Abstract:
BACKGROUND:Iodine contrast medium (ICM) is considered gold standard in endovascular revascularization procedures. However, nephrotoxicity and hypersensitivity to ICM are causes that limit its indiscriminate use. Carbon dioxide (CO2) contrast angiography has been used as an alternative in patients with formal contraindication to ICM. However, no studies to the present date have compared in a randomized and prospective way, outcomes of revascularization procedures performed with either ICM or CO2 in patients eligible for use of both contrasts. METHODS:Between April 2012 and April 2013, 35 patients with peripheral arterial disease with arterial lesions classified as Trans-Atlantic Inter-Society Consensus A or B (identified on preoperative angio computed tomography scan) and adequate runoff underwent femoropopliteal revascularization by endovascular technique in a prospective, randomized, and controlled study. Patients were randomized into 2 groups: CO2 group and ICM group, according to the contrast media selected of the procedure. We evaluated the following outcomes in both groups: feasibility of the procedures, complications, surgical outcomes (ankle-brachial index [ABI]), glomerular filtration rate using the Cockcroft-Gault formula, relationship between the volume of injected iodine and postoperative creatinine clearance, quality of the angiographic images obtained with CO2, costs of the endovascular materials, and finally, cost of contrast agents. RESULTS:We were able to perform the proposed procedures in all patients treated in this series (ICM group and CO2). There were no CO2-related complications. No procedures required conversion to open surgery. Clinical results were satisfactory, with regression of ischemia and increased levels of ABI in both groups. Variations in creatinine clearance levels showed a numerical increase in the CO2 group and a decrease in ICM group, however, with no statistically significant difference between the delta clearance in each group. All CO2 arteriograms of the supragenicular arteries were graded as good or fair by both observers with high interobserver image quality concordance. There was no statistical difference between endovascular material costs between the groups, but the contrast cost was significantly lower in CO2 group (P < 0.001). CONCLUSIONS:The use of CO2 in patients with no restriction for ICM is an alternative that does not limit the feasibility of the procedures. Similar outcomes were observed with CO2 when compared with the gold standard contrast (ICM) regarding quality of images produced, with no associated changes in creatinine clearance or hypersensitivity reactions and also allows a reduction in contrast-related costs in angioplasty procedures.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
de Almeida Mendes C,de Arruda Martins A,Teivelis MP,Kuzniec S,Nishinari K,Krutman M,Halpern H,Wolosker Ndoi
10.1016/j.avsg.2014.03.021subject
Has Abstractpub_date
2014-08-01 00:00:00pages
1473-8issue
6eissn
0890-5096issn
1615-5947pii
S0890-5096(14)00210-6journal_volume
28pub_type
杂志文章,随机对照试验abstract::Bier spots represent a benign vascular mottling characterized by multiple irregular white macules along the extensor surfaces of the arms and legs. They have been reported in a variety of diverse conditions with no consistent disease association. We have identified a novel association between these physiologic anemic ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2014.07.005
更新日期:2014-11-01 00:00:00
abstract:BACKGROUNDS:Primary aortoenteric fistula (PAEF) is a lethal cause of gastrointestinal bleeding. They mainly originate from eroding abdominal aortic aneurysms into the intestinal wall. Other known causes involve malignancies, infection, corpora aliena, or radiation therapy. Traditional treatment consists of resection of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2015.11.033
更新日期:2016-05-01 00:00:00
abstract::In an effort to identify preoperative and perioperative factors impacting outcome in repair of juxtarenal abdominal aortic aneurysm (JRAAA), hospital records and CT scans (for calcification, intraluminal thrombus, and aortic diameter) of all patients undergoing JRAAA repair over the past 10 years were reviewed. The 87...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0336-9
更新日期:2003-01-01 00:00:00
abstract::A 55-year-old woman with a history of hypertension, bilateral renal artery disease with a left renal artery stent, and a chronically occluded right renal bypass graft presented with anuria and acute renal failure. Diagnostic studies showed high-grade renal artery in-stent stenosis with thrombotic occlusion of the main...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.03.013
更新日期:2010-10-01 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::Adrenal hemorrhagic necrosis is one of several possible complications of heparin-related thrombocytopenia. We report a case in which adrenal hemorrhagic necrosis developed after aortofemoral bypass. This serious complication remains difficult to diagnose in the absence of a high index of suspicion. A routine search fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02133073
更新日期:1994-09-01 00:00:00
abstract::The need to treat an abdominal aortic aneurysm (AAA) in kidney transplanted patient is a rare event. To date, no method to protect the kidney during the aneurysm treatment has been identified as undeniably relevant. On the other hand, the advantage of endovascular treatment of the aneurysm (EVAR) is to avoid transplan...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.058
更新日期:2015-08-01 00:00:00
abstract::Percutaneous renal artery revascularization for hypertension and renal dysfunction is now common, and there is an increasing realization that renal artery intervention can be associated with parenchymal injury. The frequency, cause, and outcomes of acute functional injury associated with renal intervention are poorly ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.06.006
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:To determine whether the formation of an integrated vascular surgery residency (0 + 5) has negatively impacted the case volume and diversity of the vascular surgery fellows (5 + 2) and chief general surgeons at the same institution. METHODS:Operative data from the vascular integrated (0 + 5), independent (5...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.03.010
更新日期:2014-01-01 00:00:00
abstract::Transcatheter embolization of hypogastric artery aneurysms has become an attractive therapeutic alternative for many patients with this difficult lesion. Because of the increasing use of stent grafting for treatment of abdominal aortic aneurysms, transcatheter embolization of normal-caliber hypogastric arteries has be...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0032-7
