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https://www.readbyqxmd.com/read/28648650/planning-execution-and-follow-up-for-endovascular-aortic-aneurysm-repair-using-a-highly-restrictive-iodinated-contrast-protocol-in-patients-with-severe-renal-disease
#1
E Gallitto, G L Faggioli, M Gargiulo, A Freyrie, R Pini, C Mascoli, S Ancetti, V Vento, A Stella
BACKGROUND: The cumulative amount of iodinated-contrast-medium necessary for EVAR planning, operative procedure and subsequent follow-up is a threat for the onset of end stage renal disease in patients with pre-operative impaired kidney function. Purpose of this study is to describe a mini-invasive approach aimed to minimize the exposure of these patients to iodinated-contrast-medium and the subsequent risk of renal function worsening. METHODS: From 2012 to 2015, all patients with abdominal aortic aneurysm (AAA) at high-surgical risk and fit for standard endovascular repair (simple aortic-iliac anatomy: proximal and distal neck length ≥15mm, no severe angulation), underwent EVAR through the following "near-zero contrast" approach, if their glomerular filtration rate (GFR) was <30 mL/min: pre-operative planning was performed by non-contrast enhanced computed tomography (CT) and duplex-ultrasound (DU); the origin of renal/hypogastric arteries and aortic bifurcation was evaluated and matched with vertebral bone landmarks and the endograft deployed accordingly, using < 20cc of isotonic iodinate-contrast-medium and contrast-enhancement-DU (CEUS)...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647635/new-vein-compression-entities-in-patients-with-unexplained-leg-swelling
#2
Alaina Garrie, Lauren E Jones, Julia F Chen, Robert W Feldtman, Kenneth R Kollmeyer, Jasmine L Richmond, Craig A Ferrara, Pablo V Uceda, Lelesse Mocio, Samuel S Ahn
BACKGROUND: This retrospective study identifies often overlooked anatomical sites for non-thrombotic venous outflow obstruction (NTVO) in patients with unexplained lower extremity edema and pain. MATERIALS AND METHODS: We retrospectively reviewed the charts of 75 consecutive patients experiencing symptoms of unexplained lower extremity edema with pain that were unexplained by ultrasound, computed tomography angiography (CTA), and magnetic resonance imaging (MRI), who subsequently underwent venography in an outpatient medical office from 2010 to 2014...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28590211/a-systematic-review-of-the-effectiveness-of-palliative-interventions-to-treat-rectal-tenesmus-in-cancer
#3
Áine Ní Laoire, Lucy Fettes, Fliss Em Murtagh
BACKGROUND: Rectal tenesmus is a distressing symptom in patients with advanced cancer and challenging to treat. There is lack of consensus on the appropriate management of tenesmus in this patient population. AIM: To identify and examine the effectiveness of interventions to palliate rectal tenesmus caused by advanced cancer when surgery, radiotherapy or chemotherapy are no longer treatment options. DESIGN: A systematic review of the literature following standard systematic review methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance...
March 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28558661/uterus-preserving-surgery-versus-hysterectomy-in-the-treatment-of-refractory-postpartum-haemorrhage-in-two-tertiary-maternity-units-in-cameroon-a-cohort-analysis-of-perioperative-outcomes
#4
Julius Sama Dohbit, Pascal Foumane, Elie Nkwabong, Christelle Ogolong Kamouko, Joel Noutakdie Tochie, Bernard Otabela, Emile Mboudou
BACKGROUND: Little evidence exists on the efficacy and safety of the different surgical techniques used in the treatment of postpartum haemorrhage (PPH). We aimed to compare uterus preserving surgery (UPS) versus hysterectomy for refractory PPH in terms of perioperative outcomes in a sub-Saharan African country with a known high maternal mortality ratio due to PPH. METHODS: This was a retrospective cohort study comparing the perioperative outcomes of all women managed by UPS (defined as surgical interventions geared at achieving haemostasis while conserving the uterus) versus hysterectomy (defined as surgical resection of the uterus to achieve haemostasis) for PPH refractory to standard medical management in two tertiary hospitals in Cameroon from January 2004 to December 2014...
