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Remote endarterectomy

Yader Sandoval, Marina Zakharova, Thomas S Rector, Emmanouil S Brilakis, Todd Drexel, Edward O McFalls, Santiago Garcia
The utility of measuring cardiac troponins (cTn) in asymptomatic patients during the perioperative period has been controversial. In the present substudy of the Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery Trial (NCT01558596), we hypothesized that surveillance of myocardial injury with cTnI in the perioperative period would lead to initiation or intensification of medical therapies for coronary artery disease. Increases in cTnI ≥0.01 μg/l in the perioperative period were considered clinically significant...
September 15, 2016: American Journal of Cardiology
Steven T W van Haelst, Saskia Haitjema, Jean-Paul P M de Vries, Frans L Moll, Gerard Pasterkamp, Hester M den Ruijter, Gert J de Borst
OBJECTIVE: Diabetes mellitus (DM) is associated with peripheral arterial disease (PAD) and leads to worse clinical outcome compared with patients without DM. The objective of this study was to determine the impact of DM on iliofemoral artery plaque characteristics and to examine secondary clinical outcomes in patients with DM and PAD undergoing surgical revascularization. METHODS: We analyzed 198 patients with and 453 patients without DM from the Athero-Express biobank, a prospective ongoing biobank study, who underwent endarterectomy of the femoral or iliac artery between 2002 and 2013...
September 22, 2016: Journal of Vascular Surgery
Crystal M Kavanagh, Michael J Heidenreich, Jeremy J Albright, Abdulhameed Aziz
OBJECTIVE: Long or multisegmental external iliac-to-femoral arterial lesions treated by angioplasty and stenting have achieved disappointing results. Conventional, open approaches are often complicated by significant morbidity, and endovascular stenting alone typically requires additional outflow procedures. We hypothesized that a hybrid approach, combining endovascular techniques with remote selective external iliac endarterectomy, produces superior outcomes in terms of patency compared with stenting alone, with minimal associated morbidity...
July 28, 2016: Journal of Vascular Surgery
I M Ignat'ev
AIM: The study was aimed at improving the results of carotid endarterectomy (CEA) by means of improving technical methods of performing reconstruction of the carotid bifurcation. MATERIAL AND METHODS: From January 2012 to December 2014 at the Department of Vascular Surgery we performed a total of 703 CEA operations, including 183 (26%) according to the classical technique and 520 (74%) according to the eversion technique. The average age of patients amounted to 61...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
R A Kuzhuget, A A Karpenko, O V Kamenskaya, P V Ignatenko, V B Starodubtsev, V G Postnov
The authors analysed the results of carotid endarterectomy in a total of 469 patients with the use of simultaneous assessment of the oxygen status and collateral blood flow of the brain in order to determine feasibility of placing a temporary bypass, carried out at the Centre of Vascular and Hybrid Surgery of the Novosibirsk Scientific Research Institute of Circulatory Pathology named after Academician E.N. Meshalkin in 2008-2012. It was shown that it is more appropriate to use a temporary bypass based on simultaneous assessment of the oxygen status and collateral blood flow of the brain: in synchronous decrease of the degree of cerebral oxygenation during tentative occlusion by more than 20% of the baseline level, or in absolute values of cerebral oxygenation below 40% and simultaneous decrease of retrograde pressure below 40 mm Hg...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
A V Pokrovsky, V N Tsygankov, A A Sidorov
Timely performed reconstructive operations on carotid arteries considerably decrease the incidence rate of ischaemic-type acute impairments of cerebral circulation. Nevertheless, restenoses developing in the zone of reconstruction of carotid arteries level the positive result of the primary operation in remote terms of follow up. In such cases it is more preferable to perform stenting of the damaged portions. The article deals with cases of successful use of self-expandable stent grafts in restenoses of carotid arteries after carotid endarterectomy and operations of prosthetic repair of carotid arteries...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Christos Karathanos, Konstantinos Spanos, Vassileios Saleptsis, Georgios A Antoniou, Stylianos Koutsias, Athanasios D Giannoukas
OBJECTIVES: Remote endarterectomy (RE) is a relatively minimally invasive procedure as an alternative to femoropopliteal above-knee bypass for the treatment of long-segment superficial femoral artery (SFA) occlusion. The objective of this study was to report our experience and to evaluate the long-term outcome. DESIGN: Single-center nonrandomized retrospective study with prospective collection of patients' data. METHODS: Twelve patients (11 men; mean age 72 years, range 55-81 years) with long (>10 cm) SFA occlusion underwent RE followed by stent (aSpire) placement at the distal end of the endarterectomy...
