Abstract:
OBJECTIVE:Fenestrated and branched endovascular devices are increasingly used for complex aortic diseases, and despite the challenging nature of these procedures, early experiences from pioneering centers have been encouraging. The objectives of this retrospective study were to report our experience of intraoperative adverse events (IOAEs) during fenestrated and branched stent grafting and to analyze the impact on clinical outcomes. METHODS:Consecutive patients treated with fenestrated and branched stent grafting in a tertiary vascular center between February 2006 and October 2013 were evaluated. A prospectively maintained computerized database was scrutinized and updated retrospectively. Intraoperative angiograms were reviewed to identify IOAEs, and adverse events were categorized into three types: target vessel cannulation, positioning of graft components, and intraoperative access. Clinical consequences of IOAEs were analyzed to ascertain whether they were responsible for death or moderate to severe postoperative complications. RESULTS:During the study period, 113 consecutive elective patients underwent fenestrated or branched stent grafting. Indications for treatment were asymptomatic complex abdominal aortic aneurysms (CAAAs, n = 89) and thoracoabdominal aortic aneurysms (TAAAs, n = 24). Stent grafts included fenestrated (n = 79) and branched (n = 17) Cook stent grafts (Cook Medical, Bloomington, Ind), Ventana (Endologix, Irvine, Calif) stent grafts (n = 9), and fenestrated Anaconda (Vascutek Terumo, Scotland, UK) stent grafts (n = 8). In-hospital mortality rates for the CAAA and TAAA groups were 6.7% (6 of 89) and 12.5% (3 of 24), respectively. Twenty-eight moderate to severe complications occurred in 21 patients (18.6%). Spinal cord ischemia was recorded in six patients, three of which resolved completely. A total of 37 IOAEs were recorded in 34 (30.1%) patients (22 CAAAs and 12 TAAAs). Of 37 IOAEs, 15 (40.5%) resulted in no clinical consequence in 15 patients; 17 (45.9%) were responsible for moderate to severe complications in 16 patients, and five (13.5%) led to death in four patients. The composite end point death/nonfatal moderate to severe complication occurred more frequently in patients with IOAEs compared with patients without IOAEs (20 of 34 vs 12 of 79; P < .0001). CONCLUSIONS:In this contemporary series, IOAEs were relatively frequent during branched or fenestrated stenting procedures and were often responsible for significant complications.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Cochennec F,Kobeiter H,Gohel MS,Majewski M,Marzelle J,Desgranges P,Allaire E,Becquemin JPdoi
10.1016/j.jvs.2014.02.065subject
Has Abstractpub_date
2014-09-01 00:00:00pages
571-8issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(14)00654-5journal_volume
60pub_type
杂志文章abstract:PURPOSE:A recent overview indicated that although routine patching is safer than routine primary closure after carotid endarterectomy (CEA), there is no systematic evidence that patch type influences outcome. However, most surgeons still believe that prosthetic patches are probably more thrombogenic than vein patches. ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.2001.115005
更新日期:2001-05-01 00:00:00
abstract:PURPOSE:Cyclooxygenase, either the cox1 or cox2 isoform, controls synthesis of prostaglandin E2 (PGE2), which regulates expression of matrix metalloprotease-9 (MMP-9). PGE2 and MMP-9 are elevated in aortic aneurysms. The mechanisms and time course of the inhibition of aneurysm expansion with a nonspecific cyclooxygenas...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70216-8
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:No independent comparisons, with midterm follow-up, of standard arteriovenous grafts (SAVGs) and immediate-access arteriovenous grafts (IAAVGs) exist. The goal of this study was to compare "real-world" performance of SAVGs and IAAVGs. METHODS:Consecutive patients who underwent placement of a hemodialysis gr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.06.204
更新日期:2019-03-01 00:00:00
abstract::Vascular grafts in canines exhibit similar healing patterns to humans in that the graft surface forms a pseudointima over time but endothelializes only near the anastomotic sites. Thus the pseudointima at the midportion of the graft may represent a nidus for persistent platelet activation. The purpose of this investig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:BACKGROUND:The optimum management of isolated penetrating aortic ulceration (PAU), with no associated intramural hematoma or aortic dissection is not clear. We evaluate the short- and long-term outcomes in isolated PAU to better inform management strategies. METHODS:We conducted a retrospective review of 43 consecutiv...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.039
更新日期:2020-07-01 00:00:00
abstract::From 1995 through 1998, we encountered eight patients with infected Dacron patches after previous carotid endarterectomy. Two of the original operations had been done elsewhere, but the six patients who were collected from our own series represented 0.5% of the 1258 carotid endarterectomies we performed and 1.8% of th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.107567
