Abstract:
:The use of autologous femoral veins for in situ reconstruction of the aortoiliac segment is an effective technique to treat native aorta or prosthetic graft infections. The indications, technical details, and outcomes of this procedure are detailed. Graft infection involving the aortic segment, while rare, remains one of the most challenging vascular surgery conditions to treat. The original technique of "neo-aortoiliac surgery" with in situ autologous vein grafts has evolved over the past 25 years and remains a worthwhile alternative for the treatment of aortic graft infections, with lower mortality rates compared with other extra-anatomic or in situ surgical options. Acceptance of this surgical option is due to low graft re-infection rates, rare graft disruption, and low long-term aneurysmal degeneration. Excision of the femoral veins is associated with acceptable rates of lower limb edema. The use of an autologous femoral vein graft can be considered the standard of care in selected patients for the management of aortic graft infections. Optimal management of patients with aortic graft infections requires consideration of all potential therapeutic options because no single modality can be used, and individualizing treatment according to the clinical condition will yield the best patient outcomes.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Savlania A,Tripathi RKdoi
10.1053/j.semvascsurg.2019.07.002subject
Has Abstractpub_date
2019-01-01 00:00:00pages
73-80issue
1-2eissn
0895-7967issn
1558-4518pii
S0895-7967(19)30044-4journal_volume
32pub_type
杂志文章,评审abstract::Popliteal artery aneurysms are the most common peripheral aneurysm. They are associated with concomitant contralateral popliteal aneurysms and abdominal aortic aneurysms. Patients with unrecognized aneurysms may present with acute limb ischemia and potential for limb loss. Use of preoperative lytic therapy to improve ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2005.09.009
更新日期:2005-12-01 00:00:00
abstract::Endovascular aneurysm repair has proven to be a valuable alternative to open repair in selected patients. This less invasive procedure, however, requires long-term surveillance for its own set of potential complications, including perigraft leakage, or endoleak. This article focuses on the detection of these leaks, fi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2004.09.003
更新日期:2004-12-01 00:00:00
abstract::The management of patients with thrombosed vein grafts remains a formidable challenge for all vascular surgeons. Management strategies will vary based on a variety of criteria including the patients' overall condition and symptoms, the interval and etiology of graft failure, and the pathological anatomy and availabili...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1994-09-01 00:00:00
abstract::Chronic venous disease includes a spectrum of clinical presentations ranging from varicose veins through chronic lower extremity pain and edema to venous skin changes and ulceration. Such manifestations may result from primary venous insufficiency or be secondary to other disorders, primarily acute deep venous thrombo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract::The training of vascular surgeons in Canada has evolved over the past decade. Direct entry into a vascular surgery training program after medical school has been offered since 2012. At some institutions, it is the only option for surgery training. The smaller population of Canada and a single-payer health care system ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2019.01.009
更新日期:2019-01-01 00:00:00
abstract::Several techniques have been developed and clinically applied to reduce the spinal cord ischemia complications that follow thoracoabdominal aortic aneurysm (TAA) repair. Hypothermia as a protective adjunct is a concept that has been used throughout the evolution of cardiac and central aortic surgery. Because experimen...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2000-12-01 00:00:00
abstract::Thrombembolic complications frequently occur during and after endovascular procedures because of associated arterial injury and thrombotic characteristics of implanted devices such as stents. New strategies in platelet aggregation inhibition are now available blocking the final and common pathway of platelet aggregati...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.23171
更新日期:2001-06-01 00:00:00
abstract:UNLABELLED:A variety of intraoperative imaging and assessment techniques can be used during carotid endarterectomy (CEA) to evaluate the technical results of the arterial repair. However, the necessity of utilizing these techniques routinely in every case, and the actual ability of these studies to improve the outcomes...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.10.003
更新日期:2007-12-01 00:00:00
abstract::The first commercially available stent grafts were unable to withstand the hemodynamic forces of the vascular environment. The past 15 years have seen a gradual improvement in long-term stent graft performance as designs evolved through the elimination of features associated with late failure and the replication of fe...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2009.04.008
更新日期:2009-06-01 00:00:00
abstract::In recent years, vascular surgery fellowships have changed substantially to meet the requirements for interventional as well as open surgical training. Data from the Residency Review Committee for Surgery indicate that the average vascular fellow performed fewer than 15 interventional procedures in 2000, but that this...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2006.08.005
更新日期:2006-12-01 00:00:00
abstract::The controversies that surround the technical aspects of transabdominal reconstruction for aortoiliac occlusive disease, and more specifically ABF, have provided lively debates during the golden era of vascular surgery. It seems almost a pity that, with the resolution of many of these issues, what has become one of th...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1994-03-01 00:00:00
abstract::While carotid angioplasty and stenting has been clearly established as a minimally invasive alternative to endarterectomy for patients with carotid occlusive disease, its indications continue to evolve, being refined as more controlled data of large studies are being accumulated. The purpose of this article is to revi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.03.003
