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 and rupture could be a more sensitive predictor of rupture risk. We investigated the metabolic activity of the aneurysmal wall by whole-body positron emission tomography (PET) in 26 patients with a documented AAA (mean diameter 63 mm, extremes 45 mm and 78 mm). A positive (18)F-fluorodeoxyglucose ((18)F-FDG) uptake at the level of the AAA was observed in 38% of the cases (10 of 26 patients). Nine of these 10 patients required emergent or urgent aneurysmectomy for ruptured (n = 1), leaking (n = 1), rapidly expanding (n = 2), or painful (n = 5) aneurysms; the negative (18)F-FDG uptake patients had a more benign course. This preliminary study suggests a possible correlation between (18)F-FDG uptake by the aneurysm wall and the triggering of processes leading to rupture. The (18)F-FDG uptake in the aneurysm wall may correspond to the accumulation of inflammatory cells responsible for the production and activation of degrading enzymes. PET scan seems useful in high-risk patients. Positive PET imaging in these cases would help us to decide to proceed with surgery, despite factors favoring a surveillance strategy.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Sakalihasan N,Hustinx R,Limet Rdoi
10.1053/j.semvascsurg.2004.03.002subject
Has Abstractpub_date
2004-06-01 00:00:00pages
144-53issue
2eissn
0895-7967issn
1558-4518pii
S0895796704000171journal_volume
17pub_type
杂志文章,评审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::Elimination of the embolic potential of existing thrombus, restoration of unobstructed flow, prevention of further thrombosis, and preservation of venous valve function are the ideal goals of therapy for acute deep vein thrombosis (DVT). Meeting these goals will not only prevent pulmonary embolus, but will also minimi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2010.10.002
更新日期:2010-12-01 00:00:00
abstract::Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2010.05.001
更新日期:2010-09-01 00:00:00
abstract::Given both the high-risk nature of the critical limb ischemia (CLI) patient population, as well as the variety of available treatment options, the ability to use preprocedure variables to predict a given outcome has become increasingly important. The three main advantages associated with accurate risk stratification i...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2009.10.002
更新日期:2009-12-01 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::Duplex ultrasound testing has evolved to be a clinically useful modality for the evaluation of chronic mesenteric ischemia (CMI) due to visceral artery origin atherosclerosis. Patients with known or suspected CMI can be scanned to identify stenosis or occlusion of the celiac, superior mesenteric, and inferior mesenter...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2013.11.005
更新日期:2013-06-01 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::While open or endovascular techniques for treatment of the superficial femoral artery continue to dominate the care of most patients, there are clearly patients who benefit from a combination of these approaches. Typically these patients require treatment of more than a single level of disease. In these cases, endovas...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.11.006
更新日期:2008-12-01 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::Venous invasion is a common characteristic of renal cell carcinoma, manifesting as tumor thrombus with possible extension into the renal vein and, in extensive cases, the thrombus can reach from the renal vein to the right atrium. Currently, cytoreductive nephrectomy and tumor thrombectomy are the foundations for impr...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.06.015
更新日期:2013-12-01 00:00:00
abstract::Means for endovascular therapy have radically altered the treatment paradigm for occlusive lesions of the aortic arch vessels. Diagnosis of these problems by noninvasive means is becoming increasingly more common, allowing invasive evaluation and treatment to occur simultaneously. Most of these lesions are atheroscler...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 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::The evolution of vascular surgery during the past five decades has established what was once controversial to be mandate, what was never dreamed of as debatable, and the vast body of knowledge yet to be unraveled--but requiring clinical application--as currently controversial. Controversy results when dissimilar thera...
journal_title:Seminars in vascular surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1999-03-01 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::The continuing evolution of endovascular approaches to the repair of descending thoracic and thoracoabdominal aortic aneurysms necessitates careful evaluation of the safety and efficacy of these alternative therapies as they compare to the "gold standard" of open surgical repair. The purpose of this report is to prese...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.11.009
更新日期:2008-03-01 00:00:00
abstract::The training of vascular surgeons in Canada has evolved over the past decade. Direct entry into a vascular surgery training program after medical school has been offered since 2012. At some institutions, it is the only option for surgery training. The smaller population of Canada and a single-payer health care system ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2019.01.009
更新日期:2019-01-01 00:00:00
abstract::Aortoiliac occlusive disease is a significant cause of lower extremity ischemic symptoms. Over the past two decades, most patients have been treated with a variety of surgical procedures, including aortofemoral and extra-anatomic bypasses. Most recently, percutaneous balloon angioplasty and stents have been successful...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1997-12-01 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::Endovascular aneurysm repair has proven to be a valuable alternative to open repair in selected patients. This less invasive procedure, however, requires long-term surveillance for its own set of potential complications, including perigraft leakage, or endoleak. This article focuses on the detection of these leaks, fi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2004.09.003
更新日期:2004-12-01 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::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::Over the last decade, more than 25,000 endovascular stent grafts have been used to treat aortic aneurysms. Although results have been promising thus far, problems with endoleaks, material failure, device migration, and aneurysm rupture continue to be reported. Improvements in device material and design have contribute...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0895-7967(03)00006-1
更新日期:2003-06-01 00:00:00
abstract::The main focus when discussing acute or chronic mesenteric ischemia is on occlusive disease, arterial or venous. This article reviews present knowledge on mesenteric nonocclusive hypoperfusion syndromes. The following three clinical entities are reviewed: (1) Intraabdominal hypertension (IAH), or abdominal compartment...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2009.12.009
更新日期:2010-03-01 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::The purpose of this article is to describe the development and utilization of a unique paperless medical record system in a large multispeciality group practice setting. The Scott and White integrated health care delivery system provides care over a 34-county area in Central Texas. Since 1988, clinicians at Scott and ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/svas.2001.21253
更新日期:2001-03-01 00:00:00
abstract::The use of autologous femoral veins for in situ reconstruction of the aortoiliac segment is an effective technique to treat native aorta or prosthetic graft infections. The indications, technical details, and outcomes of this procedure are detailed. Graft infection involving the aortic segment, while rare, remains one...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2019.07.002
更新日期:2019-01-01 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::Inflammatory abdominal aortic aneurysms (IAAA) are being treated more frequently by endovascular aneurysm repair (EVAR). Some authors caution against treating IAAA by EVAR because retroperitoneal inflammation may not subside post-operatively. A recent experience of 69 IAAA treated by open and endovascular methods is p...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2012.09.008
更新日期:2012-12-01 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::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