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https://www.readbyqxmd.com/read/28430760/resuscitative-endovascular-balloon-occlusion-of-the-aorta-or-resuscitative-thoracotomy-with-aortic-clamping-for-noncompressible-torso-hemorrhage-a-retrospective-nationwide-study
#1
Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emerging treatment for noncompressible torso hemorrhage. It remains unclear if REBOA is superior to resuscitative thoracotomy with aortic cross-clamping (RT) in terms of improving outcomes. This study compared in-hospital outcomes between REBOA and RT in trauma patients with uncontrolled hemorrhagic shock, using data from a national inpatient database in Japan. METHODS: Using the Diagnosis Procedure Combination database, we identified patients who received REBOA or RT within 1 day after admission from July 1, 2010, to March 31, 2014...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424126/the-novel-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-to-explore-a-retroperitoneal-hematoma-in-a-hemodynamically-unstable-patient
#2
Martin D Rosenthal, Ahsan Raza, Stephanie Markle, Chasen A Croft, Alicia M Mohr, R Stephen Smith
Balloon occlusion of the aorta was first described by C.W. Hughes in 1954, when it was used as a tamponade device for three wounded soldiers during the Korean War suffering from intra-abdominal hemorrhage. Currently, the device is indicated in trauma patients as a surrogate for resuscitative thoracotomy. Brenner et al. reported a case series describing the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) in advanced hemorrhagic shock. Their conclusion was that "it is a feasible method for proximal aortic control...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422912/vascular-complications-from-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-life-over-limb
#3
John R Taylor, John A Harvin, Clay Martin, John B Holcomb, Laura J Moore
BACKGROUND: Vascular complications from resuscitative endovascular balloon occlusion of the aorta (REBOA) have been reported as high as 13% with some patients requiring lower extremity amputation. We sought to review our institutions series of REBOA and assess our vascular complications. METHODS: Retrospective review of all patients undergoing REBOA from October 2011 through July 2016. Data was gathered from the Memorial Hermann Trauma registry and the hospital electronic medical records...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#4
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28395494/-diagnosis-and-treatment-of-traumatic-optic-neuropathy-with-internal-carotid-artery-trauma
#5
Q J Fan, L Y Ni, X J Liu, Y Zeng, L F Jiang, B Zheng
Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness...
March 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/28392101/surgical-and-endovascular-treatments-of-extracranial-carotid-artery-aneurysms-report-of-six-cases
#6
Shusuke Yamamoto, Naoki Akioka, Daina Kashiwazaki, Masaki Koh, Naoya Kuwayama, Satoshi Kuroda
BACKGROUND: Although the natural course of extracranial carotid artery aneurysms (ECAAs) is still unknown, they may cause stroke or cranial nerve dysfunction unless they are treated. In this report, we reviewed the clinical results of 6 patients who underwent endovascular and surgical treatments for ECAAs. METHODS: A total of 6 patients underwent endovascular and surgical treatments for ECAAs for 9 years. The primary causes of ECAAs included Marfan syndrome (1 patient), infection (1 patient), trauma (2 patients), and unknown (2 patients)...
April 6, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28390919/symptomatic-deep-femoral-artery-pseudoaneurysm-endovascular-exclusion-case-report-and-literature-review
#7
Felice Pecoraro, Ettore Dinoto, Umberto M Bracale, Giovanni Badalamenti, Arduino Farina, Guido Bajardi
Deep femoral artery pseusoaneurysms (DFAPs) are rare and generally occur after penetrating trauma or surgical procedures. A 36-year old obese man presented with pain in correspondence of the anterior-lateral thigh after 6 months from gunshot wound. Duplex and computed tomography (CT) showed a bilobed right DFAP (maximal diameter 12.9 cm). The patient was managed urgently, under local anaesthesia, by placement in the distal DFA of a Viabahn 8 x 100mm stent-graft (W L Gore & Associates, Inc). The post-operative course was uneventful and the 24-months CT showed regular stent-graft patency and 20 mm DFPA shrinkage...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#8
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#9
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28386510/intraparenchymal-renal-artery-pseudoaneurysm-and-arteriovenous-fistula-on-a-solitary-kidney-occurring-38-years-after-blunt-trauma
#10
Daniel Benamran, Benedicte de Clippele, Frank Hammer, Bertrand Tombal
Pseudoaneurysm and arteriovenous fistulae of the renal artery are rare complications of kidney trauma. They commonly result from open traumas and occur within days after the injury. Common symptoms include acute haematuria, pain, or hypertension. We report the case of a fifty-three-year-old man presenting with symptomatic complex chronic high flow kidney arteriovenous fistula with interposition of a pseudoaneurysmal pouch and arterial aneurysmal dilatation in a solitary left kidney 38 years after a blunt trauma...