更新日期:2004-07-01 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::The aim of this prospective study was to compare the outcome of the Talent bifurcated endograft versus the Endofit aorto-uni-iliac endograft in the short-term and mid-term. Between March 2000 and December 2003, 86 patients were treated with the Talent bifurcated endograft (group A) and 21 with the Endofit aorto-uni-il...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2006.06.005
更新日期:2007-05-01 00:00:00
abstract::A 66-year-old man with multiple comorbidities presented with a juxtarenal perianastomotic aortic aneurysm 10 years after open abdominal aortic aneurysm repair. The aneurysmal disease also involved both iliac bifurcations, the right internal iliac artery, the left common femoral artery (CFA) up to its bifurcation, and ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.044
更新日期:2011-10-01 00:00:00
abstract::Traumatic renal arteriovenous fistula involving the inferior vena cava (IVC) are exceptionally rare, but if left untreated can have devastating clinical consequences, including development of renovascular hypertension, cardiomegaly, and congestive heart failure. We report a rare, pediatric case of a renal-caval arteri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.04.028
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Gender-related differences in iliofemoral anatomy are critically important for delivery of modern EVAR devices, however remains poorly characterized in the context of other patient-specific factors. The goal of the present study was to provide a detailed quantification of anatomic differences in iliofemoral ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.01.025
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Comorbid conditions are known to increase cardiovascular risk in patients with peripheral artery disease (PAD). However, whether comorbid conditions affect walking capacity remains controversial. Previous studies have analyzed comorbidities separately, but they are known to occur in a clustered fashion in PA...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.020
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Clinical management of wounds can benefit from objective measures of response to treatment. Wound surface area and volume are objective measures of wound healing. Using a synthetic wound model, we compare the accuracy and reproducibility of 2 commercially available 3-dimensional (3D) cameras against planimet...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.10.029
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for thoracic blunt aortic injury (TBAI). A 20 mm proximal seal zone is recommended based on aneurysmal disease literature which often results in coverage of the left subclavian artery (LSA). The aim of this study was to analyze our experi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.12.007
更新日期:2020-12-31 00:00:00
abstract:BACKGROUND:Aortic thrombus in the absence of atherosclerotic plaque or aneurysm is rare, and its optimal management remains unclear. Although atypical aortic thrombus (AAT) has been historically managed operatively, successful nonoperative strategies have been recently reported. Here, we report our experience in treati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.03.028
更新日期:2014-10-01 00:00:00
abstract::From February 1985 through November 1988, we performed 159 transluminal angioplasty in 135 patients with arterial occlusive disease of the lower limb. The indications were claudication, 114 cases (72%) and limb salvage, 45 cases (28%). Lesions consisted of one or more critical stenoses in 142 cases (61 iliac, 69 femor...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60832-7
更新日期:1990-11-01 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::Primary subclavian vein stents are not recommended for venous thoracic outlet syndrome before surgical decompression by first rib resection due to a high risk of fracture because they are compressed between the clavicle and first rib. After rib removal, however, stent insertion has been advocated for venous restenosis...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.064
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Cancer patients have an increased risk of venous thromboembolic events. Certain chemotherapeutic agents have also been associated with the development of thrombosis. Reported cases of acute arterial ischemic episodes in cancer patients are rare. METHODS:Patients who underwent surgery for acute limb ischemia...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.06.002
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to better define the clinical relevance of aneurysms affecting collateral vessels in patients with celiac artery (CA) occlusive disease. METHODS:True pancreaticoduodenal artery (PDA) and gastroduodenal artery (GDA) aneurysms associated with CA stenoses or occlusions reported fro...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.09.018
更新日期:2017-05-01 00:00:00
abstract::The search for vessel substitutes to replace small-/medium-caliber vessels is an ongoing concern for vascular surgeons. Engineered vessels were designed for use as arterial equivalents and assessed in an in vivo model in dog. Three study groups were established: clinical expanded polytetrafluoroethylene (ePTFE; contro...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.12.007
更新日期:2008-03-01 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::A 72-year-old man with suprarenal aneurysm and 2 large penetrating ulcers (PAUs) in the descending aorta was referred for endovascular treatment. To avoid long-segment aortic coverage and the attendant risk of spinal ischemia, combination of 2 different stent technologies was used. A multilayer flow modulator was impl...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.05.042
更新日期:2019-11-01 00:00:00
abstract::Melioidosis abdominal aortic aneurysm and splenic abscesses lead to poor prognosis and high mortality rate as high as 50% due to delayed/missed diagnosis. We describe an attempt to identify Burkholderia pseudomallei immediately, which was confirmed by polymerase chain reaction (PCR) and gene sequence analysis of 23S r...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.04.035
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Radiation-induced necrosis and arteriopathy are well-known iatrogenic pathologic entities. However, radiation-induced rupture of the superficial femoral artery is an exceptional life-threatening event. REPORT:We hereby report a case of radiation-induced rupture of the superficial femoral artery that was suc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.12.034
更新日期:2015-07-01 00:00:00
abstract::The use of inferior vena cava (IVC) filters has increased dramatically over the last two decades. Thrombosis of the IVC is a potentially catastrophic complication of caval filter placement, and its reported incidence ranges 3.6-11.2%, depending on filter type. We present a 69-year-old female with a history of deep vei...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.08.018
更新日期:2010-07-01 00:00:00