interventional Neuroradiology
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