2017: Case Reports in Urology
https://www.readbyqxmd.com/read/28385501/percutaneous-embolization-of-delayed-external-carotid-artery-pseudoaneurysm-eight-years-after-partial-parathyroidectomy
#11
Antonella Laurito, Holta Kasemi, Andrea Monti, Mauro Maselli, Paola Manzo, Valeria Tavolini, Andrea Gaggiano
External carotid artery pseudoaneurysm (ECAP) is very rare. The usual mechanism is trauma or iatrogenic. We report a case of a patient with an asymptomatic, chronic ECAP secondary to partial parathyroidectomy. Percutaneous injection of the two-component Fibrin Sealant (Tisseel, Baxter int., Deerfield, IL) with the two active ingredients (Sealer Protein Solution and Thrombin Solution) was carried out with successful occlusion of the pseudoaneurysmal sac. The six-month follow up CT scan confirmed the ECAP thrombosis...
April 3, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28379869/resuscitative-endovascular-balloon-occlusion-of-the-aorta-and-the-anesthesiologist-a-case-report-and-literature-review
#12
Bianca M Conti, Justin E Richards, Rishi Kundi, Jason Nascone, Thomas M Scalea, Maureen McCunn
The most common preventable cause of death after trauma is exsanguination due to uncontrolled hemorrhage. Traditionally, anterolateral emergency department thoracotomy is used for temporary control of noncompressible torso hemorrhage and to increase preload after trauma. Resuscitative endovascular balloon occlusion of the aorta is a minimally invasive technique that achieves similar goals. It is therefore imperative for the anesthesiologist to understand physiologic implications during resuscitative endovascular aortic occlusion and after balloon deflation...
April 4, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28377911/distal-femoral-arteriovenous-fistula-with-iliac-vein-thrombosis-after-blunt-trauma
#13
Duk Sil Kim, Sung Wan Kim, Hyun Seok Lee, Kyung Hwan Byun, Michael SungPil Choe
A 39-year-old woman arrived at our emergency department, complaining of severe pain and swelling of her left leg. She had slipped down stairs and injured on her left leg about 3 months ago. Computed tomography angiography showed left distal superficial femoral artery's pseudoaneurysm with arteriovenous fistula and thrombotic occlusion of left common iliac vein. We decided to do endovascular intervention due to severe venous hypertension and chronic inflammation around the fistula. The femoral arteriovenous fistula was closed via stent-graft (7 mm×5, 9 mm×5 cm) deployment...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28366308/percutaneous-fenestrated-endovascular-aortic-graft-treatment-of-aortocaval-fistula-with-aortic-pseudoaneurysms-secondary-to%C3%A2-penetrating-trauma
#14
Sheila N Blumberg, Firas F Mussa, Thomas S Maldonado
Aortocaval fistula (ACF) is a lethal complication of aortic aneurysmal disease. Traditional treatment of ACF involves open surgical approaches to fistula ligation and repair of the great vessels, with a high mortality secondary to bleeding and cardiac compromise. We present the case of a 28-year-old man with a chronic ACF with concomitant aortic pseudoaneurysms secondary to penetrating trauma treated with a fenestrated endograft.
