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https://www.readbyqxmd.com/read/28334545/-conservative-treatment-of-late-aortic-graft-infection
#1
Peter Baľa, Kamil Zeman, Renata Kološová, Ivo Pavlas, Dušan Kučera
Aortic graft infection is one of the most serious complications of aortovascular surgery. Diagnosis is based on clini-cal and radiologic findings. The emphasis is put on early diagnosis and its impact on prognosis of patients. The management should be individualized. The gold standard is surgical treatment with complete excision of the infected foreign material with debridement of the surrounding tissue and repair of vascular continuity by extra-anatomic bypass or in situ bypass with autologous femoral vein or cryopreserved arterial allografts...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28326156/porphyromonas-gingivalis-is-the-most-abundant-species-detected-in-coronary-and-femoral-arteries
#2
J-L C Mougeot, C B Stevens, B J Paster, M T Brennan, P B Lockhart, F K B Mougeot
An association between oral bacteria and atherosclerosis has been postulated. A limited number of studies have used 16S RNA gene sequencing-based metagenomics approaches to identify bacteria at the species level from atherosclerotic plaques in arterial walls. The objective of this study was to establish detailed oral microbiome profiles, at both genus and species level, of clinically healthy coronary and femoral artery tissues from patients with atherosclerosis. Tissue specimens were taken from clinically non-atherosclerotic areas of coronary or femoral arteries used for attachment of bypass grafts in 42 patients with atherosclerotic cardiovascular disease...
2017: Journal of Oral Microbiology
https://www.readbyqxmd.com/read/28318936/vector-model-supported-approach-in-prostate-plan-optimization
#3
Eva Sau Fan Liu, Vincent Wing Cheung Wu, Benjamin Harris, Margot Lehman, David Pryor, Lawrence Wing Chi Chan
Lengthy time consumed in traditional manual plan optimization can limit the use of step-and-shoot intensity-modulated radiotherapy/volumetric-modulated radiotherapy (S&S IMRT/VMAT). A vector model base, retrieving similar radiotherapy cases, was developed with respect to the structural and physiologic features extracted from the Digital Imaging and Communications in Medicine (DICOM) files. Planning parameters were retrieved from the selected similar reference case and applied to the test case to bypass the gradual adjustment of planning parameters...
March 17, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28296239/stent-placement-in-the-superficial-femoral-and-proximal-popliteal-arteries-with-the-innova-self-expanding-bare-metal-stent-system
#4
Richard J Powell, Michael R Jaff, Herman Schroë, Andrew Benko, Juan Diaz-Cartelle, Stefan Müller-Hülsbeck
OBJECTIVES: The SuperNOVA trial was designed to evaluate performance of the Innova Vascular Self-Expanding Stent System (Boston Scientific, Marlborough, MA) for treating lesions in the femoropopliteal arteries. METHODS: Patients with chronic lower limb peripheral artery disease (Rutherford category 2, 3, or 4) and atherosclerotic lesions in the native superficial femoral and/or proximal popliteal artery (lengths 30-190 mm) were enrolled in this single-arm, multinational study...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28294663/-role-of-the-homograft-bypass-in-extremity-inferior-s-reconstructions
#5
Zsuzsa Nagy, Zoltán Oláh, Judit Kókai, Anna Barbara Molnár, Ágnes Laczkó, Gábor Viktor Szabó, Viktória Juhász, Dávid Garbaisz, Márton Berczeli, Zsófia Sztupinszky, Zoltán Szeberin
INTRODUCTION: Vascular homografts are used for limb salvage in cases of graft infection after previous reconstructive vascular surgery or inadequate autologous veins. During multi-organ donation the thoracic aorta segment, aortic bifurcation, iliac arteries, femoral arteries, popliteal arteries, femoral veins and greater saphenous veins can be harvested. Our aim was to optimize the use of homografts by analyzing the results of previous procedures. METHODS: The patient information was processed retrospectively, using the clinical computer system...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28292655/a-one-dimensional-arterial-network-model-for-bypass-graft-assessment
#6
A R Ghigo, S Abou Taam, X Wang, P-Y Lagrée, J-M Fullana
We propose an arterial network model based on one-dimensional hemodynamic equations to study the behavior of different vascular surgical bypass grafts in the case of an arterial occlusive pathology: a stenosis of the Right Iliac artery. We investigate the performances of three different bypass grafts (Aorto-Femoral, Axillo-Femoral and cross-over Femoral) depending on the degree of obstruction of the stenosis. Numerical simulations show that all bypass grafts are efficient since we retrieve in each case the healthy hemodynamics downstream of the stenosed region while ensuring at the same time a global healthy circulation...
