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Lower extremity bypass

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https://www.readbyqxmd.com/read/28437263/a-randomised-trial-to-evaluate-preoperative-oral-carbohydrate-administration-on-insulin-resistance-in-off-pump-coronary-artery-bypass-patients
#1
Bora Lee, Sarah Soh, Jae-Kwang Shim, Ha Y Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: In fasting cardiac surgery patients, preoperative carbohydrate (CHO) drink intake attenuated insulin resistance and improved cardiac metabolism, although its beneficial effects were not evident after cardiac surgery possibly due to cardiopulmonary bypass-related extreme systemic inflammation. OBJECTIVE: We aimed to evaluate whether preoperative CHO intake affected insulin resistance and free-fatty acid (FFA) concentrations in off-pump coronary revascularisation...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28433335/treatment-of-peripheral-arterial-disease-via-percutaneous-brachial-artery-access
#2
Randall W Franz, Christopher F Tanga, Joseph W Herrmann
OBJECTIVE: This review was conducted to evaluate the types of endovascular procedures that can be performed via brachial artery access, evaluate the access success rate, and determine the incidence of technical complications. METHODS: A retrospective 10-year record review at a tertiary facility from January 1, 2005, through June 30, 2015, was completed. Patients who underwent attempted brachial artery access were eligible for review. Outcomes intended to be evaluated included ability to access the vessel, reach an identified lesion, and perform an indicated procedure, while describing the incidence and type of complications that occurred to clarify the utility and safety of brachial artery access...
April 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#3
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28430307/the-incidence-and-risk-factors-of-coronary-steal-after-ipsilateral-avf-in-patients-with-a-coronary-artery-bypass-graft
#4
Sanghyun Ahn, Ahram Han, Song-Yi Kim, Chanjoong Choi, Sang-Il Min, Jongwon Ha, Ho Young Hwang, Ki-Bong Kim, Seung-Kee Min
OBJECTIVE: Ipsilateral arteriovenous fistula (AVF) may cause symptoms of coronary steal in patients who had undergone coronary artery bypass graft (CABG) using internal thoracic artery. The purpose of this study was to evaluate the adverse effects of ipsilateral AVF to CABG, including the incidence of coronary steal, and to analyze the risk factors for coronary steal. METHODS: Between 2000 and 2013, a total of 25 patients undergoing hemodialysis via upper extremity AVF, ipsilateral to the preexisting CABG, were reviewed retrospectively...
April 14, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28411701/lack-of-symmetry-in-the-major-lower-limb-veins
#5
Anirudh Chandrashekar, Antonios Gasparis, Nicos Labropoulos
BACKGROUND: Contemporary texts frequently present the venous system of the lower limb as a prime example of bilateral symmetry. However, overt bilateral asymmetry may be noted. This study was designed to examine and to quantify the level of symmetry in the lower extremity veins. METHODS: This prospective cohort study evaluated major anatomic differences between right and left lower extremity veins in adult patients. Two hundred patients presenting with signs and symptoms of chronic venous disease (CVD; class 2-6) and venous reflux on duplex ultrasound were examined...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28395436/-surgical-treatment-of-aortic-dissection-with-lower-extremity-ischemia
#6
J R Xue, B Li, Y M Liu, T Bai, X D Pan, N N Liu, Z Qu, L Z Sun
Objective: To explore the clinical outcome of the surgical treatment for aortic dissection with lower extremity ischemia. Methods: Between March 2009 and April 2013, 14 patients with type A aortic dissection and lower extremity ischemia underwent Sun's procedure in Beijing Anzhen Hospital. Ascending aorta-iliac artery bypass, ascending aorta-femoral artery bypass, femoral-femoral artery bypass and axillary -femoral artery bypass were performed on some severe patients at the same time. Results: Two death occurred, and the others were improved or recovered from symptoms...
