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Peripheral vascular surgery

Gentian Caco, Dhurata Golemi, Eriola Likaj
INTRODUCTION: The saphenous vein is commonly used as a vascular graft in peripheral artery surgery but rarely used for vascular access. The literature on straight configuration saphenous vein transposition to the popliteal artery is scarce. Here we present two cases of straight configuration saphenous vein transposition to the popliteal artery for vascular access, the surgical technique and respective follow-up. CASE REPORT: Two young men, aged 29 and 36 years, were chosen for lower-limb vascular access for hemodialysis...
October 21, 2016: Journal of Vascular Access
Seth H Richman, Marcelo Bogliolo Piancastelli Siqueira, Kirk A McCullough, Mark J Berkowitz
BACKGROUND: K-wire fixation has been the most common method of fixation for hammertoe deformity. However intramedullary devices are gaining ground in both number of available choices and in procedures performed. This study aimed to compare the outcomes of hammertoe correction performed with K-wire fixation versus a novel intramedullary fusion device (CannuLink). METHODS: A retrospective review of hammertoe correction by a single surgeon was performed from June 2011 to December 2013...
October 18, 2016: Foot & Ankle International
Giulio Illuminati, Francesco G Calio', Giulia Pizzardi, Chiara Amatucci, Federica Masci, Piergaspare Palumbo
INTRODUCTION: Intra and perioperative anticoagulation in patients with heparin induced thrombocytopenia (HIT), candidates for peripheral vascular surgery remains a challenge, as the best alternative to heparin has not yet been established. We evaluated the off-label use of fondaparinux in four patients with HIT, undergoing peripheral vascular surgery procedures. PRESENTATION OF CASES: Four patients of whom 3 men of a mean age of 66 years, with proven heparin induced thrombocytopenia (HIT) underwent two axillo-femoral bypasses, one femoro-popliteal bypass and one resection of a splenic artery aneurysm under fondaparinux...
October 8, 2016: International Journal of Surgery Case Reports
Christophe Colas-Ribas, Isabelle Signolet, Samir Henni, Mathieu Feuillloy, Frédéric Gagnadoux, Pierre Abraham
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease...
October 2016: Medicine (Baltimore)
Ngai-Yin Chan, Chi-Chung Choy
OBJECTIVE: The purpose of this study was to assess the feasibility of community screening for atrial fibrillation (AF) using a smartphone-based wireless single-lead ECG (SL-ECG) and to generate epidemiological data on the prevalence and risk factors of AF in Hong Kong. METHODS: In the period between 1 May 2014 to 30 April 2015, 13 122 Hong Kong citizens consented and voluntarily participated in a territory-wide community-based AF screening programme. RESULTS: 56 (0...
October 12, 2016: Heart: Official Journal of the British Cardiac Society
Yader Sandoval, Marina Zakharova, Thomas S Rector, Emmanouil S Brilakis, Todd Drexel, Edward O McFalls, Santiago Garcia
The utility of measuring cardiac troponins (cTn) in asymptomatic patients during the perioperative period has been controversial. In the present substudy of the Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery Trial (NCT01558596), we hypothesized that surveillance of myocardial injury with cTnI in the perioperative period would lead to initiation or intensification of medical therapies for coronary artery disease. Increases in cTnI ≥0.01 μg/l in the perioperative period were considered clinically significant...
September 15, 2016: American Journal of Cardiology
Dominique Stephan, Elena-Mihaela Cordeanu, Corina Mirea, Alix Faller, Anne Lejay, Sébastien Gaertner
Non-vitamin K antagonist oral anticoagulants are becoming increasingly important in the prophylaxis and treatment of thrombosis in atrial fibrillation and venous thromboembolism. Antiplatelets are widely prescribed in the primary and secondary prevention of cardiac and vascular diseases. There are potentially numerous situations where anticoagulants and antiplatelets may be combined; these combinations have been explored in coronary artery disease, and some have been included in updated recommendations. Is it legitimate to transpose these recommendations to the management of peripheral artery disease? The specific characteristics of the treated vessels, the stents used, the respective frequencies of stent thrombosis and its effect on the target organ are probably different, and explain why opinions differ...
