Abstract:
:Although the left flank retroperitoneal incision is a useful approach for many patients undergoing major aortic reconstruction for aneurysmal and occlusive disease, it has been associated with weakening of the flank muscles, resulting in bulges varying from slight asymmetry to huge hernias. The purpose of this study was to determine if the incidence of this complication correlated with identifiable preoperative or intraoperative factors. Fifty consecutive patients undergoing aortic reconstruction via the retroperitoneal approach were followed for 1 year postoperatively for evidence of disfiguring bulges. Bulges were scored as follows: normal/mild, <1-inch protrusion; moderate, protrusion 1-2 inches; severe, protrusion >2 inches and/or pain or true herniation. Preoperatively, patients were administered a questionnaire to elicit demographic and comorbidity data. Fifty-six percent of patients developed a bulge at 1 year. In 43% of these, the bulge was deemed mild and in 54% moderate. One patient developed a severe bulge. Among preoperative comorbidities, no statistically significant correlations were found on bivariate analysis. However, likelihood ratios for bulge development of 5.5 for renal disease and 3.1 for cancer were demonstrated. Conversely, peripheral vascular disease had a likelihood ratio of 0.21 for bulge formation and emphysema, 0.28. On logistic analysis, incision >15 cm and body mass index (BMI) >23 mg/kg(2) were found to correlate strongly with bulge formation (p=0.003, odds ratio=9.1, and p=0.018, odds ratio=16.9, respectively). Together, these yielded a pseudo r (2) of 0.32. BMI >23 mg/kg(2 )was found to yield the greatest explanatory power. These same two variables were found to correlate with severity of bulge: p=0.02 for incision>5 cm and p=0.006 for BMI >23. Of note, gender, age, and extension of the incision into the interspace were not significant on logistic analysis. Preoperatively, surgeons should warn obese patients and those requiring large incisions for extensive disease of their increased risk for poor healing. Intraoperatively, surgeons should aim to minimize incision length.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Matsen SL,Krosnick TA,Roseborough GS,Perler BA,Webb TH,Chang DC,Williams GMdoi
10.1007/s10016-006-9021-3subject
Has Abstractpub_date
2006-03-01 00:00:00pages
183-7issue
2eissn
0890-5096issn
1615-5947pii
S0890-5096(06)60029-0journal_volume
20pub_type
杂志文章abstract:BACKGROUND:The natural history of penetrating aortic ulcer (PAU) has been variably described and clear guidelines are lacking. We reviewed our experience with PAUs in a tertiary referral center. METHODS:Imaging reports from January 2010 to December 2017 were retrospectively searched for the diagnosis of "penetrating a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.12.062
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Leiomyosarcoma of the inferior vena cava (IVC) is a rare mesenchymal tumor with poor prognosis. Surgical resection is currently the only potential curative treatment. This study analyzed long-term outcomes of patients who underwent surgical resection of leiomyosarcoma of the IVC. METHODS:The charts of 12 pa...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.05.053
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Blunt traumatic aortic injury (BTAI) is of very rare occurrence in adolescents. The purpose of our study was to assess the clinical presentation and treatment outcomes of BTAI in this subset of patients. METHODS:We reviewed prospective data of 18 patients who were 20 years or younger with BTAI among 28,000 ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.10.012
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease (PAD) is an underdiagnosed and undertreated disease because it remains asymptomatic for so long. The ankle-brachial index (ABI) is a valid method for detecting PAD in lower extremities. ABI ≤0.90 indicates incident PAD. Recent studies have found that subjects with borderline ABI v...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.11.004
更新日期:2016-04-01 00:00:00
abstract::This report describes the surgical management of 24 patients with concurrent abdominal aortic aneurysm (AAA) and urinary tract neoplasm. The patient population consisted of 22 men and two women whose average age was 65.5 years. AAA sizes ranged from 3.1 to 9.0 cm (mean 5.2 cm) in diameter. Urinary tract neoplasms incl...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02143854
更新日期:1995-09-01 00:00:00
abstract::Previous reports have suggested "short" focal stenoses in peripheral vein grafts (PVGs), namely less than 2 cm long, can be successfully balloon dilated with good long-term patency rates. We questioned if enthusiasm for balloon angioplasty of these lesions in failing PVGs is warranted. Between August 1, 1993 and Decem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900129
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Deep vein thrombosis (DVT) occurs in up to 600,000 patients in the United States annually and can lead to long-term morbidity because of the post-thrombotic syndrome. The multicenter isolated-pharmacomechanical thrombolysis device (ISOL-8) study was designed to determine the safety and efficacy of the Trelli...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2015.05.029
更新日期:2015-11-01 00:00:00
abstract::This study evaluates the hemodynamic effects and safety of saline irrigation necessary to obtain high-quality completion angioscopic studies, as compared with standard completion arteriography during infrainguinal bypass grafting. One-hundred ten patients undergoing primary infrainguinal bypass grafting, were prospect...
