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Vascular and Endovascular Surgery

Sungho Lim, Michael J Javorski, Sean P Nassoiy, Yaeji Park, Pegge M Halandras, Carlos F Bechara, Bernadette Aulivola, Paul R Crisostomo
OBJECTIVE: The baroreceptor at the carotid body plays an important role in hemodynamic autoregulation. Manipulation of the baroreceptor during carotid endarterectomy (CEA) or radial force from carotid artery angioplasty and/or stenting (CAS) may cause both intraoperative and postoperative hemodynamic instability. The purpose of this study is to evaluate the long-term effects of CEA and CAS on blood pressure (BP), heart rate (HR), and subsequent changes on antihypertensive medications...
February 11, 2019: Vascular and Endovascular Surgery
Zane Z Young, Mark D Balceniuk, Khurram Rasheed, Doran Mix, Antoinette Esce, Jennifer L Ellis, Roan J Glocker, Adam J Doyle, Kathleen Raman, Michael C Stoner
BACKGROUND: Anatomic severity grade (ASG) can be used to assess abdominal aortic aneurysm (AAA) anatomic complexity. High ASG is associated with complications following endovascular repair of AAAs and we have demonstrated that ASG correlates with resource utilization. The hypothesis of this study is that ASG is directly related to midterm mortality in patients undergoing AAA repair. METHODS: Patients who underwent infrarenal AAA repairs between July 2007 and August 2014 were retrospectively reviewed and ASG scores were calculated using 3-dimensional computed tomography reconstructions...
February 4, 2019: Vascular and Endovascular Surgery
Hirokazu Onishi, Toru Naganuma, Koji Hozawa, Tomohiko Sato, Hisaaki Ishiguro, Satoko Tahara, Naoyuki Kurita, Shotaro Nakamura, Sunao Nakamura
INTRODUCTION: The purpose of the current study was to investigate the periprocedural and long-term outcomes of stent implantation for de novo subclavian artery (SCA) disease. MATERIAL AND METHODS: We retrospectively investigated consecutive patients with de novo SCA lesions undergoing elective endovascular therapy procedures at our center between April 2004 and September 2015. All patients were included in the analyses of periprocedural outcomes, including procedural and clinical success...
January 29, 2019: Vascular and Endovascular Surgery
Süleyman Barutçu, Elnur Alizade, Selcuk Pala
Transcatheter closure has become the leading approach for closure of most instances of patent ductus arteriosus. However, there are some complications associated with this procedure. We report a case involving the embolization of a device in the right pulmonary artery during placement. A 20-year-old woman was referred to our hospital for percutaneous transcatheter closure of patent ductus arteriosus. During the deployment of an Amplatzer duct occluder device, it was disconnected from the connector and became embolized in the lower branch of the right pulmonary artery...
January 28, 2019: Vascular and Endovascular Surgery
Dominika Kasprzak, Krzysztof Bojakowski, Mirosław Nowicki, Michał Zawadzki, Piotr Andziak
Pseudoaneurysm formation is a rare but dangerous complication of carotid artery dissection. It can result from trauma, spontaneous artery dissection, or iatrogenic causes. Presence of symptoms and ineffective medical therapy are one of the indications for invasive treatment. We present the case of 3 symptomatic patients with dissecting pseudoaneurysms-2 traumatic and 1 spontaneous. They were treated with 3 different endovascular procedures: the use of covered stentgraft, trans-stent coil embolization, and carotid stenting...
January 10, 2019: Vascular and Endovascular Surgery
Qasim Rahman, Sailen G Naidu, Brian W Chong, William M Stone
Ehlers-Danlos syndrome (EDS) refers to a group of genetic disorders involving the connective tissues. Type IV EDS impairs type III collagen that is responsible for vessel integrity. Patients with type IV EDS are susceptible to vascular and visceral complications, including aortic aneurysms, pseudoaneurysms, dissections, and spontaneous rupture of internal organs. Treating aneurysms with open surgery versus endovascular techniques each carry a unique risk-to-benefit ratio that must be applied to each individual carefully...
January 10, 2019: Vascular and Endovascular Surgery
Anahita Dua, Kara A Rothenberg, Jisun J Lee, Rebecca Gologorsky, Sapan S Desai
OBJECTIVE: Patients with critical limb ischemia (CLI) and gangrene have a 10% to 38% rate of major amputation at 6 months. The purpose of this study is to report short- and mid-term major and minor amputation rates for patients who underwent tibial and pedal revascularization in addition to quality-of-life (QoL) scores. METHODS: All patients who presented to a single institution with CLI (defined as rest pain or nonhealing wounds) and underwent antegrade or retrograde tibial access, atherectomy and angioplasty of the tibial circulation, and angioplasty of pedal circulation (antegrade or retrograde) from June 2016 to September 2017 were included...
