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https://www.readbyqxmd.com/read/29349398/unexplained-rupture-after-endovascular-aneurysm-repair
#1
Marie Josee Elizabeth van Rijn, Sander Ten Raa, Joke M Hendriks, Frederico Bastos Goncalves, Hence J M Verhagen
We present a case of a 70-year-old man who was admitted with rupture of an abdominal aneurysm 4 years after endovascular aneurysm repair. He was compliant with yearly follow-up computed tomography angiography. One month earlier, his computed tomography angiogram showed perfect exclusion of the aneurysm and no endoleak. We explanted the stent graft and confirmed effective sealing, and the graft was intact. We found no signs of infection during 2 years of follow-up. This rupture is nonpredictable and unexplained and illustrates that unremarkable imaging does not guarantee prevention of rupture...
September 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29349381/acute-infection-of-viabahn-stent-graft-in-the-popliteal-artery
#2
S Michael Gharacholou, Marshall Dworak, Ala S Dababneh, Raj Varatharaj Palraj, Michael C Roskos, Scott C Chapman
Peripheral stents are increasingly used for treatment of peripheral arterial disease, yet all implanted devices are potentially at risk for infection. We describe a 51-year-old man who underwent stenting in the femoropopliteal artery and presented 3 days later with leg pain, fever, and evidence of peripheral stigmata of embolization. Blood cultures grew methicillin-resistant Staphylococcus aureus and remained persistently positive despite antibiotic therapy. At surgical exploration, the popliteal artery had essentially been disintegrated by the infection, with only visible stent graft maintaining arterial continuity...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29328523/improved-portal-vein-venoplasty-with-autogenous-patch-in-pediatric-living-donor-liver-transplantation
#3
Mingxuan Feng, Ping Wan, Bijun Qiu, Tao Zhou, Yi Luo, Lihong Gu, Jiachang Chi, Chengpeng Zhong, Yefeng Lu, Jianjun Zhang, Qiang Xia
BACKGROUND: An atretic or hypoplastic portal vein (PV) represents a challenge for PV reconstruction in pediatric living donor liver transplantation (LDLT). Several PV venoplastic techniques have been developed. However, we still seek improved venoplastic techniques with better efficacy and compatibility. METHOD: From June 2016 to July 2017, 271 LDLT procedures were performed at the Department of Liver Surgery, Ren Ji Hospital. A total of 16 consecutive children with atretic and sclerotic PVs underwent a novel technique - the autogenous PV patch plastic technique...
January 12, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29298371/femorofemoral-crossover-bypass-graft-has-excellent-patency-when-performed-with-evar-for-aaa-with-uiod
#4
Akinfemi A Akingboye, Bijendra Patel, Frank W Cross
OBJECTIVES: To compare the durability of the crossover femorofemoral bypass graft (CFFBG) in combination with aorto-uni-iliac stent graft (AUIS) for abdominal aortic aneurysm with the durability of CFFBG used in the treatment of unilateral iliac occlusive disease (UIOD). METHODS: We analyzed the clinical records of 69 patients who underwent CFFBG from 1992 until 2010. Group I consisted of 34 patients who received CFFBGs in combination with AUIS. Group II consisted of 35 patients treated with CFFBG for UIOD...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29248126/management-of-the-infected-aortic-endograft
#5
REVIEW
Kamphol Laohapensang, Supapong Arworn, Saranat Orrapin, Termpong Reanpang, Saritphat Orrapin
Although the incidence of abdominal and thoracic aortic endograft infection is infrequent, ranging between 0.2% and 5%, stent-graft infection carries significant morbidity and mortality and exemplifies a formidable therapeutic challenge. The treatment goal is to eradicate the infectious process by endograft explantation, regional tissue debridement, and arterial reconstruction by either an extra-anatomic or in situ grafting procedure using autologous vein, cryopreserved allograft, or antibiotic-soaked prosthetic grafts...
June 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29248122/pathology-of-graft-and-stent-graft-infections-lessons-learned-from-examination-of-explant-materials
#6
REVIEW
Anne Lejay, Antoine Monnot, Yannick Georg, Benjamin Colvard, Fabien Thaveau, Bernard Geny, Nabil Chakfé
Due to the aging population, the number of patients treated with aortic grafts or endografts continues to increase. Although infection after these procedures is uncommon, aortic graft infection is a life-threatening condition, and refinement of management guidelines based on implant pathophysiology is appropriate. In the early 1990s, our European collaborative retrieval program, European Group for Research on Prostheses Applied for Vascular Surgery (GEPROVAS) was commissioned to analyze the degenerative phenomenon occurring on explanted grafts or endografts...
