Abstract:
BACKGROUND:Percutaneous endovascular aortic repairs (pEVARs) are associated with access site complications. Two-device technique using 2 Perclose devices has been well established. Combined Perclose and Angioseal technique has been described as well. We sought to determine whether a hybrid Perclose and Angioseal closure technique would safely and effectively establish hemostasis in large-bore arteriotomies up to 20F. METHODS:Patients were identified as candidates for percutaneous access based on preoperative computed tomography findings, perioperative ultrasound of femoral vessels, or a combination of the 2 modalities. Prior to sheath insertion, 1 Perclose device was predeployed. At the end of pEVAR, device sheath and introducer were withdrawn over a 0.035″ wire, and partially deployed Perclose was fully deployed. The sheath and introducer were fully withdrawn and the arteriotomy was closed with a 6F Angioseal vascular closure device and completion deployment of the Perclose. Patients were followed at day 1 and day 30 and at least 1 year postintervention. RESULTS:A composite end point of complications was defined as an access site-related bleed or hematoma that required blood transfusion or an extended hospital stay, pseudoaneurysm, arteriovenous fistula, dissection, or retroperitoneal hematoma. The combined technique was initially successful in 44/45 arteriotomies (97.8%) in 24/25 patients (96.0%) with no conversions to cutdown. Sheath sizes ranged from 10F to 20F outer diameter (OD), with an average of 15.89F OD. The single-device failure was caused by a failure of the footplate to catch during deployment in the Angioseal with a 20F arteriotomy. Consequently, that was the only patient in which this closure was attempted for an arteriotomy larger than 19F. There were no early or late complications in this series. CONCLUSIONS:Large-bore arteriotomies may be safely and effectively closed using a hybrid percutaneous closure technique for sheaths up to 19F OD. Evaluation of this technique in closure of large-bore arteriotomies is ongoing and further investigation is needed to assess the value of this closure in 20F OD sheaths and above.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
McCarthy CK,Maqbool F,Gierman JLdoi
10.1016/j.avsg.2019.06.008subject
Has Abstractpub_date
2020-01-01 00:00:00pages
191-194eissn
0890-5096issn
1615-5947pii
S0890-5096(19)30583-7journal_volume
62pub_type
杂志文章abstract:BACKGROUNDS:Primary aortoenteric fistula (PAEF) is a lethal cause of gastrointestinal bleeding. They mainly originate from eroding abdominal aortic aneurysms into the intestinal wall. Other known causes involve malignancies, infection, corpora aliena, or radiation therapy. Traditional treatment consists of resection of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2015.11.033
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Endovenous ablation of great (GSV) and short saphenous vein (SSV) reflux has become the initial procedure for most patients with symptomatic venous insufficiency, and perforator ablation is increasingly used to assist in healing venous ulceration. Many patients have comorbid conditions, which require long-te...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.10.019
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Cerebral hyperperfusion syndrome or hemodynamic instability, caused by the hemodynamic changes, often occur within 6 hr after carotid artery stenting (CAS) The postprocedure cerebral hemodynamic change in the early phase, <6 hr after CAS, is largely unknown. In this study, we evaluated the cerebral hemodynam...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.124
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Aortic sac hygroma and concealed endoleaks (EL) after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm needs particular attention with aggressive management as they are associated with rapid sac expansion and rupture risk. However, they can be erroneously reported as type IV or V EL with supi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.11.039
更新日期:2020-12-29 00:00:00
abstract::Arterial aneurysm formation occurs in 15 to 20% of patients with Takayasu's disease. The timing of surgical intervention of these aneurysms is controversial. A case of ectasia of the descending thoracic aorta in a patient with Takayasu's disease is presented. The diagnosis and timing of surgical intervention of aneury...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02133055
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:Hereditary hemorrhagic telangiectasia (HHT) is a rare disease consistent in vascular dysplasias affecting different organs. Liver involvement includes telangiectases, arteriovenous shunting, and ischemic cholangitis, and its prevalence ranges from 8% to 31%. Spontaneous pseudoaneurysms have never been report...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.12.022