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Long-term (tunneled cuffed) hemodialysis catheters are frequently used vascular access in renal failure patients. Catheter-related bloodstream infection (CRBSI) is a common complication of long-term hemodialysis catheters, with severe morbidities and high risk of mortality. Management of CRBSI by systemic an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2017.05.119
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to identify whether revascularization by percutaneous transluminal angioplasty (PTA) for patients with intermittent claudication improved measures of functional performance including balance. METHODS:A prospective observational study was performed at a single tertiary vascular cente...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.106
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The hemodynamic effects of carotid angioplasty with stent placement (CAS) on the collateral blood supply and on the regional cerebral blood flow (rCBF) have not been established. Recently, arterial spin-labeling (ASL) magnetic resonance imaging (MRI) has been introduced as the first method to quantify the ac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2006.11.067
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:The purpose of this study was to investigate in vivo the long-term development, differentiation, and proliferation of the subendothelial tissue on Dacron prostheses seeded with microvascular cells (MVC). METHODS:Autologous MVC from omental adipose tissue were seeded on 4 mm Dacron prostheses and the prostheses...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract:PURPOSE:The purpose of this article is to assess the healing qualities of presealed knitted polyester prostheses. METHODS:Thoracic aortic replacement was performed with grafts with four different coating materials-collagen (CP), albumin (AP), and two with gelatin (GP1/GP2)-in four groups of 15 pigs each. Two weeks, 6 ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.39245
更新日期:1993-03-01 00:00:00
abstract::We present three novel techniques for creation of (1) a steerable sheath, (2) a 4F snare device, and (3) dual anterograde and retrograde double-wire percutaneous transluminal angioplasty access technique using a single femoral puncture. These techniques were conceived and bench-tested in our institution, allowing the ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.271
更新日期:2012-09-01 00:00:00
abstract::Aneurysm degeneration of internal carotid artery interposition vein grafts can occur, and their repair can be complicated by repeated neck dissection and difficulty in obtaining distal artery control. We used a covered stent graft to exclude a large internal carotid artery interposition vein graft aneurysm. Retrograde...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00144-7
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:Endovascular treatment of thoracoabdominal aortic aneurysms is becoming increasingly popular in clinical practice, mainly because of its reduced perioperative mortality and morbidity. However, the custom-made stent graft platform that companies offer requires detailed preoperative planning and production tim...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.jvs.2020.01.049
更新日期:2020-08-01 00:00:00
abstract::To define better the short-term risk and long-term benefit of carotid endarterectomy opposite an occluded carotid artery, we reviewed our experience since 1961. Angiographic data are available for 598 of 670 (89.3%) patients in our carotid registry. In 63 (10.5%) patients the internal or common carotid artery on the s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.20249
更新日期:1990-06-01 00:00:00
abstract::Renal cell carcinoma extends into the lumen of the inferior vena cava in approximately 4% of patients at the time of diagnosis. Surgical removal of the intracaval tumor thrombus with radical nephrectomy is the preferred treatment for this malignancy. From January 1977 to June 1990, 31 such patients were examined for c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.29912
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:The application of thoracic endovascular aortic repair (TEVAR) has changed treatment paradigms for thoracic aortic disease. We sought to better define specific treatment patterns and outcomes for type B aortic dissection treated with TEVAR or open surgical repair (OSR). METHODS:Medicare patients undergoing t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.12.047
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:This study reviews the results of en bloc resection of the inferior vena cava (IVC) for malignant tumor excision and reconstruction. METHODS:A prospective database was reviewed. IVC resection was categorized as suprarenal, perirenal, infrarenal, or extensive (>one segment resected). Repairs were divided into...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.054