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28346475/treatment-of-blunt-thoracic-aortic-injury-in-germany-assessment-of-the-traumaregister-dgu%C3%A2
#15
Alexander Gombert, Mohammad E Barbati, Martin Storck, Drosos Kotelis, Paula Keschenau, Hans-Christoph Pape, Hagen Andruszkow, Rolf Lefering, Frank Hildebrand, Andreas Greiner, Michael J Jacobs, Jochen Grommes
PURPOSE: Using the data delivered by the German Trauma Register DGU® from 2002 till 2013, the value of different therapies of blunt thoracic aortic injury (BTAI) in Germany was analyzed. METHODS: Prospectively collected data of patients suffering from BTAI were retrospectively analyzed with focus on the different treatment modalities for grade I-IV injuries. RESULTS: 821 patients suffering from BTAI were identified: 51.6% (424) grade I injury, 35...
2017: PloS One
https://www.readbyqxmd.com/read/28341511/open-and-endovascular-abdominal-aortic-injury-repair-outcomes-in-polytrauma-patients
#16
Anand Dayama, Aksim Rivera, Odunayo Olorunfemi, Ahmed Mahmoud, Catherine A Fontecha, John McNelis
INTRODUCTION: The management of patients with abdominal aortic injury (AAI) remains challenging. Open repair of AAI is still the standard of care although it is associated with high mortality. In past few years, endovascular surgery has evolved as a less invasive alternative to open surgery in emergency settings. The objective of this study was to compare outcomes after open repair versus endovascular repair of AAI in polytrauma patients. METHODS: The National Trauma Data Bank, from 2008 to 2012, was queried to identify trauma patients undergoing open and endovascular repair of AAI using International Classification of Diseases, ninth Edition, and Clinical Modification codes...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28341499/renal-arteriovenous-malformations-a-rare-vascular-cause-of-back-pain
#17
Tazo Inui, David Frankel
OBJECTIVE: Renal arteriovenous malformation (AVM) is a very rare phenomenon (fewer than 200 cases in the literature), most commonly (75%) presenting with hematuria in young women. Renal AVMs may be cirsoid (multi-branched) or cavernous, with cirsoid morphology predominating 3:1. The historical treatment is partial nephrectomy. Best endovascular therapy is divided among many options. We present 2 cases of large renal AVMs treated with single Amplatzer plugs. METHODS: During a 2-year period (2014-15), 2 patients presented for vascular evaluation of renal AVMs found incidentally on workup for non-specific abdominal and back pain...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#18
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28337922/acquired-pulmonary-artery-pseudoaneurysms-a-pictorial-review
#19
REVIEW
Benedicte Guillaume, Anne Vendrell, Xavier Stefanovic, Frederic Thony, Gilbert R Ferretti
Pulmonary artery pseudoaneurysms (PAPs) are uncommon but potentially lethal. They may be incidentally discovered on imaging, or following massive haemoptysis if they rupture, with high risk of mortality. The most frequent causes of PAP are trauma and infectious disease. Vasculitis, in particular Behçet's disease, neoplasm, congenital disease and pulmonary hypertension are rarer causes of PAP. A PAP can be suspected from chest X-ray and contrast CT, but requires confirmation by CT angiography. Arteriography is no longer performed for diagnostic purposes, but can be useful in preparing endovascular occlusion of the PAP...
May 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28328730/partial-occlusion-conversion-from-thoracotomy-undelayed-but-shorter-occlusion-resuscitative-endovascular-balloon-occlusion-of-the-aorta-strategy-in-japan
#20
Yosuke Matsumura, Junichi Matsumoto, Hiroshi Kondo, Koji Idoguchi, Tomohiro Funabiki
INTRODUCTION: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a viable alternative to resuscitative thoracotomy (RT) in refractory hemorrhagic patients. We evaluated REBOA strategies using Japanese multi-institutional data. PATIENTS AND METHODS: The DIRECT-IABO investigators registered trauma patients requiring REBOA from 18 hospitals. Patients' characteristics, outcomes, and time in initial treatment were collected and analyzed. RESULTS: From August 2011 to December 2015, 106 trauma patients were analyzed...
March 21, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
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