June 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29242065/preliminary-results-of-endovascular-aneurysm-sealing-from-the-multicenter-italian-research-on-nellix-endoprosthesis-irene-study
#7
Bruno Gossetti, Ombretta Martinelli, Michelangelo Ferri, Roberto Silingardi, Fabio Verzini
OBJECTIVE: Because of advances in technology and experience of the operator, endovascular aneurysm repair (EVAR) has supplanted open repair to treat abdominal aortic aneurysm (AAA). The low 30-day mortality and morbidity of EVAR make the endovascular approach particularly suitable for patients at high surgical risk. However, endoleak or endograft migration requiring secondary intervention or open surgical conversion is a limitation of EVAR. The Nellix system (Endologix, Inc, Irvine, Calif) has been designed to seal the entire AAA to overcome these limitations with EVAR...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29234735/the-case-of-the-neighbour-s-cat-causing-a-symptomatic-mycotic-aortic-aneurysm-and-an-infected-endograft
#8
Ahmed Shalan, Nicky Wilson, Jon Poels, Anna Ikponmwosa, Stephen Cavanagh
Introduction: Aortic endograft infection is a rare but serious complication following endovascular aneurysm repair. An unusual presentation associated with an uncommon organism is reported. Case report: A 69 year old female was prescribed but failed to complete a full course of co-amoxiclav following a forearm cat bite. Nine days later she was admitted with pyrexia, left flank pain, and haematuria. Empiric treatment for a urinary tract infection was started. Pasteurella multocida was isolated from blood culture performed during this attendance...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29223353/late-open-surgical-conversion-after-endovascular-abdominal-aortic-aneurysm-repair
#9
Vinay Kansal, Sudhir Nagpal, Prasad Jetty
INTRODUCTION: Late open surgical conversion following endovascular aneurysm repair (EVAR) may occur more frequently after performing EVAR in anatomy outside the instructions for use (IFU). This study reviews predictors and outcomes of late open surgical conversion for failed EVAR. METHODS: This retrospective cohort study reviewed all EVARs performed at the Ottawa Hospital between January 1999 and May 2015. Open surgical conversions >1 month post EVAR were identified...
December 6, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29198677/single-donor-derived-pseudomonas-aeruginosa-pseudoaneurysms-in-two-kidney-transplant-recipients-a-case-report-of-dichotomous-allograft-outcomes
#10
M F Berger, I R Badell
Infectious pseudoaneurysm (IPA) is a rare but devastating complication following renal transplantation that typically leads to graft loss and occasionally patient death. IPAs following kidney transplantation are most often mycotic in etiology, but have been sporadically reported to result from Pseudomonas aeruginosa infection. These IPAs occur at various anatomic sites, most commonly at the vascular anastomosis or iliac artery, and very rarely in the transplanted renal artery or hilum. Here we report the occurrence of single donor-derived P aeruginosa IPAs in two kidney transplant recipients with divergent allograft outcomes...
December 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29182741/off-label-use-of-thoracic-aortic-endovascular-stent-grafts-to-simplify-difficult-resections-and-procedures-in-general-thoracic-surgery
#11
Tanja Walgram, Nicolas Attigah, Igor Schwegler, Markus Weber, Omer Dzemali, Christian Berthold, Dirk Wagnetz, Giovanni L Carboni
OBJECTIVES: Tumour infiltration, or gross infectious involvement of the thoracic aortic wall, poses a significant intraoperative risk for fatal bleeding and therefore could compromise adequate resection or efficient surgical management of pleural infection in a considerable amount of cases. We present 3 successful cases of off-label thoracic aortic endografting to safeguard thoracic aortic wall integrity. METHODS: After all patients received thoracic stent grafts through femoral access into the descending aorta, the first patient underwent a resection of a locally advanced squamous cell carcinoma of the left inferior lobe cT4cN0-1cM0 after neoadjuvant chemoradiation, which had infiltrated the descending aortic wall...
November 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29181216/endovascular-repair-with-a-stent-graft-in-a-patient-with-aortoduodenal-fistula-after-radiation-therapy
#12
Kazuhiko Morikawa, Hirokazu Ashida, Yosuke Nozawa, Kenji Motohashi, Takao Igarashi, Hiroya Ojiri, Yuji Kanaoka, Takao Ohki
Primary aortoduodenal fistula (ADF) is a direct communication between the abdominal aorta and the gastrointestinal tract without any previous vascular intervention and represents a rare but critical cause of repeated and massive gastrointestinal bleeding. Primary ADF often occurs as a result of atherosclerotic aneurysm and infection, but ADF involving a normal-size aorta is rare; furthermore, ADF related to radiation therapy is extremely rare. We present the case of a 56-year-old man with a history of bowel obstruction due to radiation enteritis who was admitted with severe hematemesis and hemorrhagic shock...
2017: Case Reports in Radiology
https://www.readbyqxmd.com/read/29169301/utilization-of-stent-grafts-in-the-management-of-arteriovenous-access-pseudoaneurysms
#13
Afsha Aurshina, Anil Hingorani, Natalie Marks, Enrico Ascher
Objective Endovascular stent graft repair for exclusion of pseudoaneurysm is currently being explored to replace open surgical repair as current management. The objective of the study was to evaluate the clinical safety and efficacy of endovascular stent graft intervention in pseudoaneurysms complicating arteriovenous reconstructions in patients on chronic hemodialysis. Methods A retrospective analysis of all pseudoaneurysms treated with stent grafts at our institution over a period of five years was performed...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/29163957/new-therapeutic-options-provided-by-off-label-deployment-of-stent-graft-for-tailored-arteriovenous-access-salvage-two-cases
#14
Riccardo Corti, Pietro Quaretti, Franco Galli, Lorenzo Paolo Moramarco, Nicola Cionfoli, Giovanni Leati, Riccardo Corbetta, Matteo Tozzi
A tailored therapy to patient requirements by combining endovascular and surgical steps can be necessary to prolong the life of a vascular access. Stent grafts play a growing role for the therapy of dialytic access complications. Randomized multi-center trials, however, support the on-label use of stent grafts in the treatment of graft venous outflow and in-stent restenosis. The main contraindication to their use is an ongoing infection. We report two cases of new off-label application of Viabahn (Gore, flagstaff, USA) stent graft...