September 28, 2016: Archives of Cardiovascular Diseases
Santiago Garcia, Thomas S Rector, Marina Zakharova, Rebekah R Herrmann, Selcuk Adabag, Stefan Bertog, Yader Sandoval, Steve Santilli, Emmanouil S Brilakis, Edward O McFalls
BACKGROUND: Remote ischemic preconditioning (RIPC) has been shown to reduce infarct size in animal models. We hypothesized that RIPC before an elective vascular operation would reduce the incidence and amount of a postoperative rise of the cardiac troponin level. METHODS AND RESULTS: Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery (CRIPES) was a prospective, randomized, sham-controlled phase 2 trial using RIPC before elective vascular procedures...
2016: Journal of the American Heart Association
Tim Seidler, Mark Hünlich, Miriam Puls, Gerd Hasenfuß, Claudius Jacobshagen
BACKGROUND: Despite the completion of more than 60,000 transcutaneous aortic valve implantations (TAVI) per year and an approximately 10-15 % incidence of vascular access site complications (VAC), there is a paucity of data on the efficacy and safety of percutaneous VAC treatment. HYPOTHESIS: Percutaneous endovascular treatment will be an effective treatment of VAC and associated with a low rate of surgical repair. Despite stent placement in proximity to the hip joint, endovascular treatment will be only rarely associated with disabling symptoms or complications...
September 29, 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Chih-Hsun Lin, Yun-Chu Kao, Yu-Heng Lin, Hsu Ma, Ruey-Yug Tsay
: The theoretical fiber-progressive-engagement model was proposed to describe the pseudoelastic behavior of an artery pre- and post-decellularization treatments. Native porcine arteries were harvested and decellularized with 0.05% trypsin for 12 h. The uniaxial tensile test data were fitted to the fiber-progressive-engagement model proposed herein. The effects of decellularization on the morphology, structural characteristics, and composition of vessel walls were studied. The experimental stress-strain curve was fitted to the model in the longitudinal and circumferential direction, which demonstrated the adequacy of the proposed model (R(2)>0...
September 22, 2016: Acta Biomaterialia
Bryan W Tillman, Jeremy Kelly, Tara D Richards, Alex F Chen, Albert D Donnenberg, Vera S Donnenberg, Edith Tzeng
OBJECTIVE: Vascular restenosis remains a major obstacle to long-term success after vascular intervention. Circulating progenitor cells have been implicated in restenosis, and yet it has remained unclear if these cells, particularly nonendothelial progenitors, have an active role in this pathologic process. We hypothesized that circulating CD34(+)/c-kit(+) progenitors would increase after vascular injury, mirrored by changes in the injury signal, stromal cell-derived factor 1α (sdf1α)...
October 2016: Journal of Vascular Surgery
Carola Marie Wieker, Eva Schönefeld, Nani Osada, Christina Lührs, Roland Beneking, Giovanni Torsello, Dittmar Böckler
OBJECTIVE: The aim of this study was to investigate the long-term outcome of common femoral artery thromboendarterectomy in patients with peripheral arterial occlusive disease. METHODS: The study retrospectively evaluated 713 vessels in 655 patients (75% male; mean age, 69.4 ± 9.5 years) who underwent common femoral thromboendarterectomy from January 2006 until May 2012 in two high-volume vascular centers. Critical limb ischemia was present in 221 patients, and intermittent claudication was present in 434...
October 2016: Journal of Vascular Surgery
P J Chung, J S Lee, S Tam, A Schwartzman, M O Bernstein, L Dresner, A Alfonso, G Sugiyama
PURPOSE: Anterior abdominal wall hernias are among the most commonly encountered surgical disease. We sought to identify risk factors that are associated with 30-day postoperative mortality following emergent abdominal wall hernia repair using the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database. METHODS: A retrospective analysis of data from the ACS NSQIP from 2005 to 2010 was performed. Patients were selected using Current Procedural Terminology (CPT) and International Classification of Disease 9 Clinical Modification (ICD9) codes for the repair of inguinal, femoral, umbilical, epigastric, ventral, or incisional hernias that were incarcerated, obstructed, strangulated, or gangrenous...
September 16, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Neal S Kleiman, Brijeshwar J Maini, Michael J Reardon, John Conte, Stanley Katz, Vivek Rajagopal, James Kauten, Alan Hartman, Raymond McKay, Robert Hagberg, Jian Huang, Jeffrey Popma
BACKGROUND: The risk for stroke after transcatheter aortic valve replacement (TAVR) is an important concern. Identification of predictors for stroke is likely to be a critical factor aiding patient selection and management as TAVR use becomes widespread. METHODS AND RESULTS: Patients enrolled in the CoreValve US Extreme Risk and High Risk Pivotal Trials or Continued Access Study treated with the self-expanding CoreValve bioprosthesis were included in this analysis...
