Abstract:
BACKGROUND:We investigated if minimizing bowel manipulation and mesenteric traction using the retroperitoneal approach in open abdominal aortic aneurysm (AAA) repair preserves splanchnic perfusion, as measured by gastric tonometry, and reduces the systemic inflammatory response and dysfunction of the various organs. METHODS:Patients undergoing elective AAA repair were randomized into three groups. Group I had repair via the retroperitoneal approach, while groups II and III were repaired via the transperitoneal approach with the bowel packed within the peritoneal cavity or exteriorized in a bowel bag, respectively. A tonometer was used to measure gastric intramucosal pH (pHi), as an indicator of splanchnic perfusion, just prior to aortic clamping, during clamping, and at 0.5, 1, 2, 4, 6, and 12 hr after clamp release. Multiorgan dysfunction syndrome (MODS) and systemic inflammatory response syndrome (SIRS) scores were calculated and systemic interleukins (IL-6 and IL-10) measured at predetermined intervals. RESULTS:Thirty-four patients were successfully randomized. The gastric pHi was significantly lower in group II (n=12) and group III (n=11) compared to group I (n=11) during aortic clamping and immediately after clamp release (p<0.05). The aortic clamp time, blood loss, MODS and SIRS scores, and systemic cytokine response were similar in all three groups. When the three groups were combined, there were significant positive correlations between the operation time, aortic clamp time, and amount of blood lost and transfused with plasma IL-6 levels and MODS score on the first postoperative day. CONCLUSION:The retroperitoneal approach for open AAA repair is associated with gastric tonometric evidence of better splanchnic perfusion compared to the transperitoneal approach.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Arya N,Sharif MA,Lau LL,Lee B,Hannon RJ,Young IS,Soong CVdoi
10.1016/j.avsg.2009.06.003subject
Has Abstractpub_date
2010-04-01 00:00:00pages
321-7issue
3eissn
0890-5096issn
1615-5947pii
S0890-5096(09)00128-9journal_volume
24pub_type
杂志文章,随机对照试验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:BACKGROUND:Although present-generation endografts have expanded the indications for endovascular abdominal aneurysm repair, arterial anatomy frequently dictates the use of a combination of commercially available endografts and components for successful aneurysm repair. This study sought to determine whether there was a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.04.020
更新日期:2013-04-01 00:00:00
abstract::We examined changes in practice patterns after the establishment of a varicose vein center (VVC) within two tertiary university vascular surgery practices and compared differences between urban (U) and rural (R) sites. Practice patterns for the treatment of VVs were compared 3 years before (period 1) and 3 years after...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9092-1
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Endovenous thermal ablation has become the procedure of choice in the treatment of superficial venous reflux disease. The current armamentarium of devices and techniques aimed at the elimination of saphenous reflux offers surgeons and interventionalists a variety of treatment options; however, there is a lac...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.05.059
更新日期:2020-01-01 00:00:00
abstract::Resection and graft replacement of the vena cava for malignant disease is rarely performed, often because of the advanced tumor stage. Since August 1987 we have selectively performed caval replacement in conjunction with tumor resection in 11 patients. Three patients had superior vena cava reconstruction (SVCR) and ei...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02042660
更新日期:1993-01-01 00:00:00
abstract::Longitudinal elasticities of whole human blood clot, whole canine blood clot, Factor XIII cross-linked fibrin, glutaraldehyde-fixed human albumin, and formaldehyde-fixed collagen, gelatin and collagen/gelatin were determined and normalized to human whole blood clot. Matrices of a knitted Dacron graft were then impregn...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02042732
更新日期:1992-03-01 00:00:00
abstract::The hypoglossal artery is present as an anastomotic channel between the carotid and vertebrobasilar system for approximately one week during embryologic development. Rarely, it may persist into adulthood and may be encountered during cerebrovascular operations. We report a 76-year-old woman with a persistent hypogloss...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(07)60035-1
更新日期:1989-07-01 00:00:00
abstract::The aims of this study were to determine whether National Kidney Foundation (NKF) guidelines for native arteriovenous fistula (AVF) creation (at least 50% of all new end-stage renal disease [ESRD] patients and 40% of prevalent hemodialysis patients) could be met in an underserved population who presented in late stage...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.10.004
更新日期:2008-01-01 00:00:00
abstract::Prosthetic graft interposition is performed in some patients with coarctation of the aorta (CoA), and all procedures for treating CoA are associated with a risk of aneurysm formation at the site of repair. A 53-year-old woman underwent coarctectomy and descending aortic replacement with a 16-mm Dacron graft for CoA wh...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.01.021
更新日期:2017-08-01 00:00:00
abstract::Twenty-four patients who underwent surgery for pararenal aortic aneurysms between January 1992 and April 1997 are reviewed. Eighteen patients had primary atherosclerotic aneurysms, three patients had symptomatic infected aneurysms, two patients had an aneurysm proximal to a prior aortic repair, and one patient had a p...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900164
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:We performed a systematic review and meta-analysis to examine whether patients with intermittent claudication can benefit from endovascular treatment (EVT). METHODS:A prespecified search strategy was used to identify relevant studies in the MEDLINE, Embase, and Cochrane databases. A total of 10 different ra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.avsg.2013.05.022
更新日期:2014-05-01 00:00:00
abstract::The long-term impact of retroperitoneal aortic exposure regarding wound complications in all patients and erectile dysfunction in men was studied in a consecutive group of 107 patients (81 males and 26 females). Postoperative wound complications were classified into the following groups: none, flank bulge, hernia, and...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9014-2
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Endovascular therapy is first-line treatment for aortoiliac occlusive disease. This shift has altered case volume, patient selection, and risk profile for aortobifemoral bypass (ABF). Given this, we sought to investigate factors influencing morbidity and mortality after ABF in the endovascular era. METHODS:...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.03.040
