Abstract:
BACKGROUND:In the era of rising endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs), the analysis of visceral vessel (VV) patency after open surgical repair is crucial to provide a future benchmark between these different approaches. This study reports the late outcomes of a single-center experience with open TAAA repair, focusing on the results of different techniques adopted for renal and splanchnic revascularization. METHODS:Data were analyzed for 382 consecutive open TAAA repairs performed between January 2009 and July 2015 (284 men; mean age, 66 ± 10 years). Follow-up of surviving patients was carried out by computed tomography angiography and office checkups at 3 and 12 months and yearly afterward. Kaplan-Meier analysis was performed for overall survival, patency of reconstructed VVs (celiac trunk, superior mesenteric artery, right renal artery, left renal artery), and reinterventions on visceral arteries. Furthermore, VV long-term patency was analyzed in subgroups of patients according to the revascularization strategy (patch inclusion of all vessels, group 1; one-vessel separate reattachment and patch inclusion of the remaining vessels, group 2; separate reattachment of all VVs, group 3). RESULTS:In-hospital mortality and paraparesis/paraplegia occurred in 7.6% and 8.1% of patients, respectively. Among the 353 survivors, 338 complied with the follow-up protocol, and adequate computed tomography angiography images were available in 247 patients (952 VVs were analyzed). Overall follow-up survival was 94%, 91%, and 70% at 1 year, 2 years, and 5 years, respectively. At the same time points, VV patency was 99%, 98%, and 98% for celiac trunk; 100%, 100%, and 100% for superior mesenteric artery; 100%, 96%, and 96% for right renal artery; and 91%, 87%, and 82% for left renal artery (log-rank test, P < .0001). Estimates for reinterventions on VVs were 1.2%, 6.3%, and 17% at the same time points. Freedom from occlusion of any VV at 1 year and 3 years was 95% and 87% for group 1, 89% and 79% for group 2, and 92% and 92% for group 3, respectively (log-rank test, P = .13). CONCLUSIONS:Long-term patency of VVs after open TAAA repair performed in high-volume centers is high, regardless of the technique employed for revascularization. The left renal artery appears to be most prone to occlusion over time.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Kahlberg A,Ferrante AMR,Miloro R,Mascia D,Bertoglio L,Baccellieri D,Melissano G,Chiesa Rdoi
10.1016/j.jvs.2017.08.067subject
Has Abstractpub_date
2018-04-01 00:00:00pages
1017-1024issue
4eissn
0741-5214issn
1097-6809pii
S0741-5214(17)32196-1journal_volume
67pub_type
杂志文章abstract:PURPOSE:Aortoiliac occlusive disease may preclude retrograde thoracic endovascular aortic repair. This study evaluated the physiologic and anatomic feasibility of introducing an aortic endograft in an antegrade manner into the descending thoracic aorta of a pig through the left ventricular apex. METHODS:Twelve adult p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.06.043
更新日期:2008-11-01 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: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:PURPOSE:This study was designed to determine whether magnetic resonance angiography (MRA) will allow preoperative management decisions without the need for contrast arteriography in patients with lower extremity ischemia caused by infrainguinal arterial occlusive disease. METHODS:Forty-five patients with lower extremi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70241-0
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVE:While autogenous arteriovenous access is preferred, prosthetic arteriovenous grafts (AVG) are still required in a large number of patients. Infection of AVGs occurs frequently and may cause life-threatening bleeding or sepsis. Multiple treatment strategies have been advocated (ranging from graft preservation ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.04.030
更新日期:2008-09-01 00:00:00
abstract::Portal and mesenteric venous thrombosis is an uncommon condition that is usually treated with systemic anticoagulation. Catheter-directed thrombolysis via the superior mesenteric artery may be a viable adjunct to treatment of this potentially morbid condition. We present a case of portal and mesenteric venous thrombos...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)01052-8
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:Obesity is recognized as an independent predictor of coronary artery disease; however, its importance in peripheral arterial disease is less clear. The aim of this study was to assess the association between obesity and the severity and outcome of intermittent claudication. METHODS:This study was a prospect...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.09.006
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Severe carotid stenosis is a frequent cause of stroke in both men and women. Whereas several sex-related comparisons are available on coronary atherosclerosis, there are few data appraising gender-specific features of carotid plaques. We aimed to systematically compare the pathology and inflammatory features ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.07.052
更新日期:2013-02-01 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:INTRODUCTION:The long-term prognosis of arteriovenous polytetrafluoroethylene (PTFE) hemodialysis grafts remains poor, causing significant morbidity and costs. The high failure rate is due to a stenosis development of the graft-vein anastomosis, consisting of two pathophysiologically separate and characteristic lesions...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.03.019
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To examine the outcome of a comprehensive follow-up program for autogenous arteriovenous hemodialysis access (AVF) when performed by the hemodialysis access surgeon. METHODS:Patients with first time AVFs between 2000 and 2005 underwent history and physical examination between the third and sixth postoperativ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.013
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared wit...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.03.420
更新日期:2017-11-01 00:00:00
abstract:PURPOSE:It has been suggested that propranolol has unique effects that slow aneurysm expansion by remodeling the structural proteins of the aorta. These effects are believed to be independent of blood pressure reduction, a hypothesis we tested in this investigation with a rat model of abdominal aortic aneurysm (AAA). ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90004-3
