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, endovascular interventions for complicated AAD have become more acceptable. We reviewed our experience with endovascular treatment of AAD since January 2005. METHODS:Medical records of patients admitted for AAD from January 1, 2005, to December 31, 2008, were entered into our vascular registry and analyzed for risk factors, extent of dissection, type of management, fate of the false lumen, complications, and survival. There were 249 admissions for aortic dissections during the study period. Our study group included 28 patients with complicated AAD who underwent endovascular intervention. RESULTS:During the study interval, 28 patients (16 male) underwent 44 procedures. The average age was 54 years. Risk factors differed from the typical atherosclerotic patient and were dominated by an 89.3% incidence of hypertension. Five patients (17.9%) presented with a history of recent cocaine use. The average length of stay was 25.1 days (range, 1-196 days). Stanford type B dissections were present in all but one patient. Twenty-six thoracic endografts were placed in 25 patients. Eight patients required multiple procedures in addition to a thoracic endograft. Morbidity occurred in 17 (60.7%) patients, with renal insufficiency occurring in 11 patients (39.3%) and one requiring permanent dialysis. Four neurologic events occurred: three strokes (10.7%) and one patient (3.6%) with temporary paraplegia. Three patients (10.7%) died in the periprocedural period, with ruptured dissection in one and pericardial tamponade in another. Eight of 10 computed tomography scans (80%) available for review in follow-up showed complete thrombosis of the thoracic false lumen. CONCLUSIONS:Complicated AAD remains a challenging problem, with significant morbidity and mortality rates. However, our early experience with endovascular management offers a favorable reduction in mortality from historic controls.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
O'Donnell S,Geotchues A,Beavers F,Akbari C,Lowery R,Elmassry S,Ricotta Jdoi
10.1016/j.jvs.2011.04.025subject
Has Abstractpub_date
2011-11-01 00:00:00pages
1283-9issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(11)00889-5journal_volume
54pub_type
杂志文章abstract::Surgical management of major venous injuries remains controversial. The medical records of 184 patients with major venous injury were reviewed. Forty-three patients had isolated venous injury; 31 of 43 patients (72%) underwent ligation to treat their vein injury. Another 141 patients had combined arterial and venous i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract::This study retrospectively analyzes the nature of postoperative thrombotic complications in patients with the lupus anticoagulant. Tests in 84 patients were positive for the presence of antiphospholipid antibodies by an abnormal rabbit brain neutralization procedure, positive for the presence of anticardiolipin antibo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0070749
更新日期:1988-06-01 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::Compartment syndrome of the leg is a well-recognized complication known to follow urgent revascularization done for acute limb ischemia, but compartment syndrome of the foot has not been reported after the ischemia-reperfusion sequence. Herein we report a case of foot fasciotomy done for compartment syndrome that occu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.01.043
更新日期:2016-03-01 00:00:00
abstract::We previously described a para-anastomotic hypercompliant zone (PHZ), located 3 to 4 mm from end-to-end continuous anastomoses in canine femoral arteries, in which arterial compliance first increases approximately 50% above adjacent reference values before falling to a minimum at the anastomosis. To determine if PHZ i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030591
更新日期:1986-04-01 00:00:00
abstract:PURPOSE:Neointimal hyperplasia is a leading cause of restenosis after vascular procedures. Recent findings showed that smooth muscle cell (SMC) migration from the media into the neointima is a critical step in the development of the hemodynamically compromising neointimal lesion. Moreover, integrins are believed to pla...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70127-x
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:The Hardman index, which has five variables, has been recommended as a predictor of outcome after open repair of ruptured abdominal aortic aneurysms (RAAAs). It has been reported that the presence of three or more variables is uniformly fatal. The aim of this study was to test the same model in an independen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.065
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:Owing to the lack of comparative evidence between the endovascular technologies for arteriovenous fistula (AVF) stenosis treatments, we sought to summarize the reported data comparing the effectiveness of different endovascular approaches for the treatment of AVF stenoses at the juxta-anastomotic site. METHO...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.jvs.2019.07.075
更新日期:2020-03-01 00:00:00
abstract::Recurrent carotid stenosis occurs randomly in approximately 10% of patients undergoing endarterectomy. Previous studies have described several histologic features but have failed to clearly elucidate the pathogenesis of this disorder. To improve our understanding of this disease, we reviewed pathologic lesions from 20...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050280
更新日期:1987-02-01 00:00:00
abstract:PURPOSE:Although routine noninvasive surveillance is recommended after carotid endarterectomy (CEA), there are little data to show that identification and eradication of recurrent carotid artery stenosis are necessary to avoid the risk of subsequent neurologic complications. METHODS:We reviewed our experience over a 1...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVE:Percutaneous intervention for symptomatic renal artery atherosclerosis is rapidly replacing surgery in many centers. This study evaluated the anatomic and functional outcomes of endovascular therapy for atherosclerotic renal artery stenosis on a combined vascular surgery and interventional radiology service a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2003.09.024
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:We investigated the intraobserver and interobserver variability of using semiautomatic finite element analysis to calculate the von Mises stress and peak wall rupture risk (PWRR) in patients with an abdominal aortic aneurysm (AAA) in longitudinal studies. METHODS:Four independent observers made 3-dimensional...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.012
更新日期:2012-02-01 00:00:00