March 11, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28288887/transapical-endovascular-repair-of-thoracic-aortic-pathology
#7
Takashi Murakami, Shinsuke Nishimura, Mitsuharu Hosono, Yoshitsugu Nakamura, Etsuji Sohgawa, Yukimasa Sakai, Toshihiko Shibata
BACKGROUND: Alternative access for thoracic endovascular aortic repair (TEVAR) has been explored for patients with unsuitable femoral and iliac access, but few cases of transapical access have been described. We report our experience with transapical access for various aortic pathologies. METHODS: We reviewed six cases undergoing transapical access for endovascular repair of thoracic aortic pathology between December 2013 and August 2015. Five patients had an aortic arch aneurysm and 1 patient presented with Stanford type A subacute aortic dissection...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28288326/a-hybrid-approach-to-appendicitis-with-right-external-iliac-artery-pseudo-aneurysm-a-case-report
#8
Benjamin T Chandler, Evan J Ryer, Benjamin M Keyser, James R Elmore
INTRODUCTION: While acute appendicitis is a common surgical problem, the simultaneous occurrence of appendicitis and an infected iliac artery pseudoaneurysm is exceedingly rare. We report the successful treatment of an infected right external iliac artery pseudo aneurysm in the 1setting of acute appendicitis. PRESENTATION OF CASE: The patient is an 83-year-old male who presents with severe sepsis, right lower quadrant and right leg pain. Additional past medical history is significant for rectal cancer status post resection and radiation therapy in 1997...
March 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28271745/very-distal-vein-bypass-in-patients-with-thromboangiitis-obliterans
#9
Achim Neufang, Carolina Vargas-Gomez, Patrick Ewald, Nicolaos Vitolianos, Tolga Coskun, Nael Abu-Salim, Rainer Schmiedel, Peter von Flotow, Savvas Savvidis
BACKGROUND: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. PATIENTS AND METHODS: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking...
March 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28261878/hemodynamic-and-perioperative-management-in-two-different-preclinical-pig-to-baboon-cardiac-xenotransplantation-models
#10
Tanja Mayr, Andreas Bauer, Bruno Reichart, Sonja Guethoff, Uwe Schoenmann, Matthias Längin, Alessandro Panelli, Alexander Kind, Paolo Brenner, Jan-Michael Abicht
BACKGROUND: The perioperative phase of preclinical cardiac xenotransplantations significantly affects the experimental outcome. Moderate or even severe hemodynamic and respiratory impairment occurs frequently in baboons after receiving a cardiac transplant. The perioperative management of such postoperative instability is very demanding, especially in the experimental setting. We compared perioperative changes of hemodynamic and laboratory findings during orthotopic and heterotopic thoracic cardiac xenotransplantations and describe our monitoring, treatment and intensive care...
March 5, 2017: Xenotransplantation
https://www.readbyqxmd.com/read/28255132/extra-anatomical-veno-venous-surgical-bypass-for-central-vein-occlusion-in-patients-with-ipsilateral-arterio-venous-fistula-avf-for-haemodialysis-a-single-centre-experience
#11
K S Saravana, A A Zainal
OBJECTIVE: Central vein occlusion is a common complication related to central vein catheter insertion for haemodialysis which can be unmasked by an ipsilateral fistula creation, leading to a dysfunctional arteriovenous fistula (AVF). We describe an extra-anatomical venous bypass surgical procedure performed to maintain vascular access and reduce the symptoms of swelling of the ipsilateral upper limb, neck and face. MATERIALS AND METHODS: We report 20 consecutive patients with end-stage renal failure (ESRF) who had central vein occlusion and were not amenable to endovascular intervention...
February 2017: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28236917/outcomes-of-native-superficial-femoral-artery-chronic-total-occlusion-recanalization-after-failed-femoropopliteal-bypass
#12
Mark G Davies, Hosam F El-Sayed
OBJECTIVE: When a bypass fails, the options are lysis, redo bypass, or endovascular intervention. If lysis of the original bypass is not considered an option, which is better-redo bypass or attempts at endovascular recanalization of the native system? This retrospective study examined the outcomes of native superficial femoral artery (SFA) chronic total occlusion (CTO) recanalization compared with redo bypass after failed femoropopliteal bypass. METHODS: Patients presenting with a symptomatic failed femoropopliteal bypass that underwent attempted CTO endovascular (EV) recanalization of the native SFA or a redo femoropopliteal bypass (BP) from 2000 to 2015 were analyzed...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28225505/nonrevascularizable-buttock-claudication-improved-with-sildenafil-a-case-report
#13
Loukman Omarjee, Audrey Camarzana, Samir Henni, Pierre Abraham
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor (PDE5i), could represent a new treatment in addition to the medical treatment and advice to walk in peripheral arterial disease (PAD). PATIENT CONCERNS AND DIAGNOSES: We report a case of a 62-year-old heavy smoker man who developed a buttock claudication and a severe walking limitation following an aorto-bi-femoral bypass in 1992. Since 2003, each year, he has been referred for investigation of bilateral buttock claudication on treadmill using transcutaneous oxygen pressure (tcpO2) measurement during exercise to argue for the vascular origin of the walking impairment...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28216364/clinical-outcomes-of-obturator-canal-bypass
#14
Jonathan Bath, Maham Rahimi, Becky Long, Efthymios Avgerinos, Joseph Giglia
OBJECTIVE: Infected aortofemoral grafts pose a formidable challenge with a significant risk of limb loss and high mortality. Despite successful reports of obturator canal bypass (OCB) for infected aortofemoral graft and complicated groins, the technique has not gained widespread use. We reviewed our experience with OCB and performed a systematic review of the literature. METHODS: A retrospective review of patients who underwent OCB in our institution between 1995 and 2013 was conducted...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28214141/feasibility-and-safety-of-same-day-discharge-after-complex-percutaneous-coronary-intervention-using-forearm-approach
#15
Michael Koutouzis, Aris Karatasakis, Emmanouil S Brilakis, Maria Agelaki, Christos Maniotis, Panagiotis Dimitriou, Efstathios Lazaris
OBJECTIVES: We sought to assess the feasibility and safety of same-day discharge (SDD) after complex percutaneous coronary intervention (PCI) using a forearm approach. BACKGROUND: SDD has been shown to be safe after elective, low-risk PCI. However, the feasibility and safety of SDD in more complex patients and lesions has received limited study. METHODS: We retrospectively reviewed 1190 elective PCIs that were performed between January 2013 and December 2015 at the Red Cross General Hospital...
