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aortobifemoral reconstructions

Ricardo Correia, Rita Ferreira, Ana Garcia, Frederico Gonçalves, Rodolfo Abreu, Nelson Camacho, Joana Catarino, Maria Emília Ferreira
INTRODUCTION: Nowadays, axillofemoral bypass is viewed as an end-of-line solution for lower limb revascularization, owing to its classically described poor long-term patency, and recent advances in endovascular options for patients with complex aortoiliac anatomy not suitable for open reconstruction. There is a marked difference in patient profiles in published series of axillofemoral bypass, reflecting changing procedures indications due to technical innovations. The objective of this study is to determine the contemporary profile of patients treated with axillofemoral bypass and their outcome...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
Mário Moreira, Gabriel Anacleto, Óscar Gonçalves
Anastomotic aneurysm is a possible complication after arterial reconstruction with highest incidence at femoral anastomosis; open surgery is the standard treatment, but endovascular exclusion can be useful in selected cases. The authors report a case of femoral anastomotic aneurysm, 19 years after aortobifemoral grafting, treated successfully using stent grafts, under local anesthesia and percutaneous brachial access. Review of published articles regarding endovascular management of femoral anastomotic aneurysm was performed...
May 2018: Annals of Vascular Surgery
Luigi Pascarella, Maen Aboul Hosn
BACKGROUND: Peripheral arterial disease (PAD) is a complex and highly prevalent pathology. It has been estimated that ∼8.5 million people in the United States are affected by PAD, of which 12%-20% are older than age 60. The TransAtlantic Inter-Society Consensus (TASC) guidelines classified aortoiliac atherosclerotic disease based on morphology and level of lesions. TASC II guidelines recommend bilateral surgical bypass to the femoral arteries for TASC II C and D lesions. The aortobifemoral bypass (ABF) has been considered the gold standard in the treatment of aortoiliac occlusive disease (AIOD)...
January 18, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
November 2017: Vascular and Endovascular Surgery
Russell J Pepe, Priya Patel, Lauren A Huntress, Naiem Nassiri
According to the 2007 TransAtlantic Inter-Society Consensus (TASC II) guidelines, surgery is the preferred treatment for extensive (TASC II type C and D) aortoiliac occlusive disease (AIOD). Recent studies, however, have shown that endovascular management can be an effective first-line treatment option for TASC II type C and D categories. While endovascular therapy is now commonly performed in patients with TASC II type D lesions, very few studies have investigated the feasibility and effectiveness of extending endovascular therapy to the most severe subcategory of TASC II D lesions, chronic infrarenal aortoiliac occlusion (CIAO)...
June 23, 2017: Annals of Vascular Surgery
Didem Melis Oztas, Cagla Canbay, Yilmaz Onal, Metin Onur Beyaz, Omer Ali Sayin, Mehmet Barburoglu, Mehmet Buget, Mesut Yornuk, Aziz Ari, Murat Ugurlucan, Bulent Acunas, Ufuk Alpagut, Enver Dayioglu
Treatment of thoracic aortic aneurysms constitutes high mortality and morbidity rates despite improvements in surgery, anesthesia, and technology. Endovascular stent grafting may be an alternative therapy with lower risks when compared with conventional techniques. However, sometimes the branches of the aortic arch may require transport to the proximal segments prior to successful thoracic aortic endovascular stent grafting. Atherosclerosis is accounted among the etiology of both aneurysms and occlusive diseases that can coexist in the same patient...
2017: Case Reports in Medicine
H S Natraj Setty, T R Raghu, B C Srinivas, C M Nagesh, Babu Reddy, Jayashree Kharge, B K Geetha, B N Krishnamurthy, Shivanand Patil, C N Manjunath
Complex iliac artery obstructions, particularly bilateral stenosis or total iliac artery occlusions, are usually treated with aortofemoral or aortobifemoral graft surgery. However, surgical treatment is associated with 3% mortality rate and significant morbidity such as intestinal ischemia, spinal cord injury, and ureteral damage. Percutaneous interventions of aortic bifurcation offer a promising alternative to surgery with potentially lower morbidity and mortality risk. We report a case of peripheral artery disease who had underwent right transfemoral iliac angioplasty with femoropopliteal bypass presented again with bilateral lower limb ischemia, who was successfully treated with stent implantation with the kissing balloon technique...
