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Lower extremity bypass

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https://www.readbyqxmd.com/read/28222991/perioperative-clopidogrel-is-associated-with-increased-bleeding-and-blood-transfusion-at-the-time-of-lower-extremity-bypass
#1
Douglas W Jones, Marc L Schermerhorn, Benjamin S Brooke, Mark F Conrad, Philip P Goodney, Mark C Wyers, David H Stone
OBJECTIVE: Controversy persists surrounding the perceived bleeding risk associated with perioperative clopidogrel use in patients undergoing lower extremity bypass (LEB). The purpose of this study was to examine the LEB bleeding risk and clinical sequelae associated with clopidogrel. METHODS: All LEBs in the Vascular Quality Initiative (VQI) from 2008 to 2014 were studied. The exposure was perioperative clopidogrel. Primary outcomes were blood transfusion, estimated blood loss ≥500 mL, and reoperation for bleeding...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#2
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216361/the-effect-of-ambulatory-status-on-outcomes-of-percutaneous-vascular-interventions-and-lower-extremity-bypass-for-critical-limb-ischemia-in-the-vascular-quality-initiative
#3
Kimberly Lu, Alik Farber, Marc L Schermerhorn, Virendra I Patel, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Ambulatory status has been shown to be an important predictor of postoperative morbidity and mortality for a variety of surgical procedures. We sought to assess contemporary practice patterns in treating critical limb ischemia (CLI) and outcomes based on ambulatory status. METHODS: The Vascular Quality Initiative (2010-2015) was queried for patients undergoing percutaneous vascular interventions (PVIs) or lower extremity bypass (LEB) for CLI. Ambulatory status was classified as ambulatory, ambulatory with assistance, and nonambulatory (composite of wheelchair bound and bedridden)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28188590/pesticide-stress-on-plants-negatively-affects-parasitoid-fitness-through-a-bypass-of-their-phytophage-hosts
#4
Andries A Kampfraath, Daniel Giesen, Cornelis A M van Gestel, Cécile Le Lann
Pesticides taken up by plants from the soil or interstitial (pore) water can cascade to higher trophic levels, which are expected to be more affected due to cumulative bottom-up effects. Knowledge about the impact of indirect exposure to pesticides on non-target terrestrial trophic chains, however, is still lacking. Therefore, we examined the direct and indirect effects of three concentrations of the herbicide 2,6-dichlorobenzonitrile (DCBN) and an insecticide with a similar molecular structure (1,4-dichlorobenzene, DCB) on the fitness traits of a tritrophic system: the wheat plant Triticum aestivum, the aphid Sitobion avenae and its specialist parasitoid Aphidius rhopalosiphi...
February 10, 2017: Ecotoxicology
https://www.readbyqxmd.com/read/28162904/bilateral-internal-carotid-artery-aneurysms-at-the-subpetrosal-portion-with-unilateral-lower-cranial-nerve-palsies-review-and-consideration-of-surgical-strategy
#5
Kei Noguchi, Takachika Aoki, Rokudai Sakamoto, Kimihiko Orito, Yasuharu Takeuchi, Masaru Hirohata, Motohiro Morioka
BACKGROUND: Symptomatic bilateral extracranial internal carotid artery (ICA) aneurysms at the subpetrosal portion are extremely rare, and their treatment strategy remains unknown. CLINICAL PRESENTATION: A 42-year-old man presented to our hospital with a 2-month history of sudden onset of hoarseness, dysarthria, and dysphagia. Magnetic resonance imaging, magnetic resonance angiography, and computed tomography angiography revealed extracranial bilateral ICA aneurysms at the subpetrosal portion...
February 2, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#6
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#7
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28149590/one-stage-hybrid-surgery-for-acute-stanford-type-a-aortic-dissection-with-david-operation-aortic-arch-debranching-and-endovascular-graft-a-case-report
#8
Lulu Liu, Chaoyi Qin, Jianglong Hou, Da Zhu, Bengui Zhang, Hao Ma, Yingqiang Guo
Acute Stanford type A aortic dissection requires an extremely complex surgical strategy and presents high risk of complications. Although many different procedures were reported to treat this aortic dissection, high mortality rate and incidences of complications still exist. This study presents a 59-year-old lady with acute Stanford type A aortic dissection, which originated from the aortic root to proximal part of right external iliac artery and involved the brachiocephalic trunk, left carotid artery, celiac trunk, and left renal artery...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#9
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28110616/oncotic-pressure-and-paediatric-cardiopulmonary-bypass-establishing-baseline-data-for-complex-congenital-cardiac-surgery-and-its-relation-to-risk-stratification
#10
Richard Crook, Richard Issitt
OBJECTIVES: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very few baseline data are available for those patients requiring surgery within the first few weeks and months of life. Our aim was to determine if our CHD population exhibited COP similar to that of other extremely ill subsets of patients and, if so, whether this related to risk stratification model scores...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28109967/subclavian-artery-disease-diagnosis-and-therapy
#11
REVIEW
Tisa Saha, Syed Yaseen Naqvi, Omar Abine Ayah, Daniel McCormick, Sheldon Goldberg
The diagnosis of brachiocephalic disease is often overlooked. Symptoms include arm claudication and vertebrobasilar insufficiency. In patients who have had the use of the internal mammary artery for coronary bypass surgery, the development of symptoms of myocardial ischemia should alert the clinician to the possibility of subclavian artery stenosis. Also, in patients who have had axillofemoral bypass, lower-extremity claudication may occur. Recognition involves physical examination and accurate noninvasive testing...
