Abstract:
:Several techniques have been developed and clinically applied to reduce the spinal cord ischemia complications that follow thoracoabdominal aortic aneurysm (TAA) repair. Hypothermia as a protective adjunct is a concept that has been used throughout the evolution of cardiac and central aortic surgery. Because experimental regional hypothermic perfusion delivered directly to the epidural or intrathecal space showed protective effects against cord injury, we developed and applied a method for providing regional cord hypothermia with epidural cooling during TAA repair. This review describes the technical considerations with epidural cooling and the clinical results obtained in our experience.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Cambria RP,Davison JKsubject
Has Abstractpub_date
2000-12-01 00:00:00pages
315-24issue
4eissn
0895-7967issn
1558-4518pii
S0895-7967(00)70009-3journal_volume
13pub_type
杂志文章,评审abstract::Chronic venous disease includes a spectrum of clinical presentations ranging from varicose veins through chronic lower extremity pain and edema to venous skin changes and ulceration. Such manifestations may result from primary venous insufficiency or be secondary to other disorders, primarily acute deep venous thrombo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract::The traditional dogma of putting mobile patients with acute deep vein thrombosis into bed for several days has been challenged by some studies that showed a better clinical outcome with walking exercises under good compression. Repeated lung scans did not show an increased risk of new pulmonary embolism. There was a f...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2005.05.006
更新日期:2005-09-01 00:00:00
abstract::The vascular surgeon, in the absence of effective medical options for the treatment of atherosclerosis, has in the past assumed primary responsibility for the care of patients with peripheral vascular disorders. During the past two decades, management of these patients has become increasingly complex, the direct resul...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::Nutcracker syndrome is one of the abdominal venous entrapments, caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Occasionally a retro-aortic left renal vein is compressed between the aorta and the vertebral body (posterior nutcracker syndrome). The renal vein...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2013.04.006
更新日期:2013-03-01 00:00:00
abstract::Various endovascular techniques, including the placement of embolization coils, intravascular stents, and the use of stented grafts, have been used in the setting of traumatic upper extremity injuries. Coil embolization and stent placement are effective in a limited number of cases. Endovascular grafts have greatly ex...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract::Acute limb ischemia is one of the most potentially devastating but treatable diseases faced by the vascular surgeon. It is crucial to identify the ischemic process early, as the outcomes of early intervention can lead to limb salvage, whereas late recognition places the patient at risk for limb loss and potential mort...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.12.004
更新日期:2009-03-01 00:00:00
abstract::The pathophysiology of the diabetic foot ulcer and soft-tissue infection is due to neuropathy, trauma, and, in many patients, concomitant peripheral artery occlusive disease. Diabetic neuropathy results in foot deformity, leading to increased skin pressure with walking. Once a foot ulcer develops, the limb is at high ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2019.02.001
更新日期:2018-01-01 00:00:00
abstract::There is a need for a standardized consistent language in vascular surgery that allows easy flow of information and comparison of results among clinicians. Beginning with current nomenclature, a common language serves as a framework for more detailed efforts. Understanding the outcomes assessment tools available provi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2010.01.002
更新日期:2010-06-01 00:00:00
abstract::Prophylaxis for venous thromboembolism is an area that has received intense study in certain conditions, but less than adequate coverage in other areas. In considering who needs prophylaxis, patients are categorized into levels of risk. Clinical venous thromboembolism can be correlated to these levels of risk. Methods...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2000-09-01 00:00:00
abstract::Arterial and venous trauma of the cervicothoracic region continues to present challenging problems for the surgeon, despite advances in vascular diagnostics and surgical technique. Whether due to penetrating or blunt mechanisms, overall incidence of these injuries is low, whereas morbidity and mortality remain high. D...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Thromboembolic vascular diseases remain the main cause of death in Western industrialized societies. Anticoagulants retard the formation, growth, and embolization of thrombi and are effective agents in the prevention and treatment of thromboembolic disease. Anticoagulants in venous thromboembolism have been investigat...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2002.36261
更新日期:2002-12-01 00:00:00
abstract::The decision to operate on a patient with an aortic aneurysm is based on the risk of aneurysm rupture versus the risk of aneurysm repair, within the context of the patient's overall life expectancy. Risk of rupture is still primarily based on the maximum aneurysm diameter, with some allowances made for factors that mo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.04.001
更新日期:2007-06-01 00:00:00
abstract::Aortic infection is an uncommon but life-threatening condition. Conservative medical treatment is insufficient in many cases because of the high risk of persistent infection, aortic rupture, and death. Conventional open surgical treatment consists of extensive tissue debridement, complete removal of the infected prost...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.10.009
更新日期:2011-12-01 00:00:00
abstract::Vascular surgeons well versed in peritoneal dialysis applications understand the importance of this modality among the limited options afforded to patients in renal failure. Peritoneal and hemodialysis strategies are interdependent and should be considered in concert. Careful assessment often shows that patients with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1997-09-01 00:00:00
