Abstract:
PURPOSE:This is a review of 100 consecutive supraaortic trunk reconstructions (SAT) performed over 16 years. METHODS:There were eight innominate endarterectomies and 92 bypass procedures based on the thoracic aorta (n = 86) or proximal innominate artery (n = 6) in 98 patients 24 to 79 years of age. Indications included cerebrovascular ischemia in 83 and upper extremity ischemia in four. Thirteen patients were asymptomatic. An innominate lesion was bypassed in 78 cases. The left common carotid and left subclavian arteries required reconstruction in 38 and nine patients, respectively. Multiple trunks were reconstructed by direct bypass grafting in 35. Approach was via median sternotomy in 92, partial sternotomy in six, and left thoracotomy in two. Seven patients underwent concomitant cardiac surgery. RESULTS:Eight deaths and eight nonfatal strokes occurred, for a combined stroke/death rate of 16%. The operative mortality rate was 6% for SAT and 29% for SAT/cardiac operations. Perioperative complications included two asymptomatic graft occlusions, three nonfatal myocardial infarctions, seven significant pulmonary complications, three sternal wound infections, and one recurrent laryngeal nerve injury. Follow-up ranged from 1 to 184 months (mean, 51 +/- 4.8 months). Eight patients were lost to follow-up. Twenty-one late deaths occurred. Two SATs required late revision. The cumulative primary patency rates at 5 and 10 years were 94% +/- 3% and 88% +/- 6%, respectively. The stroke-free survival rates at 5 and 10 years were 87% +/- 4% and 81% +/- 7%, respectively. Patients who survived beyond 30 days had a median stroke-free life expectancy of 10 years, 7 months (SE, 6%). CONCLUSIONS:Direct reconstruction of complex symptomatic SAT lesions can be performed with acceptable death/stroke rates and with long-term patient benefit. Asymptomatic lesions in patients who have significant concomitant conditions should be managed with a less-morbid cervical or endovascular approach, even if long-term outcome of the latter is inferior.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Berguer R,Morasch MD,Kline RAdoi
10.1016/s0741-5214(98)70289-7subject
Has Abstractpub_date
1998-01-01 00:00:00pages
34-41; discussion 42issue
1eissn
0741-5214issn
1097-6809pii
S0741521498000299journal_volume
27pub_type
杂志文章abstract::Vascular grafts in canines exhibit similar healing patterns to humans in that the graft surface forms a pseudointima over time but endothelializes only near the anastomotic sites. Thus the pseudointima at the midportion of the graft may represent a nidus for persistent platelet activation. The purpose of this investig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::During your preoperative visit, a very wealthy patient, Gill Bates, who donated a wing to the large teaching hospital in which you practice, has an unusual request: He does not want any residents involved with his care. He is scheduled for an open infrarenal aneurysmectomy. He explains that his decision is based on th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.099
更新日期:2013-10-01 00:00:00
abstract::The 10-year experience of a single community was reviewed and a multivariate analysis was performed to determine the relative importance of clinical and environmental factors in mortality after ruptured abdominal aortic aneurysm resection. Ruptured aneurysms were repaired in 243 patients in six area hospitals (one uni...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.18639
更新日期:1990-04-01 00:00:00
abstract::A 15-year-old male complained of easy fatigability, leg weakness, and pain on exertion with episodes of syncope while playing baseball. His past medical history was significant for aortic coarctation associated with a congenital bovine hypoplastic aortic arch. A recent arteriogram revealed innominate and left common c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.09.035
更新日期:2005-03-01 00:00:00
abstract::The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.047
更新日期:2009-05-01 00:00:00
abstract::Chronic venous insufficiency is a frequent sequel to lower extremity venous thrombosis. A relatively uncommon, but potentially lethal, cause of the thrombosis is congenital antithrombin III deficiency. Recognition and treatment of this occult deficiency is critical. The following report describes a family treated by t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.17918
更新日期:1990-04-01 00:00:00
abstract:PURPOSE:The purpose of this study is to describe a technique for resection of extensive thoracoabdominal aneurysms, which the authors believe will lower morbidity and mortality rates. METHODS:In an effort to minimize the risk of spinal cord ischemia, we have used a combination of sided heart bypass (left atrium to lef...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE:Aortic clamping proximal to the renal arteries is sometimes necessitated during infrarenal and juxtarenal aortic surgery and may be associated with an increased risk of renal ischemia and its consequences. The aim of the study was to estimate this risk and possibly identify a "safe" duration of renal ischemia...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.123679
更新日期:2002-07-01 00:00:00
abstract:PURPOSE:Recent studies have suggested that transrenal artery fixation of endovascular stent-grafts is safe and may be a desirable means of reducing the risk of type I endoleaks, particularly those with short infrarenal necks. The close proximity of the superior mesenteric and celiac arteries to the renal arteries may c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119387
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:Arteriovenous grafts remain reliable substitutes for permanent hemodialysis access in patients without a suitable autogenous conduit. Advances in conduit design and endovascular management of access-related complications question the preference for synthetic conduits over biologic grafts in contemporary pract...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.080
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To assess the effect of extremity vascular complications (EVCs, including ischemia or vessel trauma) on the outcomes of patients receiving cardiac support devices (CSDs, including ventricular assist device [VAD] and extracorporeal membrane oxygenation [ECMO]). METHODS:Institutional Review Board-approved, ret...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.12.014
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Evidence to guide management of postdissection abdominal aortic aneurysms (PDAAA) is lacking. This study describes the outcomes of open repair of PDAAA. METHODS:A retrospective cohort study was conducted of all consecutive patients treated with open repair for PDAAA after a Stanford type A or type B thoraci...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.04.483
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:This report presents the 30-day results of the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure (ROADSTER) multicenter trial and evaluates the safety and efficacy of ENROUTE Transcarotid NPS (Silk Road Medical Inc, Sunnyvale, Calif), a novel transcarotid neuroprotection...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jvs.2015.04.460