May 30, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28548474/aortic-aneurysm-endovascular-treatment-with-the-parallel-graft-technique-from-the-aortic-arch-to-the-iliac-axis
#5
Gian F Fadda, Mario Marino, Holta Kasemi, Costantino L DI Angelo, Carlo P Dionisi, Valeria Cammalleri, Carlo Setacci
BACKGROUND: The chimney technique has been developed for the treatment of complex aortic aneurysms. We analyzed the midterm to long-term outcomes of this approach from a single- centre experience. METHODS: From October 2008 to July 2016, 58 patients underwent endovascular aortic aneurysm repair using the chimney technique. Indications for treatment were thoracic aortic aneurysm (TAA) (n = 11), thoracoabdominal aortic aneurysm (TAAA) (n = 2), pararenal aortic aneurysm (PAAA) (n= 15), aortoiliac/isolated hypogastric artery aneurysm (n = 25), type I endoleak after previous TEVAR/EVAR (n=4), proximal pseudoaneurysm after AAA open repair (n = 1)...
May 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28537567/intraoperative-neuromonitoring-of-hypogastric-plexus-branches-during-surgery-for-rectal-cancer-preliminary-report
#6
Piotr Wałęga, Michał Romaniszyn, Maciej Wałęga, Jarosław Szymon Świrta, Wojciech Nowak
AIM: The aim of this study was to present our preliminary experience with intraoperative neuromonitoring during rectal resection. MATERIALS AND METHODS: We qualified 4 patients (2 women, 2 men; age 42 - 53 years) with rectal cancer for surgery with intraoperative neuromonitoring. In all patients, functional tests of the anorectal area were performed before surgery. Action potentials from the sphincter complex in response to nerve fiber stimulation were recorded with electrodes implanted before surgery...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28537446/clinical-outcomes-of-hypogastric-artery-occlusion-for-endovascular-aortic-aneurysm-repair
#7
Wuttichai Saengprakai, Joost A van Herwaarden, George S Georgiadis, Worawong Slisatkorn, Frans L Moll
PURPOSE: To determine the midterm outcomes of internal iliac artery (IIA) coverage by a stent-graft in endovascular aortic aneurysm repair (EVAR) under specific anatomic and technical circumstances. MATERIAL AND METHODS: From January 2003 until January 2014, 57 patients with aortoiliac aneurysms, including 20 with 24 IIA aneurysms (IIAAs), underwent EVAR with IIA coverage. IIAA diameter change or IIA thrombosis, buttock claudication, type II endoleak, and secondary interventions related to the IIA were studied...
May 24, 2017: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/28537347/adnexal-torsion-in-the-first-trimester-of-pregnancy-diagnosis-laparoscopic-management-and-review-of-the-literature
#8
Rafael Bras, Jorge Braga, António Tomé, Helder Ferreira
We report a case of an adnexal torsion in a 27-year-old woman in her 12th week of gestation. She presented with hypogastric and lumbar pain with biliary vomiting and nausea. Upon physical examination, tenderness in the right lower quadrant with rebound tenderness was apparent, and gynecological examination revealed right adnexal tenderness with absence of abnormal cervical discharge. The transvaginal ultrasonography demonstrated an enlarged cystic right ovary with no flow detected on color and power Doppler mode...
May 24, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28520297/the-optimal-approach-for-a-superior-hypogastric-plexus-block
#9
Ji Won Choi, Won Ho Kim, Chul Joong Lee, Woo Seog Sim, Sukhee Park, Hyun Byung Chae
INTRODUCTION: Superior hypogastric plexus block (SHGPB) is technically difficult and accurate procedure is required to avoid potential complications. We attempted to determine the reference angles for fluoroscopy-assisted SHGPB and to establish a predictor that can guide to select optimal approach between classic posterior approach and transdiscal approach. METHODS: Abdomino-pelvic CT scans from 268 patients diagnosed with pelvic malignancies were examined. The oblique and axial angles needed for the fluoroscope were measured both for posterior and transdiscal approaches by simulating the needle trajectory on CT imaging...
