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https://www.readbyqxmd.com/read/28723765/perioperative-management-of-intracardiac-leiomyomatosis-an-observational-cohort-study
#1
Jiaying Xu, Min Wei, Qi Miao, Bin Zhu, Chunhua Yu, Yuguang Huang
Intracardiac leiomyomatosis (ICLM) is a rare condition in which the benign tumor extends into the right heart chambers through inferior vena cava. The best surgical approach still remains unclear.We present a retrospective cohort of 36 patients diagnosed with ICLM in Peking Union Medical College Hospital between 2002 and 2016.The mean patient age was 44.5 (range 25-55) years. The clinical manifestations were various, including shortness of breath, chest tightness, edema of the lower extremities, palpitations, syncope, etc...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#2
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28689939/variation-in-transfusion-practices-and-the-association-with-perioperative-adverse-events-in-patients-undergoing-open-abdominal-aortic-aneurysm-repair-and-lower-extremity-arterial-bypass-in-the-vascular-quality-initiative
#3
Zachary Osborne, Kristine Hanson, Benjamin S Brooke, Marc Schermerhorn, Peter Henke, Rumi Faizer, Andres Schanzer, Philip Goodney, Thomas Bower, Randall R DeMartino
INTRODUCTION: Blood transfusions are associated with adverse events. We examined perioperative transfusion practices and associated complications following open vascular procedures nationwide in the Vascular Quality Initiative (VQI). METHODS: Adults undergoing open abdominal aortic aneurysm repair (OAR) and lower extremity arterial bypass (Bypass) within VQI (2003-2016) were identified. All emergent cases, patients with pre-operative hemoglobin<7 g/dL, pre-operative hospitalization >1 day, or a return to OR during the index hospitalization were excluded...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28679373/a-comprehensive-overview-on-the-surgical-management-of-secondary-lymphedema-of-the-upper-and-lower-extremities-related-to-prior-oncologic-therapies
#4
REVIEW
Ramon Garza, Roman Skoracki, Karen Hock, Stephen P Povoski
Secondary lymphedema of the upper and lower extremities related to prior oncologic therapies, including cancer surgeries, radiation therapy, and chemotherapy, is a major cause of long-term morbidity in cancer patients. For the upper extremities, it is most commonly associated with prior oncologic therapies for breast cancer, while for the lower extremities, it is most commonly associated with oncologic therapies for gynecologic cancers, urologic cancers, melanoma, and lymphoma. Both non-surgical and surgical management strategies have been developed and utilized, with the primary goal of all management strategies being volume reduction of the affected extremity, improvement in patient symptomology, and the reduction/elimination of resultant extremity-related morbidities, including recurrent infections...
July 5, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28678999/association-of-centers-for-medicare-medicaid-services-overall-hospital-quality-star-rating-with-outcomes-in-advanced-laparoscopic-abdominal-surgery
#5
Christina Y Koh, Colette S Inaba, Sarath Sujatha-Bhaskar, Ninh T Nguyen
Importance: The Centers for Medicare & Medicaid Services (CMS) recently released the Overall Hospital Quality Star Rating to help patients compare hospitals based on a 5-star scale. The star rating was designed to assess overall quality of the institution; thus, its validity toward specifically assessing surgical quality is unknown. Objective: To examine whether CMS high-star hospitals (HSHs) have improved patient outcomes and resource use in advanced laparoscopic abdominal surgery compared with low-star hospitals (LSHs)...
July 5, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28674697/cell-free-vascular-grafts-recent-developments-and-clinical-potential
#6
Sindhu Row, Ana Santandreu, Daniel D Swartz, Stelios T Andreadis
Recent advances in vascular tissue engineering have led to the development of cell-free grafts that are available off-the-shelf for on demand surgery. Challenges associated with cell-based technologies including cell sourcing, cell expansion and long-term bioreactor culture motivated the development of completely cell-free vascular grafts. These are based on decellularized arteries, decellularized cultured cell-based tissue engineered grafts or biomaterials functionalized with biological signals that promote in situ tissue regeneration...
