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Renal artery reconstruction

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https://www.readbyqxmd.com/read/28507439/infrainguinal-open-reconstruction-a-review-of-surgical-considerations-and-expected-outcomes
#1
REVIEW
Sevan R Komshian, Kimberly Lu, Steven L Pike, Jeffrey J Siracuse
Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0-5...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28457423/mycotic-pseudoaneurysm-after-kidney-transplantation-two-case-reports
#2
A Ministro, T Ferreira, L Batista, A Santana, N Alves, J Guerra, J Fernandes E Fernandes
BACKGROUND: Vascular complications after kidney transplantation may cause allograft loss. Here, we describe 2 patients with extrarenal mycotic pseudoaneurysm after kidney transplantation. PATIENTS: Patient 1 was a 54-year-old man who developed pseudoaneurysm 60 days after transplantation, and patient 2 was a 48-year-old woman who was diagnosed with a pseudoaneurysm 5 months after transplantation. RESULTS: Patient 1 had a deceased-donor kidney transplant with end-to-side external iliac arterial anastomosis that was reconstructed 8 days after transplantation owing to rupture and major bleeding...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28341512/change-in-aortic-neck-diameter-after-endovascular-aortic-aneurysm-repair
#3
Marcus R Kret, Kenneth Tran, Jason T Lee
INTRODUCTION: and Objectives: Implications of aortic neck dilatation following EVAR are unclear. Previous studies are limited to comparisons of individual, early-generation devices. We compared aortic neck dilatation among contemporary stent-grafts. METHODS: We reviewed pre- and post-op CTA for EVARs performed from 2008-2014. Images were analyzed using 3-D centerline reconstructions. Aortic neck diameter was measured in orthogonal planes at and 10 mm below the lowest renal artery...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28332957/three-dimensional-computed-tomography-reconstruction-in-transplant-renal-artery-stenosis
#4
Xufeng Zhang, Hongwei Wang, Shuangde Liu, Jieke Yan, Xiaoli Liu, Dongsheng Xu, Chuan Tian
OBJECTIVES: Transplant renal artery stenosis is a frequently recognized complication of kidney transplant procedures. A single-center retrospective study was conducted to examine the use of 3-dimensional computed tomography reconstruction in diagnosing transplant artery stenosis. MATERIALS AND METHODS: During 2013 at our center, 86 patients underwent kidney transplant. All patients underwent ultrasonographic analyses. Patients with clinically suspected transplant renal artery stenosis were examined by 3-dimensional computed tomography reconstruction and were treated with endovascular approaches or medically managed...
March 22, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#5
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28238921/geometric-alteration-of-renal-arteries-after-fenestrated-grafting-and-the-impact-on-renal-function
#6
Jiale Ou, Yiu-Che Chan, Crystal Yin-Tung Chan, Stephen W K Cheng
BACKGROUND: This study aims to investigate the degree of geometric change on renal arteries and its impact on renal function after fenestrated endovascular aortic repair (fEVAR). METHODS: Twenty-five patients with fEVAR were included. There were 47 renal arteries target vessels, and 43 of these (22 left and 21 right vessels) stented successfully. Their preoperative and first postoperative follow-up computed tomography (CT) images were reconstructed using the Aquarius workstation (TeraRecon, San Mateo, CA, USA)...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28229801/successful-implantation-of-a-renal-allograft-with-quintuple-arteries-retrieved-from-a-living-donor
#7
Sunil Kumar, Nikhil Mahajan, Soham Dasgupta, Shivakumar Shankarrao Patil, Sarbpreet Singh, Deepesh Benjamin Kenwar, Manphool Singhal, Ashish Sharma, Anupam Lal, Mukut Minz
In renal transplant, multiple renal arteries in a donor require meticulous vascular reconstruction for successful allograft function in the recipient. Presence of more than 4 renal arteries is usually considered to be a relative contraindication for proceeding with renal donation. We report a living-donor renal transplant procedure where preoperative radiologic imaging of the donor showed 3 left renal arteries. Two additional arteries were identified intraoperatively. All 5 arteries were reconstructed during the back-table procedure, and the allograft was implanted in the recipient...
February 23, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28216502/-treatment-of-ureteral-fistula-and-stricture-following-renal-transplantation-with-boari-flap
#8
Peng Jin, Jinliang Xie, Jingeng Dun, Xiang Ding, Cheng Zhou, Xiangrong Zhu, Lielin Wu, Bo Yang, Gang Zhang
To estimate the incidence rate of ureteral fistula and stricture after kidney transplantation, and to evaluate the effect of bladder flap (Boari flap) on ureteral complication of the transplanted kidney. 
 Methods: The clinical data and risk factors from 270 recipients of renal transplantation, who came from the Centre of Organ Transplantation, Xiangya Hospital, Central South University from January 2010 to January 2015, were retrospectively analyzed. The surgical management included Boari flap for ureteral reconstruction, neoureterocystostomy and endoscopic therapy with double-J (DJ) stent placement...