September 2016: Circulation. Cardiovascular Interventions
Dmitry Pevni, Benjamin Medalion, Rephael Mohr, Yanai Ben-Gal, Adam Laub, Avner Nevo, Amir Kramer, Yosef Paz, Nachum Nesher
BACKGROUND: Bilateral internal thoracic artery (BITA) grafting in patients with diabetes mellitus is controversial because of a higher risk for sternal infection. The purpose of this study is to compare the outcome of BITA grafting to that of single ITA (SITA) grafting in patients with diabetes. METHODS: Between 1996 and 2010, 964 diabetic patients with multivessel disease who underwent primary coronary artery bypass graft surgery with BITA were compared with 564 patients who underwent coronary artery bypass graft surgery with SITA and saphenous vein grafts...
September 1, 2016: Annals of Thoracic Surgery
Kamel Mohammedi, Mark Woodward, Yoichiro Hirakawa, Sophia Zoungas, Stephen Colagiuri, Pavel Hamet, Stephen Harrap, Neil Poulter, David R Matthews, Michel Marre, John Chalmers
BACKGROUND: Peripheral arterial disease (PAD) is known to be associated with high cardiovascular risk, but the individual impact of PAD presentations on risk of macrovascular and microvascular events has not been reliably compared in patients with type 2 diabetes. We aimed to evaluate the impact of major PAD, and its different presentations, on the 10-year risk of death, major macrovascular events, and major clinical microvascular events in these patients. METHODS: Participants in the action in diabetes and vascular disease: PreterAx and DiamicroN modified-release controlled evaluation (ADVANCE) trial and the ADVANCE-ON post-trial study were followed for a median of 5...
2016: Cardiovascular Diabetology
K Trieb
Neuropathic changes in the foot are common with a prevalence of approximately 1%. The diagnosis of neuropathic arthropathy is often delayed in diabetic patients with harmful consequences including amputation. The appropriate diagnosis and treatment can avoid an extensive programme of treatment with significant morbidity for the patient, high costs and delayed surgery. The pathogenesis of a Charcot foot involves repetitive micro-trauma in a foot with impaired sensation and neurovascular changes caused by pathological innervation of the blood vessels...
September 2016: Bone & Joint Journal
Sabina Licholai, Wojciech Szczeklik, Marek Sanak
BACKGROUND: Abdominal aortic aneurysms (AAA) are usually asymptomatic and mostly diagnosed incidentally. Aortic dilatation progresses along with the wall weakening and eventually leads to a life-threatening rupture. Currently, there are no effective screening biomarkers for AAA. MicroRNAs, a class of small non-coding RNA molecules, offer great potential as biomarkers because of their stability in the bloodstream and expression characteristic for different diseases. OBJECTIVE: To assess the circulating miR-29c-3p as a potential biomarker of AAA and to elucidate the biological functions of miR-29c-3p in terms of pathogenesis of aneurysms...
September 1, 2016: MicroRNA
Konrad Paczkowski, Ireneusz Haponiuk, Maciej Chojnicki, Grażyna Brzezińska-Rajszys
An iatrogenic aneurysm of an innominate artery is an extremely rare complication, especially in children. Nevertheless, this pathology was diagnosed in a child given palliative care with chronic respiratory insufficiency and a history of encephalitis requiring permanent ventilation at home via a tracheal tube.A nine-year-old girl with colitis ulcerosa and a history of hemorrhagic encephalitis, with chronic home ventilation therapy, was admitted in an emergency setting because of massive bleeding from the upper respiratory tract and the area surrounding the tracheotomy...
2016: Heart Surgery Forum
J A Capdevila, M Guembe, J Barberán, A de Alarcón, E Bouza, M C Fariñas, J Gálvez, M A Goenaga, F Gutiérrez, M Kestler, P Llinares, J M Miró, M Montejo, P Muñoz, M Rodríguez-Creixems, D Sousa, J Cuenca, C A Mestres
The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. Short peripheral catheters have been found to be associated with the risk of nosocomial bacteremia resulting in morbidity and mortality. Staphyloccus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been elaborated by a panel of experts of the Spanish Society of Cardiovascular Infections in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy and Spanish Society of Thoracic-Cardiovascular Surgery and aims at define and establish the norm for management of short duration peripheral vascular catheters...
August 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
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