March 2017: Technology
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#7
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#8
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28625753/detection-of-acute-arterial-occlusion-during-artery-bypass-surgery-for-a-lower-extremity-by-monitoring-regional-saturation-of-oxygen-of-the-sole-of-the-foot
#9
Hiromichi Kurosaki, Misako Higuchi, Rika Nogawa, Tomoyuki Kawamata
No abstract text is available yet for this article.
March 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28612619/-isolated-perfusion-of-the-upper-extremity-with-tnf-%C3%AE-double-venous-cannulation
#10
M Špaček, P Mitáš, M Vočka, L Lacina, G Hodková, R Špunda, O Kodet, I Krajsová, L Petruželka, J Trnka, J Kubinyi, Z Matějovský, L Lambert, J Lindner
BACKGROUND: The authors present a technical variation of the standard cannulation for cardiopulmonary bypass perfusion during hyperthermic isolated limb perfusion (ILP) procedures in selected patients with unresectable soft tissue sarcoma or malignant melanoma. PATIENTS: Of 55 ILP procedures performed at our institution since the procedure was established in 2009, nine were performed at the upper extremity. Standard single venous cannulation was used in five cases, and extended, double venous cannulation in the last four...
2017: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
https://www.readbyqxmd.com/read/28605479/collapsed-stent-graft-and-severe-malperfusion-2%C3%A2-years-after-endovascular-aortic-repair
#11
Yoshihiro Goto, Soh Hosoba, Shinji Ogawa, Yoshihisa Kinoshita
Late collapsing of a stent graft is an extremely rare event, with one existing report describing this phenomenon. A 65-year-old man with a history of endovascular aortic repair for an abdominal aortic aneurysm presented with paraplegia and bilateral lower limb ischaemia. Contrast-enhanced computed tomography showed a dissection of the descending thoracic aorta and a collapsed stent graft, resulting in bilateral lower limb ischaemia. Subsequent axillo-bifemoral bypass resolved his lower extremity functions. The patient required haemodialysis due to acute kidney failure...
June 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28602895/risk-factors-for-sub-optimal-utilization-of-statins-and-antiplatelet-therapy-in-patients-undergoing-revascularization-for-symptomatic-peripheral-arterial-disease
#12
Andrew J Meltzer, Art Sedrakyan, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The objective of this study is to identify risk factors for sub-optimal medical therapy (defined as reported antiplatelet and statin use) among patients undergoing lower extremity bypass (LEB) and percutaneous interventions (PVI) for symptomatic peripheral arterial disease (PAD). METHODS: The Vascular Study Group of Greater New York (VSGGNY) database was used to identify all patients undergoing PVI or LEB for PAD (2011-2013). Bivariate analyses were performed to identifycharacteristics of patients who were not prescribed statins and/or antiplatelet agents prior to revascularization...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28559173/surgeon-not-institution-case-volume-is-associated-with-limb-outcomes-after-lower-extremity-bypass-for-critical-limb-ischemia-in-the-vascular-quality-initiative
#13
Lily E Johnston, Margaret C Tracci, John A Kern, Kenneth J Cherry, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Studies from large administrative databases have demonstrated associations between institutional case volume and outcomes after lower extremity bypass (LEB). We hypothesized that increased institutional and surgeon volume would be associated with improved outcomes after LEB. Using a national, prospectively collected clinical database, the objective of this study was to determine the effects of both surgeon and institutional volume on outcomes after LEB. METHODS: The Vascular Quality Initiative (VQI) was queried to identify all LEBs for critical limb ischemia or claudication between 2004 and 2014...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527931/predictors-of-surgical-site-infection-after-open-lower-extremity-revascularization
#14
MULTICENTER STUDY
Frank M Davis, Danielle C Sutzko, Scott F Grey, M Ashraf Mansour, Krishna M Jain, Timothy J Nypaver, Greg Gaborek, Peter K Henke