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:Long-term results of precuffed expanded polytetrafluoroethylene (ePTFE) grafts used for peripheral bypass surgery are lacking. The aim of this study was to obtain the long-term outcomes of precuffed ePTFE grafts compared with autologous saphenous vein (ASV) grafts used in patients with peripheral arterial dis...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.01.062
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Contemporary data on outcomes in open thoracoabdominal aortic aneurysm (TAAA) repair are limited to reports from major aortic referral centers showing excellent outcomes. This study aimed to characterize the national experience of open TAAA repair using national outcomes data, with a primary focus on the asso...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.05.027
更新日期:2021-02-01 00:00:00
abstract:PURPOSE:This study was performed to determine whether comprehensive cost-cutting strategies adversely affect the outcome in patients undergoing carotid endarterectomy. METHODS:From December 1994 to December 1995, 237 consecutive patients undergoing 260 carotid endarterectomies were prospectively studied. The following...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/s0741-5214(96)70052-6
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVE:Ruptured aortic aneurysms (rAAs) are associated with high mortality. The purpose of this study was to describe the trends of deaths due to rAA in the United States. METHODS:A retrospective review of the national death certificate data from the U.S. National Vital Statistics System was done to identify deaths...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.03.435
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the long-term safety and efficacy of the titanium Greenfield filter-modified hook for prevention of pulmonary embolism. METHODS:We conducted a prospective study in 173 patients from four institutions who underwent clinical examination, abdominal radiography, and duplex...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90146-5
更新日期:1994-09-01 00:00:00
abstract:PURPOSE:We have purified and partially sequenced a protein from the adventitia of the human aorta (aortic aneurysm antigenic protein 40 kDa; AAAP-40) that has homologies to bovine aortic microfibril-associated glycoprotein (MAGP-36). It is immunoreactive with immunoglobulin G (IgGs) purified from the serum and aortic w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70194-0
更新日期:1997-08-01 00:00:00
abstract:PURPOSE:Little is known about the long-term growth and outcomes of vascular surgery procedures over time. Trends in the use of three major vascular surgery procedures by a general population-lower extremity arterial bypass (LEAB), carotid endarterectomy (CEA), and abdominal aortic aneurysm repair (AAA)-are described. T...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70199-5
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVE:End-stage renal disease (ESRD) imparts a significant survival disadvantage to individuals undergoing lower extremity revascularization; however, the influence of lesser degrees of renal impairment remains unclear. This study examined the prognostic significance of the chronic kidney disease (CKD) classificati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.025
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to investigate variations between states and changes in state-specific carotid endarterectomy (CEA) and 30-day mortality rates. Cross-sectional variations and changes over time in such measures may be indicative of improvement in the quality of care. METHODS:We performed re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00616-5
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:The Hardman index, which has five variables, has been recommended as a predictor of outcome after open repair of ruptured abdominal aortic aneurysms (RAAAs). It has been reported that the presence of three or more variables is uniformly fatal. The aim of this study was to test the same model in an independen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.065
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the effect of aortoiliac tortuosity, as assessed by observers and 3-dimensional (3D) computer-based methods, on the conduct and outcome of endovascular repair of abdominal aortic aneurysms. METHODS:Infrarenal aortoiliac tortuosity was measured in 75 patients (mean fol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.118586
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Varicose veins and other vascular abnormalities are common clinical entities. Treatment options include vein stripping, sclerotherapy, and endovenous laser treatment, but all involve some degree of invasive intervention. The purpose of this study was to determine ex vivo the effectiveness of a novel hand-hel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.10.049
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Risk of death in dialysis patients is lowest with arteriovenous fistulas (AVFs), followed by arteriovenous grafts (AVGs) and then intravenous hemodialysis catheters (HCs). Our aim was to analyze the effects of age at hemodialysis initiation on mortality across different access types. METHODS:All patients ≥18...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.07.091
更新日期:2015-02-01 00:00:00
abstract::Intra-aortic inferior vena cava filter placement is a rare event. We describe a case in which a permanent vena caval filter was retrieved from the aorta with endovascular techniques. Knowledge of filter design, catheters, and available wires is important to perform this procedure safely. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.05.090
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess the prognostic value of hemodynamic parameters measured with duplex ultrasound scan, together with other important graft and patient characteristics, in predicting lower extremity vein graft thrombosis. METHODS:A total of 165 lower extremity vein grafts were entered ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.112214
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin A5 on treatment of venous malformation (VM) in cervical-facial region. METHODS:Seventy-five patients (32 male, 43 female), ranging in age from 13 to 60 years old, suffering from VM in cervical-facial region were ad...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.11.038
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Critical limb ischemia (CLI) represents the most severe clinical manifestation of peripheral arterial disease (PAD) and is the major cause of ischemic amputation in the United States. Risk factors and the associated incidence and prevalence of CLI have not been well described in the general population. This ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.03.290
更新日期:2014-09-01 00:00:00