Abstract:
OBJECTIVE:Endovascular therapy for chronic mesenteric ischemia (CMI) has been increasingly utilized. Early outcomes compare favorably with open mesenteric bypass--the current gold standard. The goal of this study is documentation of intermediate-term anatomic and functional outcomes of endovascular mesenteric revascularization for symptomatic CMI. METHODS:This is a retrospective review of all patients undergoing endovascular treatment of symptomatic CMI from July 2002 to March 2008. Study endpoints included periprocedural mortality, major morbidity, patency, symptomatic recurrence, and survival. Endpoints were analyzed using actuarial methods. RESULTS:Sixty-six mesenteric arteries (78.8% stenotic/21.2% occluded) were treated in 49 patients. One or more vessels were treated in each case; however, four mesenteric artery total occlusions (3 SMAs/1 IMA) could not be crossed. Initial symptom relief was noted in 89.8% (n = 44) with no change in 5 patients. Single-vessel treatments were performed in 32 patients (65.3%) and two-vessel interventions in 17 (34.7%). The 30-day mortality rate was 2.0% (n = 1). Major complications occurred in 8 patients (16.3%). The mean follow-up duration was 37.4 +/- 2.98 months (range, 0-66). Restenosis on follow-up imaging occurred in 64.9% (n = 24) of the 37 patients who had radiographic surveillance at a mean follow-up interval of 8.5 +/- 1.9 months and was diagnosed most often by Duplex scan or computed tomographic angiography (CTA). Fourteen patients (28.6%) developed recurrent symptoms with 13 requiring a reintervention. Actuarial 36-month freedom from symptomatic recurrence was 60.9% +/- 9.4%. Two-vessel treatment was protective against symptom recurrence (P = .0014) and reintervention (P = .0060) by univariate analysis. A total of 19 reinterventions were required in 14 patients (28.6%) at a mean of 17 months from the original treatment. Primary patency at 36 months was 63.9 +/- 8.5%. Actuarial survival at 48 months was 81.1% +/- 6.1% with no CMI-related deaths in the study cohort. CONCLUSION:Intermediate (3-year) follow-up indicates that significant restenosis and symptom recurrence are common following the endovascular treatment of symptomatic CMI. Thirty percent of the cohort required a reintervention, one-third of which were conversions to surgical reconstruction. Similar to the surgical paradigm of two-vessel revascularization, endovascular treatment of multiple mesenteric arteries produced better outcomes. A first-line endovascular approach to patients with CMI is a reasonable clinical strategy, but close follow-up is mandatory.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Peck MA,Conrad MF,Kwolek CJ,LaMuraglia GM,Paruchuri V,Cambria RPdoi
10.1016/j.jvs.2009.06.064subject
Has Abstractpub_date
2010-01-01 00:00:00pages
140-7.e1-2issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(09)01611-5journal_volume
51pub_type
杂志文章abstract:PURPOSE:We set out to assess the new Aberdeen Varicose Veins Questionnaire (Aberdeen Questionnaire) for the properties necessary for a valid measure of health outcome, to determine quality of life of patients with varicose veins, and to determine the effect of surgery on quality of life. METHODS:A prospective consecut...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70110-2
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Vascular smooth muscle cell (SMC) migration is an important component of the development of intimal hyperplasia. Sphingosine-1-phosphate (S-1-P) is a lipid released from activated platelets with numerous cellular effects including the stimulation of SMC migration in vitro. We examined the role of the mammali...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.058
更新日期:2005-01-01 00:00:00
abstract::In a series of six patients, a single-bar anterior external fixator was used to treat combined vascular and orthopedic injuries of the leg. This method of external fixation facilitated operative vascular exposure without sacrificing bony stability or alignment. It may be the preferred method of external fixation for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::We herein present a case of primary malignant lymphoma of the saphenous vein. A 72-year-old man suffered from tumor and pain of the anteromedial aspect of the left upper thigh. Local thigh ultrasound scanning and computed tomography revealed a mass within the superior third of the internal saphenous vein. The patient ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119753
更新日期:2002-01-01 00:00:00
abstract::We reviewed the results, systemic effects, and complications associated with the selective infusion of low-dose streptokinase in 151 patients. Successful thrombus lysis was achieved in 78% of atherosclerotic thrombotic occlusions less than 30 days old, in 81% of post-procedural occlusions less than 14 days old, and in...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020406
更新日期:1985-05-01 00:00:00
