Abstract:
OBJECTIVE:Whereas uncomplicated acute type B aortic dissections are often medically managed with good outcomes, a subset develop subacute or chronic aneurysmal dilation. We hypothesized that computational fluid dynamics (CFD) simulations may be useful in identifying patients at risk for this complication. METHODS:Patients with acute type B dissection complicated by rapidly expanding aortic aneurysms (N = 7) were compared with patients with stable aortic diameters (N = 7). Three-dimensional patient-specific dissection geometries were generated from computed tomography angiography and used in CFD simulations of pulsatile blood flow. Hemodynamic parameters including false lumen flow and wall shear stress were compared. RESULTS:Patients with rapid aneurysmal degeneration had a growth rate of 5.3 ± 2.7 mm/mo compared with those with stable aortic diameters, who had rates of 0.2 ± 0.02 mm/mo. Groups did not differ in initial aortic diameter (36.1 ± 2.9 vs 34.4 ± 3.6 mm; P = .122) or false lumen size (22.6 ± 2.9 vs 20.2 ± 4.5 mm; P = .224). In patients with rapidly expanding aneurysms, a greater percentage of total flow passed through the false lumen (78.3% ± 9.3% vs 56.3% ± 11.8%; P = .016). The time-averaged wall shear stress on the aortic wall was also significantly higher (12.6 ± 3.7 vs 7.4 ± 2.8 Pa; P = .028). CONCLUSIONS:Hemodynamic parameters derived from CFD simulations of acute type B aortic dissections were significantly different in dissections complicated by aneurysm formation. Thus, CFD may assist in predicting which patients may benefit from early stent grafting.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Shang EK,Nathan DP,Fairman RM,Bavaria JE,Gorman RC,Gorman JH 3rd,Jackson BMdoi
10.1016/j.jvs.2015.02.048subject
Has Abstractpub_date
2015-08-01 00:00:00pages
279-84issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(15)00300-6journal_volume
62pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to report a feasibility trial approved by the Institutional Review Board for insertion of inferior vena cava (IVC) filters with intravascular ultrasound (IVUS) guidance in the intensive care unit. METHODS:Between October 1998 and May 2000, 26 patients (15 men, 11 women; age rang...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115599
更新日期:2001-07-01 00:00:00
abstract::Dr F. Inest practices surgery at a renowned medical center but is concerned because increasing numbers of medical insurers are excluding his institution from coverage. Many of his former referring physicians are beginning to send their patients elsewhere for this reason. The marketing people have been busy increasing ...
journal_title:Journal of vascular surgery
pub_type: 社论
doi:10.1016/j.jvs.2016.02.001
更新日期:2016-04-01 00:00:00
abstract::Von Recklinghausen's Type 1 neurofibromatosis (NF) is a genetic disorder of neuroectodermal tissue. Arterial involvement has also been recognized. Stenotic lesions predominate, but aneurysms have been documented as well. Aortoiliac, visceral, and cervical aneurysms are well represented in the literature. Rarely noted,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.112704
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:Proanthocyanidins are abundantly found in grape seeds and have been suggested to inhibit the pathogenesis of systemic diseases. We investigated the antithrombotic effects of proanthocyanidins in a rat model of deep vein thrombosis (DVT) and examined the underlying mechanisms. METHODS:DVT was induced in rat m...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.09.017
更新日期:2011-03-01 00:00:00
abstract::Dilatation of the common iliac arteries is one of the most frequent causes for exclusion of patients in a series of endovascular correction of abdominal aortic aneurysms (AAAs). In this article we describe the banding technique we use to constrict the large iliac arteries. Four patients underwent endovascular treatmen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.109771
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:Considering the poor efficacy of local intramuscular injections with endothelial progenitor cells (EPCs) for critical limb ischemia in patients with diabetes, the study aimed to investigate the effect of α-tocopherol (α-T) and α-tocopherol phosphate (α-TP) on apoptosis and angiogenesis in a rat model under ox...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.051
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:This is a randomized prospective study comparing the treatment of superficial femoral artery occlusive disease percutaneously with an expanded polytetrafluoroethylene (ePTFE)/nitinol self-expanding stent graft (stent graft) versus surgical femoral to above-knee popliteal artery bypass with synthetic graft ma...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2010.03.071
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.043
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:During endovascular aneurysm repair (EVAR), severely tortuous aortoiliac anatomy can alter the deployment and conformability of the endograft. The accuracy of treatment length measurements is commonly recognized to be affected by severe tortuosity. However, the exact mechanism of the postintervention length d...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.09.041
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:Vascular procedures reoxygenate ischemic endothelial cells (EC) and arterialize saphenous vein (HSV) EC. The balance between the EC-derived fibrinolytic components, plasminogen activator (tPA), and plasminogen inhibitor (PAI-1) contributes to maintaining thromboresistance. This balance also affects proteolysis ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-12-01 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::Contrast angiography with carbon dioxide (CO2) is frequently used in patients with renal dysfunction or iodinated contrast allergies, as CO2 is nonallergenic, nontoxic, and rapidly absorbed in the blood. However, when delivered intra-arterially, there is a possibility that CO2 may create a vapor lock with resultant tr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.06.075
更新日期:2012-12-01 00:00:00
