Abstract:
:In vascular surgery, the gold standard for evaluation of the lower-extremity arterial tree has long been contrast arteriography (CA). Associated risks of CA are well-documented and include severe allergic reactions, arterial injury and/or hemorrhage, and contrast-induced nephropathy. Increasingly, less-invasive techniques, with fewer inherent risks for complication, are being explored as diagnostic alternatives. Magnetic resonance angiography, computed tomography angiography, and duplex arteriography, each offer distinct advantages, though are not without limitation. This review explores the indications, advantages, and disadvantages of these newer technologies and provides a comparison to CA as a means for defining the anatomic features of patients undergoing lower-extremity revascularization. This data suggests that noninvasive imaging technologies may, in the future, play an increasingly important role in the surgical evaluation of the patient with lower-extremity ischemia.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Hingorani A,Ascher E,Marks Ndoi
10.1053/j.semvascsurg.2007.02.005subject
Has Abstractpub_date
2007-03-01 00:00:00pages
15-28issue
1eissn
0895-7967issn
1558-4518pii
S0895-7967(07)00006-3journal_volume
20pub_type
杂志文章,评审abstract::Endovascular treatment of thoracic aortic pathology (ETAP) has been under development for over a decade. Only recently has one device been approved in the United States for treatment of descending thoracic aortic aneurysms. The length of this development process is due to multiple device and deployment system modifica...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2005.11.003
更新日期:2006-03-01 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::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::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::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::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::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::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::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::Ischemia-reperfusion injury is a continuing challenge to vascular surgeons. Microvascular factors and mechanisms underlying edema and compartment syndrome provide a useful end point for analysis and planning of therapy. We review the pivotal role of endothelium-leukocyte interactions and of cytokines in the genesis of...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 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::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::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::For generations, the use of techniques to defer skin pressure and protect the lower-extremity wound has been a cardinal goal to achieve therapeutic success and healing. Choosing the appropriate postoperative offloading device or shoe is often difficult, as it is challenging to merge optimal mechanical protection with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.10.002
更新日期:2014-03-01 00:00:00
abstract:UNLABELLED:A variety of intraoperative imaging and assessment techniques can be used during carotid endarterectomy (CEA) to evaluate the technical results of the arterial repair. However, the necessity of utilizing these techniques routinely in every case, and the actual ability of these studies to improve the outcomes...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.10.003
更新日期:2007-12-01 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::Our understanding of cerebrovascular disease in women is hampered by a paucity of studies that include adequate numbers of female patients. Most studies are heavily biased toward men. Although women have fewer strokes than men and have a better long-term prognosis after strokes or TIAs, cerebrovascular disease still a...
journal_title:Seminars in vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:
更新日期:1995-12-01 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::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::Early detection of abdominal aortic aneurysms potentially can save many lives by preventing aneurysm rupture. Screening programs, however, have yet to be proven as an efficient means of accomplishing this goal and improving overall life expectancy. Until more information is available, selective high-risk screening may...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.25491
更新日期:2001-09-01 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 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::Venous hypertension is a significant problem for the patient on chronic hemodialysis. This condition can result in impairment of arteriovenous access function, disabling upper extremity edema with bluish discoloration and pigmentation of the skin, and, in advanced cases, ulceration of the finger tips and neuralgias. V...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2003.11.002
更新日期:2004-03-01 00:00:00
abstract::The recent endovascular aneurysm repair (EVAR) 1 and 2 and Dutch Randomized Endovascular Aneurysm Management (DREAM) trials addressed management of abdominal aortic aneurysms (AAAs) larger than 5.5 cm in diameter. The DREAM and EVAR 1 trials randomized patients appropriate for open repair between endovascular repair (...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2006.03.001
更新日期:2006-06-01 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 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::Endovascular aneurysm repair has enabled a broad population of patients with infrarenal abdominal aortic aneurysm to be treated by a less-invasive technique. However, endovascular aneurysm repair has therapeutic limitations, including the need for lifelong surveillance and a higher rate of secondary interventions than...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2016.06.004
更新日期:2016-03-01 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::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 experimen...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 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