abstract:PURPOSE:We evaluated the effects of wearing 20 to 30 mm Hg gradient thigh-length stockings during daily activity on the lower leg venous system. METHODS:Twenty-one healthy women volunteers, aged 39 +/- 12 years, were examined. One subject was clinical class 4, one was class 2, two were class 1, and the remainder were ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70007-8
更新日期:1999-11-01 00:00:00
abstract::Chronic aortic dissection is one of the most challenging pathologies faced by aortic surgeons. The variety of presentations and the multiple comorbidities of the patients make treatment and follow-up a subject of much debate. Historical data is difficult to interpret because of the heterogeneity of the included popula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2016.01.025
更新日期:2016-05-01 00:00:00
abstract::A variety of complications secondary to thromboembolectomy with balloon catheters have been described. The present report describes an unusual and previously unreported complication following retrograde thrombectomy of an occluded limb of an aortofemoral graft. The variety of arterial injuries and technical misadventu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Type IIIB endoleak from material failure can lead to aneurysmal sac enlargement and latent rupture after endovascular repair of abdominal aortic aneurysm. Long-term durability of the endovascular stent graft is largely unknown, and the complication rate from device failure due to material fatigue may be unde...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2019.06.183
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:The aim of this systematic review is to describe the literature and assessment tools evaluating vascular surgical operative performance that could potentially be used for the assessment of educational outcomes applicable to the Milestone Project and the Next Accreditation System. METHODS:A systematic review ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2014.02.018
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To evaluate early and mid-term results of endovascular repair of acute type B aortic dissection by stent graft. METHODS:From June 2001 to May 2005, 63 patients with acute type B aortic dissection underwent stent graft implantation. The study included 59 men and 4 women with an average age of 50.4 +/- 11.4 ye...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.12.070
更新日期:2006-06-01 00:00:00
abstract::This is a case report of a 68-year-old woman in whom a late and previously unreported complication developed that resulted from penetration of an aortic aneurysm by the prong of a stainless steel Greenfield filter. This complication came into view 7 years after placement of the filter, at the time of aneurysm resectio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.44346
更新日期:1993-08-01 00:00:00
abstract::Two elderly men were referred to our vascular clinic for the management of bilateral lower extremity edema of 2 to 3 months' duration. Their evaluation included phlebograms, which demonstrated external compression of their iliac veins. CT scans of the pelvis suggested that large bladders caused the compression. Each p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0070778
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:Promising results of thoracic endovascular aortic repair (TEVAR) in patients with complicated type B aortic dissection (TBAD) have been well documented. However, whereas early results have led many to hypothesize a benefit of TEVAR in uncomplicated patients, the natural history of TEVAR after the treatment o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2017.06.067
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:We investigated the factors determining postexercise pressure and the relationship of venous valve closure and venous column segmentation to ambulatory venous pressure changes. METHODS:Valve closure and venous segmentation were observed during dynamic ascending phlebography in 40 nonrefluxive limbs and by dupl...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
abstract::Patients with carotid body tumors referred to vascular surgeons usually undergo magnetic resonance imaging (MRI) as part of the workup. We present a case report of a 39-year-old woman with a presumed carotid body tumor, as was expected from clinical and MRI findings. At surgery, the ectopic thyroid tissue was suspecte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2003.07.018
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the early efficacy of endovascular aortouniiliac stent grafts with femorofemoral bypass graft in the treatment of aortoiliac aneurysmal disease. METHODS:We analyzed 51 consecutive patients from January 1997 to March 1999 with a mean follow-up of 15.8 months. Patient...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.107120