January 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#9
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28191012/application-of-modified-small-bladder-patch-to-bladder-double-layer-sutures-to-improve-renal-transplantation-in-mice
#10
Chen Wenwei, Yang Yirong, Katarzyna M Stevens, Michal Heger, Xia Peng
BACKGROUND: This study aimed to introduce an improved surgical procedure to reduce the incidence of urinary tract complications after renal transplantation in mice using a modified bladder patch-to-bladder anastomosis technique. METHODS: Renal isotransplantation was performed in 28 male C57BL/6 mice. The urinary tract was reconstructed with a ureteral anastomosis between the donor's small bladder patch and the recipient's bladder. The bladder patch was secured through a cystotomy in the recipient's bladder mucosa and seromuscular layers, which were sutured in a double-layer manner...
2017: European Surgery: ACA: Acta Chirurgica Austriaca
https://www.readbyqxmd.com/read/28176396/multiresolution-imaging-using-golden-angle-stack-of-stars-and-compressed-sensing-for-dynamic-mr-urography
#11
Abhishek Pandey, Umit Yoruk, Mahesh Keerthivasan, Jean-Philippe Galons, Puneet Sharma, Kevin Johnson, Diego R Martin, Maria I Altbach, Ali Bilgin, Manojkumar Saranathan
PURPOSE: To develop a novel multiresolution MRI methodology for accurate estimation of glomerular filtration rate (GFR) in vivo. MATERIALS AND METHODS: A three-dimensional golden-angle radial stack-of-stars (SoS) trajectory was used for data acquisition on a 3 Tesla MRI scanner. Multiresolution reconstruction and analysis was performed using arterial input function reconstructed at 1-s. temporal resolution and renal dynamic data reconstructed using compressed sensing (CS) with 4-s temporal resolution...
February 8, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28161484/twenty-year-experience-with-aorto-enteric-fistula-repair-gastrointestinal-complications-predict-mortality
#12
Atish Chopra, Lucyna Cieciura, J Gregory Modrall, R James Valentine, Jayer Chung
BACKGROUND: Aorto-enteric fistulas (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, comorbidities, and perioperative variables were obtained. Descriptive statistics, chi-square, Kruskall-Wallis, and Cox proportional-hazards modeling were used where appropriate...
February 2, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28152259/four-dimensional-phase-contrast-vastly-undersampled-isotropic-projection-reconstruction-4d-pc-vipr-mr-evaluation-of-the-renal-arteries-in-transplant-recipients-preliminary-results
#13
Daisuke Motoyama, Yasuo Ishii, Yasuo Takehara, Masataka Sugiyama, Wang Yang, Hatsuko Nasu, Takasuke Ushio, Yuko Hirose, Naoki Ohishi, Tetsuya Wakayama, Hiroyuki Kabasawa, Kevin Johnson, Oliver Wieben, Harumi Sakahara, Seiichiro Ozono
PURPOSE: To assess the performance of four-dimensional phase-contrast vastly undersampled isotropic projection reconstruction (4D PC-VIPR) at 3.0T in depicting intrarenal arteries compared with computed tomography angiography (CTA), and its correlation with arterial flowmetry in comparison with Doppler ultrasonography (DUS). MATERIALS AND METHODS: In our prospective single-arm study, subjects were 25 patients who underwent renal transplant-related surgery at our hospital between July 2011 and June 2015...
February 2, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28141679/abdominal-arterial-anomalies-in-children-with-alagille-syndrome-surgical-aspects-and-outcomes-of-liver-transplantation
#14
Jules Kohaut, Romain Pommier, Florent Guerin, Danièle Pariente, Emmanuel Jacquemin, Hélène Martelli, Sophie Branchereau
OBJECTIVES: Angiogenic defects secondary to gene mutations of JAG1 and NOTCH2, causing arterial anomalies in Alagille syndrome (AGS), are well described in the literature. The study analyzes the frequency of abdominal arterial anomalies in children with AGS with an emphasis on outcomes following liver transplantation (LT). METHODS: Between 1988 and 2013, 242 children with AGS were treated at our institution. We performed a retrospective analysis of 55 who underwent LT during the study period...