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Dual antiplatelet therapy (DAPT) usually refers to the administration of aspirin plus a platelet P2Y12 receptor blocker. This combination is commonly prescribed after revascularization procedures in patients with peripheral arterial disease (PAD) to prevent failure of the intervention. However, there is not ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2018.02.047
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Hyperspectral imaging technology is a novel method of using transcutaneous measurement of oxyhemoglobin (HT-Oxy) and deoxyhemoglobin (HT-Deoxy) concentrations to create a two-dimensional, color-coded "oxygen map." The aims of this study were to compare the use of a hyperspectral imaging device with the trans...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.047
更新日期:2017-10-01 00:00:00
abstract::Biochemical (or functional) adaptation of venoarterial grafts has been demonstrated recently. We reexamined one aspect of this biochemical "arterialization" process: prostacyclin (PGI2) production by canine venoarterial autologous grafts and the responsiveness of this biosynthetic pathway to maximal stimulation with s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060496
更新日期:1987-11-01 00:00:00
abstract::Despite the proven experimental success of endothelial cell seeding of prosthetic vascular grafts, the process has not been widely accepted for clinical use because of its complexity and the need for a relatively large length of autologous vein to provide the requisite number of cells. Using autologous endothelial cel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030264
更新日期:1986-02-01 00:00:00
abstract::We have developed an infection resistant vascular prosthesis by bonding rifampin to Dacron grafts with the use of a collagen matrix release system. The purpose of this study was to determine the efficacy of this antibiotic-bonded graft in resisting infection after an in situ reconstruction of a previously infected pro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992/39117
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to assess the outcome of infrapopliteal bypass when an adjuvant arteriovenous (AV) fistula was reconstructed as means of rescue as a result of poor runoff. The design was a retrospective multicenter case-control study. METHODS:Seventy-seven infrapopliteal vein bypasses required an a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2006.06.037
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effect of patient compliance on a program of watchful waiting in cases of small abdominal aortic aneurysms and to document the proportion of patients who become prohibitive operative risks during follow-up. STUDY DESIGN:A retrospective review was conducted at a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.108635
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to describe characteristics and in-hospital outcomes of patients treated with carotid endarterectomy (CEA) and carotid artery stenting (CAS) for stroke in evolution (SIE) under routine conditions in Germany. METHODS:This secondary data analysis is based on the German statutory...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.085
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Simulation has an increasingly prominent role in modern vascular surgery training. However, it is important to understand how simulation is most effectively delivered to best use the time and resources available. The aim of this narrative review is therefore to critically appraise open technical skill acquis...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2020.09.042
更新日期:2020-11-25 00:00:00
abstract::We report a case of primary aortoappendiceal fistula in a patient with chronic, relapsing abdominal symptoms and acute lower gastrointestinal hemorrhage. The diagnosis was evident with abdominal computed tomographic scan results. The patient's condition was successfully managed with appendectomy, abdominal aortic aneu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2002.121751
更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:Our aim was to evaluate the effect of gender on early and late procedural and functional outcomes of lower extremity bypass (LEB). METHODS:We reviewed the records of 2576 patients (828 women; 32%) who underwent LEB for claudication or critical limb ischemia (CLI) in the Vascular Study Group of New England fr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2014.05.008
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:Subintimal angioplasty (SIA) is an increasingly used method of lower extremity revascularization for patients with chronic arterial occlusions. To assess the technical feasibility, safety, and 3-year outcomes of patients treated with SIA, we performed a retrospective review of our early experience. METHODS:P...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.06.031
更新日期:2007-11-01 00:00:00