January 2017: Journal of Natural Science, Biology, and Medicine
Lazar B Davidovic, Milanko Maksic, Igor Koncar, Nikola Ilic, Marko Dragas, Nikola Fatic, Miroslav Markovic, Igor Banzic, Perica Mutavdzic
OBJECTIVE: To assess results of open repair (OR) of AAA in a single high volume center. METHODS: We analyzed prospectively collected data of 450 patients who underwent elective OR of AAA at the Clinic for Vascular and Endovascular Surgery of the Serbian Clinical Centre in the period between January 2013 and September 2014. RESULTS: Postoperative death occurred in seven patients (1. 55%) during the first 30 postoperative days. The mortality was caused by: uncontrolled bleeding-1, acute myocardial infarction-1, ischemic colitis-2, MOFS-2, sepsis due to infection and dehiscence of laparotomy wound-1...
March 2017: World Journal of Surgery
Kokichi Miyamoto, Mototaka Inaba, Toru Kojima, Takefumi Niguma, Tetsushige Mimura
INTRODUCTION: Secondary aortoduodenal fistula (SADF) is a rare but life-threatening complication after aortic reconstruction. Although a number of reports describing treatments for SADF have been published, the optimal management is unclear. A review of the literature suggested methods of reconstruction, control of bleeding, and reduction of infection in the management of SADF. The most important factor for acute intervention is controlling the bleeding from the fistula. We report one case treated using intra-aortic balloon occlusion (IABO) for SADF...
2016: International Journal of Surgery Case Reports
Carlos A Hinojosa, Javier E Anaya-Ayala, Hugo Laparra-Escareno, Rene Lizola, Adriana Torres-Machorro
The aortic bifurcation and iliac vessels are common sites of atherosclerotic occlusive disease causing the clinical expression known as "Leriche's syndrome". An aortobifemoral bypass grafting in the setting of a septic groin remains a significant challenge to vascular surgeons. We present a 65-year-old male with complete occlusion of the distal aorta and iliac arteries; he had undergone a left axillo-femoral and femoral-femoral artery bypass 2 years prior to our evaluation. Owing to a complex graft infection in the right groin and worsening lower extremity ischemia, we performed an aortobifemoral reconstruction through the right obturator membrane...
June 2016: Vascular Specialist International
Zoltán Oláh, László Hidi, László Entz, Zoltán Szeberin
INTRODUCTION: The adequate exposure of the upper abdominal aorta and its side branches are essential for vascular reconstruction of this region. Besides the traditional transperitoneal, retroperitoneal approach or thoracolaparotomy, left medial visceral rotation (MVR) is an option to explore this hardly accessible region. We present our MVR experiences in aortic surgery. METHODS: Using median or subcostal laparotomy we mobilised the left colon, the spleen, the pancreas and performed dissection in the retroperitoneal area leaving the left kidney in place...
August 2015: Magyar Sebészet
Ildikó Szelechman, Gábor Jancsó, Gergely Vadász, Gábor Kasza, László Sínay, Gábor Fazekas, Péter Hardi, Tibor Nagy, László Benkő, Melinda Gadácsi, Nikoletta Lima, Gábor Menyhei, Endre Arató
INTRODUCTION: In the pelvic region thrombendarterectomy and bypass procedures are the most commonly performed procedures to treat peripheral artery occlusive diseases with chronic, severe circulation failure caused by atherosclerosis. Biologic and synthetic grafts can also be used in bypass surgeries. Application of synthetic grafts can acutely increase the development of the infectious graft complication and its mortality is still between 70 and 75% in pelvic processes. We describe the difficulties and dilemmas of an infectious aortobifemoral graft...
February 2015: Magyar Sebészet
Petar Popov, Slobodan Tanasković, Vuk Sotirović, Srdjan Babić, Dragoslav Nenezić, Djordje Radak
INTRODUCTION: Severe extremity ischemia and the presence of the"blue-toe"syndrome are rarely the first complications of the present abdominal aortic aneurysm.We report two interesting cases of this rare entity. OUTLINE OF CASES: A 61-year-old man presented with the rest pain of his toes accompanied with digital ischemia of both feet. Physical examination confirmed regular arterial pulses at lower extremities accompanied with palpable pulsate mass in the abdomen...