journal_title:Annals of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02000670
更新日期:1992-01-01 00:00:00
abstract::The aim of this article is to report a case of symptomatic fibromuscular dysplasia (FMD) involving the external iliac arteries (EIAs). An 88-year-old woman was admitted to the vascular service, with a painful right posterior ankle ulcer that had progressively worsened during the course of a month. Her medical history ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.09.010
更新日期:2012-05-01 00:00:00
abstract::We present our experience with 5 patients with chronic limb threatening ischemia (CLTI) treated with distal revascularization and omental flap coverage. We decided to investigate the efficacy and safety of negative-pressure wound therapy (NPWT) in promoting the fixation and remodeling of the omental flap as there is s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.03.006
更新日期:2018-10-01 00:00:00
abstract::From 1990 to 1992 there was a 43% increase in the number of carotid endarterectomies (CEAs) performed at our institution. Not coincidentally the North American Symptomatic Carotid Endarterectomy Trial study was published in August 1991. To determine whether CEAs could be performed safely at community medical centers, ...
journal_title:Annals of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1007/BF02133062
更新日期:1994-09-01 00:00:00
abstract::Takayasu's arteritis (TA) is a systemic large vessel vasculitis that affects the aorta and its branches. Most patients with TA respond to medical therapy with a minority of patients requiring surgical intervention. In our report, we describe the case of a 59-year-old Caucasian female with TA who underwent revasculariz...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.09.019
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:Ministernotomy has been advocated over recent years as an alternative technique for different cardiovascular surgical procedures to reduce the surgical trauma associated with conventional full sternotomy. In recent years, several reports have addressed minimally invasive approaches to the proximal aorta and ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.10.078
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Ligation and division of the saphenofemoral junction (L/D SFJ) can protect against the danger of venous thromboembolism (VTE) associated with greater saphenous vein (GSV) radiofrequency ablation (RFA). Although this procedure is regarded as clean from an infection standpoint, surgical site infection (SSI) ca...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.10.013
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:To compare aortic sac changes after endovascular aneurysm repair (EVAR) assessed by three-dimensional ultrasound (3D-US), two-dimensional ultrasound (2D-US), and traditional computed tomographic angiography (CTA). METHODS:Using volume assessment with three-dimensional CTA (3D-CTA-volume) as the gold standar...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.061
更新日期:2020-11-04 00:00:00
abstract:BACKGROUND:We investigated the outcome of vein stenting placement for chronic proximal venous outflow obstruction (PVOO) in a predominantly Asian-American cohort to improve patient selection, enhance technical approach, and better define quality measurements of this emerging vascular intervention. METHODS:A total of 4...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.01.018
更新日期:2020-07-01 00:00:00
abstract::Ischemia occurring during hyperextension of the upper limb in a 25-year-old woman led to the discovery of a supracondylar spur responsible for compression of the brachial artery with anomalous insertion of the pronator teres muscle. Resection of all abnormal structures provided immediate relief of symptoms. When atypi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60736-X
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:Comorbid conditions are known to increase cardiovascular risk in patients with peripheral artery disease (PAD). However, whether comorbid conditions affect walking capacity remains controversial. Previous studies have analyzed comorbidities separately, but they are known to occur in a clustered fashion in PA...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.020
更新日期:2014-02-01 00:00:00
abstract::During the last 20 years, we encountered 14 arterioportal fistulas in 12 patients. Gastrointestinal hemorrhage or mesenteric artery insufficiency were the most frequent conditions found after the diagnosis. Arterioportal arterial fistulas were congenital in two cases and acquired in 10; seven of these 10 were iatrogen...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60834-0