November 2015: Vascular and Endovascular Surgery
Wesley S Moore, Jeffrey J Popma, Gary S Roubin, Jenifer H Voeks, Donald E Cutlip, Michael Jones, George Howard, Thomas G Brott
OBJECTIVE: The Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) demonstrated a higher periprocedural stroke and death (S+D) rate among patients randomized to carotid artery stenting (CAS) than to carotid endarterectomy (CEA). Herein, we seek factors that affect the CAS-CEA treatment differences and potentially to identify a subgroup of patients for whom CAS and CEA have equivalent periprocedural S+D risk. METHODS: Patient and arterial characteristics were assessed as effect modifiers of the CAS-CEA treatment difference in 2502 patients by the addition of factor-by-treatment interaction terms to a logistic regression model...
April 2016: Journal of Vascular Surgery
Max Wohlauer, Jesse K McKenney, Woosup Michael Park
BACKGROUND: A 68-year-old woman with a thoracoabdominal aortic aneurysm recently status after first-stage elephant trunk procedure with right brachiocephalic artery endarterectomy and reimplantation of the innominate and left carotid using a 14 × 10-mm branch graft presented to clinic with increasing pain in her right arm and shoulder for 2 weeks. She also had a remote history of radiation to the right axilla for breast cancer. On physical examination, she had a tender mass under her clavicle, numbness in shoulder and right hand weakness...
January 2016: Annals of Vascular Surgery
A G Edemskiĭ, A M Cherniavskiĭ, M A Cherniavskiĭ, A R Tarkova, V G Efimenko
Over the period from 2004 to 2013, a total of 146 patients presenting with chronic post-embolic pulmonary hypertension (CPEPH) underwent the operation of pulmonary thromboendarterectomy (TEE) at the Centre for Surgery of the Aorta, Coronary and Peripheral Arteries. The operation was carried out according to the conventional technique with the use of hypothermia and circulatory arrest. The dynamics of the clinical and functional state was assessed by analysing the following parameters: 6-minute walk test, mean pulmonary artery pressure, and resistance of lesser circulation vessels (according to the data of catheterization of the right parts of the heart), as well as the diameter of the pulmonary artery trunk (by data of MSCT angiography of the pulmonary artery)...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
I M Ignat'ev
The article reviews the materials of the 29th International Conference of the Russian Association of Angiologists and Vascular Surgeons "New trends and remote results of open endovascular interventions in treatment of vascular patients". Presented herein are the main results of scientific research in carotid surgery (carotid endarterectomy in the acute period of stroke, stenting), reconstructive, endovascular interventions in Leriche syndrome, pathology of lower-limb arteries, present-day technologies of treatment of aortic aneurysms (hybrid operations, endovascular prosthetic repair)...
2015: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Carola Heneweer, Markus Siggelkow, Michael Helle, Rainer Petzina, Asmus Wulff, Joost P Schaefer, Rouven Berndt, Rene Rusch, Thilo Wedel, Guenther Klaws, Magdalena Müller-Gerbl, Christoph Röcken, Olav Jansen, Georg Lutter, Joachim Cremer, Justus Groß
Stenosis and occlusion of the superficial femoral artery (SFA) are most common in arterial occlusive disease. There are numerous interventional, surgical, and combined approaches to reconstitute maximum blood supply to the lower limb; however, despite intense clinical research, the long-term success rates are still poor. We present the first results with a catheter prototype for laser-based minimal invasive endarterectomy, called laser scoop desobliteration (LSD). The tip of a glass fiber containing a catheter was modified with a spatula head design and connected to an ultraviolet laser...
February 2015: Journal of Biomedical Optics
Sachinder Singh Hans, Irina Catanescu
OBJECTIVE: Many surgeons favor routine shunting during carotid endarterectomy (CEA) in patients with recent stroke who otherwise prefer selective shunt placement for other indications of CEA. We analyzed the results of CEA in this group of patients with the strategy of selective shunting. METHODS: A retrospective review was performed of 59 patients (group A) undergoing CEA ≤8 weeks of a stroke (2000-2014) from two midsized teaching hospitals with stroke certification; of these, 38 patients had CEA ≤2 weeks and 21 other had CEA >2 weeks but <8 weeks...
