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 primary, patch, or circumferential. Tumor type, perioperative morbidity, mortality, and graft patency were recorded. RESULTS:Between 1990 and 2011, 47 patients (21 women; mean age, 56; range, 35-89 years) underwent IVC resection for en bloc tumor excision. Sarcomas were most common (36 [77%]: 30 primary IVC). Eleven patients had primary IVC repair, nine patch repair (two autogenous), and 27 had circumferential replacement with a polytetrafluoroethylene ringed graft. Extensive IVC reconstruction in 18 patients included the entire IVC, with renal (RV) and hepatic vein reimplantation in eight; suprarenal and perirenal in six (seven RVs reimplanted); and infrarenal and perirenal in four (four RVs reimplanted). Nine single-segment IVC replacements were infrarenal. Morbidity was 10.6%: one each with bowel obstruction, chyle leak, renal failure with complete recovery (left RV reimplant, right nephrectomy), reoperation for bleeding, and IVC graft thrombosis. Morbidity did not differ by type of reconstruction. There was no mortality. Follow-up ranged from 1.5 to 216 months (18 years) with a mean of 3.5 years. Computed tomography or duplex scans were available in 28 of 47 patients and in 15 of 27 patients in group 3 at a mean follow-up of 36 and 20 months, respectively. One IVC graft thrombosis was documented at 10 months after chemotherapy/sepsis. Tumor recurrence caused three graft stenoses. Cumulative 5-year patency in group 3 was 80% (imaging) and 92% (clinical). Lower extremity edema was universally avoided. Cumulative 5-year survival for the series was 45% ± 8.5%. Mean long-term survival was 5.8 ± 0.56 years (range, 4 months-17 years), with a significant difference between primary or patch (mean, 6.5 years) and circumferential or extensive repair (mean, 4.2 years; P < .005). Cumulative (47% vs 52%) and mean (3.1 vs 3.6 years; P > .12) survival was similar between patients with single-segment and extensive IVC resection and replacement. CONCLUSIONS:IVC resection and reconstruction for en bloc tumor excision is safe, even when extensive repairs are necessary. Replacement of the IVC with prosthetic graft avoids extremity venous complications and likely contributes to quality of survival. Survival depends on tumor behavior and degree of IVC involvement, where primary and patch repair has a better prognosis than circumferential resection.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Quinones-Baldrich W,Alktaifi A,Eilber F,Eilber Fdoi
10.1016/j.jvs.2011.11.054subject
Has Abstractpub_date
2012-05-01 00:00:00pages
1386-93; discussion 1393issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(11)02686-3journal_volume
55pub_type
杂志文章abstract::We report the fifth case of a graft appendiceal fistula. The four previously reported cases are reviewed. This is the first report of the utility of the tagged red blood cell study in the evaluation of a patient with a graft appendiceal fistula. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0070814
更新日期:1988-06-01 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:PURPOSE:The study objective was to apply laparoscopic techniques to conventional bypass procedures for aortoiliac occlusive disease. METHODS:From October 1995 to August 1997, we performed seven iliofemoral (IFB), five unilateral aortofemoral (UAFB), and 11 aortobifemoral (AFB) bypass procedures and one aortic endarter...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70209-5
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Endovascular aortic aneurysm repairs (EVARs) with fenestrated (FEVAR) stent grafts are high radiation dose cases, yet no skin injuries were found retrospectively in our 61 cases with a mean peak skin dose (PSD) of 6.8 Gy. We hypothesize that skin injury is under-reported. This study examined deterministic ef...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.11.044
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:Thrombolysis as a treatment for acute limb ischemia (ALI) has become a first-line therapy based on studies published over 2 decades ago. The purpose of this study was to assess outcomes of patients treated for ALI using contemporary thrombolytic agents and endovascular techniques. METHODS:Consecutive patient...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.10.054
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Endoscopic ligation of perforating veins is useful in treatment of perforating vein incompetence. Over the last few years the topic of interest has been the medial side of the lower leg; however, laterally located venous ulcers (10% of all) are of equal importance. Our poor results with lateral subfascial en...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)01045-0
更新日期:2003-12-01 00:00:00
abstract:OBJECTIVE:This retrospective study was performed to investigate prolonged postoperative pain in the area of the proximal or distal scar or the bypass tunnel after femoropopliteal bypass surgery to treat symptomatic peripheral arterial disease. PATIENTS AND METHODS:Ninety-three patients with peripheral arterial disease...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.02.003
更新日期:2004-06-01 00:00:00
abstract::Polytetrafluoroethylene interposition grafts were used for carotid reconstruction in 26 operations performed in 23 patients during a 7-year period. There were 10 men and 13 women with a mean age of 66 years. The indication for interposition graft placement was recurrent stenosis with inability to perform endarterectom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.39750
更新日期:1992-10-01 00:00:00
abstract:BACKGROUND:Trends in the management of renovascular hypertension were evaluated by using a representative national database to determine whether a shift in treatment technology and outcomes has occurred. METHODS:Clinical information regarding the treatment of renovascular hypertension in 5433 patients from 1988 to 200...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.07.029
更新日期:2004-10-01 00:00:00
abstract::Until fairly recently, experience with advanced endovascular technologies, including fenestrated endovascular repair (FEVAR), has been limited to a relatively small number of practitioners worldwide. Excellent outcomes have been achieved by these accomplished surgeons who, at least initially, have primarily used custo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.01.001
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Complex forms of congenital venous malformation have defied proper classification and confounded therapy. Through a newly designed multidisciplinary approach, these venous defects were properly diagnosed and classified according to the Hamburg classification. Absolute ethanol was adopted as a new scleroagent...