February 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28203538/robotic-mitral-valve-repair-for-degenerative-posterior-leaflet-prolapse
#16
Hoda Javadikasgari, Rakesh M Suri, Bassman Tappuni, Ashley M Lowry, Tomislav Mihaljevic, Stephanie Mick, A Marc Gillinov
BACKGROUND: Robotic mitral valve (MV) repair is the least invasive surgical approach to the MV and provides unparalleled access to the valve. We sought to assess technical aspects and clinical outcomes of robotic MV repair for isolated posterior leaflet prolapse by examining the first 623 such cases performed in a tertiary care center. METHODS: We reviewed the first 623 patients (mean age 56±9.7 years) with isolated posterior leaflet prolapse who underwent robotic primary MV repair from 01/2006 to 11/2013...
January 2017: Annals of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28190718/unilateral-inline-replacement-of-infected-aortofemoral-graft-limb-with-femoral-vein
#17
Christian D Simmons, Ahsan T Ali, Kousta Foteh, Matthew R Abate, Matthew R Smeds, Horace J Spencer, G Patrick Clagett
OBJECTIVE: Aortic graft infection remains a formidable challenge for the vascular surgeon. Traditionally, reconstruction with a neoaortoiliac system (NAIS) involves removal of the entire synthetic graft with in situ reconstruction using femoral vein. Whereas the NAIS procedure is durable with excellent graft patency and a low reinfection rate, it can take up to 10 hours and result in a high perioperative complication rate with significant mortality. Not infrequently, the infection is limited to a single limb...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28190713/transient-atrial-fibrillation-after-open-abdominal-aortic-revascularization-surgery-is-associated-with-increased-length-of-stay-mortality-and-readmission-rates
#18
Barbara A Blanco, Anai N Kothari, Pegge M Halandras, Robert H Blackwell, Dawn M Graunke, Paul C Kuo, Jae S Cho
BACKGROUND: It is well established that transient postoperative atrial fibrillation (TPAF) is associated with adverse postoperative outcomes after major cardiac and noncardiac operations. The purpose of this study was to elucidate the incidence, impact, and risk factors associated with the development of TPAF in patients undergoing revascularization surgery for occlusive diseases of the abdominal aorta and its branches (AAB). METHODS: By use of the Healthcare Cost and Utilization Project State Inpatient Database from Florida and California, patients who underwent open revascularization of AAB between 2006 and 2011 were identified...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28163172/endovascular-management-of-para-prosthetic-aortocaval-fistula-case-report-and-systematic-review-of-the-literature
#19
Claudio Bianchini Massoni, Giulia Rossi, Tiziano Tecchio, Paolo Perini, Antonio Freyrie
The aim of this article is to report a case of asymptomatic para-anastomotic aortocaval fistula (ACF) treated by endovascular aortic repair, and to review data of the literature on arteriovenous fistulae secondary to abdominal aortic surgery. A 78-year-old male complained of worsening pain in the right lower limb since 2 months. He presented a history of right femoropopliteal bypass for peripheral arterial occlusive disease and elective surgical treatment for a non-ruptured infrarenal aortic aneurysm (Dacron tube graft)...
February 3, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28161484/twenty-year-experience-with-aorto-enteric-fistula-repair-gastrointestinal-complications-predict-mortality
#20
Atish Chopra, Lucyna Cieciura, J Gregory Modrall, R James Valentine, Jayer Chung
BACKGROUND: Aorto-enteric fistulae (AEF) represent a lethal subset of aortic graft infections. The optimal management of AEF remains unclear. We aimed to identify predictors of morbidity and mortality. STUDY DESIGN: We performed a single-center retrospective review of consecutive AEF repairs. Demographics, co-morbidities, and peri-operative variables were obtained. Descriptive statistics, Chi-squared, Kruskall-Wallis, and Cox proportional-hazards modeling were utilized where appropriate...
February 1, 2017: Journal of the American College of Surgeons
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