abstract::In an attempt to assess the efficacy of thrombolytic infusions for arterial ischemia, a questionnaire was distributed to 142 vascular surgeons. Data from 45 respondents who had experience with thrombolytic infusion in 623 patients were reviewed. A successful outcome was obtained in 313 of 623 patients (50.2%). Morbidi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060045
更新日期:1987-07-01 00:00:00
abstract:BACKGROUND:Endovascular aneurysm repair (EVAR) is an accepted approach for patients presenting with ruptured abdominal aortic aneurysm (rAAA) and suitable anatomy. The effect of anesthesia modality on mortality outcomes in rAAA has not been well described. Using the Vascular Quality Initiative database, this study comp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.090
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:The aim of this study is to determine whether adenoviral inducible nitric oxide synthase (iNOS) gene transfer could inhibit intimal hyperplasia (IH) in porcine internal jugular veins interposed into the carotid artery circulation. METHODS:Porcine internal jugular veins were transduced passively with 1 x 10(1...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.113983
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:Open surgical repair (OSR) for chronic type B aortic dissection (CTBAD) has an associated morbidity and mortality. The role of thoracic endovascular aortic repair (TEVAR) in CTBAD has not been determined. We analyzed our contemporary experience of CTBAD undergoing OSR to identify high-risk patients who may be...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.11.002
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:Thoracic endovascular aortic repair (TEVAR) is the preferred operative treatment of blunt thoracic aortic injuries (BTAIs). Its use is associated with improved outcomes compared with open surgical repair and nonoperative management. However, the optimal time from injury to repair is unknown and remains a subj...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.05.079
更新日期:2020-07-15 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:OBJECTIVE:The objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.043
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:Determining operative risk in patients undergoing aortic surgery is a difficult process, as multiple variables converge to affect overall mortality. Patient frailty is certainly a contributing factor, but is difficult to measure, with surgeons often relying on subjective or intuitive influences. We sought to...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.111
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:Many authors report inferior patency rates of distal arteriovenous fistulas in elderly patients and others present contradictory results. A meta-analysis of available evidence was performed to assess (1) whether non-elderly adults have the same risk of forearm arteriovenous fistula failure as elderly patient...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2006.10.035
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Abdominal aortic aneurysms (AAAs) are associated with generalized arterial dilation, torturosity, and altered matrix composition, which suggests a generalized systemic weakness throughout the entire vasculature. The aim of this study was to determine whether this phenomenon was present in the venous tissue of...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.122877
更新日期:2002-05-01 00:00:00
abstract::Distal internal carotid artery exposure can be technically demanding even for experienced vascular surgeons. Although a variety of techniques have been described to facilitate such exposure, temporary mandibular subluxation has emerged as the simplest and least debilitating approach. Current techniques for maintaining...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:It has been previously shown that the SCD Response Compression System, by sensing the postcompression refill time of the lower limbs, delivers more compression cycles over time, resulting in as much as a 76% increase in the total volume of blood expelled per hour. Extended indications for pneumatic compressio...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jvs.2005.03.031
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease is a significant problem worldwide. In developing countries such as India, the increased incidence of smoking and other forms of nicotine intake has resulted in a large proportion of young individuals with Buerger's disease. The results of surgical and endovascular treatment for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.09.005
更新日期:2008-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the midline retroperitoneal approach with the midline transperitoneal approach for abdominal aortic aneurysm (AAA) repair with respect to operative details, gastrointestinal complications, and wound complications. METHODS:From January 1990 through January 1998, 128 pati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mva.2000.106946
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To define diameter at three levels along the popliteal artery and its relation to the inflow arteries in the normal state and in popliteal aneurysms. METHODS:The external diameter of the arteries was determined by duplex ultrasound scanning at the common femoral (CFA), superficial femoral artery (SFA), proxi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.11.026
更新日期:2006-03-01 00:00:00
abstract::We report a patient with a transient ischemic attack presumably caused by an entrapment of the internal carotid artery by the hyoid bone and without a significant carotid artery stenosis. The patient was operated on, with a release of the right internal and external carotid artery and resection of the right greater co...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.04.062
更新日期:2008-10-01 00:00:00
abstract:PURPOSE:The major cause of vascular prosthesis failure is anastomotic intimal hyperplasia caused by the proliferation and migration of smooth muscle cells. Hepatocyte growth factor (HGF) is an endothelium-specific growth factor that exerts a mitogenic action on endothelial cells. This study was designed to examine the ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119747
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:The study was conducted to demonstrate improved survival (30-day mortality) after the introduction of an emergency endovascular therapy protocol for ruptured abdominal aortic aneurysms (rAAA). Numerous authors have successfully demonstrated reduced mortality in patients with rAAA using endovascular technique...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.11.047
更新日期:2007-03-01 00:00:00