May 18, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28504499/-transverse-vaginal-septum-diagnosed-in-sisters-cases-report
#10
Gonzalo González García, Patricia Bretón Hernández, María J Boillos Calvo, Anna Miralles Puigbert
Transverse vaginal septum is a disorder that would arise from a failure in the fusion and/or channeling of the urogenital sinus and the müllerian ducts with low frequency but with a significant impact on the health of patients. The treatment is surgical and it will depend on the location and thickness of the septum. Sometimes, it described a female sex-limited autosomal recessive transmission but few cases of family association have been reported. We present the cases of two sisters who had this rare entity 5 years apart and were diagnosed by the presentation of an intense hypogastric abdominal pain at the age of 11 and 12 years when they had a Tanner stage III pubertal development and primary amenorrhea...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28498243/a-controlled-study-on-vaginal-blood-flow-during-sexual-arousal-among-early-stage-cervical-cancer-survivors-treated-with-conventional-radical-or-nerve-sparing-surgery-with-or-without-radiotherapy
#11
Rinske Maria Bakker, Quirine D Pieterse, Luc R C W van Lonkhuijzen, Baptist J B M Z Trimbos, Carien L Creutzberg, Gemma G Kenter, Cor D de Kroon, Moniek M Ter Kuile
OBJECTIVE: Sexual problems among cervical cancer survivors may in part be caused by reduced vaginal blood flow due to damaged hypogastric nerves during radical hysterectomy with pelvic lymphadenectomy and/or by radiation-induced vaginal changes after pelvic radiotherapy. A nerve-sparing modification of radical hysterectomy (NSRH) may preserve vaginal blood flow. Vaginal blood flow during sexual arousal was compared between different treatment modalities. METHODS: We investigated premenopausal women treated for early-stage cervical cancer with radical hysterectomy (n = 29), NSRH (n = 28), NSRH with radiotherapy (n = 14), and controls (n = 31)...
June 2017: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/28495214/lesson-learned-with-the-use-of-iliac-branch-devices-single-centre-10-year-experience-in-157-consecutive-procedures
#12
G Simonte, G Parlani, L Farchioni, G Isernia, E Cieri, M Lenti, P Cao, F Verzini
OBJECTIVE/BACKGROUND: Absence of an adequate iliac seal rarely represents an absolute contraindication to endovascular abdominal aortic aneurysm repair. Iliac branch devices (IBD) are increasingly used in patients with extensive aorto-iliac aneurysmal disease, but few data are available on the long-term results of these procedures. METHODS: Between 2006 and 2016, 157 consecutive IBD procedures performed at a single centre were entered into a prospective database...
May 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28483625/parallel-stenting-technique-in-a-sandwich-configuration-for-hypogastric-preservation-during-evar-an-in-vitro-study
#13
Xavier Yugueros, Gaspar Mestres, Savino Pasquadibisceglie, Xavier Alomar, Ana Apodaka, Vincent Riambau
PURPOSE: to identify the best conditions in iliac sandwich procedure for hypogastric preservation during EVAR; testing different devices, different oversizing degrees as well as different methods of measure it. METHODS: Four external iliac devices (16mm Endurant and 12mm Aorfix limb extensions; 11 and 13mm Viabahn endografts) were tested with two distinct internal iliac stentgrafts (8mm Advanta/V12 and 8mm Viabahn) inside different proximal silicon iliac limbs models (10, 12, 14, 16 and 18mm), simulating an iliac sandwich procedure for hypogastric preservation...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483617/a-steerable-sheath-to-deploy-hypogastric-bridging-stent-by-contralateral-femoral-approach-in-an-iliac-branch-procedure-after-evar
#14
Ciro Ferrer, Luigi Venturini, Raffaele Grande, Katia Raccagni, Luca Ginanni Corradini, Mario Corona, Luca di Marzo
Aneurysmal degeneration of distal landing zones after endovascular aneurysm repair (EVAR), can be a potential cause of late failure of this technique. Aneurysmal degeneration of common iliac arteries increases the risk of rupture of the iliac aneurysm itself as well as of the abdominal aortic aneurysm (AAA) owing to aneurysm's reperfusion as a type Ib endoleak. Reoperation consists in plugging and covering the internal iliac artery (IIA), by extension into the external iliac artery, or preservation of antegrade flow in IIA by iliac branch devices (IBD) or sandwich technique...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479466/perioperative-and-late-outcomes-after-endovascular-treatment-for-isolated-iliac-artery-aneurysms
#15
Claudio Bianchini Massoni, Antonio Freyrie, Mauro Gargiulo, Tiziano Tecchio, Chiara Mascoli, Enrico Gallitto, Gianluca Faggioli, Rodolfo Pini, Matteo Azzarone, Paolo Perini, Andrea Stella
AIM: The aim of the study was to report early and follow-up outcomes of the endovascular treatment with iliac endografts for isolated iliac artery aneurysms (IIAA). METHODS: Records of patients who underwent elective endovascular repair for isolated iliac artery aneurysms (both primary and para-anastomotic) from 2005 to 2015 in two Italian centres were retrospectively examined. Demographics data, preoperative patient comorbidities, iliac aneurysm characteristics, contralateral iliac axis involvement, patency of hypogastric arteries and inferior mesenteric artery (IMA) and data of endovascular treatment were obtained for analysis...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479430/accentuation-of-insufficient-landing-zone-using-high-volume-3d-coils-during-iliac-aneurysm-stent-grafting-for-hypogastric-artery-preservation
#16
Uei Pua, Lawrence Han Hwee Quek, Glenn Wei Leong Tan
We describe the technique of of using high volume 3D coils to "augment" an insufficient stent graft landing zone. This was performed in order to preserve hypogastric artery perfusion in a case of common iliac artery aneurysm which resides next to the internal iliac artery.
