Abstract:
PURPOSE:Revascularization for the treatment of aortic graft infection is usually accomplished by remote prosthetic axillofemoral bypass combined with cross-femoral bypass. When infection at the femoral level precludes placement of a prosthetic cross-femoral graft, we have used a variety of autogenous tissue conduits to restore circulation to the contralateral leg. To determine which of these conduits offers the most durable reconstruction, we have reviewed 78 patients treated for aortic graft infection. METHODS:Between 1980 and 1991 we used either autogenous saphenous vein (ASV, n = 34), endarterectomized superficial femoral artery (SFA, n = 14), or direct ilioiliac anastomosis (iliac, n = 10) to provide cross-femoral flow. We compared the performance of these tissue conduits with a concurrent patient group with aortic graft infection in whom a prosthetic cross-femoral graft was used (prosthetic, n = 20). RESULTS:Follow-up was available for 98.7% of patients, average 3.8 +/- 2.9 years, and was not different between the four groups. Bleeding complications occurred exclusively in the ASV group (n = 3, 8.8%) and were all in the perioperative period. In addition one ASV and one iliac conduit developed multiple false aneurysms. Hemodynamic conduit failure (thrombosis or stenosis) occurred in nine (26.5%) ASV conduits, six (42.8%) SFA conduits, and one iliac conduit, but not in the prosthetic group. When all of these adverse events were combined for each conduit group, both ASV and SFA conduits had a higher rate of conduit failure when compared with the prosthetic conduits (p < 0.05, log-rank test). Limb loss resulting from cross-femoral conduit failure occurred in six (17.6%) patients in the ASV group, four (28.6%) patients in the SFA group, and one patient each in the iliac and prosthetic groups. These differences were not significant. CONCLUSIONS:We conclude that ASV and SFA conduits do not provide stable long-term cross-femoral revascularization and should be regarded as bridge grains until femoral infection is eradicated. When femoral infection mandates their use, frequent postoperative conduit surveillance is required. If ASV or SFA caliber is marginal, consideration should be given to the use of a larger autogenous conduit, such as superficial femoral vein.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Jicha DL,Reilly LM,Kuestner LM,Stoney RJdoi
10.1016/s0741-5214(95)70006-4subject
Has Abstractpub_date
1995-10-01 00:00:00pages
393-405; discussion 406-7issue
4eissn
0741-5214issn
1097-6809pii
S0741521495002266journal_volume
22pub_type
杂志文章abstract:BACKGROUND:Peripheral arterial disease (PAD) can be diagnosed noninvasively by segmental blood pressure measurement and calculating an ankle-brachial index (ABI) or toe-brachial index (TBI). The ABI is known to be unreliable in patients with vascular stiffness and fails to detect the early phase of arteriosclerotic dev...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2013.03.044
更新日期:2013-07-01 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:OBJECTIVE:In peripheral arterial disease (PAD) patients, a limiting factor in the success of percutaneous transluminal angioplasty (PTA) is the development of restenosis secondary to vascular smooth muscle cell (SMC) proliferation. Following endothelial damage and platelet activation, there is release of factors and ad...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2009.06.017
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Patients with tumors in the limbs who undergo surgical treatment may have involvement of major vessels. Major arteries are always reconstructed for limb salvage. Major veins may be reconstructed to avoid the onset of venous hypertension signs and symptoms. The objective of this study was to analyze the resul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.07.033
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:Thoracoabdominal aortic replacement requires visceral vessel revascularization and is usually performed with Crawford's inclusion technique or a large Carrel patch. This segment of retained native aorta may be prone to recurrent aneurysmal disease. We reviewed our experience with patients in whom aneurysma...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.117149
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to su...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.02.033
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Little is known about acute peripheral arterial thrombosis in patients with concomitant cancer. Small studies suggest that revascularization in this patient group is associated with thrombosis and increased risk of amputation and death. We investigated the frequency of cancer in patients operated on for acute...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.223
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Although peripheral arterial occlusive disease (PAOD) is a public health issue in the elderly population, limited population-based data are available on use of interventional procedures in Canada. We describe trends in use of interventional procedures to treat PAOD in Ontario over the past decade. METHODS:A re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00273-8
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:Pivotal and comparative trial data are emerging for stent graft (SG) vs open repair of the thoracic aorta. We reviewed procedure-related perioperative morbidity, mortality, and mid-term outcomes in a contemporary series of patients treated with SG of the thoracic aorta. The data were compared with those of a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.08.005
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Controversy exists surrounding gender outcome disparity and abdominal aortic aneurysm (AAA) repair. Previous reports have demonstrated worse outcomes for women undergoing open aneurysm repair (OAR); however, these differences are less evident with endovascular aneurysm repair (EVAR). Epidemiologic studies ha...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.086
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Carotid angioplasty and stenting (CAS) is a percutaneous alternative to carotid endarterectomy (CEA) for treating patients with carotid artery stenosis. This study sought to evaluate whether patients at increased perioperative risk for CEA may be treated with CAS while maintaining equivalent outcomes. METHOD...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.12.049