April 2015: Journal of Vascular Surgery
A I Pityk, V A Prasol, V V Boĭko
AIM: The study was aimed at comparative analysis of efficacy of endovascular and surgical revascularization in patients presenting with lower limb critical ischaemia (LLCI) due to lesions of infrainguinal arteries. MATERIAL AND METHODS: The retrospective study included a total of 236 patients with LLCI undergoing revascularization of lower extremities performed at our Institute from 2007 to 2011. The patients were subdivided into two groups. Group One consisted of 135 patients subjected to transcutaneous endovascular interventions...
2014: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
I S Abramov, D A Maĭtesian, T A Lazarian, V L Baldin, A V Verigo, A G Eremenko, S A Papoian
AIM: To compare the results of semiclosed retrograde loop endarterectomy from the superficial femoral artery (SFA) and proximal femoropopliteal bypass grafting (FPBG) with a synthetic prosthesis. MATERIAL AND METHODS: From 2007 to 2011, at the Department of Vascular Surgery of Municipal Clinical Hospital No 15 named after O.M. Filatov we operated on a total of 97 patients with occlusive and stenotic lesions of the femoropopliteal segment, with 83 (86%) of them being men...
2014: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Sh I Karimov, R D Sunnatov, A A Irnazarov, R T Muminov, A A Iulbarisov, A M Akhmatov, Kh K Alidzhanov
The work was aimed at studying the remote results of reconstructive operations performed on brachiocephalic arteries in a total of 1,483 patients presenting with chronic cerebrovascular insufficiency. The findings obtained from our experience confirmed that carotid endarterectomy up to now remains the gold standard of treatment for both symptomatic and asymptomatic patients suffering from haemodynamically significant lesions of carotid arteries, requiring, however, timely performance and consequent active follow up of the patients involved...
2014: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
A V Pokrovskiĭ, D F Beloiartsev, O L Talybly
Analysed herein are remote results of surgical management of patients presenting with atherosclerotic stenoses of carotid arteries by means of eversion carotid endarterectomy. Over the period from 2002 to 2007 specialists of the Department of Vascular Surgery of the Institute of Surgery named after A.V. Vishnevsky under the RF Ministry of Public Health carried out a total of 393 eversion carotid endarterectomies in 356 patients. We assessed the remote results of 338 (86%) operations in 303 (85%) patients, analysing survival, freedom from stroke, patency of the reconstructed internal carotid artery and effects of risk factors on these indices...
2014: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
V B Starodubtsev, A A Karpenko, P V Ignatenko, I N Kim, D G Zoloev, V N Gorbatykh
AIM: comparative assessment of immediate and remote outcomes of various methods of reconstruction of the zone of bifurcation of the common carotid artery in stenotic lesions. MATERIAL AND METHODS: the authors carried out retrospective and prospective analysis of a total of 457 reconstructive operations on the bifurcation of the common carotid artery in 432 patients presenting with haemodynamically significant stenoses. Depending on the type of reconstruction of the carotid artery bifurcation, the patients were subdivided into four groups: group I - eversion carotid endarterectomy (CEA) - 157 (34...
2014: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
L I Pyshkina, D T Khatagova, A A Kabanov, N A Darvish, Zh M Alibekova
Objectives. To study the cerebral and central hemodynamics in patients with stenotic lesions of inner carotid arteries (ICA) before and after reconstructive surgery. Material and methods. Fifty-nine patients, aged from 46 to 78 years, with >50% atherosclerotic stenosis of ICA who underwent preventive carotid endarterectomy (CEAE) were examined. The isolate stenosis of ICA was identified in 13.6% of patients, concomitant lesions of brachiocephalic arteries in 86.4%. Atherosclerotic lesions of coronary arteries were found in 91...
2014: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
A R Chandrashekar, Rajendra Prasad B, Sanjay C Desai, A H Harsha
We present our preliminary results of remote endarterectomy performed during June 2003 to June 2010. 8 cases of unilateral ileofemoral disease, 3 cases of bilateral ileofemoral disease and 4 cases of femoro-popliteal disease constituting 18 limbs were successfully operated. All patients had comorbid conditions like Diabetes mellitus, hypertension, cardiac disease and smoking. Patency at 3 months with loss of one patient for follow up was 100 %. At one year follow up, the overall success rate was 90.90 %...
August 2013: Indian Journal of Surgery
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