April 11, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28390912/endovascular-re-intervention-for-failing-infrainguinal-bypass-grafts
#7
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
OBJECTIVE: Patients with lower extremity bypass grafts that develop stenosis commonly undergo endovascular treatment (EVT) procedures. This study was performed to evaluate the outcomes of EVT procedures for infrainguinal grafts with bypass at risk (BAR). METHODS: We performed a retrospective review of 24 grafts in 22 patients from July 2010 to June 2016. The demographic information of the patients and the characteristics of lesions were examined, and the outcomes with regard to the patency and survival rates were calculated...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390911/critical-limb-ischemia-secondary-to-antiphospholipid-syndrome-in-a-pediatric-patient-case-report-and-review
#8
Andrew J Soo Hoo, Joseph M White, Paul W White
A pediatric patient with critical limb ischemia secondary to antiphospholipid syndrome (APS) is reported. A 14-year-old male underwent extensive evaluation for worsening right lower extremity pain and ulcerative lesions of his right foot. He was discovered to have proximal occlusion of the superficial femoral artery (SFA), the distal popliteal artery, the anterior tibial artery at the mid-calf, and the posterior tibial artery at the ankle. Laboratory analysis revealed a diagnosis of APS, and he underwent a common femoral artery to above-knee-popliteal artery bypass with reversed greater saphenous graft...
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
#9
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/28390768/creation-of-spliced-vein-conduit-using-microvascular-anastomotic-coupler
#10
Yana Etkin, Suhail K Kanchwala, David W Low, Paul J Foley, Oksana A Jackson, Benjamin M Jackson
The single-segment great saphenous vein continues to be a conduit of choice for lower extremity arterial bypass. In patients without an adequate continuous segment of great saphenous vein, a spliced vein graft may be used as an alternative. Creating a spliced vein conduit can be technically challenging and time consuming. We present a technique of creating a spliced vein conduit by using a microvascular anastomotic coupler.
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#11
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/28335141/will-thrombosed-lower-extremities-bypasses-treated-with-intra-arterial-in-situ-fibrinolysis-keep-a-good-secondary-patency
#12
Tchala Kassegne, Myriam Ammi, Francine Thouveny, Mickaël Daligault, Xavier Papon, Bernard Enon, Jean Picquet
No abstract text is available yet for this article.
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28316309/high-resolution-ct-angiogram-for-lower-extremity-vein-mapping
#13
Mark P Wright, Matthew R Smeds, Lonnie Wright, Ahsan T Ali
High-resolution CT angiogram (CTA) has replaced traditional diagnostic angiography as the main preoperative imaging modality for vascular surgery patients. Although the use of CTA is increasing for arterial imaging, it has not been used routinely for vein mapping. The goal of this study was to evaluate the accuracy of CTA for venous anatomy and compare it to a standard venous duplex ultrasound (DUS). When the vein was used for bypass, the quality and size of the vein were evaluated in the operating room. As part of a preoperative workup before lower extremity revascularization, 16 patients underwent a CTA followed by a DUS...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28300677/wound-disruption-after-lower-extremity-bypass-surgery-is-a-predictor-of-subsequent-development-of-wound-infection
#14
Faisal Aziz, Tiffany Bohr, Erik B Lehman
OBJECTIVES: Despite advances in endovascular surgery, lower extremity arterial bypass (LEB) remains the gold standard treatment for severe, symptomatic Peripheral Arterial Disease (PAD). With recent changes in healthcare, there has been an increasing emphasis on reducing the hospital length of stay (LOS). The purpose of this study is to identify the postoperative complications, which occur after discharge from hospital, and to find risk factors for developing such complications. METHODS: The 2013 lower extremity revascularization -targeted American College of Surgeons (ACS-NSQIP) database and generalized 2013 general and vascular surgery ACS-NSQIP PUF were used for this study...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28300675/the-morphofunctional-changes-in-the-wall-of-varicose-veins
#15
Jeļena Birdina, Māra Pilmane, Artūrs Ligers
INTRODUCTION: Varicose vein (VV) disease is a frequently occurring pathology of the lower extremities. Although the pathogenesis of varicosity development is not clearly defined, the final common pathway leading to chronic venous insufficiency is the development of venous hypertension, which is associated with severe changes in the venous wall. The aim of this study was to clarify the histological and immunohistochemical changes in great saphenous veins in chronic venous insufficiency...
