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) can offset its thromboembolic benefit. We questioned whether SSI associated with L/D SFJ could be minimized by a single preoperative dose of antibiotic. METHODS:A retrospective cohort study was performed on 902 ambulatory surgery patients who underwent 953 consecutive RFAs of the GSV in combination with L/D SFJ. A single dose of preoperative antibiotic was administered 1 hour before incision to some patients (n = 449 extremities), with all other patients receiving no antibiotic (n = 504). Primary outcome measure was SSI categorized based on type of therapy required (1: oral antibiotic, 2: hospitalization for intravenous antibiotic and/or wound debridement), with a secondary outcome measure of VTE. RESULTS:VTE occurred in 10 patients (1%) and included three pulmonary emboli. The majority of VTE were calf deep vein thromboses (n = 7). SSI developed in 78 patients (8.2%) with groin, thigh, and calf distributions of 47%, 8%, and 45%, respectively. All category 2 infections (n = 8, 10%) occurred in control subjects, and the majority were located in the groin. Body mass index significantly increased risk for both overall (odds ratio [OR]: 1.09, 95% confidence interval [CI]: 1.05-1.14, P < 0.0001) and groin (OR: 1.08, 95% CI: 1.02-1.14, P = 0.01) SSI as well as VTE (OR: 1.17, 95% CI: 1.08-1.30, P = 0.003). Diabetes was a significant risk for groin SSI (OR: 5.13, 95% CI: 1.44-18.26, P = 0.01). Antibiotic was associated with a significantly reduced risk for both overall (OR: 0.54, 95% CI: 0.37-0.89, P = 0.02) and groin (OR: 0.34, 95% CI: 0.16-0.73, P = 0.01) SSI. Furthermore, prophylaxis eliminated category 2 infections (P = 0.008) and was associated with a significantly lower risk of VTE (OR: 0.11, 95% CI: 0.01-0.85, P = 0.01). Although SSI was noted more commonly in extremities with thromboembolic complications (20% [n = 2] vs. 8.1% [n = 76] in those without), this trend was not significant and could not account for the antibiotic effect on VTE. CONCLUSIONS:L/D SFJ combined with RFA of the GSV, when treated as a clean procedure and not prophylaxed with antibiotic, carries a significant risk of SSI. While diabetes and high body mass index are patient-associated SSI risk factors, a single dose of preoperative antibiotic significantly reduces the rate of all infection, eliminates the danger of serious infection, and is associated with minimal VTE.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Singh R,Mesh CL,Aryaie A,Dwivedi AK,Marsden B,Shukla R,Annenberg AJ,Zenni GCdoi
10.1016/j.avsg.2011.10.013subject
Has Abstractpub_date
2012-07-01 00:00:00pages
612-9issue
5eissn
0890-5096issn
1615-5947pii
S0890-5096(11)00577-2journal_volume
26pub_type
杂志文章abstract::Buerger's disease is frequently diagnosed in young smokers, based on clinical presentation rather than histologic criteria. This report describes a young male with idiopathic aortitis who had been managed for 10 years as Buerger's disease solely on the basis of clinical manifestations. This case emphasizes the need fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)61447-7
更新日期:1987-12-01 00:00:00
abstract::Use of pedal bypass can salvage limbs of patients with critical ischemia. The aim of this study was to evaluate the results of surgical revascularization of pedal arteries in diabetic patients and to assess the impact of diabetes on long-term outcome. We performed a retrospective analysis of all consecutive pedal bypa...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910114
更新日期:2000-11-01 00:00:00
abstract::Beginning in April 1989, we have performed eight upper thoracic chemical sympathectomies by transthoracic endoscopy. The indications were occlusive arterial disease in four patients and Raynaud's syndrome and palmar hyperhidrosis in two patients each. Transthoracic endoscopy was performed under general anesthesia, thr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02008799
更新日期:1992-07-01 00:00:00
abstract::The etiology of varicose veins remains elusive. We hypothesized that abnormal cell cycle events in the vein wall may contribute to changes in its structural integrity predisposing to varicosity development. Since cell cycle checkpoint controls are linked to the signaling and execution of apoptotic cascades, possibly a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910005
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Lower-limb revascularization surgery, especially when performed using the great saphenous vein, predisposes patients to major surgical trauma on initially ischemic tissue. Vein harvest wounds (VHWs) after infrainguinal revascularization heal slowly. This study's aim was to assess the factors associated with ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.06.007
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Primary closure (PC) and patch angioplasty (PA) during carotid endarterectomy (CEA) have been disputed in many studies. Some studies announced that PC is associated with a higher restenosis rate. The aim of this study was to evaluate the outcomes of PC and PA using propensity score matching (PSM). METHODS:B...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.11.011
更新日期:2020-01-01 00:00:00
abstract::We describe a case of intestinal angina caused by spontaneous dissection of the celiac artery and thrombosis of the superior mesenteric artery. Spontaneous dissection of a visceral artery is an uncommon occurrence that is usually diagnosed after fatal hemorrhage or ischemia. The underlying mechanism is unclear but the...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900070
更新日期:1997-07-01 00:00:00
abstract::We present a case of brachial artery mycotic aneurysm caused by methicillin-resistant Staphylococcus epidermidis in a patient with infective endocarditis. A 66-year-old woman suffered two transient ischemic attacks over an 8-week period secondary to septic emboli from mitral valve endocarditis. Following valve replace...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9065-4
更新日期:2006-09-01 00:00:00
abstract::Arterial aneurysms, rarely encountered in childhood, pose difficult etiologic and therapeutic problems. We report the case of a seven-year-old Algerian girl with aortoiliac, visceral, and limb aneurysms revealed by a tumefaction in the left popliteal fossa. Aortic rupture subsequently occurred. The aneurysms were rese...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02042684
更新日期:1990-01-01 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::This report describes a case of defecation syncope secondary to functional inferior vena cava (IVC) obstruction. Preoperative hemodynamic assessment revealed a marked decrease in blood pressure and IVC obstruction when the patient performed a Valsalva maneuver. The intraoperative approach included continuous hemodynam...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02002893
更新日期:1993-07-01 00:00:00