June 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28057275/anatomic-suitability-for-transcaval-access%C3%A2-based-on-computed-tomography
#15
REVIEW
Robert J Lederman, Adam B Greenbaum, Toby Rogers, Jaffar M Khan, Melissa Fusari, Marcus Y Chen
Transcaval access has been used successfully for over 200 transcatheter aortic valve replacements, large-bore percutaneous left ventricular assist devices, and thoracic endovascular aortic aneurysm repairs. This review teaches how to plan transcaval access and closure based on computed tomography. The main planning goals are to: 1) identify calcium-free crossing targets in the abdominal aorta along with optimal fluoroscopic projection angles and level with respect to lumbar vertebrae; 2) identify obstacles such as interposed bowel or pedunculated aortic atheroma; 3) plan covered stent bailout; and 4) identify jeopardized vascular branches such as renal arteries that might be obstructed by bailout covered stents if employed...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28051019/hemodynamics-in-transplant-renal-artery-stenosis-and-its-alteration-after-stent-implantation-based-on-a-patient-specific-computational-fluid-dynamics-model
#16
Hong-Yang Wang, Long-Shan Liu, Hai-Ming Cao, Jun Li, Rong-Hai Deng, Qian Fu, Huan-Xi Zhang, Ji-Guang Fei, Chang-Xi Wang
BACKGROUND: Accumulating studies on computational fluid dynamics (CFD) support the involvement of hemodynamic factors in artery stenosis. Based on a patient-specific CFD model, the present study aimed to investigate the hemodynamic characteristics of transplant renal artery stenosis (TRAS) and its alteration after stent treatment. METHODS: Computed tomography angiography (CTA) data of kidney transplant recipients in a single transplant center from April 2013 to November 2014 were reviewed...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28043466/increasing-complexity-of-heart-transplantation-in-patients-with-congenital-heart-disease
#17
William Y Shi, Pankaj Saxena, Matthew S Yong, Silvana F Marasco, David C McGiffin, Anne Shipp, Robert G Weintraub, Yves d'Udekem, Christian P Brizard, Igor E Konstantinov
Owing to improved surgical results, there is a growing population of patients with repaired congenital heart disease (CHD) requiring heart transplantation. The objective of the study was to review our experience in these patients. A retrospective review of the outcomes of heart transplantation in patients with CHD (n = 77) between 1988 and 2014 was performed. Outcomes of early (1988-1999) and late (2000-2014) eras were compared. In results, the mean age was 18 ± 14 years (range: 16 days-58 years). Seventy (91%) patients underwent a mean of 2...
July 2016: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27988157/successful-microscopic-renal-autotransplantation-for-left-renal-aneurysm-associated-with-segmental-arterial-mediolysis
#18
Takashi Yoshioka, Motoo Araki, Yuichi Ariyoshi, Koichiro Wada, Noriyuki Tanaka, Yasutomo Nasu
Segmental arterial mediolysis (SAM) is an uncommon, nonarteriosclerotic vascular disease. SAM is characterized by lysis of arterial media and can lead to aneurysm formation. The renal arteries are the third most common arteries associated with SAM. We report the case of a 32-year-old man with left renal artery aneurysm associated with SAM. We successfully performed left renal autotransplantation using microscopic vascular reconstruction. SAM is characterized by vascular fragility; therefore, microscopic surgery is favorable for treating aneurysms associated with SAM...
December 14, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27928064/3d-printing-guiding-stent-graft-fenestration-a-novel-technique-for-fenestration-in-endovascular-aneurysm-repair
#19
Jianhua Huang, Gan Li, Wei Wang, Keming Wu, Tianming Le
Objective To describe a novel approach, 3D printing guiding stent graft fenestration, for fenestration during endovascular aneurysm repair for juxtarenal abdominal aortic aneurysm. Methods A 69-year-old male with juxtarenal abdominal aortic aneurysm underwent endovascular aneurysm repair with "off the label" fenestrated stent graft. To precisely locate the fenestration position, we reconstructed a 3D digital abdominal aortic aneurysm model and created a skin template covering this abdominal aortic aneurysm model...
January 1, 2016: Vascular
https://www.readbyqxmd.com/read/27888303/dual-energy-ct-workflow-multi-institutional-consensus-on-standardization-of-abdominopelvic-mdct-protocols
#20
Bhavik N Patel, Lauren Alexander, Brian Allen, Lincoln Berland, Amir Borhani, Achille Mileto, Courtney Moreno, Desiree Morgan, Dushyant Sahani, William Shuman, Eric Tamm, Mitchell Tublin, Benjamin Yeh, Daniele Marin
PURPOSE: To standardize workflow for dual-energy computed tomography (DECT) involving common abdominopelvic exam protocols. MATERIALS AND METHODS: 9 institutions (4 rsDECT, 1 dsDECT, 4 both) with 32 participants [average # years (range) in practice and DECT experience, 12.3 (1-35) and 4.6 (1-14), respectively] filled out a single survey (n = 9). A five-point agreement scale (0, 1, 2, 3, 4-contra-, not, mildly, moderately, strongly indicated, respectively) and utilization scale (0-not performing and shouldn't; 1-performing but not clinically useful; 2-performing but not sure if clinically useful; 3-not performing it but would like to; 4-performing and clinically useful) were used...
November 25, 2016: Abdominal Radiology
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