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:In our prior study, we showed that delta-opioid peptide [D-Ala(2), D-Leu(5)] enkephalin (DADLE), by regional perfusion into the abdominal aorta, could protect the spinal cord against ischemia-reperfusion (I/R) injury caused by aortic occlusion. However, the relative dose-response effects of DADLE still remain...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.11.074
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2016.10.099
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify whether revascularization by percutaneous transluminal angioplasty (PTA) for patients with intermittent claudication improved measures of functional performance including balance. METHODS:A prospective observational study was performed at a single tertiary vascular cente...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.106
更新日期:2013-12-01 00:00:00
abstract:PURPOSE:Experiments were designed to determine the function of the endothelium and smooth muscle in cryopreserved and fresh canine saphenous vein allografts. METHODS:Reversed interposition saphenous vein grafts were implanted into the femoral arteries of two groups of dogs: group 1 received one freshly harvested saphe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract:OBJECTIVE:Diabetic foot disease poses a significant and rising financial burden on health care systems worldwide. This study investigated the effect of a new multidisciplinary diabetic foot clinic (MDDFC) in a large tertiary hospital on patient outcomes and treatment cost. METHODS:Patients' records were retrospectivel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.11.032
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:Although anticoagulation therapy for iliofemoral venous thrombosis prevents pulmonary embolism, it is not designed to avoid the postthrombotic syndrome. Mechanical removal of the thrombus in the form of venous thrombectomy should yield better long-term results. The purpose of our study was to analyze the clinic...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70249-0
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVE:To determine whether a physician-modified endovascular graft (PMEG) is a safe and effective method for treating patients with juxtarenal aortic aneurysms who are deemed unsuitable for open repair. METHODS:A nonrandomized, prospective, consecutively enrolling investigational device exemption clinical trial wa...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jvs.2013.01.029
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Studies on the safety of carotid endarterectomy (CEA) under different anesthetic techniques are sometimes contradictory. The aim of this study was to compare real-world outcomes of CEA under general anesthesia (GA) vs regional or local anesthesia (RA/LA). METHODS:A retrospective analysis of the Vascular Qual...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.028
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:The outcome of infrainguinal bypass surgery for limb salvage has traditionally been assessed by graft patency rates, limb salvage rates, and patient survival rates. Recently, functional outcome of limb salvage surgery has been assessed by patient ambulatory status and independent living status. These assessment...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70356-8
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:A mycotic aneurysm of the aorta and adjacent arteries is a dreadful condition, threatening life, organs, and limbs. With regard to the aortic segment involved, repair by either in situ replacement or extra-anatomic reconstruction can be quite challenging. Even when surgery has been successful, the prognosis i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.110356
更新日期:2001-01-01 00:00:00
abstract::Nutcracker syndrome is an entity resulting from left renal vein compression by the superior mesenteric artery and the aorta, leading to symptoms of left flank pain and hematuria. Conventional treatment has been surgical, commonly through transposition of the left renal vein to a more caudal location on the inferior ve...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.112
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The national burden of venous disease and use of ultrasound (US) in the outpatient and emergency department (ED) settings has not been well described. The objective of this study is to describe venous disease in the outpatient and ED settings nationally as well as to characterize the use of US for diagnosis ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.12.070
更新日期:2010-06-01 00:00:00
abstract::This review considers the roles of endovascular and open surgery for critical lower limb ischemia. The TransAtlantic Inter-Society Consensus document offers sensible guidelines for the treatment of both suprainguinal and infrainguinal disease. For bilateral/diffuse suprainguinal disease, aortobifemoral bypass remains ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2008.08.036
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVES:To determine (a) whether patients with peripheral artery disease (PAD) who walked at least 7,000 and 10,000 steps/day had better ambulatory function and health-related quality of life (HRQoL) than patients who walked less than 7,000 steps/day, and (b) whether differences in ambulatory function and HRQoL in p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.10.073
更新日期:2020-11-27 00:00:00
abstract::The patient with bilateral internal carotid artery occlusion is at high risk for development of stroke. Medical management and extracranial-intracranial bypass do not appear to offer these patients any protection from symptoms of cerebrovascular insufficiency. Our initial treatment in 11 of 12 patients who had this pa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050715
更新日期:1987-05-01 00:00:00
abstract:PURPOSE:Radiofrequency ablation (RFA) of the greater saphenous vein (GSV; "closure") is a relatively new option for treatment of venous reflux. However, our initial enthusiasm for this minimally invasive technique has been tempered by our preliminary experience with its potentially lethal complication, deep venous thro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.04.032
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioper...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.04.059
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Prosthetic graft infection is a major complication of peripheral vascular surgery. We investigated the experience of a single institution over 10 years with bypass grafts involving the femoral artery to determine the incidence and risk factors for prosthetic graft infection. METHODS:A retrospective cohort s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.09.049
更新日期:2013-03-01 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