abstract::Constructing vascular access for hemodialysis causes changes in blood flow to the extremity, which can lead to distal ischemia. Ischemic steal syndrome is manifested by pain; weakness; pallor; and, in severe cases, ulceration and tissue loss. Severe ischemia, requiring reintervention, has an incidence of 4%, although ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.07.009
更新日期:2007-09-01 00:00:00
abstract::Increased intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) are important clinical problems after repair of ruptured abdominal aortic aneurysms and are reviewed here. IAP >20 mm Hg occurs in approximately 50% of patients treated with open abdominal aortic aneurysm repair after rupture, and approx...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2012.03.002
更新日期:2012-03-01 00:00:00
abstract::The failure of an autogenous or prosthetic arteriovenous hemodialysis access is usually related to the failure of the venous outflow resulting from a stenosis somewhere in the venous system, commonly at the venous anastomosis for a prosthetic access or within the central veins. The National Kidney Foundation's Kidney ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.05.008
更新日期:2011-06-01 00:00:00
abstract::The size of abdominal aortic aneurysms (AAA) is the most usual predictor of the risk for rupture. Because chronic metalloproteinases production and activation by inflammatory cells causes degradation of elastin and collagen in the aneurysmal wall, the detection of an increased metabolic process preceding fissuration a...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2004.03.002
更新日期:2004-06-01 00:00:00
abstract::Radiotherapy (XRT) plays a prominent role in the therapy of a variety of malignancies. Improved survival for malignancies treated with XRT has produced a growing subset of patients who present several years later with arterial occlusive disease in the irradiated field. Establishing a presumptive diagnosis of radiation...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0895-7967(03)00026-7
更新日期:2003-09-01 00:00:00
abstract::Restenosis following lower-extremity revascularization remains a significant and costly public health burden. Technical advances in endovascular therapy afford us the choice of treating longer and more distal lesions, which were heretofore reserved for vein bypass surgery. While contemporary vascular surgeons are well...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.05.007
更新日期:2008-09-01 00:00:00
abstract::Although numerically far less than claudicants, patients with critical leg ischemia (CLI) demand a disproportionately large commitment both in medical effort and economically and represent the major workload for vascular surgical units. The incidence and prevalence of CLI is approximately 500 to 1,000/million/year. Th...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::The obturator bypass is a useful method for revascularizing the lower extremity in the presence of a hazardous groin dissection. The most common indication for employing this method of reestablishing arterial continuity is in circumventing infected vascular prostheses. One- and 5-year patency rates of 72.7% and 56.9% ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::While carotid angioplasty and stenting has been clearly established as a minimally invasive alternative to endarterectomy for patients with carotid occlusive disease, its indications continue to evolve, being refined as more controlled data of large studies are being accumulated. The purpose of this article is to revi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.03.003
更新日期:2008-06-01 00:00:00
abstract::The management of patients with thrombosed vein grafts remains a formidable challenge for all vascular surgeons. Management strategies will vary based on a variety of criteria including the patients' overall condition and symptoms, the interval and etiology of graft failure, and the pathological anatomy and availabili...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Innominate and subclavian artery lesions run a wide spectrum of disease manifestation and treatment options. Since the first surgical treatment, multiple variances have been attempted with the desire to maintain high long-term patency rates while reducing perioperative morbidity and mortality. The advent of endovascul...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.04.001
更新日期:2011-03-01 00:00:00
abstract::In this article, the use of prosthetic grafts for above-the-knee femoral-popliteal arterial bypass reconstruction is discussed. The issue as to whether prostheses should be used preferentially, selectively, or not at all, remains both topical and controversial in vascular surgical circles. The debate has been heighten...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract::Because endovascular procedures represent an ever-increasing portion of many vascular surgery practices, many surgeons are faced with difficult choices. Endovascular procedures often require open surgery, and open surgical techniques increasingly require fluoroscopic imaging. Without good intraoperative imaging, endov...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::Ultrasound-guided sclerotherapy with foam is able to suppress blood flow in almost all types of varicose veins. The technique is efficient, simple, safe, inexpensive, and easily repeatable, although it requires training and skill. It should be considered as the best primary treatment for most varicose patients. Evalua...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2004.12.008
更新日期:2005-03-01 00:00:00
abstract::It is estimated that 20% to 40% of the patients who survive the acute phase of aortic dissection will develop significant aneurysmal dilatation of the descending thoracic or thoracoabdominal aorta. Aortic dissection has long been considered a risk factor for mortality and neurologic deficit following surgical repair o...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2002.33088
更新日期:2002-06-01 00:00:00
abstract::In recent years, vascular surgery fellowships have changed substantially to meet the requirements for interventional as well as open surgical training. Data from the Residency Review Committee for Surgery indicate that the average vascular fellow performed fewer than 15 interventional procedures in 2000, but that this...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2006.08.005
更新日期:2006-12-01 00:00:00