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:In this study we analyzed embolization and stent-graft results. METHODS:Demographics, indications, procedures, and outcomes of patients treated with embolization or stent grafting for late postoperative bleeding after major abdominal surgery were retrospectively recorded. Outcomes were analyzed on an intent...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.10.024
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Neuromuscular electrical stimulator (NMES) devices increase blood flow to the lower limb by a process of intermittent muscular contraction initiated by a transdermal stimulus to the common peroneal nerve. However, its effects on localized microvascular blood supply to lower limb wounds are unknown. This stud...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.07.030
更新日期:2020-08-05 00:00:00
abstract:BACKGROUND:Increasing evidence supports that urgent carotid endarterectomy (CEA), defined as CEA during the index hospitalization, may be undertaken in select patients with acute carotid-related neurologic symptoms to prevent recurrent ischemic events. We aimed to determine the effect of a stroke/vascular neurology ser...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.10.002
更新日期:2014-07-01 00:00:00
abstract::From 1981 to 1995 a total of 14 patients with a mean age of 52 years (range: 23-71) underwent surgery for 15 aneurysms of the extracranial internal carotid artery. Fusiform aneurysms of the carotid bifurcation were not included in this study. Aneurysm led to brain ischemia in 10 cases and rupture in one case. In the r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900079
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Postmenopausal women taking hormone replacement therapy (HRT) require secondary intervention after vascular reconstruction more frequently than women not taking HRT, often due to increased development of intimal hyperplasia (IH). Matrix metalloproteinases (MMPs) play a role in IH by degradation and remodelin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.010
更新日期:2013-04-01 00:00:00
abstract::Existing animal models do not replicate all aspects of abdominal aortic aneurysms (AAAs), including the rupture mechanisms. From histopathological analyses conducted in humans, it has been found that the vasa vasorum of the AAA wall is the starting point of circulatory failure and that bulging and dilatation of the ab...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2019.08.082
更新日期:2020-02-01 00:00:00
abstract::Accurate patient selection based on preoperative imaging is imperative to good risk reduction in patients undergoing carotid endarterectomy (CEA). The goal of this study was to assess the accuracy of gadolinium-enhanced magnetic resonance angiography (GE MRA) versus time-of-flight (TOF) MRA in the work-up of patients ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-005-7974-2
更新日期:2005-11-01 00:00:00
abstract::Beginning in April 1989, we have performed eight upper thoracic chemical sympathectomies by transthoracic endoscopy. The indications were occlusive arterial disease in four patients and Raynaud's syndrome and palmar hyperhidrosis in two patients each. Transthoracic endoscopy was performed under general anesthesia, thr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02008799
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:Risk factors for early catheter-directed intra-arterial thrombolysis failure in acute lower limb ischemia remain unclear. METHODS:One hundred forty-nine limbs with acute artery or bypass graft thrombosis underwent catheter-directed thrombolysis (maximum of 48 hours). A retrospective data analysis was carrie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.11.016
更新日期:2014-01-01 00:00:00
abstract::Melioidosis abdominal aortic aneurysm and splenic abscesses lead to poor prognosis and high mortality rate as high as 50% due to delayed/missed diagnosis. We describe an attempt to identify Burkholderia pseudomallei immediately, which was confirmed by polymerase chain reaction (PCR) and gene sequence analysis of 23S r...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.04.035
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:MicroRNAs (miRNAs or miRs) have been highlighted to be involved in abdominal aortic aneurysm (AAA) with the emergence of recent miRNA microarray profiling studies. miR-516a-5p has been shown to be significantly overexpressed in vascular smooth muscle cells (VSMCs) from human AAA tissues from our previous mic...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.10.062
更新日期:2017-07-01 00:00:00
abstract::The decision-making involved in managing type 2 aortic dissections remains challenging despite the advances in endovascular technology. We report a challenging case of a patient presenting with a type 2 aortic dissection and false lumen extension into an infrarenal abdominal aortic aneurysm (AAA). Severe back pain and...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.10.035