更新日期:1990-11-01 00:00:00
abstract::A 72-year-old man with suprarenal aneurysm and 2 large penetrating ulcers (PAUs) in the descending aorta was referred for endovascular treatment. To avoid long-segment aortic coverage and the attendant risk of spinal ischemia, combination of 2 different stent technologies was used. A multilayer flow modulator was impl...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.05.042
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Much has been made of obesity's health impact, largely founded on data regarding patient weight and circulating adipose-derived mediator levels. Paradoxically, a "healthy obese" state exists, but substantial knowledge gaps also exist regarding human adipose-phenotype determinants. Surgical major amputation (...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.07.017
更新日期:2013-04-01 00:00:00
abstract::Salmonella aortitis is a known complication of Salmonella infection that usually requires surgical therapy. It is unknown whether endovascular aortic repair (EVAR) is an acceptable alternative to conventional aortic surgery for patients with Salmonella aortitis who are at high risk for perioperative complications. We ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.09.015
更新日期:2014-07-01 00:00:00
abstract::A 21-year-old man was referred to our department for treatment of multiple aneurysms, including bilateral renal artery aneurysms. He was clinically diagnosed with Loeys-Dietz syndrome. So, we developed a 2-stage surgical strategy. The first surgery involved reconstructing the right renal artery and replacing part of t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.10.032
更新日期:2019-05-01 00:00:00
abstract::Large-vessel occlusion is uncommon in association with antiphospholipid antibodies. This report describes the first case involving occlusion of the infrarenal abdominal aorta and inferior vena cava in a 46-year-old woman with circulating lupus-like anticoagulants who presented with subacute lower extremity ischemia. T...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0231-4
更新日期:2002-05-01 00:00:00
abstract::Synovial hemangioma is a rare benign vascular malformation. We report a case of chronic swelling in the left knee of a 7-year-old boy. An intra-articular tumor of synovial origin could was detected after a magnetic resonance imaging scan. Surgical excision of the mass associated with partial synovectomy was carried ou...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.08.019
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Loeys-Dietz syndrome (LDS) is characterized by a triad of aortic aneurysm, vessel tortuosity, and hypertelorism. LDS patients often harbor additional aneurysms and dissections throughout their vasculature. The optimal management of these additional lesions is poorly understood. Accordingly, we sought to anal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.007
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Treatment of venous ulcers is demanding for patients, as well as clinicians, and the investigation of underlying venous hypertension is the cornerstone of therapy. We propose that occult iliac vein stenosis should be ruled out by iliac vein interrogation (IVI) in patients with advanced venous stasis. METHOD...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.11.036
更新日期:2016-07-01 00:00:00
abstract::We present endovascular treatment of abdominal aortic aneurysm in a 26-year-old man with a 10-year follow-up. A young patient presenting with an abdominal aortic aneurysm is extremely rare, and data describing this population are limited. Open aneurysm repair (OAR) is the treatment of choice in these patients. However...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.01.025
更新日期:2015-07-01 00:00:00
abstract::Spinal cord ischemic injury is one of the feared complications during aortic cross-clamping. The aim of this study was to investigate whether cyclosporin A (CsA) has a protective effect on spinal cord during ischemia in a rabbit model. A total of 22 New Zealand white rabbits were studied in three groups. One of the gr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9022-2
更新日期:2006-03-01 00:00:00
abstract::The prevalence of combined severe aortic stenosis and abdominal aortic aneurysm is increasing with the aging of the population. Both conditions are associated with adverse outcome if not adequately managed. The choice of the optimal treatment of these patients is challenging and no clear recommendations are available....
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.03.028
更新日期:2019-10-01 00:00:00