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:All humans have natural, protective antibodies directed against phosphorylcholine (PC) epitopes, a common inflammatory danger signal appearing at sites of cell injury, oxidative stress, and on bacterial capsules. In large human cohorts, low levels of anti-PC IgM were associated with a significantly increased...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.04.042
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The technique of balloon angioplasty of infrainguinal arteries requires standard arteriography and fluoroscopic guidance. We attempted to perform this procedure under duplex guidance to avoid the use of nephrotoxic contrast material and radiation exposure in patients with renal insufficiency. METHODS:Over 1...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.024
更新日期:2005-12-01 00:00:00
abstract:PURPOSE:To evaluate the efficacy of intravascular stents used to treat long-segment stenoses and occlusions of the superficial femoral artery (SFA) after suboptimal angioplasty. METHODS:Fifty-eight limbs in 55 patients who underwent stenting of the SFA were identified from a vascular registry. Indications for stent pl...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:The two techniques for carotid endarterectomy (CEA)--conventional (C-CEA) and eversion (E-CEA)--have different effects on blood pressure. This study compared sympathetic activity after C-CEA and E-CEA, as measured by renin and catecholamine levels. METHODS:E-CEA (n = 40) and C-CEA (n = 34) were performed in ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.01.051
更新日期:2012-08-01 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::Transcatheter embolization has emerged as the treatment of choice for pelvic arteriovenous malformations (AVMs), because surgical resection may be difficult and is associated with a high recurrence rate. We report a patient with a large recurrent pelvic AVM in whom transcatheter embolization was not feasible. This pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.02.004
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:A variety of endovascular specialists perform carotid artery stenting (CAS), but little data exist on outcomes and resource utilization among these specialists. We analyzed differences in outcomes after CAS was performed by radiologists (RAD), cardiologists (CRD), and vascular surgeons (VAS). METHODS:Second...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.006
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Venous valves are still discussed controversially, mainly because it is still uncertain whether primarily missing or insufficient valves or the weakness of the venous walls cause varices. Furthermore, the distribution and frequencies of major superficial tributary veins (MSTVs), which should discharge the gr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.02.241
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the efficacy of temporin A as a prophylactic agent in a rat model of vascular graft infection from methicillin sodium-susceptible and methicillin sodium-resistant Staphylococcus epidermidis. METHODS:The prospective, randomized, controlled animal study set in a res...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.127530
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:The use of cross-sectional area (CSA) measurements obtained from computed tomographic angiography (CTA) for the calculation of carotid artery stenosis has been suggested but not yet validated in a large population. The objective of this study was to determine whether CTA-derived CSA measurements were able to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.031
更新日期:2013-09-01 00:00:00
abstract::True aneurysms of the innominate artery are rare. Successful axial reconstruction in the past has required a combined cervical and transthoracic approach with placement of a prosthetic graft. We describe herein the occurrence of an innominate artery aneurysm that extended to and involved the proximal common carotid ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.06.034
更新日期:2007-12-01 00:00:00
abstract:PURPOSE:We analyzed the short- and long-term results for patients undergoing thrombolysis of occluded infrainguinal bypass grafts at our institution over a 62-month period. METHODS:Thirty-one patients with 40 episodes of graft thrombosis in 33 grafts managed by thrombolysis were retrospectively reviewed. The effects o...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0741-5214(94)90283-6
更新日期:1994-10-01 00:00:00
abstract:BACKGROUND:Simultaneous treatment of multilevel aortic disease is controversial due to the theoretic increase in morbidity. This study was conducted to define the outcomes in patients treated electively with simultaneous thoracic endovascular aortic aneurysm repair (TEVAR) and abdominal aortic endovascular endografting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.272
更新日期:2012-10-01 00:00:00