Abstract:
BACKGROUND:Acute type B aortic dissection (AoD) with malperfusion is a rare and complex disease. In this specific setting, invasive treatment is generally required to improve aortic branch vessel flow. Thoracic aorta stent grafting (TEVAR) of the proximal descending thoracic aorta to cover/exclude the proximal intimal entry tear would promote resolution of the dynamic component (the most prevalent) of the malperfusion conflict by redirecting the flow within the true lumen. The aim was to study outcomes of patients undergoing TEVAR for acute (<14 days) type B AoD complicated with malperfusion and to depict any preoperative and intraoperative predictors that could affect the prognosis of those patients. METHODS:From March 2005 to January 2016, all patients treated with TEVAR for acute type B AoD with malperfusion in 2 European high-volume aortic centers were retrospectively studied. Preoperative, intraoperative, and postoperative details were collected. Preoperative computed tomography angiogram was reanalyzed on a dedicated 3D workstation (Aquarius iNtuition Viewer, TeraRecon). Thirty-day malperfusion-related complication and mortality rates were determined. Logistic regression model was used to assess preoperative and intraoperative factors affecting postoperative outcomes; in particular, details on the mechanisms of malperfusion and organ(s) involved were entered into the model and tested. RESULTS:A total of 41 patients (60 years old [interquartile range (IQR): 51-68.5]; 78% men) have been included in the analysis. Patients were mostly (68.3%) affected by only 1 malperfusion syndrome, with renal ischemia being the most frequent (53.6%). The median length of aortic coverage was 197 mm (IQR: 157-209). Additional visceral/renal/iliac stentings were performed after stent graft implantation for 25 branches in 17 patients (41%). The 30-day mortality rate was 17.1%. All but 2 early deaths were related to malperfusion. The number of malperfusion syndromes was the only independent factor associated to increasing 30-day malperfusion-related complications or deaths (3 vs 1, HR = 30.3 [P = 0.001]; 3 vs 2, HR = 9.9 [P = 0.004]). CONCLUSIONS:Prognosis of patients with acute type B AoD complicated initially with malperfusion syndrome(s) is severe, especially if several territories are ischemic. Early identification of those complications can be lifesaving but still lacks hard criteria.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Sobocinski J,Delloye M,Hongku K,Resch T,Sonesson B,Haulon S,Dias NVdoi
10.1016/j.avsg.2019.01.030subject
Has Abstractpub_date
2019-08-01 00:00:00pages
119-126eissn
0890-5096issn
1615-5947pii
S0890-5096(19)30267-5journal_volume
59pub_type
杂志文章,多中心研究abstract::Carotid stenosis is currently estimated using methods based on flow velocity or two-dimensional projection images. Manipulation of magnetic resonance (MR) images in three dimensions (3-D MR) allows for direct measurement of carotid artery cross-sectional luminal area. The objectives of this study were (1) to assess th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0102-z
更新日期:2002-05-01 00:00:00
abstract::We cultured bone marrow-derived endothelial progenitor cells by a simple ex vivo expansion method and observed the expansion efficacy. Bone marrow mononuclear cells from five mongrel adult dogs were cultured with EGM-2MV medium in culture flasks coated with fibronectin. Morphology was observed with phase contrast micr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9047-6
更新日期:2006-05-01 00:00:00
abstract::Infected or mycotic aneurysms (MAs) of the aorta and adjacent arteries are rare and difficult to treat. We report a unique case of a Salmonella serotype enteritidis-induced rapidly expanding aortic and iliac pseudoaneurysm during preoperative workup. Based on the presented case, we postulate that the agressive nature ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2017.05.034
更新日期:2017-10-01 00:00:00
abstract::Ruptured abdominal aortic aneurysm (AAA) remains a common and highly lethal problem. This study evaluates the morbidity and mortality rates and aims to identify which clinical variables could predict the outcome. We reviewed the records of 112 patients (97 men and 15 women) operated on for ruptured infrarenal AAA with...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02018826
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The impact of presence of an IVC filter in patients undergoing stenting for symptomatic femoroiliocaval obstruction has not been explored in detail. This study attempts to fill this gap by evaluating clinical and stent-related outcomes in such patients. The incidence of deep vein thrombosis (DVT) in this set...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.03.041
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Fully implantable catheters are important for oncology treatments. They can be functionally categorized as valved or nonvalved. Theoretically, a valve prevents spontaneous blood reflux into the catheter, reducing the incidence of complications. We sought to compare the results from the implantation of valved...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.025
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:This study is to investigate the causes, treatment methods, and preventive measures of retrograde type A aortic dissection (RAAD) complicating thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). METHODS:From January 2005 to December 2013, 360 TBAD patients receiving TEVAR were e...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.09.028
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Many individuals who are candidates for thoracic endovascular aortic repair (TEVAR) are found to have iliac artery anatomy and/or disease that preclude transfemoral endovascular access and require retroperitoneal surgical approach through more proximal arteries. This relatively more invasive technique could ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.09.015
更新日期:2011-04-01 00:00:00
abstract::Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotom...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2006.05.003
更新日期:2007-01-01 00:00:00
abstract::Advanced complicated atherosclerotic lesions have been related to many factors, including inflammation, infectious agents, and growth factors. Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP), inflammation, and growth factors have been associated with severe atherosclerotic lesions in necropsy material in rece...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9076-1
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:Endovascular (EV) techniques are being advocated as the preferred method for mesenteric interventions because of their safety profile. However, midterm and long-term results are thought to be inferior to open interventions. We sought to compare our institutional experience with treatment of acute and chronic...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.07.038
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Postopertive troponin elevation may occur without typical or atypical cardiac symptoms and is associated with an increased 30-day morbidity and mortality. The objective of the study was to implement a quality improvement initiative of postoperative troponin surveillance algorithm aimed at intensifying medica...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.025
