Abstract:
OBJECTIVE:The objective of this study was to analyze the early and late outcomes of patients who require a suprarenal aortic cross-clamp during elective open repair of an abdominal aortic aneurysm (AAA). METHODS:Patients from 1998 to 2012 who required a suprarenal aortic cross-clamp during elective open AAA repair were reviewed. Data abstracted included demographics and comorbidities; preoperative, perioperative, and late renal function; late interventions related to AAA repair; and late mortality. A decrease in renal function was defined as a >30% decline in estimated glomerular filtration rate (eGFR) compared with the preoperative value. Primary outcomes included renal function, intervention-free survival, and overall survival. RESULTS:During the study period, 211 patients underwent open elective or urgent AAA repair; 69 required a suprarenal cross-clamp. The mean age was 71 years, and 80% were men. The mean preoperative creatinine concentration was 1.2 mg/dL, and the mean preoperative eGFR was 66 mL/min/1.73 m2. Location of the aortic cross-clamp was suprarenal (37), supramesenteric (21), and supraceliac (11). Perioperatively, 21 patients (30%) experienced a significant decrease in eGFR; four patients required hemodialysis. Six patients had full recovery of renal function by discharge. Perioperative morbidity and mortality were 35% and 4%, respectively. At a mean follow-up of 3 years, seven patients had an eGFR significantly less than the preoperative value. Late interventions related to the AAA repair were required in eight patients. Indications included wound complication (3), anastomotic aneurysm (2), incisional hernia (1), anastomotic graft stenosis (1), and proximal aortic dilation (1). Overall 5-year intervention-free survival was 62% and overall survival 77%. Intervention-free survival was enhanced by antiplatelet use (P = .04), whereas overall survival was decreased by chronic obstructive pulmonary disease (P = .003) and perioperative pneumonia (P = .001). CONCLUSIONS:More than a quarter of patients requiring a suprarenal cross-clamp during open AAA repair experience renal dysfunction. Late graft-related complications are few, with preoperative and perioperative pulmonary function negatively affecting overall patient survival.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Wartman SM,Woo K,Yaeger A,Sigman M,Huang SG,Ham SW,Rowe V,Weaver FAdoi
10.1016/j.jvs.2014.04.034subject
Has Abstractpub_date
2014-10-01 00:00:00pages
893-9issue
4eissn
0741-5214issn
1097-6809pii
S0741-5214(14)00835-0journal_volume
60pub_type
杂志文章abstract::A 46-year-old woman was admitted with acute abdominal pain radiating to the back. Computed tomography examinations showed a needle-thin perforation of the aorta, opposite the origin of the superior mesenteric artery, with a pseudoaneurysm. A needle-sharp spinal osteophyte was located exactly opposite the perforation. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.12.070
更新日期:2007-05-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the long-term safety and efficacy of the titanium Greenfield filter-modified hook for prevention of pulmonary embolism. METHODS:We conducted a prospective study in 173 patients from four institutions who underwent clinical examination, abdominal radiography, and duplex...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90146-5
更新日期:1994-09-01 00:00:00
abstract:OBJECTIVE:The clinical impact of peripheral arterial disease (PAD) is well characterized and is associated with significant morbidity and mortality. Health care-related expenditures among individuals with PAD, particularly for patients, are not well described. METHODS:Health care-related expenditure data from the 2011...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.102
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:The use of cross-sectional area (CSA) measurements obtained from computed tomographic angiography (CTA) for the calculation of carotid artery stenosis has been suggested but not yet validated in a large population. The objective of this study was to determine whether CTA-derived CSA measurements were able to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.031
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:Embolization of the internal iliac artery (IIA) may be performed during endovascular abdominal aortic aneurysm (AAA) repair if aneurysmal disease of the common iliac artery precludes graft placement proximal to the IIA orifice. The IIA may also be unintentionally occluded because of iliac trauma or coverage b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.109750
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVE:Successful thoracic endovascular aneurysm repair (TEVAR) requires adequate proximal and distal fixation and seal. We report our experience of planned celiac artery coverage during endovascular repair of complex thoracic aortic aneurysms (TAA). METHODS:Since 2004, 228 patients underwent TEVAR under elective (...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.105
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Contemporary data on outcomes in open thoracoabdominal aortic aneurysm (TAAA) repair are limited to reports from major aortic referral centers showing excellent outcomes. This study aimed to characterize the national experience of open TAAA repair using national outcomes data, with a primary focus on the asso...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.05.027
更新日期:2021-02-01 00:00:00
abstract::An 84-year-old female was lost to follow-up after endovascular aneurysm repair at another hospital with known type II endoleak. She later presented with presyncope and hematemesis. A referral center esophagogastroduodenoscopy showed possible duodenal diverticulum. She had recurrent symptoms and repeat computed tomogra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.04.049