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28463672/genito-urinary-function-and-quality-of-life-after-elective-totally-laparoscopic-sigmoidectomy-after-at-least-one-episode-of-complicated-diverticular-disease-according-to-two-different-vascular-approaches-the-ima-low-ligation-or-the-ima-preservation
#17
Giulio Mari, Jacopo Crippa, Andrea Costanzi, Michele Mazzola, Carmelo Magistro, Giovanni Ferrari, Dario Maggioni
The arterial ligation during elective laparoscopic sigmoidectomy for diverticular disease can affect genito-urinary function injuring the superior hypogastric plexus, and can weaken the distal colonic stump arterial perfusion. Ligation of the inferior mesenteric artery distal to the left colic artery or the complete preservation of the inferior mesenteric artery can therefore be compared in terms of preservation of the descending sympathetic fibres running along the aorta to the rectum resulting in a different post operative genito urinary function...
March 2017: Chirurgia
https://www.readbyqxmd.com/read/28428520/-prevention-of-spinal-cord-ischemia-during-thoracic-endovascular-aortic-repair
#18
Shinya Takahashi, Taijiro Sueda
Spinal cord ischemia(SCI) has been devastating complication of endovascular thoracic and thoracoabdominal aortic repair. Spinal cord blood supply arises from not only segmental artery, subclavian artery, hypogastric artery and these branches, but also perivertebral vasculature and paravertebral muscle and small arterial network, and risk factors of SCI were multifactorial. There are several adjuncts/strategies which are utilized to minimize the incidence of SCI: cerebrospinal fluid drainage, perioperative management of high mean arterial pressure, intraoperative evoked potential monitoring, and staged thoracoabdominal aortic repair...
April 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28424038/a-novel-method-for-the-treatment-of-bilateral-hypogastric-aneurysms-using-hybrid-polytetrafluoroethylene-graft
#19
Sam Tyagi, D Pineda, H Zheng, M Dougherty, K Calligaro, D Troutman
Open aortic aneurysm repair in the setting of bilateral hypogastric aneurysms is technically challenging. We present a novel technique for open surgical repair for bilateral hypogastric aneurysms using the Gore hybrid vascular graft (GVHG; W. L. Gore and Associates Inc, Flagstaff, Arizona). The GVHG is an expanded polytetrafluoroethylene graft with a nitinol stent at 1 end designed for hemodialysis access. The GVHG has been also been used for aortic debranching and treatment of occlusive disease. We describe the first report using GVHG to repair hypogastric aneurysms...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28420598/1-5-t-augmented-reality-navigated-interventional-mri-paravertebral-sympathetic-plexus-injections
#20
David R Marker, Paweena U Thainual, Tamas Ungi, Aaron J Flammang, Gabor Fichtinger, Iulian I Iordachita, John A Carrino, Jan Fritz
PURPOSE: The high contrast resolution and absent ionizing radiation of interventional magnetic resonance imaging (MRI) can be advantageous for paravertebral sympathetic nerve plexus injections. We assessed the feasibility and technical performance of MRI-guided paravertebral sympathetic injections utilizing augmented reality navigation and 1.5 T MRI scanner. METHODS: A total of 23 bilateral injections of the thoracic (8/23, 35%), lumbar (8/23, 35%), and hypogastric (7/23, 30%) paravertebral sympathetic plexus were prospectively planned in twelve human cadavers using a 1...
May 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
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