Abstract:
INTRODUCTION:Despite its presumed effectiveness and clinical use, the physiology of selective visceral perfusion combined with distal aortic perfusion during open thoracoabdominal aortic surgery has not been characterized. Thus, the aim of this study was to establish a translatable model of thoracic aortic-clamping to assess the effect of selective visceral perfusion with added distal aortic perfusion on local intestinal macrohemodynamics and microhemodynamics, intestinal histopathology, and markers of inflammation and intestinal damage. METHODS:A thoracolaparotomy was performed in 15 pigs, and the aorta was exposed, including the origins of celiac trunk and superior mesenteric artery. The animals were divided into three cohorts: control (I), thoracic aortic cross-clamping (II), and thoracic aortic cross-clamping with selective visceral perfusion plus distal aortic perfusion using extracorporeal circulation (III). Macrocirculatory and microcirculatory blood flow was assessed by transit time ultrasound volume flow measurements and fluorescent microspheres. Intestinal ischemia-reperfusion injury was determined by the analysis of perioperative intestinal fatty acid-binding protein (IFABP) and interleukin-8 (IL-8) levels and correlated with histopathologic changes. RESULTS:Severe intestinal tissue injury and an inflammatory response were observed in cohort II compared with cohort III for IL-8 (38.2 vs 3.56 pg/mL; P = .04). The procedure in cohort III resulted in a flow and pressure-associated intestinal hypoperfusion compared with cohort I in the superior mesenteric artery (mean blood pressure, 24.1 ± 10.4 vs 67.2 ± 7.4 mm Hg; P < .0001; mean flow rates: 353.3 ± 133.8 vs 961.7 ± 310.8 mL/min; P < .0001). This was paralleled in cohort III vs cohort I by a significant mucosal injury (IFABP, 713 ± 307.1 vs 170 ± 115.4 pg/mL; P = .014) despite a profound recruitment of intestinal microcirculation (338% ± 206.7% vs 135% ± 123.7%; P = .05). CONCLUSIONS:This study reports a novel large-animal model of thoracic aortic cross-clamping that allows the study of visceral perfusion strategies. However, we demonstrated with IL-8 and IFABP measurements that thoracoabdominal aortic aneurysm surgery with selective visceral perfusion and distal aortic perfusion is superior to the clamp-and-sew technique, even though small intestinal tissue damage cannot be completely avoided by selective visceral perfusion and distal aortic perfusion. In any case, this model seems to be a platform to evaluate and optimize measures for gut wall protection.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Kalder J,Keschenau P,Hanssen SJ,Greiner A,Vermeulen Windsant IC,Kennes LN,Tolba R,Prinzen FW,Buurman WA,Jacobs MJ,Koeppel TAdoi
10.1016/j.jvs.2011.11.126subject
Has Abstractpub_date
2012-07-01 00:00:00pages
149-58issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(11)02926-0journal_volume
56pub_type
杂志文章abstract::We have performed a prospective, randomized, multicenter study to compare in situ and reversed vein grafts for long limb salvage bypasses from the proximal thigh to an infrapopliteal artery. Three hundred eighty-four patients required an infrapopliteal bypass for critical lower extremity ischemia. Of these, 259 were e...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1991-02-01 00:00:00
abstract::Over a 7-year period (1980 to 1987) 24 patients (18 men: mean age 67 years; range, 52 to 78 years, and six women: mean age 67 years; range, 46 to 82 years) undergoing serial carotid artery duplex scans were observed to progress to unilateral carotid artery occlusion. The occlusions were associated with ipsilateral str...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.15723
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Ankle-brachial pressure index (ABI) is a simple, inexpensive, and useful tool in the detection of peripheral arterial occlusive disease (PAD). The current guidelines published by the American Heart Association define ABI as the quotient of the higher of the systolic blood pressures (SBPs) of the two ankle ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.016
更新日期:2006-09-01 00:00:00
abstract::This study tests the hypothesis that reperfusion injury is the principal cause of limb loss after acute arterial occlusion and that this injury is avoidable. Of 61 isolated hindlimbs amputated at the level of the hip joint, 17 were controls (group I), 5 were perfused without ischemia to establish the validity of the m...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 00:00:00
abstract::The use of percutaneous angioplasty with subsequent intravascular metallic stent placement has gained increasing acceptance over the past decade. Infections of these stents appear to be uncommon; however, the rarity of this complication may in part be the result of a lack of availability of long-term follow-up data. A...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.127340
更新日期:2002-09-01 00:00:00
abstract:PURPOSE:Autogenous aortoiliac/femoral reconstruction with superficial femoral-popliteal veins (SFPVs) has been successfully used to treat prosthetic infection and failure, but outcome data are scant. In this prospective, observational study, we hypothesized that (1) replacement of the aortoiliac/femoral system with SFP...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70347-1
更新日期:1997-02-01 00:00:00
abstract::Several different modes of achieving a bloodless operating field by proximal and distal occlusion of blood vessels have been described. Vascular clamps, vessel loops, intraluminal occluding devices, and tourniquets have been used to control the tibial and pedal vessels but may cause injury or fail to control heavily c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.03.055
更新日期:2005-07-01 00:00:00
abstract::To determine the influence of unilateral internal carotid arterial occlusion (ICO) on Doppler frequency spectral analysis (DFSA) of the patent contralateral carotid artery, a retrospective review of 154 patients between July 1987 and December 1991 with angiographically confirmed ICO was performed, correlating duplex a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract::The Budd-Chiari syndrome is an unusual form of portal hypertension caused by hepatic vein occlusion, which results in centrilobular congestion and necrosis. Its overall mortality rate exceeds 50% at 2 years, and optimal treatment remains controversial. To determine optimal therapy on the basis of clinical and angiogra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-01-01 00:00:00