January 8, 2019: Vascular and Endovascular Surgery
Muhammad Rizwan, Hanaa Dakour Aridi, Tru Dang, Widian Alshwaily, Besma Nejim, Mahmoud B Malas
OBJECTIVES: Carotid artery endarterectomy (CEA) and carotid artery stenting (CAS) are 2 effective treatment options for carotid revascularization and stroke prevention. The long-term outcomes of Carotid Revascularization Endarterectomy versus Stenting Trial (CREST) reported similar stroke and death rate between the 2 procedures. This study presents the short- and long-term outcomes of CEA and CAS of all risk patients performed by a single vascular surgeon in a real-world setting. METHODS: We retrospectively reviewed all patients who underwent CEA and CAS from September 2005 to June 2017 at our institute...
January 6, 2019: Vascular and Endovascular Surgery
Jacob Budtz-Lilly, Krister Liungman, Anders Wanhainen, Kevin Mani
INTRODUCTION: The use of fenestrated and branched endovascular technologies in complex aortic aneurysm repair (F/BEVAR) is increasing, with a trend toward using longer sealing zones and incorporating more target vessels. Successful aneurysm exclusion and prevention of long-term treatment failure need to be balanced against the increased complexity of more extensive procedures. The aim of this study was to analyze relationships between the number of catheterized vessels and multiple operative variables as a means for evaluating procedural complexity...
January 6, 2019: Vascular and Endovascular Surgery
Aleem K Mirza, Nishant Saran, Kenneth J Warrington, Alberto Pochettino, Fahad Shuja
Isolated aortic mural thrombus (AMT) is an infrequent occurrence in the setting of an otherwise normal aorta and is a similarly rare occurrence in Takayasu arteritis (TAK). As such, consensus on optimal treatment strategy does not exist, however, invariably necessitates anticoagulation. We report a case of a 21-year-old female who presented with acute chest pain with an isolated descending thoracic AMT on imaging. Diagnosis was elusive after an exhaustive, multidisciplinary evaluation including structural, hypercoagulable, and rheumatologic etiologies...
January 3, 2019: Vascular and Endovascular Surgery
Mohamed I El-Maadawy, Ahmed M Balboula, Hossam Zaghloul
Ostial lesions of the superficial femoral artery preclude the use of ipsilateral common femoral artery antegrade approach. Access via either the contralateral common femoral or the brachial arteries are the 2 alternative classical approaches. Conversely, using an ipsilateral antegrade approach, through a partially inserted sheath, usually leaves the sheath insecure and frequently hits ostial lesion itself during insertion. Dislodgment from the artery frequently occurs, resulting in loss of access. We describe a technique whereby we insert 2 to 3 cm of the sheath into the common femoral artery and the remaining part of the sheath resides in a fashioned subcutaneous tunnel of the lowermost abdomen...
January 3, 2019: Vascular and Endovascular Surgery
Satinderjit Locham, Hanaa Dakour-Aridi, Jatminderpal Bhela, Besma Nejim, Apurva Bhavana Challa, Mahmoud Malas
BACKGROUND: Fenestrated endovascular repair (FEVAR) and chimney endovascular repair (ChEVAR) endovascular repair offer a less invasive alternative to open aortic repair (OAR) in managing juxtarenal, pararenal, and suprarenal abdominal aortic aneurysms (AAAs). The aim of this study is to evaluate the 30-day postoperative outcomes following endovascular and open repair of nonruptured AAA involving the renal vessels. STUDY DESIGN: All patients undergoing endovascular (FEVAR and ChEVAR) and open repair of juxtarenal, pararenal, and suprarenal AAA in National Surgical Quality Improvement Program database from 2012 to 2016 were included...
December 26, 2018: Vascular and Endovascular Surgery
Yoshikatsu Nomura, Kanetsugu Nagao, Shota Hasegawa, Motoharu Kawashima, Takanori Tsujimoto, So Izumi, Masamichi Matsumori, Hirohisa Murakami, Tasuku Honda, Nobuhiko Mukohara
New-onset antegrade Stanford type B aortic dissection (TBAD) after endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) is rare. The extension of aortic dissection leads to various symptoms and affects the stent graft. Moreover, various symptoms may arise owing to a stent graft being present. We describe 2 cases of complicated acute TBAD occurring after EVAR, which were ultimately fatal. The case in which rupture occurred could not be treated and the patient died. In another case with bilateral lower extremity malperfusion caused by collapse and occlusion of the endograft, extra-anatomical bypass was performed...