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The aim of this study is to compare 2 groups of patients treated for great saphenous vein (GSV) reflux with open surgical saphenofemoral ligation (SFL) and endovenous laser ablation (EVLA). METHODS:Consecutive patients with primary unilateral GSV reflux undergoing EVLA treatment since 2014 were enrolled, an...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.11.029
更新日期:2019-07-01 00:00:00
abstract::Acute lower limb ischemia (ALLI) in the pediatric population is rare but may lead to limb loss and life-long complications. We report the technique and outcomes of microsurgical salvage of ALLI in a preterm newborn after open reduction of congenital hip dysplasia. A 2-month-old girl was born premature at week 36 with ...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.06.064
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Infected aneurysms of the extracranial carotid arteries are uncommon. This article presents a complete review of the literature on this condition, illustrated with a case report. This case report describes a mycotic aneurysm of carotid bifurcation with proven infection of the arterial wall from Salmonella en...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.10.025
更新日期:2013-08-01 00:00:00
abstract::Intrathoracic subclavian artery aneurysms are extremely rare, <1% of all aneurysms. The formation of these aneurysms is often multifactorial, with the most common contributing factor being atherosclerosis. This case report describes a right subclavian artery aneurysm that required a surgical hybrid approach. These ope...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.12.106
更新日期:2019-08-01 00:00:00
abstract::Surgical reconstruction for patients with symptomatic lower extremity arterial occlusive disease is successful when a suitable distal target vessel is present. In patients with unreconstructable disease, practical surgical options are at a minimum. We report our initial experience with dorsal venous arch arterializati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0148-y
更新日期:2002-03-01 00:00:00
abstract::Internal jugular vein (IJV) thrombosis is a rare vascular event. The most common causes of internal jugular vein thrombosis are prolonged central venous catheterization, infection, malignancy and ovarian hyperstimulation syndrome. We have presented here a case of an 82-year-old male with chronic kidney disease who pre...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.08.074
更新日期:2020-01-01 00:00:00
abstract::Twenty-nine cases of post-traumatic false aneurysms and arteriovenous fistulas (AVF), with a mean follow-up of 24 months (1-65 months), are presented here. Diagnosis was established by color duplex and arteriogram. The time between injury and treatment varied between 3 days and 61 months. Endovascular treatment was ac...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900230
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:Aberrant origin of right subclavian arteries represents the most common of the aortic arch anomalies. This variant has few published series to guide management. Our goal was to review treatment options and results for these potentially complex reconstructions. METHODS:A retrospective review was performed on...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2011.02.012
更新日期:2011-05-01 00:00:00
abstract:BACKGROUND:We report 2 cases of patients undergoing endovascular aneurysm repair (EVAR) using reentry devices to recanalize unilateral iliac artery occlusions and complete a bifurcated endovascular repair. METHODS:Patient 1 is a 70-year-old male with an enlarging 6.5-cm abdominal aortic aneurysm (AAA) and disabling le...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.05.008
更新日期:2014-10-01 00:00:00
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journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.051
更新日期:2019-08-01 00:00:00
abstract::Heparin is routinely added to vascular cell cultures to inhibit smooth muscle cell proliferation. The in vivo effects of heparin upon atherogenesis have remained controversial, however. In this experiment 13 four-month-old, heritably hyperlipidemic, Watanabe rabbits were randomly assigned to three treatment groups: 15...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000497
更新日期:1990-07-01 00:00:00
abstract::Percutaneous endovenous techniques, such as radiofrequency ablation (RFA), have become the preferred method for treatment for varicose veins associated with great saphenous vein (GSV) insufficiency. Reports have shown safety and efficacy of these techniques with relatively few complications. Deep venous thrombosis aft...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.07.005
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Endovascular aneurysm repair (EVAR) becomes the treatment of choice for patients with abdominal aortic aneurysm (AAA). Type I or III endoleak is related to high risk of rupture and reintervention, but little is known about the delayed presentation of these. We sought to evaluate the delayed type I or III end...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.09.020
更新日期:2017-05-01 00:00:00
abstract::Regional anesthesia (RA) is the gold standard of neuromonitoring during carotid endarterectomy (CEA). Recent data show that RA for CEA is associated with fewer postoperative complications. The aim of the present study was to assess hemodynamic stability and vasoactive drug use for CEA performed under RA versus general...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.05.015
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:We report a rare case of severe spinal cord ischemia with neurological consequences in a patient who presented after endovascular treatment of a type II endoleak following endovascular aneurysm repair. METHODS AND RESULTS:An enlarging abdominal aortic aneurysm post-endovascular aneurysm repair was detected ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.12.018
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Choosing the optimal treatment modality for patients with recurrent carotid artery stenosis depends upon many variables, including the etiology of the recurrent plaque morphology and the location of the recurrent lesion. The most important considerations for interventions are the safety, short- and long-term...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.07.020
更新日期:2014-05-01 00:00:00
abstract::In patients with Takayasu's arteritis presenting with cerebrovascular insufficiency, deciding whether and how to perform surgical intervention is difficult. We report successful extra-anatomical cerebrovascular reconstruction in a patient with Takayasu's arteritis involving the aortic arch. A 27-year-old woman was dia...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-005-7714-7
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Smartphone apps provide novel ways for triggering lifestyle change by coupling objective measurements of health behavior with tailored feedback. Little is known about end-user preferences regarding the content of mobile health (mHealth) interventions. The aim of this study was to assess smartphone use and pr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.08.020
更新日期:2018-01-01 00:00:00