更新日期:2008-06-01 00:00:00
abstract::In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (ap...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2017.04.011
更新日期:2017-03-01 00:00:00
abstract::Given both the high-risk nature of the critical limb ischemia (CLI) patient population, as well as the variety of available treatment options, the ability to use preprocedure variables to predict a given outcome has become increasingly important. The three main advantages associated with accurate risk stratification i...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2009.10.002
更新日期:2009-12-01 00:00:00
abstract::In vascular surgery, the gold standard for evaluation of the lower-extremity arterial tree has long been contrast arteriography (CA). Associated risks of CA are well-documented and include severe allergic reactions, arterial injury and/or hemorrhage, and contrast-induced nephropathy. Increasingly, less-invasive techni...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.02.005
更新日期:2007-03-01 00:00:00
abstract::Endovascular aneurysm repair has enabled a broad population of patients with infrarenal abdominal aortic aneurysm to be treated by a less-invasive technique. However, endovascular aneurysm repair has therapeutic limitations, including the need for lifelong surveillance and a higher rate of secondary interventions than...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2016.06.004
更新日期:2016-03-01 00:00:00
abstract::For generations, the use of techniques to defer skin pressure and protect the lower-extremity wound has been a cardinal goal to achieve therapeutic success and healing. Choosing the appropriate postoperative offloading device or shoe is often difficult, as it is challenging to merge optimal mechanical protection with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.10.002
更新日期:2014-03-01 00:00:00
abstract::The vascular surgeon, in the absence of effective medical options for the treatment of atherosclerosis, has in the past assumed primary responsibility for the care of patients with peripheral vascular disorders. During the past two decades, management of these patients has become increasingly complex, the direct resul...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1997-06-01 00:00:00
abstract::Although numerically far less than claudicants, patients with critical leg ischemia (CLI) demand a disproportionately large commitment both in medical effort and economically and represent the major workload for vascular surgical units. The incidence and prevalence of CLI is approximately 500 to 1,000/million/year. Th...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1999-06-01 00:00:00
abstract::The relative merits of aortomonoiliac and bifurcated stent-graft configurations depend on the patient's arterial anatomy and clinical status. Aortomonoiliac stent-grafts are simple to make, simple to insert, and versatile. They are most useful when the iliac artery anatomy is severely distorted and the patient is old,...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::Prophylaxis for venous thromboembolism is an area that has received intense study in certain conditions, but less than adequate coverage in other areas. In considering who needs prophylaxis, patients are categorized into levels of risk. Clinical venous thromboembolism can be correlated to these levels of risk. Methods...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2000-09-01 00:00:00
abstract::Because endovascular procedures represent an ever-increasing portion of many vascular surgery practices, many surgeons are faced with difficult choices. Endovascular procedures often require open surgery, and open surgical techniques increasingly require fluoroscopic imaging. Without good intraoperative imaging, endov...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2018.03.002
更新日期:2018-03-01 00:00:00
abstract::Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2010.05.001
更新日期:2010-09-01 00:00:00
abstract::Aortic infection is an uncommon but life-threatening condition. Conservative medical treatment is insufficient in many cases because of the high risk of persistent infection, aortic rupture, and death. Conventional open surgical treatment consists of extensive tissue debridement, complete removal of the infected prost...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.10.009
更新日期:2011-12-01 00:00:00
abstract::Over the last decade, more than 25,000 endovascular stent grafts have been used to treat aortic aneurysms. Although results have been promising thus far, problems with endoleaks, material failure, device migration, and aneurysm rupture continue to be reported. Improvements in device material and design have contribute...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0895-7967(03)00006-1
更新日期:2003-06-01 00:00:00
abstract::The main focus when discussing acute or chronic mesenteric ischemia is on occlusive disease, arterial or venous. This article reviews present knowledge on mesenteric nonocclusive hypoperfusion syndromes. The following three clinical entities are reviewed: (1) Intraabdominal hypertension (IAH), or abdominal compartment...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2009.12.009
更新日期:2010-03-01 00:00:00
abstract::The evolution of vascular surgery during the past five decades has established what was once controversial to be mandate, what was never dreamed of as debatable, and the vast body of knowledge yet to be unraveled--but requiring clinical application--as currently controversial. Controversy results when dissimilar thera...
journal_title:Seminars in vascular surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1999-03-01 00:00:00
abstract::Ultrasound-guided sclerotherapy with foam is able to suppress blood flow in almost all types of varicose veins. The technique is efficient, simple, safe, inexpensive, and easily repeatable, although it requires training and skill. It should be considered as the best primary treatment for most varicose patients. Evalua...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2004.12.008
更新日期:2005-03-01 00:00:00
abstract::The etiology of foot lesions in diabetics is multifactorial. Arterial insufficiency, neuropathy, and susceptibility to infection are major factors contributing to the formation of nonhealing diabetic foot lesions. These factors lead to a 15% ulceration rate in diabetics with 20% resulting in amputation. This amputatio...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2012.04.001
更新日期:2012-06-01 00:00:00