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Sex-related differences in outcomes have been identified in patients with peripheral artery disease (PAD). We hypothesized that women with PAD would have equivalent inpatient mortality with men after vascular intervention. METHODS:Patients with a primary diagnosis of critical limb ischemia (CLI) or lifestyl...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.01.006
更新日期:2019-07-01 00:00:00
abstract::Fifty-eight patients underwent lower limb amputation for arterial disease over a 30-month period. Mean age of the patients was 72 years. Cardiopulmonary and metabolic risk factors were present in the majority of the patients. Postoperative one-year and three-year mortality rates were 24, 40, and 76%, respectively. Con...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02009459
更新日期:1990-05-01 00:00:00
abstract::A 38-year-old hemodialysis-dependent diabetic female patient underwent a laparoscopic cholecystectomy for symptomatic cholelithiasis. Postoperatively, she developed chronic back pain. Eight months following laparoscopic cholecystectomy, she developed fevers and recurrent bacteremia with methicillin-resistant Staphyloc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010124
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Today transdermal continuous oxygen therapy (TCOT) is used in wound care to promote healing by improving local hypoxia and preventing infection, and it has been described to reduce local inflammation over 1 month of administration. The present study aims to investigate the effects of this treatment on wound ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.09.036
更新日期:2020-04-01 00:00:00
abstract::Traumatic renal arteriovenous fistula involving the inferior vena cava (IVC) are exceptionally rare, but if left untreated can have devastating clinical consequences, including development of renovascular hypertension, cardiomegaly, and congestive heart failure. We report a rare, pediatric case of a renal-caval arteri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.04.028
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to explore whether preoperative white blood cell (WBC) count may predict 30-day mortality and long-term survival following surgery for abdominal aortic aneurysm (AAA). Secondarily, we wanted to assess the potential sex differences in WBC in these patients. METHODS:The study ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.08.028
更新日期:2017-05-01 00:00:00
abstract::Aneurysms of the inferior thyroid artery (ITA) are extremely rare and potentially determine severe sequelae. We report a case of true ITA aneurysm in a 45-year-old Caucasian woman treated with endovascular embolization; postoperative course was uneventful and, at 6-month follow-up, the aneurysm is completely thrombize...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.08.024
更新日期:2017-04-01 00:00:00
abstract::Successful treatment by percutaneous catheter drainage of an acute aortic graft infection with an associated pancreatic fistula is reported. Percutaneous catheter drainage can be considered in selected patients when the risk of reoperation is deemed unacceptable or when other reasonable treatment options do not exist....
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000598
更新日期:1996-09-01 00:00:00
abstract:BACKGROUND:Intermittent claudication (IC) is a common condition which is associated with significant quality of life limitation. National Institute for Health and Care Excellence guidelines recommend a group-based supervised exercise program as the primary treatment option for claudication, based on clinical and cost e...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2015.05.043
更新日期:2016-01-01 00:00:00
abstract::Endoleaks remain a significant challenge after endovascular abdominal aortic aneurysm repair (EVAR). Translumbar thrombin injection of the aneurysm sac has been used to treat endoleaks, with low reported morbidity. We present an unusual case of ischemic colitis following translumbar thrombin injection of an endoleak. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-003-0102-2
更新日期:2004-01-01 00:00:00
abstract::Twelve cases of emboli to the renal artery (one of which was recurrent) were reviewed. In seven patients, emboli were unilateral and the opposite kidney was functional. In five patients, emboli were bilateral or occurred in a solitary kidney, leading to anuria. Cardiac rhythm disorders were encountered in eight patien...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60800-5
更新日期:1988-04-01 00:00:00
abstract::Renal transplantation has increased the longevity of patients with uremia. An increasing number undergo aortic reconstruction, which exposes the transplanted kidney to ischemic injury. To evaluate the risk for renal failure, loss of the transplant, and methods of renal protection, we reviewed our experience. Clinical ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02000752
更新日期:1996-03-01 00:00:00
abstract::Surgical reconstruction for patients with symptomatic lower extremity arterial occlusive disease is successful when a suitable distal target vessel is present. In patients with unreconstructable disease, practical surgical options are at a minimum. We report our initial experience with dorsal venous arch arterializati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0148-y
更新日期:2002-03-01 00:00:00
abstract::Despite high initial technical success, the long-term durability of endovascular abdominal aortic aneurysm repair (EVAR) continues to be a concern. Following EVAR, patients can experience endoleaks, device migration, device fractures, or aneurysm growth that may require intervention. The purpose of this study was to r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.10.003
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Thoracoabdominal aortic aneurysm (TAAA) repairs are technically challenging. The advent of endovascular aneurysm repair in combination with visceral/renal artery bypasses has allowed for hybrid endovascular repair of these aneurysms. The purpose of this study was to evaluate whether outcomes were affected by...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.06.004
更新日期:2011-01-01 00:00:00
abstract::OMNEX (Ethicon, Inc.; Somerville, NJ) is a cyanoacrylate-based synthetic surgical sealant. To date, the use of OMNEX has only been described in a limited number of vascular surgery procedures. We present the cases of two patients who underwent successful extracorporeal renal artery aneurysm repair with the aid of OMNE...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.07.009
更新日期:2011-11-01 00:00:00
abstract::Expanded polytetrafluoroethylene (ePTFE) is the most commonly employed vascular prosthetic for constructing arteriovenous fistulas for hemodialysis. Venous aneurysm is a rare complication following construction of such fistulas. We describe the case of a saccular aneurysm of the cephalic vein arising after constructio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0057-0
更新日期:2002-03-01 00:00:00