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 some degree of ischemia causing pain or parasthesias occurs in 10% to 20% of patients following access construction. Pathophysiology may be on the basis of inadequate arterial collateral inflow due to occlusive disease, particularly involving the medium-sized vessels, or high flow in a fistula exceeding the inflow capacity in the absence of intrinsic occlusive disease of the inflow arteries. Predicting steal remains difficult, although certain patient characteristics and preoperative techniques can help identify those patients in whom arteriovenous fistulas have an increased risk of causing steal. Patients with diabetes, multiple access procedures, and constructions based on proximal arteries are more prone to ischemia. Ultrasonography and digital-brachial indices measured by photoplethysmography or Doppler techniques have been used to predict fistulas that are more likely to cause ischemia, but these fall short of reliability. Operative techniques for correcting steal include arteriovenous fistula ligation, percutaneous transluminal angioplasty, banding or restrictive procedures, and distal revascularization interval ligation or modifications of this technique. Operative intervention for ischemic steal syndrome successfully resolves ischemia in 80% to 95% of patients. Some patients can have persistent pain despite healing of ulceration.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Suding PN,Wilson SEdoi
10.1053/j.semvascsurg.2007.07.009subject
Has Abstractpub_date
2007-09-01 00:00:00pages
184-8issue
3eissn
0895-7967issn
1558-4518pii
S0895-7967(07)00052-Xjournal_volume
20pub_type
杂志文章,评审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：: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 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 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：:Patients with end-stage liver disease (ESLD) who develop hepatorenal syndrome (HRS) have very high mortality rates. For patients with HRS type I, median survival without specific therapy is only 2 weeks. Due to worsening clinical condition in such patients secondary to uremia and hepatic disease, some form of renal re...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,meta分析,评审
doi：10.1053/j.semvascsurg.2017.04.001
更新日期：2016-12-01 00:00:00
abstract：:Thrombembolic complications frequently occur during and after endovascular procedures because of associated arterial injury and thrombotic characteristics of implanted devices such as stents. New strategies in platelet aggregation inhibition are now available blocking the final and common pathway of platelet aggregati...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/svas.2001.23171
更新日期：2001-06-01 00:00:00
abstract：:Renal artery stenting remains an important adjuvant treatment for true-resistant hypertension, although recent disappointing randomized trials highlight the importance of careful patient selection. Safe and successful renal interventions begin with critical core knowledge regarding renal artery anatomy and understandi...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2014.06.002
更新日期：2013-12-01 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 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：: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：: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：: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 clinical application of serum biomarkers (d-dimer, C-reactive protein) to predict the natural history of descending thoracic aortic dissection remains elusive. In this review, our current understanding of biomarkers in descending thoracic aortic dissection detection, predicting complications, and aiding in patient...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2015.01.001
更新日期：2014-12-01 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：: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 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：:Management of venous ulceration has evolved tremendously during the last 2 decades. There has been considerable progress in our understanding of the pathophysiology, hemodynamics, venous imaging, and therapeutic options for venous ulcers, including endovenous ablation, iliac vein stenting, and vein-valve repair techni...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2015.07.002
更新日期：2015-03-01 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：: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：: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 etiology of foot lesions in diabetics is multifactorial. Arterial insufficiency, neuropathy, and susceptibility to infection are major factors contributing to the formation of nonhealing diabetic foot lesions. These factors lead to a 15% ulceration rate in diabetics with 20% resulting in amputation. This amputatio...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2012.04.001
更新日期：2012-06-01 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 increasing availability of and vascular surgeons' familiarity with digital cine-fluoroscopy in the operating room has been facilitated by the advent and growing popularity of endovascular aortoiliac aneurysm repair and other endovascular techniques that are being incorporated into vascular surgical practice. Digit...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2003.08.006
更新日期：2003-12-01 00:00:00
abstract：:Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physi...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2018.03.002
更新日期：2018-03-01 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：: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：: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：:In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (ap...
journal_title：Seminars in vascular surgery
pub_type： 杂志文章,评审
doi：10.1053/j.semvascsurg.2017.04.011
更新日期：2017-03-01 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：: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
