Abstract:
BACKGROUND:Surgical bypass as treatment for chronic mesenteric ischemia (CMI) is performed to alleviate symptoms of weight loss and postprandial pain and to prevent catastrophic intestinal necrosis. Among the studies that report outcomes for mesenteric bypass, few focus on the type of conduit. The purpose of this study was to evaluate contemporary short-term outcomes of patients who underwent aortomesenteric bypass for CMI, with specific attention given to the conduit used--prosthetic versus vein. METHODS:Data from the American College of Surgeons National Surgical Quality Improvement Program Participant Use File were analyzed for demographic and clinical risk variables, mortality, and 22 defined complications (morbidity) between 2005 and 2009 from more than 200 participating hospitals. The database was queried for patients undergoing aortomesenteric bypass with vein (Current Procedural Terminology [CPT] 35531) or nonvein (CPT 35631) whose preoperative diagnosis was CMI (International Classification of Diseases, 9th Revision code 557.1). Outcomes and risk variables were compared using univariate analysis and independent sample t tests for continuous variables. RESULTS:One hundred fifty-six patients underwent mesenteric revascularization--119 (76%) women and 37 (24%) men with an average age of 65 ± 13 years. The conduit used was vein in 44 (28%) and prosthetic graft in 112 (72%). There were no statistically significant differences between the two groups in mean age, smoking history, recent weight loss, obesity (body mass index: >25) rates, length of operation, reoperation frequency, and early graft failure. More patients undergoing bypass with vein had an associated bowel resection and preoperative sepsis or systemic inflammatory response syndrome. Additionally, patients with a vein graft had a higher percentage of a contaminated surgical site (30% vs. 7%, P = 0.001) and underwent emergent surgery more frequently (16% vs. 4%, P = 0.012). Mortality was higher in patients in whom a vein graft was used (16% vs. 5%, P = 0.039). There were no differences noted between the two groups in length of stay or postoperative complications, including infectious complications, renal insufficiency, myocardial infarction, and stroke. CONCLUSIONS:Thirty-day mortality was higher in patients who underwent mesenteric bypass with vein. However, this group also had a higher incidence of emergent surgery, bowel resection, and contaminated operative field. This suggests that vein grafts were preferentially used when bowel infarction was suspected. The higher mortality is likely due to patient factors, such as the extent of bowel ischemia at the time of operation, rather than the type of conduit used. If expeditious revascularization is done before development of bowel infarction, vein or prosthetic conduit would be expected to function equally well.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Davenport DL,Shivazad A,Endean EDdoi
10.1016/j.avsg.2011.11.006subject
Has Abstractpub_date
2012-05-01 00:00:00pages
447-53issue
4eissn
0890-5096issn
1615-5947pii
S0890-5096(11)00511-5journal_volume
26pub_type
杂志文章,多中心研究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::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::Between 1975 and 1985, 43 patients underwent simultaneous aortic and renal artery reconstruction. Twenty-two patients had infrarenal abdominal aortic aneurysms and 21 had aortoiliac occlusive disease. In addition, 40 patients had severe lesions of one or both renal arteries and three patients had a lesion in an access...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60808-X
更新日期:1988-10-01 00:00:00
abstract::Many patients are not considered candidates for radiocephalic fistula (RCF) or brachiocephalic fistula (BCF) creation or have fistulas that do not mature because the cephalic vein is too deep or tortuous to be accessed. Other patients have not been candidates for the basilic vein transposition (BVT) because limited le...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0140-6
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The pathophysiological mechanisms that induce postrevascularization edema after femoropopliteal bypass surgery are not completely understood. Reperfusion-associated injury to revascularized tissue and damage to lymphatic structures are both likely to play a role. Aim of this study was to study edema formatio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.04.010
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Solid organ transplantation in elderly patients has become more common in recent years. An increasing number of patients present with renal failure requiring transplantation and comorbid occlusive or aneurysmal aortic pathology. The optimal strategy for the timing and management of the aortic disease and ren...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.007
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:Embolic stroke is a formidable complication of transcatheter aortic valve implantation (TAVI) and thoracic endovascular aortic repair (TEVAR). Mechanical strategies to reduce the risk of ischemic embolic lesions include embolic protection devices (EPDs) and carbon dioxide flushing (CDF). This study aims to a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.06.035
更新日期:2019-02-01 00:00:00
abstract::The case being presented is a 35-year-old female with a 3-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.033
更新日期:2017-11-01 00:00:00
abstract::Behcet disease (BD) is a chronic systemic inflammatory disorder characterized by recurrent oral and genital ulcerations, üveitis, and skin lesions. Vascular system involvement is common in BD. Aneurysm formation appears to be more common than arterial occlusion. Extracranial carotid aneurysms in BD are extremely rare....
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.10.033
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:To report the prevalence of silent brain infarcts (SBI) at magnetic resonance imaging (MRI) before and after surgery for asymptomatic high grade carotid stenosis. METHODS:This is a single center retrospective observational study. Asymptomatic patients who underwent carotid endarterectomy between October 201...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.10.067
更新日期:2017-08-01 00:00:00
abstract::Arthroscopy of the foot and ankle is a common orthopedic procedure with low complication rates. Arterial injuries from these procedures are an even more rare subset of the complications. Hemophilia A is a genetic disorder of aberrant coagulation, which leads to increased risk of bleeding even after minor trauma. We pr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.12.017
更新日期:2016-07-01 00:00:00
abstract::A prospective study with random selection between primary closure and saphenous vein patching after carotid endarterectomy was conducted. Patients were evaluated with intravenous digital subtraction angiography during the initial postoperative period, followed by duplex scanning at 3 and 6 months, and then yearly exam...
