Abstract:
OBJECTIVE:Cryopreserved human arterial allografts are a recognized acceptable alternative for vascular reconstruction when other traditional conduits are either unavailable or contraindicated. We reviewed our experience using cryopreserved arterial allografts for peripheral artery reconstructions in contaminated and infected surgical fields. METHODS:A single-center, retrospective review was conducted of 57 patients who underwent a peripheral vascular reconstruction using a cryopreserved arterial allograft from January 2002 through July 2017. Indications for repair included removal of infected prosthetic bypass (n = 29), revascularizations in contaminated fields (n = 11), primary arterial repair in the setting of infection (n = 10), and infected vascular closure devices (n = 7). Aorta-based repairs were excluded. Demographics, index procedural details, postoperative complications, and conduit patency were analyzed. Primary end points included conduit-related mortality and graft failure as measured by reinfection, hemorrhage, or aneurysmal degeneration. Mean follow-up for the study is 27.8 months (range, 2-125 months). RESULTS:A total of 57 peripheral vascular reconstructions using cryopreserved arterial allografts were performed during the 15-year period. Among the 22 women and 35 men treated, the mean age was 61 years. The vascular beds involved included iliofemoral (n = 39), femoropopliteal or femoral-distal (n = 10), axillosubclavian or brachial (n = 2), mesenteric (n = 3), and carotid (n = 3) arteries. Adjunctive muscle flap coverage of the allograft conduit was performed in the majority of cases (61%; n = 35). The 30-day mortality was 9%; one death was directly related to conduit insertion. The 30-day conduit-related complication rate was 14% and included hemorrhage from the graft requiring return to the operating room (n = 4) and graft infection (n = 4). The late conduit-related complication rate was 15.8% and included graft infection (n = 1), graft thrombosis (n = 3), major amputation resulting from conduit failure (n = 1), pseudoaneurysm degeneration requiring repair (n = 2), graft hemorrhage (n = 1), and symptomatic graft stenosis (n = 1). CONCLUSIONS:A cryopreserved arterial allograft is a useful alternative conduit for peripheral vascular reconstruction in infected or contaminated surgical fields when other autologous or prosthetic conduits are either unavailable or contraindicated. In the immediate postoperative period, these repairs demonstrate acceptable resistance to graft failure and reinfection, particularly in conjunction with adjunctive rotational muscle flap coverage. Late conduit-related complications appear to be infrequent.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Furlough CL,Jain AK,Ho KJ,Rodriguez HE,Tomita TM,Eskandari MKdoi
10.1016/j.jvs.2018.10.111subject
Has Abstractpub_date
2019-08-01 00:00:00pages
562-568issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(18)32653-3journal_volume
70pub_type
杂志文章abstract:PURPOSE:Cryopreserved human blood vessels are important tools in bypass surgery. However, several in vitro studies have demonstrated diminished postthaw functional activity. Therefore the aim of this study was to investigate the consequences of various freezing/thawing protocols and the role of protein kinase C in the ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70328-3
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:Successful adaptation of a vein graft to an arterial environment is incompletely understood. We sought to investigate whether early vein graft remodeling is predictive of subsequent patency. METHODS:A prospective longitudinal study was conducted of 67 patients undergoing lower extremity bypass with autogenou...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.06.098
更新日期:2013-01-01 00:00:00
abstract::The cause of hypertension in the immediate postoperative period after carotid endarterectomy is unknown. In order to elucidate the etiology of hypertension following carotid endarterectomy, blood samples were drawn intraoperatively from internal jugular vein and external carotid artery prior to and subsequent to carot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Endovascular treatment of ruptured abdominal aortic aneurysms (r-AAAs) has the potential to offer improved outcomes. As our experience with endovascular repair of r-AAA evolved, we recognized that the development of abdominal compartment syndrome (ACS) led to an increase in morbidity and mortality. We theref...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.033
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:We compared results of angioplasty with those of concomitant stent placement to treat thrombosed forearm hemodialysis grafts with results for upper arm grafts. MATERIAL AND METHODS:Between October 1998 and July 2002, stents were deployed in 61 patients undergoing balloon angioplasty because of venous anastom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00947-9
更新日期:2003-10-01 00:00:00
abstract::Extracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. As the technique has become more widely available, some deleterious effects on...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104592
更新日期:2000-05-01 00:00:00
abstract:OBJECTIVE:The aim of this systematic review is to describe the literature and assessment tools evaluating vascular surgical operative performance that could potentially be used for the assessment of educational outcomes applicable to the Milestone Project and the Next Accreditation System. METHODS:A systematic review ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2014.02.018
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate morphologic changes in dissected aortas after thoracic endovascular aortic repair (TEVAR) with the use of the Relay Nonbare stent graft stent graft by focusing on the geometric stent graft's performance in remodeling aortas. METHODS:We conducted a retrospective three-dim...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.02.026
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:In 2007, Medicare guidelines were established to identify persons at risk for the presence of an abdominal aortic aneurysm (AAA). The purpose of this study is to evaluate the 5-year outcomes of an AAA screening program in a regional Veterans Affairs (VA) health care system. METHODS:Data were extracted from a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.08.038
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze our 25-year experience with surgical treatment of visceral artery aneurysms (VAAs), with particular attention paid to early and long-term results. MATERIALS AND METHODS:From January 1982 to September 2007, 55 patients (32 males, 58%, and 23 females, 42%) underwent surgica...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.043
更新日期:2008-08-01 00:00:00
abstract:PURPOSE:The endovascular technique has revolutionized the treatment of infrarenal abdominal aortic aneurysm (AAA). At our institution, we examined the impact of an endovascular program on the traditional operative training of the vascular fellows in the treatment of infrarenal AAA. METHODS:We examined the records of o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111675