abstract::Acute occlusion of the visceral arteries is a threatening complication following branched endovascular aortic repair (EVAR). Its prompt diagnosis and treatment are mandatory to restore renal function. Several techniques have been used to manage this complication. We report 2 clinical cases of patients, previously trea...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.07.015
更新日期:2017-11-01 00:00:00
abstract::Twenty-nine cases of post-traumatic false aneurysms and arteriovenous fistulas (AVF), with a mean follow-up of 24 months (1-65 months), are presented here. Diagnosis was established by color duplex and arteriogram. The time between injury and treatment varied between 3 days and 61 months. Endovascular treatment was ac...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900230
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Venous resection during pancreaticoduodenectomy for the excision of pancreatic cancer allows for a more complete resection with negative margins, which increases survival. When the resected vein is greater than 3 cm, reconstruction with an interposition graft is recommended. However, consensus regarding the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.11.008
更新日期:2020-05-01 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:BACKGROUND:Percutaneous mechanical thrombectomy is commonly used to treat acute thrombotic syndromes. AngioJet (AJ) forcibly sprays fibrinolytics to fragment and aspirate thrombus. It is known to cause hemolysis and gross hematuria, yet potential consequences to renal function after AJ remain unstudied. We sought to de...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.12.018
更新日期:2017-07-01 00:00:00
abstract::Patients with severely diseased or occluded infrageniculate arteries, limited runoff, and tissue loss may often present for primary amputation. In this study, we review our experience with plantar artery revascularization when no other bypass options are feasible. All patients requiring infrainguinal bypass to the pla...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010006
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Chronic limb threatening ischemia in octogenarians presents unique treatment challenges in patients with multiple comorbidities and variable functional status. Endovascular interventions offer a better risk profile; however, this is not always a feasible option for anatomic or disease-specific reasons. This ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.08.094
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:The impact of presence of an IVC filter in patients undergoing stenting for symptomatic femoroiliocaval obstruction has not been explored in detail. This study attempts to fill this gap by evaluating clinical and stent-related outcomes in such patients. The incidence of deep vein thrombosis (DVT) in this set...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.03.041
更新日期:2020-10-01 00:00:00
abstract::We present a case of extra-anatomic axillo-mesenteric reconstruction for chronic mesenteric ischemia. Endovascular access and retrograde bypass options were prohibited by severe aortoiliac occlusive disease. Standard antegrade bypass was impossible because of the presence of a thoracoabdominal aortic aneurysm. This un...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.08.005
更新日期:2016-02-01 00:00:00
abstract::Thoracic outlet syndrome (TOS) refers to the compression of the neurovascular bundle within the thoracic outlet. Cases are classified by primary etiology-arterial, neurogenic, or venous. In addition to the typical symptoms of arm swelling and paresthesias, headaches have been reported as a potential symptom of TOS. In...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.05.109
更新日期:2017-02-01 00:00:00
abstract::Duplex scanning used to determine graft flow velocities is an effective means of identifying lower extremity bypass grafts at risk for failure before they occlude. We implemented a graft surveillance protocol using duplex scanning and over a two-year interval evaluated fifty-four lower extremity bypasses utilizing gra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02016753
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:Many studies have identified features of the emboli traveling in the arterial system by Doppler ultrasound, and estimated their composition and size for anticipation of cerebral infarct. Another concern is features of the emboli in the venous system for anticipation of pulmonary embolism (PE). The objective ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.03.004
更新日期:2010-08-01 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::This report summarizes our recent experience with two patients who presented with symptoms ipsilateral to a severe carotid stenosis at the bifurcation, with one having a severe stenosis at the siphon and the other an occlusion of the internal carotid artery in its intracranial portion. These lesions were documented on...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900312
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:Historically, carotid procedures incur a readmission rate of approximately 6%; however, these studies are not nationally representative and are limited to tracking only the index hospitals. We sought to evaluate a nationally representative database for readmission rates (including different hospitals) after ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.025
更新日期:2020-10-01 00:00:00
abstract::Spontaneous dissection of the superior mesenteric artery represents a rare cause of abdominal angina. Conservative or more aggressive treatments such as surgery or endovascular therapy depend on the symptoms. We present a case report of acute mesenteric ischemia due to spontaneous dissection of the superior mesenteric...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2008.12.004
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:We propose a novel technique for endovenous treatment of varicose veins (VVs) using combined coil embolization and foam sclerotherapy of the great saphenous vein (GSV). METHODS:A retrospective case-series analysis on patients undergoing fluoroscopically guided coil embolization of the GSV and foam sclerothe...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.05.101
更新日期:2017-01-01 00:00:00
abstract::While endovascular repair (ER) has become a routine procedure in the treatment of arteriosclerotic abdominal aortic aneurysms with a suitable configuration, only rare reports of interventional treatment of inflammatory aortic abdominal aneurysms (IAAA) exist. We present a case study of a male patient with IAAA, who pr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s10016-004-0031-8
更新日期:2004-05-01 00:00:00
abstract::Sixty-two bypass grafts to the peroneal artery were performed at the University of Rochester Medical Center between 1984 and 1990. An autogenous conduit was used in 45 patients and a prosthetic conduit in 17 patients. Primary cumulative patency rates were 49% at two years and 30% at four years following operation. Lim...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000661
更新日期:1992-01-01 00:00:00