Abstract:
PURPOSE:A technique to decrease visceral ischemic time during thoracoabdominal aneurysm (TAA) repair is reported. METHODS:A 10 mm Dacron side-arm graft is attached to the aortic prosthesis and positioned immediately distal to the planned proximal thoracic aortic anastomosis. On completion of the anastomosis, a 16 to 22 Fr perfusion catheter is attached to the side-arm graft and inserted into the orifice of the celiac axis or superior mesenteric artery. The cross-clamp is then placed on the aortic graft distal to the mesenteric side-arm graft. Pulsatile arterial perfusion is thus established to the visceral circulation while intercostal anastomoses or reconstruction of celiac, superior mesenteric, and right renal arteries is performed. Visceral ischemic time and the rise in end-tidal Pco2 after reconstruction of the visceral vessels in patients with mesenteric shunting was compared with a control group matched for aneurysm extent and treated immediately before use of the mesenteric shunt technique. RESULTS:Between July and Oct, 1996, the technique was applied in 15 patients undergoing type I, II, or III TAA repair with a clamp and sew technique. The mean decrease in systolic arterial pressure was 12.5 +/- 8.5 mm Hg, with a concomitant rise in end-tidal Pco2 (mean, 6.9 +/- 5.8 mm Hg), after perfusion was established through the mesenteric shunt. Mean time to establishment of visceral perfusion through the shunt was 25.5 +/- 4.4 minutes; the resultant decrement in visceral ischemic time averaged 31.3 minutes (i.e., until celiac, superior mesenteric, and right renal arteries were reconstructed). Compared with controls, patients with shunts had a significantly decreased (6.9 +/- 5.8 versus 21.6 +/- 8.4 mm Hg; p = 0.0003) rise in end-tidal CO2 on completion of visceral vessel reconstruction. CONCLUSIONS:In-line mesenteric shunting is a simple method to decrease visceral ischemia during TAA repair, and it is adaptable to clamp and sew or partial bypass and distal perfusion operative techniques.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Cambria RP,Davison JK,Giglia JS,Gertler JPdoi
10.1016/s0741-5214(98)70242-3subject
Has Abstractpub_date
1998-04-01 00:00:00pages
745-9issue
4eissn
0741-5214issn
1097-6809pii
S074152149800113Xjournal_volume
27pub_type
杂志文章abstract::Arterial-ureteral fistulas are rare complications of iliac artery reconstruction or ureteral manipulation. The diagnosis should be considered in patients with intermittent hematuria who have had ureteral catheterization, arterial bypass, or nephrectomy. The following case demonstrates the difficulty in making the diag...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:A suitable ipsilateral great saphenous vein (GSV) autograft is widely considered the best material for arterial reconstruction of a popliteal artery aneurysm (PAA). There are, however, cases in which such a GSV is absent, diseased, or of too small diameter for this use. Alternatives to GSV are synthetic condu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.049
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:The decision about the type and location of a hemodialysis vascular access is challenging and can be affected by multiple factors. We explored the effect of several a priori chosen patient characteristics on access outcomes. METHODS:We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2016.01.053
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:Fenestrated and branched endovascular devices are increasingly used for complex aortic diseases, and despite the challenging nature of these procedures, early experiences from pioneering centers have been encouraging. The objectives of this retrospective study were to report our experience of intraoperative a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.02.065
更新日期:2014-09-01 00:00:00
abstract::Secondary vascular procedures to below-knee vessels for lower extremity ischemia present a challenge to the vascular surgeon. Autogenous vein is often unavailable and failure of the previous bypass often limits the choice of distal vessels suitable for revascularization. This dilemma raises the question of amputation ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080137
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:The problems with first-generation stent grafts for endovascular aneurysm repair are well known, but their long-term outcome remains to be established. The purpose of the study was to characterize the outcome of patients treated for abdominal aortic aneurysm (AAA) with a first-generation stent graft, Vanguard...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.11.027
更新日期:2020-09-01 00:00:00
abstract::Our experience with 63 patients who had popliteal artery injuries sustained in civilian accidents is reported. Blunt injuries occurred in 53 patients and 49 had associated skeletal injuries. Eighteen patients suffered knee dislocation; six of these patients had associated fractures. Fractures of the upper third of the...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0040055
更新日期:1986-07-01 00:00:00
abstract:OBJECTIVE:Lifelong imaging follow-up is essential to the safe and appropriate management of patients who undergo endovascular abdominal aortic aneurysm repair (EVAR). We sought to evaluate the rate of compliance with imaging follow-up after EVAR and to identify factors associated with being lost to imaging follow-up. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.06.006
更新日期:2015-01-01 00:00:00
abstract::Endovascular techniques with coil embolization have been used in certain visceral aneurysm cases, often resulting in sacrifice of the involved visceral vessel and end-organ thrombosis. We describe two cases in which stent grafts were used to treat these aneurysms, allowing preservation of visceral artery and end-organ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.129645
更新日期:2002-12-01 00:00:00
abstract::Surgery under controlled ischemia has been extensively practiced by cardiac, plastic, orthopedic, vascular, and general surgeons. During the past 20 years, we have routinely used this technique to operate on a clean, bloodless field in complex cases of congenital vascular malformations. Based on our favorable experien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.118806
更新日期:2001-11-01 00:00:00
abstract::Pulsed Doppler ultrasonography (UA), sound spectrum analysis, and subjective interpretation of the audible signal are valuable methods for assessing carotid arterial disease; however, the relative contribution of each in making a diagnosis is disputed. To investigate this issue, 258 noninvasive carotid studies with me...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030502
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:Aortoaortic tube graft repair was the first technique used for the endovascular treatment of abdominal aortic aneurysms (AAAs). However, progressive changes in the morphology of the distal aortic neck may be responsible for procedural failure. This study examines the use of aortoaortic tube prostheses and ana...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.123684