更新日期:2011-10-01 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: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::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: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:Wounding patterns, methods of repair, and outcomes from femoropopliteal injury have been documented in recent civilian literature. In Operation Iraqi Freedom, as in past conflicts, these injuries continue to be a therapeutic challenge. Therefore, the objective of the current study is to document the pattern o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.01.052
更新日期:2008-06-01 00:00:00
abstract::Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of sy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess the reduction in quality of life (QoL) caused by the persistence of primary plantar hyperhidrosis (PPH) symptoms and the level of satisfaction in PPH patients after retroperitoneoscopic lumbar sympathectomy (RLS). The efficacy, safety, and procedure of bilateral RLS i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.05.126
更新日期:2017-12-01 00:00:00
abstract::We report an unusual case of type IV Thoracoabdominal Aneurysm (TAA) with Superior Mesenteric Artery (SMA), celiac artery, and bilateral renal artery aneurysms in a patient who underwent an earlier repair of two infrarenal Abdominal Aortic Aneurysm (AAA) ruptures. Because of the presence of the visceral artery aneurys...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70084-4
更新日期:1999-09-01 00:00:00
abstract::Secondary vascular procedures to below-knee vessels for lower extremity ischemia present a challenge to the vascular surgeon. Autogenous vein is often unavailable and failure of the previous bypass often limits the choice of distal vessels suitable for revascularization. This dilemma raises the question of amputation ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080137
更新日期:1988-08-01 00:00:00
abstract::In a 34-year-old woman with intermittent calf claudication, cystic adventitial disease of the popliteal artery was demonstrated by intravascular ultrasound imaging. Multiple intramural cystic masses were seen to be compressing the arterial lumen. The diagnoses of cystic adventitial disease was confirmed by surgery. In...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(96)80023-1
更新日期:1996-03-01 00:00:00
abstract:OBJECTIVE:Acute kidney injury (AKI) has been identified as a common complication after fenestrated and branched endovascular aneurysm repair (F/BEVAR), occurring in 5% to 29% of patients. Predictors of AKI and its impact on long-term outcomes remain unknown. We sought to identify independent predictors of AKI and its e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.034
更新日期:2020-07-01 00:00:00
abstract::Surgical repair of proximal right subclavian artery aneurysms can be difficult. They typically require a combined mediastinal exposure to control the innominate and right common carotid arteries and a supra- or infraclavicular exposure for distal control, with either a segmental resection and bypass or a bifurcated re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.07.050
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Carbon monoxide (CO) and nitric oxide (NO) have both been shown to possess vasoprotective properties. NO has successfully inhibited intimal hyperplasia in both small-animal and large-animal experimental models, whereas CO has only been studied in rodents. Evidence suggests that these two molecules may exert t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.04.004
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Open bypass is the gold standard for treatment of mesenteric ischemia. With the refinement of endovascular therapy, visceral stenting is an attractive minimally invasive alternative, but the data are limited and which vessel responds best to stenting has not been addressed. This study compares the outcomes o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.081
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.08.228
更新日期:2020-05-01 00:00:00
abstract::We performed radiofrequency ablation to treat a symptomatic facial venous malformation of a 24-year-old woman under ultrasound scan-guidance. The 20.25-cm sized original facial venous malformation in her right cheek markedly reduced without any scar formation and was grossly not visible after 1 month of the procedure....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.03.047
更新日期:2009-08-01 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::The endothelial injury induced by the placement of a synthetic graft has been implicated as a stimulus for the development of MIH. In this study we compared the degree of EC coverage and the early SMC-PR in the arterial segments proximal and distal to 2 mm diameter PTFE grafts that had been placed in rabbit carotid ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050389
更新日期:1987-02-01 00:00:00
abstract::A 64-year-old man was admitted with abdominal pain 6 weeks after treatment with intravenous flucloxacillin for cellulitis of his right leg. Urgent operation was necessary for a mycotic aneurysm of the abdominal aorta due to infection with Pasteurella multocida, a microorganism residing in the oral cavity of domestic a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.06.052
更新日期:2009-12-01 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: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: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