abstract::Two hundred forty-three bypasses to paramalleolar arteries were performed in 224 extremities of 208 patients since 1971; 166 were implanted in men (68%) and 77 in women (32%). The median age was 73 years. Gangrene (61%), nonhealing ulcer (15%), rest pain (22%), and trauma (2%) were the indications for bypass. Usual ri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0070785
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perfor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.11.041
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:Hyperhomocysteinemia has been implicated as a causative factor in intimal hyperplasia development. The addition of dietary folate in a hyperhomocysteinemia, carotid endarterectomy rat model is postulated to decrease plasma homocysteine levels and, in turn, reduce post-carotid endarterectomy intimal hyperplasi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.117144
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:Wound complications after major lower extremity amputations (LEAs) are a cause of significant morbidity in vascular surgery patients. Recent publications have demonstrated the efficacy of the closed incision negative pressure dressing at preventing surgical site infections (SSIs); however, there are few data ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.07.061
更新日期:2020-07-21 00:00:00
abstract:OBJECTIVE:This study aimed to determine predictors and outcomes associated with bleeding or anemia requiring transfusion (BAT) after fenestrated or branched endovascular aneurysm repair (FB-EVAR). METHODS:Health insurance claims data of Germany's third largest insurance provider, DAK-Gesundheit, were used to investiga...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.02.059
更新日期:2020-02-01 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:PURPOSE:Vascular surgeons are ideally suited to select and perform endovascular interventions either as primary therapy or as an adjunct to bypass surgery. Attaining proficiency in endovascular techniques is an important goal in the training of vascular surgeons. We report our initial experience with a program of endov...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70042-3
更新日期:1996-12-01 00:00:00
abstract::This study was performed to evaluate the results of peripheral vascular reconstruction for arterial occlusive disease in patients with juvenile-onset diabetes mellitus. The results of 67 bypass procedures performed on 60 patients with juvenile-onset diabetes mellitus between Jan. 1, 1984 and Dec. 31, 1989, were review...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract::We report the case of a 78-year-old man who presented with an aortic arch aneurysm that involved the origin of the left carotid artery and extended up to the origin of the brachiocephalic trunk. The left vertebral artery originated separately from the arch. The patient was treated by a reversed bifurcated prosthesis f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.04.017
更新日期:2005-08-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine whether endogenous basic fibroblast growth factor (bFGF) production contributes to the intimal hyperplastic response to injury in a model of rabbit femoral artery balloon injury. Inhibition of de novo production of bFGF protein was targeted by intramural adenoviral gen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70299-x
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The mechanisms of neointima formation after synthetic vascular grafting are not clear. The aim of this study was to investigate the intima and perigraft adventitia remodeling process in terms of cell apoptosis versus proliferation after synthetic patch implantation. METHODS:Female Merino sheep were randomiz...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.123749
更新日期:2002-08-01 00:00:00
abstract:PURPOSE:A review of popliteal-crural bypasses via the posterior approach was done to evaluate the results of this technique. METHODS:During a period of 36 months, 21 patients with limb-threatening ischemia underwent 21 popliteal-crural bypasses via the posterior approach in the prone position with reversed lesser saph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00
abstract:PURPOSE:To determine which patients require subfascial endoscopic perforator surgery (SEPS) in addition to saphenous surgery to correct pathologic outward flow within incompetent medial calf perforating veins (IPVs). METHODS:Sixty-two limbs of 47 patients undergoing sapheno-femoral ligation, stripping of the long saph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70058-8
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVE:This review was performed to analyze the current knowledge and controversies in the pathophysiology, diagnosis, treatment, and outcomes of pediatric venous thromboembolism (VTE) compared with adults. METHODS:Searches of the MEDLINE database and manual searches of the references of selected articles were perf...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2011.07.047
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The number of hemodialysis patients with peripheral artery disease is increasing, and critical limb ischemia develops in some of these patients. The clinical outcomes in such patients after major amputation remain unclear. We therefore examined the mortality rates after major amputation in hemodialysis patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.03.452
更新日期:2016-10-01 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::This study evaluated the role of duplex scanning in the management of patients with normal or minimally diseases carotid arteries. Carotid duplex scans were interpreted according to previously established criteria and considered normal when pulsed Doppler spectral waveforms showed laminar flow or only minor flow distu...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract::The LaPlace transform damping (LTD) method of common femoral artery Doppler waveform analysis is a new method for assessing aortoiliac stenosis. A microcomputer was used to analyze the waveform to determine the value of the damping parameter, which is related to inflow stenosis. The study included 60 limbs with arteri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1984.avs0010520
更新日期:1984-07-01 00:00:00