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:The majority of endovascular aneurysm repair procedures are performed through the common femoral artery (CFA). Arterial access is gained by surgical cutdown or percutaneous approach. The surgical approach has a relatively high local complication rate. We describe superficial femoral artery (SFA) access as an ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.07.081
更新日期:2020-05-01 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:OBJECTIVE:We performed a systematic review and meta-analysis aiming to assess the mortality and morbidity of all published case series on thoracoabdominal aortic aneurysms (TAAAs) in experienced centers treated with open repair. METHODS:A systematic search of the literature published until April 2017 was performed acc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2018.03.410
更新日期:2018-08-01 00:00:00
abstract::A 71-year-old woman came to the hospital with a 24-hour-old occlusion of the left limb of an aortoiliac knitted Dacron graft and was treated with an intra-arterial infusion of urokinase, 40,000 U/hr. Although the graft limb was successfully recanalized in 16 hours, the patient suffered a massive retroperitoneal hemorr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta. Patients with disease refractory to medical management will usually require either endovascular therapy or surgery with use of prosthetic graft material for bypass or patch angioplasty. We report our early experien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.052
更新日期:2018-06-01 00:00:00
abstract:PURPOSE:Although the United Kingdom small aneurysm trial reported no survival benefit for early operation in patients with small (4. 0-5.5 cm) abdominal aortic aneurysms (AAAs), the trial lacked statistical power to detect small but potentially meaningful gains in life expectancy, particularly for specific subgroups. W...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0741-5214(00)90152-6
更新日期:2000-02-01 00:00:00
abstract:PURPOSE:This study was performed to determine whether early duplex findings predicted restenosis after carotid endarterectomy. METHODS:One hundred ninety-two symptomatic patients who underwent carotid endarterectomy were studied with color duplex imaging at 1 day and 1 week after surgery to identify minor residual dis...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70145-9
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:Neck radiation therapy (XRT) can induce carotid artery stenosis and may increase the technical difficulty of endarterectomy. It is considered a relative indication for carotid angioplasty and carotid artery stenting (CAS). This study sought to evaluate differences in CAS embolic potential and restenosis perfo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2015.04.390
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:The effect of a rat carotid endarterectomy (CEA) on homocysteine and the metabolic enzymes methylenetetrahydrofolate reductase (MTHFR) and cystathionine beta-synthase (CBS) was studied. METHODS:Rats were placed into 7 groups: (1) no anesthesia (NA), (2) anesthesia only (AO), (3) skin opened and closed (O/C),...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.07.011
更新日期:2004-10-01 00:00:00
abstract:PURPOSE:To describe an exclusion endoluminal technique for management of abdominal aortic aneurysms among high-risk patients with complex anatomic features. METHODS:From January 1995 to December 1996, among 143 patients with infrarenal abdominal aortic aneurysm treated by means of endograft placement, 9 (6.3%) had com...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70090-4
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:When an autogenous vein is harvested and used for arterial bypass, it suffers physical and biologic injuries that may set in motion the cellular processes that lead to wall thickening, fibrosis, stenosis, and ultimately graft failure. Whereas the injurious effects of surgical preparation of the vein conduit h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.03.436
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether calf muscle hemoglobin oxygen saturation (Sto2) obtained during a standardized treadmill test is associated with ambulatory function and health-related quality of life (HRQoL) in patients with symptomatic peripheral artery disease (PAD). We hypothesized tha...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.057
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Treatment of chronic venous insufficiency (CVI) has largely focused on reflux. Minimally-invasive techniques to address superficial and perforator reflux have evolved, but correction of deep reflux continues to be challenging. The advent of intravascular ultrasound (IVUS) scan and minimally invasive venous s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.032
更新日期:2010-02-01 00:00:00
abstract::We investigated the flow field within a rigid-walled in vitro model of an end-to-side 45 degree anastomosis in an attempt to identify possible hemodynamic factors that may contribute to the pathogenesis of distal anastomotic intimal hyperplasia. A high-resolution photochromic tracer technique was used to visualize the...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.24365
更新日期:1990-12-01 00:00:00
abstract::The burgeoning field of vascular tissue engineering holds promise for the creation of a practical and successful small-diameter arterial bypass graft. Many creative combinations of autologous cells and scaffolds exist along with an equally long list of microenvironmental cues used to create a functional arterial condu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.02.046
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Renal artery aneurysms (RAAs) are uncommon, and rates of growth and rupture are unknown. Limited evidence therefore exists to guide clinical management of RAAs, particularly small aneurysms that are asymptomatic. To further characterize the natural history of RAAs, we studied anatomic characteristics and chan...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.03.006
更新日期:2014-08-01 00:00:00
abstract::Aortic and renal vascular reconstruction often involve significant renal ischemia. Profound hypothermia during renal ischemia preserves renal tissue. However, in the clinical setting of vascular reconstruction specific attempts at cooling the kidney are often impractical, and renal ischemia frequently occurs at physio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00