March 2014: Srpski Arhiv za Celokupno Lekarstvo
Amy E Reppert, Omid Jazaeri, Ashok Babu, Joshua I Greenberg, Erica Deluka, Mark R Nehler, Thomas B Reece
BACKGROUND: Endoluminal revascularization has supplanted open techniques for most aortoiliac occlusive disease with open surgery reserved for endovascular failure or long-segment aortoiliac occlusions. A number of clinical and anatomic issues can preclude the use of the infrarenal aorta for inflow. Our approach in these select patients is minimal thoracotomy thoracic bifemoral (mini-TBF) bypass. METHODS: Mini-TBF bypass used a 2-team approach. The cardiac surgery team focused on arterial inflow from the distal descending aorta via a ≤8-cm thoracotomy at ninth interspace...
August 2014: Annals of Vascular Surgery
Sinisa Pejkic, Dragan Opacic, Perica Mutavdzic, Oliver Radmili, Nevena Krstic, Lazar Davidovic
Although mural thrombosis frequently accompanies aneurysmal disease, complete thrombosis is distinctly unusual complication of abdominal aortic aneurysm (AAA). A case study of a patient with chronic, asymptomatic complete thrombosis of a large juxtarenal AAA is presented along with a literature review and discussion of the potential secondary complications, mandating aggressive management of this condition. A 67-year-old man with multiple atherogenic risk factors and unattended complaints consistent with a recent episode of a transient right hemispheric ischemic attack was referred to our clinic with a diagnosis of a thrombosed AAA established by computed tomography...
February 2015: Vascular
Urska Marolt, Stojan Potrc, Andrej Bergauer, Nuhi Arslani, Dino Papes
Secondary aortoenteric fistulas (SAEF) are a relatively rare but dangerous complication of aortal reconstructive surgery. We present a patient that underwent aortobifemoral bypass three years before developing the signs of aortoenteric fistula, and we reviewed the literature on the topic. Since the clinical signs are nonspecific, physicians should have a high index of suspicion for SAEF in patients who underwent aortal reconstructive surgery. The most useful diagnostic tools for stable patients are upper gastrointestinal endoscopy and computed tomography scan with contrast that can, in combination with history and clinical signs, enable accurate diagnosis in more than 90% of patients...
September 2013: Acta Clinica Croatica
V Treska, B Certík, M Cechura, J Molácek, R Sulc, K Houdek
INTRODUCTION: Leriche's syndrome is defined as atherosclerotic occlusion of the infrarenal aorta and/or the iliac axis. It is associated with claudications or critical limb ischaemia and erectile dysfunction in men. MATERIAL AND METHODS: Twenty patients with Leriche's syndrome were operated on at the Department of Surgery, University Hospital in Pilsen between 2008 and 2012. There were 6 women and 14 men of average age 60.3 years (41-76 years). Three patients were in group C and 17 in group D according to the Trans-Atlantic Inter-Society Classification IIb (TASC IIb)...
April 2013: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Antonino Cavallaro, Antonio V Sterpetti, Luca Dimarzo, Paolo Sapienza
BACKGROUND: The goal of this study was to describe and review the results of a technique in which reconstruction of the common and profunda femoral arteries is combined with a femoro-femoral crossover graft using the same synthetic graft. A synthetic bifurcated graft (such as the ones used for aortobifemoral reconstruction), in which one limb is cut off, is used, leaving an enlarging patch at the end where the proximal anastomosis will be fashioned. METHODS: From January 1972 to January 2000, 6 patients underwent this reconstruction for severe limb ischemia...
July 2013: Annals of Vascular Surgery
K Schürmann
CLINICAL ISSUE: Diseases of the aortic bifurcation, whether stenotic or dilating, are mostly a manifestation of arteriosclerosis. If only stenosis is present aortic bifurcation disease is equivalent to a certain form of peripheral arterial occlusive disease (PAOD) characterized by the specific anatomical location. Aneurysmal disease and PAOD of the aortic bifurcation may occur together and men older than 60 years are particularly affected. The main symptom of aortic bifurcation PAOD is bilateral claudication whereas aneurysmal disease of the aortic bifurcation is frequently asymptomatic...
June 2013: Der Radiologe
Nikola S Ilic, Marko Dragas, Igor Koncar, Dusan Kostic, Sinisa Pejkic, Markovic Miroslav, Lazar Davidovic
The infection in vascular surgery is a nightmare of every vascular surgeon. There are numerous ways of treatment but neither one is definitive. We present the case of the patient with infectious limb following aortobifemoral reconstruction treated by partial graft extirpation and with re-implantation of the superficial femoral artery into deep femoral artery.
June 2013: Vascular
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