更新日期:2013-11-01 00:00:00
abstract::Patients with tumors in limbs who undergo surgical treatment may present involvement of major vessels. The artery must be reconstructed for limb salvage and the vein may be reconstructed to avoid the onset of venous hypertension. The objective of this study was to analyze the results from surgical treatment of tumors ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-003-0031-0
更新日期:2003-07-01 00:00:00
abstract::Septic thrombophlebitis is a rare diagnosis in this era of widespread antibiotic usage. The clinical diagnosis requires astute clinical suspicion and evaluation. We describe an asplenic 63-year-old woman who presented to the emergency department with a 24-hour history of a tender, swollen, right neck and upper chest w...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.03.011
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to explore the impact of surgeon characteristics (including annual volume, specialty, and years in practice) on outcomes of carotid endarterectomy (CEA) for asymptomatic carotid atherosclerosis in New York State. METHODS:The New York Statewide Planning and Cooperation System dat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.05.015
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Gender-related differences in iliofemoral anatomy are critically important for delivery of modern EVAR devices, however remains poorly characterized in the context of other patient-specific factors. The goal of the present study was to provide a detailed quantification of anatomic differences in iliofemoral ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.01.025
更新日期:2017-10-01 00:00:00
abstract::Blunt injuries of the great vessels arising from the aortic arch are usually fatal. The innominate artery lesions represent the most common site of injury after the aortic isthmus distal to the left subclavian artery. Injuries are usually located at the origin of the vessel from the aortic arch, especially in patients...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.10.047
更新日期:2020-04-01 00:00:00
abstract::Pseudoaneurysm (PA) formation after carotid endarterectomy (CEA) is a very uncommon but dangerous complication, potentially responsible for cerebral embolism or rupture. Therefore, the PA treatment is imperative. Until few years ago, the treatment of choice was represented by open surgical repair, with a higher mortal...
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:BACKGROUND:To preliminary report on epidemiology, risk factors, diagnosis, treatments, and outcomes in a multicenter series of patients treated for endovascular aortic repair (EVAR) infection and detected by an Italian National enquiry. METHODS:From June 2012, 26 cases of abdominal aortic endograft infection were coll...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.07.017
更新日期:2016-01-01 00:00:00
abstract::Pseudoaneurysms of the lingual artery are extremely rare and are commonly iatrogenic in nature or less frequently a result of blunt or penetrating trauma. Traditionally, these vascular abnormalities have been repaired with open or endovascular techniques. Although ultrasound-guided percutaneous thrombin injection has ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.10.013
更新日期:2014-07-01 00:00:00
abstract::Intraluminal aortic malignant masses are extremely rare. Clinical symptoms of these tumors include locally occlusive aortic disease, peripheral emboli, or mesenteric emboli. Eventually, general symptoms, such as fatigue, weight loss, or fever, will occur. Nevertheless, the diagnosis is most often made after surgery or...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.12.014
更新日期:2014-02-01 00:00:00
abstract::We report a rare case of primary aortoduodenal fistula (ADF) secondary to a Coxiella burnetii (Q fever) infection in a patient with an abdominal aortic aneurysm. A review of the available literature on the vascular complications of Q fever is presented. Q fever should be suspected in vascular patients with close anima...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910046
更新日期:2000-05-01 00:00:00
abstract::Infections involving the aorta are associated with high rates of morbidity and mortality, and their management is complex. Saturating Dacron grafts in rifampin (60 mg/mL) inhibits the growth of organisms commonly found to be involved in both primary aortic infections and aortoenteric fistulas. Open repair and replacem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.10.006
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Carotid endarterectomy (CEA) is the gold standard for treatment of carotid artery stenosis. CEA can be challenging, even technically impossible. Prosthetic carotid bypass grafting is a proven and safe alternative when CEA is hazardous. An alternative technique that is prosthetic carotid bifurcation resection...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.05.025
更新日期:2015-11-01 00:00:00