更新日期:2001-02-01 00:00:00
abstract:PURPOSE:Carotid endarterectomy (CEA) has proven to be effective in the prevention of stroke in patients with significant internal carotid artery (ICA) stenosis. However, whether increased cerebral blood flow after CEA improves the cerebral metabolism in patients with asymptomatic ICA flow lesions is unknown. Localized ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126555
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVE:Our aim was to identify the incidence of and predictors for common carotid artery (CCA) stent fractures (SFs) and to examine the effect of SFs on the development of in-stent restenosis (ISR). METHODS:Seventy patients (37 women; median age, 60.9 years) who were stented for significant (≥60%) proximal CCA sten...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.04.492
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:Haptoglobin (Hp) polymorphism is associated with the prevalence and clinical evolution of many inflammatory diseases and atherosclerosis. Circulating neutrophils and neutrophil-associated proteases are an important initial component of experimental abdominal aortic aneurysm (AAA) formation. Elastase and C-re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.03.016
更新日期:2010-09-01 00:00:00
abstract:PURPOSE:This study was undertaken to evaluate in vivo the effect of recombinant hirudin (r-hirudin [HBW 023]), a potent thrombin inhibitor, on the process of microvascular thrombus formation and recanalization. METHODS:Thrombosis was induced photochemically in distinct arterioles (n = 25) and venules (n = 30) of the e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70136-3
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:Aberrant subclavian artery (aSCA) is a rare anatomic variant whose association with other aortic branch variations and aortic pathology has yet to be established. Knowledge of such an association could be relevant to recommendations for screening and awareness as associated variations are important for operat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.01.042
更新日期:2020-11-01 00:00:00
abstract::Aortobifemoral bypass (ABF) is the preferred operation for patients with bilateral aortoiliac occlusive disease, but for those with unilateral occlusion without significant stenosis of the contralateral iliac artery, alternative reconstructions, such as femorofemoral (FF) or iliofemoral (IF) bypass have been advocated...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0080211
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to investigate changes in health-related quality of life (QOL) in patients treated for pararenal aortic aneurysms (PAAs) and thoracoabdominal aortic aneurysms (TAAAs) with fenestrated-branched endovascular aneurysm repair (F-BEVAR). METHODS:A total of 159 consecutive patients ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.07.060
更新日期:2019-05-01 00:00:00
abstract::Ergotism is a rare condition of acute vasospasm found classically in young and middle-aged women taking ergot alkaloid agents to treat migraine headache. We report the case of a young man with human immunodeficiency virus (HIV) positivity and describe the drug interaction between protease inhibitors and ergot alkaloid...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.80
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Patients with venous thromboembolic disease are treated with anticoagulation or vena cava filter placement to prevent pulmonary embolism. A recent report suggested that filter placement may increase the risk of recurrent deep venous thrombosis (DVT) and prompted a review of our experience. METHODS:Prospecti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111733
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Iliofemoral deep vein thrombosis (DVT) is associated with severe postthrombotic morbidity when treated with anticoagulation alone. Catheter-directed thrombolysis (CDT), with or without the addition of mechanical techniques, is increasingly recommended for patients with iliofemoral DVT, although its effect on...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.10.032
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.068
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate midterm clinical and morphologic outcomes after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm (AAA) with large (≥28 mm) infrarenal neck. METHODS:From 2009 to 2012, we prospectively collected and retrospectively analyzed clinical, morphologic, and intra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2017.01.066
更新日期:2017-10-01 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::Although there have been previous cases of ascending (type I) aortic dissection recognized in young weight lifters, this is the first reported instance of a descending (type III) dissection in such an individual. Successful treatment included aortic fenestration and an aortoiliac bypass. A new entity of aortic dissect...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1993.40230
更新日期:1993-04-01 00:00:00
abstract:PURPOSE:Nitric oxide (NO), frequently cited for its protective role, can also generate toxic metabolites known to degrade elastin. Both abdominal aortic aneurysms (AAAs) and inducible nitric oxide synthase (iNOS) are associated with inflammatory states, yet the relationship between NO production by iNOS and AAA develop...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111805
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Complex forms of congenital venous malformation have defied proper classification and confounded therapy. Through a newly designed multidisciplinary approach, these venous defects were properly diagnosed and classified according to the Hamburg classification. Absolute ethanol was adopted as a new scleroagent...
journal_title:Journal of vascular surgery
pub_type: 评论,杂志文章
doi:10.1067/mva.2001.112209
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:Among Basque handball players, the repeated impact of a ball on the palms of their hands hundreds of thousands of times throughout their sporting careers produces Raynaud syndrome. Treating this patient group is complex. Our objective was to assess the efficacy of digital periarterial sympathectomy in this pa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.08.102
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the trend in inpatient vascular procedures in the United States over the past decade and predict the future demand for vascular surgeons. METHODS:The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried to determine the weighted national est...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.061
更新日期:2012-05-01 00:00:00
abstract:PURPOSE:Artery-wall hypoxia has been proposed to contribute to many kinds of artery-wall pathologic conditions, including atherosclerosis and intimal hyperplasia. Intimal hyperplasia is common at sites of arterial injury, including an anastomosis. The purpose of this study was to determine the effect of a prosthetic va...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104590
更新日期:2000-06-01 00:00:00