journal_title:Journal of vascular surgery
pub_type: 评论,杂志文章
doi:10.1067/mva.2001.112209
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVES:Technical proficiency in carotid artery stent (CAS) procedures is paramount to ensure patient safety. If virtual reality (VR) simulation is to be used as a valid means for credentialing physicians for CAS procedures, the assessment parameters must be able to evaluate the performance during CAS and to differe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.06.028
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to develop a protocol for evaluation of patients suspected of having deep venous thrombosis (DVT) who came to the hospital after normal noninvasive vascular laboratory (NIVL) working hours in an attempt to both retain registered vascular therapists and provide excellent patient c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.125021
更新日期:2002-07-01 00:00:00
abstract::Increasing evidence points toward local production of renin and angiotensinogen in the artery wall. Because angiotensin converting enzyme (ACE) inhibitors have been shown to block intimal hyperplasia after arterial injury in the rat, it has been suggested that angiotensin II is an important mediator of the proliferati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-04-01 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:INTRODUCTION:Although all areas of the body are susceptible to radiation injury, different tissues have varying tolerances for radiation exposure. The goal of this summary is to introduce basic concepts of radiation biology and discuss the effects of radiation on various tissues. METHODS:Reference texts and literature...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.175
更新日期:2011-01-01 00:00:00
abstract::The diagnosis-related groups have encouraged physicians to become more efficient in the care of their patients; often, however, raising the question of safety. For 3 years all patients undergoing carotid endarterectomy at our institution were monitored in the intensive care unit for 24 hours and the majority were disc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(92)90056-e
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Spinal cord ischemia is a rare complication after open surgical repair for ruptured abdominal aortic aneurysms (rAAA). The use of emergency endovascular aortic aneurysm repair (eEVAR) is increasing, and paraplegia has been observed in a few patients. The objective of this study was to assess the incidence an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.06.023
更新日期:2005-10-01 00:00:00
abstract::The failure of dialysis access grafts leads to significant morbidity rates in patients with end-stage renal disease. We describe a novel technique for the insertion of new polytetrafluoroethylene graft segments designed to reduce this morbidity rate. Patients found to have significant intragraft deterioration at throm...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2002.122890
更新日期:2002-05-01 00:00:00
abstract:INTRODUCTION:Acute aortic dissection (AAD) is one of the most common aortic emergencies that vascular specialists are asked to manage. Traditional surgical interventions for cases complicated by malperfusion have resulted in significant morbidity and mortality. With increasing availability of thoracic endografts, endov...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.04.025
更新日期:2011-11-01 00:00:00
abstract::A 38-year-old woman with neurofibromatosis type 1 was referred for massive swelling of the left thigh, pain, and anemia. Angiography demonstrated three saccular aneurysms of the femoropopliteal artery. The largest measured 3 cm in diameter. Resection of the aneurysms and femoropopliteal interposition grafting using re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.05.034
更新日期:2007-10-01 00:00:00
abstract::We report seven cases of dissection of the abdominal aorta. Three patients had acute back pain, whereas four patients had more chronic courses. In six cases, as a result of the palpation of a pulsatile abdominal mass, clinical diagnosis was an atheromatous aneurysm. Angiography and CT scanning demonstrated a dissected...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract::A 38-year-old woman, with no comorbidities, presented to an outside institution with a 10-cm aortic arch and descending thoracic aortic aneurysm. After an aborted attempt at hybrid repair, she underwent successful, staged repair with zone 1 thoracic endovascular aortic repair and open aneurysmal sac revision. The pati...
journal_title:Journal of vascular surgery
pub_type:
doi:10.1016/j.jvs.2018.09.038
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:Preoperative testing for carotid endarterectomy (CEA) often includes blood typing and antibody screen (T&S). In our institutional experience, however, transfusion for CEA is rare. We assessed transfusion rate and risk factors in a national clinical database to identify a cohort of patients in whom T&S can saf...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.04.059
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Whereas thermal ablation of incompetent saphenous veins is highly effective, all heat-based ablation techniques require the use of perivenous subfascial tumescent anesthesia, involving multiple needle punctures along the course of the target vein. Preliminary evidence suggests that cyanoacrylate embolization...
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.2014.11.071
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Sarcopenia has been proposed as a prognostic factor for various diseases. Patients with critical limb ischemia (CLI) have a very poor prognosis, but sarcopenia has not been reported as a prognostic factor for CLI patients. If sarcopenia is associated with the prognosis of CLI patients, it could help select t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.10.094
更新日期:2015-04-01 00:00:00
abstract::Arterial tumor embolization is a rare complication of neoplasms. This report describes a 64-year-old female with metastatic melanoma and acute arterial embolization to the left lower extremity. With surgical embolectomy, a clot was retrieved that had an atypical bland solid lead point. Pathologic examination confirmed...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2002.123327
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Remodeling of the aortoiliac anatomy is a challenge to the long-term performance of stent grafts for endovascular aneurysm repair. Changes in vessel diameter and length can result in loss of seal at attachment sites, limb disunion, or kinking, with the development of high-pressure endoleaks, migration, or li...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.09.059
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:We sought to analyze the results of lower limb arterial injury (LLAI) management in a busy metropolitan vascular unit and to identify risk factors associated with limb loss. PATIENTS AND METHODS:Between 1987 and 1997, prospectively collected data on 550 patients with 641 lower limb arterial injuries were analy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2001.113982
更新日期:2001-06-01 00:00:00
abstract::Thrombolysis for the treatment of occluded bypass grafts is used in selected clinical circumstances. Unfortunately, a minority of these procedures are technical failures because of the inability to access the occluded graft. We describe a technique that greatly increases the chances of technical success. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70328-9
更新日期:1999-04-01 00:00:00