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to describe the technique of transfemoral superselective coil embolization of type II endoleak and its influence on abdominal aortic aneurysm diameter. METHODS:Over 23 months, 104 aortic stent grafts were deployed to exclude abdominal aortic aneurysms, at an academic medical center....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(02)75467-0
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:Acute kidney injury (AKI) has been identified as a common complication after fenestrated and branched endovascular aneurysm repair (F/BEVAR), occurring in 5% to 29% of patients. Predictors of AKI and its impact on long-term outcomes remain unknown. We sought to identify independent predictors of AKI and its e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.034
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Intermittent claudication (IC) is the most common symptom of peripheral arterial disease, which significantly affects walking ability, functional capacity and quality of life. Supervised exercise programs (SEP) are recommended as first-line treatment, but recruitment and adherence rates are poor. The time re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.03.050
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Endovascular repair (EVR) is emerging as first-line treatment for patients with superior vena cava (SVC) syndrome of benign etiology, but data on its durability remain scarce. The aims of this study were to assess the efficacy and durability of EVR and compare results of EVR with open surgical reconstruction...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.09.071
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:The optimal strategy for revascularization in chronic limb-threatening ischemia (CLTI) is not yet completely known and is still under debate. Endovascular treatment methods predominate despite limited evidence for their advantage. In this concurrent, prospective observational cohort study, we investigated ou...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.03.029
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:Few studies have examined factors that influence an individual's decision to enter an academic medical career after residency training. We sought to evaluate whether sex, ethnicity, child care issues, and debt burden influenced residents' choice for a career in academic vascular surgery. METHODS:A 39-item We...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.141
更新日期:2012-05-01 00:00:00
abstract::Two simple methods for direct antibacterial protection of synthetic vascular grafts were investigated. In the first protocol the highly protein-bound antibiotics nafcillin (90% protein bound), cefazolin (80%), and cefamandole (70%) were added directly to preclotting blood. Knitted Dacron grafts preclotted in the prese...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1984.avs0010372
更新日期:1984-03-01 00:00:00
abstract:PURPOSE:Fifty-one consecutive patients with premature lower extremity atherosclerosis were prospectively evaluated for atherogenic risk factors and primary or acquired hypercoagulability, which might contribute to early ischemia and revascularization failure. METHODS:Laboratory tests included plasma assays of (1) natu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(05)80033-3
更新日期:1996-01-01 00:00:00
abstract::Lower extremity paraplegia or paraparesis is an extremely rare event after operative repair of infrarenal abdominal aortic aneurysms (AAAS). We report two such cases that occurred after endovascular repair or attempted endovascular repair of routine AAAS. To our knowledge, these are the first two cases reported specif...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111801
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:We sought to determine the effects of renal insufficiency on thoracic endovascular aortic repair (TEVAR) outcome and to identify predictors for adverse events. METHODS:Eighty-four patients with renal insufficiency (creatinine >or=1.5 mg/dL) were analyzed from a prospective TEVAR database from April 1, 1999, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.07.070
更新日期:2009-01-01 00:00:00
abstract::Missile embolism into the cerebral circulation is a very unusual complication of shotgun wounds to the chest or neck. We report a case of an 11-year-old boy who sustained an air gunshot wound and pellet embolism to the intracranial carotid artery. The cerebral artery pellet embolus resulted in contralateral hemiplegia...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2011.07.091
更新日期:2012-02-01 00:00:00
abstract::Chronic aortic dissection is one of the most challenging pathologies faced by aortic surgeons. The variety of presentations and the multiple comorbidities of the patients make treatment and follow-up a subject of much debate. Historical data is difficult to interpret because of the heterogeneity of the included popula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2016.01.025
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:The feasibility and safety of combining carotid surgery and thrombolysis for occlusions of the internal carotid artery (ICA) and the middle cerebral artery (MCA), either as a simultaneous or as a staged procedure in acute ischemic strokes, was studied. METHODS:A nonrandomized clinical pilot study, which includ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0741-5214(99)70274-0
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:Spinal cord ischemia (SCI) is a potentially devastating complication of thoracic endovascular aortic repair (TEVAR) that can result in varying degrees of short-term and permanent disability. This study was undertaken to describe the clinical outcomes, long-term functional impact, and influence on survival of ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.036
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft. METHODS:A single-center retrospective review of prospectively collected data was performed. We extracted demographic variables as well a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.07.065
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the midline retroperitoneal approach with the midline transperitoneal approach for abdominal aortic aneurysm (AAA) repair with respect to operative details, gastrointestinal complications, and wound complications. METHODS:From January 1990 through January 1998, 128 pati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mva.2000.106946
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:In the last decade, there has been a dramatic increase in the number of women entering vascular surgery. Our goal was to evaluate the differences in career paths based on gender and to determine some of the factors that influence career decisions among young vascular surgeons. METHODS:A 17-item web-based sur...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.055
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Endovascular therapy for chronic mesenteric ischemia (CMI) has been increasingly utilized. Early outcomes compare favorably with open mesenteric bypass--the current gold standard. The goal of this study is documentation of intermediate-term anatomic and functional outcomes of endovascular mesenteric revascula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.06.064
更新日期:2010-01-01 00:00:00