OBJECTIVE: Surgical site infection (SSI) after open lower extremity bypass (LEB) is a serious complication leading to an increased rate of graft failure, hospital readmission, and health care costs. This study sought to identify predictors of SSI after LEB for arterial occlusive disease and also potential modifiable factors to improve outcomes. METHODS: Data from a statewide cardiovascular consortium of 35 hospitals were used to obtain demographic, procedural, and hospital risk factors for patients undergoing elective or urgent open LEB between January 2012 and June 2015...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#15
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28526559/a-single-nucleotide-polymorphism-of-cyclin-dependent-kinase-inhibitor-1b-p27-kip1-associated-with-human-vein-graft-failure-affects-growth-of-human-venous-adventitial-cells-but-not-smooth-muscle-cells
#16
Richard D Kenagy, Shinsuke Kikuchi, Lihua Chen, Errol S Wijelath, Andrew B Stergachis, John Stamatoyannopoulos, Gale L Tang, Alexander W Clowes, Michael Sobel
BACKGROUND: Cyclin-dependent kinase inhibitor 1B (p27(Kip1)) is a cell-cycle inhibitor whose -838C>A single nucleotide polymorphism (rs36228499; hereafter called p27 SNP) has been associated with the clinical failure of peripheral vein grafts, but the functional effects of this SNP have not been demonstrated. METHODS: Human saphenous vein adventitial cells and intimal/medial smooth muscle cells (SMCs) were derived from explants obtained at the time of lower extremity bypass operations...
May 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#17
Alessandro Thione, Pedro C Cavadas
Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28502548/lifelong-limb-preservation-a-patient-centered-description-of-lower-extremity-arterial-reconstruction-outcomes
#18
Katie E Shean, Peter A Soden, Marc L Schermerhorn, Sara L Zettervall, Sarah E Deery, Jeremy D Darling, Allen Hamdan, Frank W LoGerfo
BACKGROUND: Life expectancy is short for patients with critical limb ischemia (CLI), many of whom may fear amputation more than death. In light of the reduced life expectancy of these patients, the traditional 5-year freedom from amputation (FFA) statistic may not accurately address their concern. We developed a more relevant patient-centered calculation of major amputation risk during a patient's remaining lifetime to better answer the question, Will I ever lose my leg? METHODS: We identified all limbs undergoing first-time intervention for CLI in a large institutional database from 2005 to 2013...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28495542/endothelial-function-is-preserved-in-veins-harvested-by-either-endoscopic-or-surgical-techniques
#19
Adam R Wheeler, Daniel E Kendrick, Matt T Allemang, Andre F Gosling, Ann H Kim, Alfred Hausladen, Vikram S Kashyap
OBJECTIVES: Endoscopic vein harvest for lower extremity arterial bypass grafting has been questioned due to concern for endothelial damage during procurement. We sought to compare Nitric Oxide (NO)-mediated endothelial dependent relaxation (EDR) in vein segments harvested using open surgical (OH) versus endoscopic (EH) techniques. METHODS: Saphenous vein segments were harvested for lower extremity bypass, and a single, minimally handled section of saphenous vein, free of branches, was taken from the end of the graft...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479461/superior-lower-extremity-vein-graft-bypass-patency-among-married-patients-with-peripheral-arterial-disease
#20
Emily Lagergren, Kelly Kempe, Timothy E Craven, Susan T Kornegay, Justin B Hurie, Nitin Garg, Gabriela Velazquez Ramirez, Matthew S Edwards, Matthew A Corriere
INTRODUCTION: Outcomes disparities associated with lower extremity bypass (LEB) for peripheral arterial disease (PAD) have been identified but are poorly understood. Marital status may affect outcomes through factors related to health risk behaviors, adherence, and access to care but has not been characterized as a predictor of surgical outcomes and is often omitted from administrative datasets. We evaluated associations between marital status and vein graft patency following LEB using multivariable models adjusting for established risk factors...
May 4, 2017: Annals of Vascular Surgery
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