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/BF02133406
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The Vascular Quality of Life Questionnaire (VascuQoL-6) was proposed to evaluate specific quality of life of peripheral artery disease (PAD) patients. However, there is no Brazilian-Portuguese version available, blunting its use in Brazilian patients. The objective of the study was to analyze the psychometri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.02.026
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Most of the experience on fenestrated endovascular aneurysm repair involves the custom-made Zenith® endograft (Cook). The fenestrated Anaconda® endograft (Vascutek) was introduced with the potential advantages of complete repositioning and lack of stent material on the main aortic body for more versatility. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2017.03.171
更新日期:2017-08-01 00:00:00
abstract::This study was undertaken to evaluate the ability of intraoperative duplex scanning during infrainguinal vein bypass to identify technical abnormalities and to determine the relation between intraoperative scan result and early primary graft patency. We retrospectively reviewed of 78 consecutive intraoperative duplex ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900257
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the predictive factors of reduction in diameter ≥10 mm of the aneurysm sac after endovascular treatment and analyze evolution in these patients. METHODS:Between December 1997 and December 2008, all patients electively treated at our center for an infrarenal abdominal a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.12.016
更新日期:2015-01-01 00:00:00
abstract::Percutaneous endovenous techniques, such as radiofrequency ablation (RFA), have become the preferred method for treatment for varicose veins associated with great saphenous vein (GSV) insufficiency. Reports have shown safety and efficacy of these techniques with relatively few complications. Deep venous thrombosis aft...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.07.005
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Loss of critical endothelial cell function and subsequent vascular smooth muscle cell (VSMC) migration is central to the pathology of injury-induced neointimal hyperplasia and recurrent stenosis. Thrombomodulin (TM), well known for its function as an endothelial surface anticoagulant, may have an unknown dir...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.10.002
更新日期:2016-01-01 00:00:00
abstract::Endovascular repair of peripheral arterial lesions was performed in 10 patients including two iliac aneurysms, two iliac anastomotic pseudoaneurysms, one subclavian pseudoaneurysm, one axillary anastomotic disruption, two prosthetic pseudoaneurysms, and two posttraumatic arteriovenous (AV) fistulas. The indications fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900043
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to evaluate 2 patients who underwent endovascular repair directly after acute life-threatening vascular injury complicating lumbar disc surgery, and to update an overview of the literature from 2002 to gain insights into characteristics, diagnosis, treatment, and outcomes of this...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.07.019
更新日期:2013-08-01 00:00:00
abstract::Infections involving the aorta are associated with high rates of morbidity and mortality, and their management is complex. Saturating Dacron grafts in rifampin (60 mg/mL) inhibits the growth of organisms commonly found to be involved in both primary aortic infections and aortoenteric fistulas. Open repair and replacem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.10.006
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS:We conducted a retrospective analysis of critical limb ischemia patients...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.045
更新日期:2017-11-01 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
abstract:BACKGROUND:Vascular surgery fellowship training has evolved with the widespread adoption of endovascular interventions. The purpose of this study is to examine how general surgery trainee exposure to vascular surgery has changed over time. METHODS:Review of the Accreditation Council for Graduate Medical Education nati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.02.008
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Type II endoleaks are the most common complications after endovascular repair of abdominal aortic aneurysms (EVARs). Some studies have shown the benefit of preventive inferior mesenteric artery (IMA) embolization, but its efficacy and cost-effectiveness continue to be controversial. The aim of this study was...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.03.012
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:To evaluate the 24-month outcome of stenting in Trans-Atlantic Inter-Society Consensus (TASC) A & B and TASC C & D iliac lesions in a controlled setting. METHODS:The BRAVISSIMO study is a prospective, nonrandomized, multicenter, multinational, monitored registry including 325 patients with aortoiliac lesion...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2014.12.027
更新日期:2015-01-01 00:00:00
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 w...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9021-3
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Carotid endarterectomy (CEA) for asymptomatic patients with limited life expectancy may not be beneficial or cost-effective. The purpose of this study was to examine relationships among survival, outcomes, and costs within 2 years following CEA among asymptomatic patients. METHODS:Prospectively collected da...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.01.024
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Strategies available to facilitate decision making for patients with peripheral arterial disease (PAD) include a Markov-based decision analysis (DA) model and the Lower Extremity Grading System (LEGS) score. Both have suggested inferior outcomes when the actual treatment received (ATX) differs from that pred...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.08.006
更新日期:2015-02-01 00:00:00
abstract::Spontaneous venous aneurysms of the upper extremities and neck are rare and typically asymptomatic. We present the first reported case of a symptomatic, primary upper extremity venous aneurysm in a patient who initially presented with pulmonary emboli. A 22-year-old patient was admitted with chest pain, dyspnea, and a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.019
更新日期:2013-02-01 00:00:00