December 20, 2018: Vascular and Endovascular Surgery
Andrew M T L Choong, Ian J Y Wee, Mark Almond, Masafumi Muratani, Ferenc Kovari, Rita Russai, Michael P Jenkins
INTRODUCTION: Despite advances in perioperative critical care and surgical technique, spinal cord ischemia remains a devastating complication of thoracic and thoracoabdominal aortic aneurysm repair. Biochemical markers present in peripheral blood and cerebrospinal fluid (CSF) may be useful in assessing spinal cord injury. We systematically analyze and report the role of all reported biochemical markers that have been used in assessing and diagnosing spinal cord ischemia in thoracic and thoracoabdominal aortic aneurysm repair...
December 20, 2018: Vascular and Endovascular Surgery
Yoshito Kadoya, Kan Zen, Taku Kato, Naotoshi Wada, Noriyuki Wakana, Kenji Yanishi, Naohiko Nakanishi, Takeshi Nakamura, Satoaki Matoba
PURPOSE: We evaluated the feasibility and safety of the reverse catheterization technique of the superficial femoral artery (ReCAT) for single-stage endovascular treatment (EVT) in patients with bilateral infrainguinal diseases. MATERIALS AND METHODS: We retrospectively evaluated 24 consecutive patients (overall median age: 79 years; male patients: 21 [87.5%]) who underwent EVT for bilateral infrainguinal diseases. The objective of ReCAT was to perform single-stage EVT in patients with bilateral infrainguinal diseases with a one-time unilateral femoral artery puncture...
December 18, 2018: Vascular and Endovascular Surgery
Masato Furui, Shoji Sakaguchi, Bunpachi Kakii, Gaku Uchino, Mai Asanuma, Hiroaki Nishioka, Takeshi Yoshida
OBJECTIVES: Patients with chronic aortic dissection often require repeat interventions due to enlargement of the pressurized false lumen or disseminated intravascular coagulation even after additional thoracic endovascular aortic repair (TEVAR) to occlude the entry tear. Residual false lumen flow can persist even after performing the candy-plug technique or branched stent-graft placement in some cases. We have devised a new method for false lumen closure. METHODS: From December 2010 to May 2017, 5 patients (mean age: 57 [13] years, range: 43-77 years) with chronic dissection at the aortic arch and descending aorta, who underwent initial TEVAR, required additional treatment...
December 17, 2018: Vascular and Endovascular Surgery
Fadi Taher, Afshin Assadian, Markus Plimon, Corinna Walter, Miriam Uhlmann, Juergen Falkensammer
Iliac branch devices (IBDs) are undergoing rapid popularization. They allow for treatment of an iliac aneurysm while preserving blood flow to the hypogastric artery. Certain anatomic criteria are necessary for the use of an iliac side branch device to be technically feasible. Custom-made fenestrated iliac stent grafts may provide an alternative when anatomic criteria for an IBD are not met.
December 4, 2018: Vascular and Endovascular Surgery
Preston Marcus, Angela Echeverria, Mathew Cheung, Elias Kfoury, Kevin Shim, Peter H Lin
INTRODUCTION: In patients who receive chronic hemodialysis but do not have autogenous venous conduit for a native dialysis access, nonautologous grafts serve as an alternative conduit of choice. This study compared the clinical outcome of hemodialysis access using bovine carotid artery graft (BCAG) and prosthetic polytetrafluoroethylene (PTFE) graft in patients who receive chronic hemodialysis. METHODS: An analysis of all patients undergoing hemodialysis using either BCAG or PTFE grafts from 2010 to 2017 was performed...
November 29, 2018: Vascular and Endovascular Surgery
Thomas Kotsis, Georgios Exarchos, Linda Metaxa, Stylianos Triantos
Lymphangiomas are rare benign malformations of the lymphatic system, commonly present in children, over the head and neck area. Occasionally, they can grow significantly in size and especially those located over the cervical region can cause airway obstruction and become life-threatening. Recurrent lymphangiomas usually occur during the early postsurgical period and 80% of them within the first 3 to 5 years. However, in a new onset of clinical manifestations affecting the head and neck, even many years after the successful surgical treatment, a recurrent lymphangioma should be considered in the differential diagnosis...
November 29, 2018: Vascular and Endovascular Surgery
Hyun Yong Lee, Young Nam Roh, Hyoung Tae Kim, Ui Jun Park
Late occurrence of arterial aneurysms following ligation of a hemodialysis arteriovenous fistula (AVF) is rare. Here, we report the case of 51-year-old male patient with an AVF in which arterial aneurysms developed. The patient had undergone left arm radiocephalic (RC) AVF creation for hemodialysis in 2000. He had received a living related donor kidney transplantation from his father in the same year. His RC AVF was ligated in 2009. However, his arm continued to gradually grow in size even after ligation and he visited a hospital for acute pain and erythema around the left elbow in 2017...
November 28, 2018: Vascular and Endovascular Surgery
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