March 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28282599/severe-fatal-protein-malnutrition-and-liver-failure-in-a-morbidly-obese-patient-after-mini-gastric-bypass-surgery-case-report
#16
Mohammad Ali Kalantar Motamedi, Maryam Barzin, Mohammadreza Ebrahimi, Reza Ebrahimi, Alireza Khalaj
INTRODUCTION: Mini-gastric bypass (MGB) is a bariatric surgical technique popular in many centers due to shorter duration, easier technique, and excellent weight loss results. However, it may be associated with postoperative malnutrition. This case describes the clinical course and unfortunate outcome of a morbidly obese patient who underwent MGB and developed malnutrition in the first postoperative year. PRESENTATION OF CASE: A 37 year-old female patient with a BMI of 44kg/m(2) successfully underwent MGB surgery in June 2015 and was discharged uneventfully...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28279729/access-to-post-hospitalization-acute-care-facilities-is-associated-with-payer-status-for-open-abdominal-aortic-repair-and-open-lower-extremity-revascularization-in-the-vascular-quality-initiative
#17
Jesus G Ulloa, Karen Woo, Chi-Hong Tseng, Melinda Maggard-Gibbons, David Rigberg
OBJECTIVE: Uninsured patients may not have access to post-acute care facilities that play an important role in clinical recovery and functional outcomes after vascular surgery. We sought to determine whether discharge disposition is associated with insurance status. METHODS: We retrospectively reviewed data from the Vascular Quality Initiative(®) for patients who underwent open abdominal aortic repair (OAR), infra-inguinal bypass (IB) or supra-inguinal bypass (SB) between January 2012 and July 2015...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28279718/the-role-of-endovascular-in-situ-revascularization-in-the-treatment-of-arterial-and-graft-infections
#18
David S Strosberg, Babatunde Oriowo, Mark Davies, Hosam F El Sayed
Mycotic aneurysms and prosthetic graft infections are traditionally treated with excision of the infected tissue or graft, often requiring anatomical or extra-anatomical bypass, carrying significant morbidity and mortality. Currently, the role of endovascular repair without excision in this setting has yet to be defined. We present two case scenarios whereby mycotic pseudoaneurysms were successfully treated with endovascular stent graft coverage, and to present an in-depth review of endovascular in-situ revascularziation in the treatment of arterial and graft infections...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28274753/results-for-primary-bypass-versus-primary-angioplasty-stent-for-lower-extremity-chronic-limb-threatening-ischemia
#19
Jeremy D Darling, John C McCallum, Peter A Soden, Lindsey Korepta, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Marc L Schermerhorn
BACKGROUND: Long-term results comparing percutaneous transluminal angioplasty with or without stenting (PTA/S) and open surgical bypass for chronic limb-threatening ischemia (CLTI) in patients who have had no prior intervention are lacking. METHODS: All patients undergoing a first-time lower extremity revascularization for CLTI by vascular surgeons at our institution from 2005 to 2014 were retrospectively reviewed. Outcomes included perioperative complications, wound healing, restenosis, primary patency, reintervention, major amputation, RAS events (ie, reintervention, major amputation, or stenosis), and mortality...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28258020/lower-extremity-bypass-surgery-on-patients-transferred-from-other-hospitals-is-associated-with-increased-morbidity-and-mortality
#20
Faisal Aziz, Youngmin Chu, Erik B Lehman
BACKGROUND: Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease (PAD). Patients who are transferred to other hospitals have generally complex medical problems compared to those patients who are directly admitted from home. The purpose of this study is to identify factors associated with an interfacility transfer in patients with PAD and compare the postoperative outcomes of these patients to those who are directly admitted to the hospital...
February 28, 2017: Annals of Vascular Surgery
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