January 19, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28088603/hospital-readmissions-after-surgery-how-important-are-hospital-and-specialty-factors
#12
Robert H Hollis, Laura A Graham, Joshua S Richman, Melanie S Morris, Hillary J Mull, Tyler S Wahl, Edith Burns, Laurel A Copeland, Gordon L Telford, Amy K Rosen, Kamal F Itani, Jeffrey Whittle, Todd H Wagner, Mary T Hawn
BACKGROUND: Hospital readmission rates after surgery may represent an overall hospital effect or a combination of specialty and patient effects. We hypothesized that hospital readmission rates for procedures within specialties were more strongly correlated than rates across specialties within the same hospital. STUDY DESIGN: For general, orthopedic, and vascular specialties at Veterans Affairs hospitals during 2008-2014, 30-day risk-adjusted readmission rates were estimated for six high-volume procedures and each specialty...
January 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#13
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28042555/lower-extremity-arterial-bypass-with-arm-vein-conduits-and-literature-review
#14
Dae-Joon Park, Yang-Jin Park, Kyoung Won Yoon, Seon-Hee Heo, Dong-Ik Kim, Young-Wook Kim
PURPOSE: The superiority of autogenous vein conduits is well known in lower extremity arterial bypass (LEAB). Among various alternative conduits for LEAB, long-term results of arm vein grafts were investigated in this study. MATERIALS AND METHODS: We retrospectively reviewed clinical characteristics of 28 patients who underwent infrainguinal LEAB with autogenous arm vein grafts at a single institute between January 2003 and December 2015. All procedures were performed in the absence of adequate saphenous veins...
December 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27943281/latissimus-dorsi-flap-with-vascularized-lymph-node-transfer-for-lymphedema-treatment-technique-outcomes-indications-and-review-of-literature
#15
REVIEW
Amir Inbal, Chad M Teven, David W Chang
BACKGROUND AND OBJECTIVES: One of the surgical treatment options for lymphedema is vascularized lymph node transfer (VLNT). We present our experience with latissimus dorsi (LD) flap based VLNT for lymphedema treatment. METHODS: We reviewed 14 consecutive patients treated with pedicled or free LD VLNT between 2014 and 2016 for recalcitrant upper or lower extremity lymphedema. Seven patients underwent lymphovenous bypass in addition to LD VLNT. Limb volume and quality of life scores using the Lymphedema Life Impact Scale (LLIS) were analyzed for quantitative and qualitative assessment...
January 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27935900/-thromboangiitis-obliterans-buerger-s-disease-state-of-the-art
#16
REVIEW
D D Zerbino, E A Zimba, N N Bagry
Thromboangiitis obliterans (Buerger's disease) is systemic vasculitis with predominant development of thrombotic occlusions of small-to-medium diameter arteries of distal portions of both upper and lower limbs. A distinctive feature of Buerger's disease from other vasculitides is the involvement of the venous bed into the pathological process in the form of migrating thrombophlebitis. The disease is encountered more often in young adult males, predominantly tobacco smokers. The clinical pattern is presented by symptoms of increasing insufficiency of blood supply of tissues of extremities...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27928034/below-knee-endovascular-interventions-have-better-outcomes-compared-to-open-bypass-for-patients-with-critical-limb-ischemia
#17
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral artery disease, but minimal data exist comparing outcomes performed at and below the knee. The purpose of this study was to compare outcomes following infrageniculate lower extremity open bypass (LEB) versus peripheral vascular intervention (PVI) in patients with critical limb ischemia. Using data from the 2008-2014 Vascular Quality Initiative, 1-year primary patency, major amputation, and mortality were compared among all patients undergoing LEB versus PVI at or below the knee for rest pain or tissue loss...
February 2017: Vascular Medicine
https://www.readbyqxmd.com/read/27914772/vascular-reconstruction-after-retroperitoneal-and-lower-extremity-sarcoma-resection
#18
M Wortmann, I Alldinger, D Böckler, A Ulrich, A Hyhlik-Dürr
PURPOSE: Soft tissue sarcomas (STS) of the retroperitoneum and the lower limb with invasion of major blood vessels are very rare malignancies. This study analyses the outcome of patients with vascular replacement during resection of STS of the retroperitoneum and the lower extremity with either arterial or concomitant arterial and venous infiltration. METHODS: Patients with vascular replacement during resection of sarcoma of the retroperitoneum and the lower extremity between 1990 and 2014 were included in this retrospective single center study...
February 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27884944/ruptured-abdominal-aortic-aneurysm-after-endovascular-aortic-aneurysm-repair-thrombosis
#19
Jesse Victory, Syed Ali Rizvi, Enrico Ascher, Anil Hingorani
BACKGROUND: Complete thrombosis of an aortic endograft after an endovascular aortic aneurysm repair is a rare complication. The majority of thrombotic events occur in the iliac limbs. CASE PRESENTATION: We present the case of a patient who presented with acute limb ischemia as the result of a thrombosed infra-renal aortic endograft. After restoration of blood flow to the lower extremities with an axillary to bi-femoral artery bypass, the patient was lost to follow-up...
November 24, 2016: Vascular
https://www.readbyqxmd.com/read/27879533/the-angiovac-device-understanding-the-failures-on-the-road-to-success
#20
Berhane Worku, Arash Salemi, Marcus D DʼAyala, Robert F Tranbaugh, Leonard N Girardi, Iosif M Gulkarov
OBJECTIVE: Current percutaneous thromboembolectomy techniques may obviate surgical intervention in high-risk patients with iliocaval thrombus or thrombus of the right side of the heart, but typically require thrombus fragmentation and thrombolysis with associated bleeding and thromboembolic complications. The AngioVac (Angiodynamics, Latham, NY USA) device uses a percutaneous venovenous bypass circuit to aspirate intact thrombus. A review of the literature was performed with regard to the AngioVac device to determine the factors correlating with successful thrombus extraction...
November 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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