abstract:PURPOSE:Conventional pre-endovascular procedural evaluation uses both noninvasive testing and diagnostic arteriography. Diagnostic and therapeutic procedures often must be performed separately because of concerns about excessive contrast administration or inappropriate location of vascular access for the interventional...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70025-4
更新日期:1998-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to investigate the hypothesis that abdominal aortic aneurysm (AAA) expansion may be slowed by beta-adrenergic antagonists. METHODS:One hundred twenty-one patients with infrarenal AAA were monitored with serial aortic ultrasound examinations. Eighty-three patients received no beta-...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70048-6
更新日期:1994-04-01 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:BACKGROUND:Induction of collateral development to improve tissue perfusion is a promising approach for the treatment of arterial occlusive diseases. Several growth factors and cells have been reported to increase collateral circulation; however, the appropriate site for the delivery of these factors and cells is unclea...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.02.004
更新日期:2015-07-01 00:00:00
abstract:PURPOSE:Many viruses have evolved mechanisms to evade detection by the host immune system. The herpes simplex gene ICP47 encodes a protein that binds to the host antigen-processing transporter, inhibiting the formation of major histocompatibility complex class I (MHC-I) antigens in infected cells. MHC-I antigen express...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 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::Carotid endarterectomy has been advocated to prevent further neurologic deterioration in patients who have had a stroke. Previous reports have shown that endarterectomy within 2 weeks of a stroke is associated with high morbidity and mortality rates presumably from hemorrhagic complications in the brain. Some recommen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:PURPOSE:This study was conducted to assess the efficacy of antibiotic-loaded polymethylmethacrylate (PMMA) beads in the management of lower extremity extracavitary prosthetic arterial graft infection. METHODS:This was a retrospective review of 34 patients treated for vascular surgical site (VSS) infections involving 3...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.056
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Constrictive extracellular matrix (ECM) remodeling contributes significantly to restenosis after arterial reconstruction, but its molecular regulation is poorly defined. Hyaluronan (HA) accumulates within ECM at sites of injury where it is thought to facilitate smooth muscle cell (SMC) trafficking and collage...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.03.047
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The national burden of venous disease and use of ultrasound (US) in the outpatient and emergency department (ED) settings has not been well described. The objective of this study is to describe venous disease in the outpatient and ED settings nationally as well as to characterize the use of US for diagnosis ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.12.070
更新日期:2010-06-01 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:PURPOSE:The purpose of this study was to investigate the blood flow changes and venous wall movements that occur in the perivalvular area during venous flow, to learn how these physiologic events influence the movements of the valve cusps, and to learn how the movements of the valve cusps influence the venous flow. MA...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00711-0
更新日期:2003-11-01 00:00:00
abstract:PURPOSE:Animal models have been used to assess the function of vascular smooth muscle and endothelium of veins grafted into arterial circulation. The primary model consists of grafting the external jugular vein into the carotid artery of the rabbit. These studies suggest a selective increase in the responsiveness of th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.42071
更新日期:1993-07-01 00:00:00
abstract:INTRODUCTION:Although lower-extremity bypass grafting has been the gold standard for infrainguinal revascularization, endovascular therapies have been increasingly applied to avoid operative morbidities. This study addresses the initial results of an implementation of infrainguinal percutaneous transluminal angioplasty...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.06.024
更新日期:2005-11-01 00:00:00
abstract::A 57-year-old man had subacute embolic ischemia of his right foot and subsequent acute embolic ischemia of his left foot after angiography. Thrombus removed at the time of the left femoral thromboembolectomy grew Histoplasma capsulatum confirming the diagnosis of disseminated histoplasmosis. Surgical revascularization...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.23270
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2017.04.057
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Arteriovenous fistula (AVF) is the preferred access for hemodialysis. Percutaneous transluminal angioplasty(PTA) has become a choice for AVF stenosis and ultrasound has been used in PTA more frequently. METHODS:This single-center retrospective cohort study analyzed 129 patients who underwent PTA in the First...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.11.041
更新日期:2020-12-16 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the stenosis-free patency of open repair (vein-patch angioplasty, interposition, jump grafting) and percutaneous transluminal balloon angioplasty (PTA) of 144 vein graft stenoses that were detected during duplex scan surveillance after infrainguinal vein bypass grafting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70361-7
更新日期:1999-01-01 00:00:00
abstract::This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.04.054
更新日期:2010-07-10 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:OBJECTIVE:Outcomes of infrainguinal bypass surgery (IBS) in patients with renal transplants are largely undescribed. This study evaluated perioperative and long-term outcomes of IBS using autogenous and prosthetic conduits in a large population-based cohort of renal transplantation patients. METHODS:A retrospective re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.086
更新日期:2018-12-01 00:00:00