2017: SAGE Open Medical Case Reports
https://www.readbyqxmd.com/read/29149963/urinary-tract-infections-in-the-first-year-post-kidney-transplantation-potential-benefits-of-treating-asymptomatic-bacteriuria
#15
P Kotagiri, D Chembolli, J Ryan, P D Hughes, N D Toussaint
BACKGROUND: Urinary tract infections (UTIs) are the commonest infectious complication in kidney transplant recipients (KTRs). No recommendations exist regarding treatment of asymptomatic bacteriuria. We aimed to identify potential risk factors and microbiological profile for UTIs, the role of treatment of asymptomatic bacteriuria, and effects on graft outcomes of bacteriuria within the first year post-transplantation. METHODS: We performed a retrospective analysis of UTIs in KTRs transplanted between January 2012 and December 2013 in 2 transplantation centers...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29142494/endovascular-treatment-of-abdominal-aortic-aneurysm-with-complete-iliac-occlusion-case-series-and-literature-review
#16
Randall W Franz, M Taha Ibrahim, Christopher F Tanga, David A Epstein
In patients with abdominal aortic aneurysms (AAA) and complete iliac occlusion, endovascular aortic aneurysm repair (EVAR) using a bifurcated stent graft has clear advantages over aortouniiliac stent grafts. Bifurcated stent grafts had improved hemodynamic flow and increased primary and secondary patency rates compared with aortouniiliac stent grafts. The use of aortouniiliac stent grafts with femorofemoral crossover bypass is associated with complications including infection of the prosthesis, steal phenomenon, and the associated difficulties for further endovascular access at the site of the femoral anastomosis...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29082822/endovascular-treatment-of-penetrating-arterial-trauma-with-stent-grafts
#17
Rodrigo Bruno Biagioni, Marcelo Calil Burihan, Felipe Nasser, Luisa Ciucci Biagioni, José Carlos Ingrund
BACKGROUND: The endovascular management of arterial injuries has resulted in reduced operating time, blood loss, hospital mortality, lower incidence of sepsis, and decrease in mortality rates. For penetrating trauma, however, the benefits of endovascular therapy are questionable. PATIENTS AND METHODS: Data were obtained by retrospective analysis of electronic medical records. All patients with vascular trauma seeking care at our institution from January 2010 to December 2015 were reviewed...
October 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29078248/-management-of-endograft-infection-after-evar-and-tevar-a-case-series-and-literature-review
#18
Thomas Betz, Ingolf Töpel, Markus Steinbauer, Christian Uhl
Introduction Endograft infection after EVAR (Endovascular aortic repair) or TEVAR (Thoracic endovascular aortic repair) is a rare but severe complication with high mortality. As the number of patients with endovascular aneurysm repair has increased over the last decade, the number of patients with endograft infection might also have increased. However, no guideline defines the treatment of endograft infection. Diagnosis is difficult and depends on clinical symptoms, radiological imaging and blood cultures. Surgery with graft excision, debridement and revascularisation should be proposed...
October 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29073499/management-of-major-vascular-injury-during-pedicle-screw-instrumentation-of-thoracolumbar-spine
#19
Aleem K Mirza, Mohammed Ali Alvi, Ryan M Naylor, Panagiotis Kerezoudis, William E Krauss, Michelle J Clarke, Daniel L Shepherd, Ahmad Nassr, Randall R DeMartino, Mohamad Bydon
OBJECTIVES: Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. PATIENTS AND METHODS: We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29066243/sustained-local-delivery-of-high-concentration-vancomycin-from-a-hybrid-biodegradable-antibiotic-eluting-nanofiber-loaded-endovascular-prosthesis-for-treatment-of-mycotic-aortic-aneurysms
#20
Kuo-Sheng Liu, Cheng-Hung Lee, Demei Lee, Michelle Liu, Feng-Chun Tsai, Yuan-Yun Tseng
BACKGROUND: Endovascular repair for mycotic aortic aneurysm (MAA) is a less invasive alternative to open surgery, although the placement of a stent graft in an infected environment remains controversial. In this study, we developed hybrid biodegradable, vancomycin-eluting, nanofiber-loaded endovascular prostheses and evaluated antibiotic release from the endovascular prostheses both in vitro and in vivo. METHODS: Poly(D,L)-lactide-co-glycolide and vancomycin were dissolved in 1,1,1,3,3,3-hexafluoro-2-propanol...
October 21, 2017: Journal of Vascular Surgery
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