Abstract：
BACKGROUND:The aim of this study was to detail our experience in the management of skin necrosis/ulceration over hemodialysis vascular accesses. METHODS:We collected demographics and operative data about patients undergoing surgery for skin necrosis over native or prosthetic vascular accesses. The different procedural techniques used and outcomes achieved were analyzed. RESULTS:Over a six-year period (2013-2019), 593 hemodialysis accesses were created and 16 patients (50%, 8 male; median age 63.6 years, range 42-87; 12 native and 4 prosthetic accesses) were emergently/urgently treated for skin necrosis with danger of rupture (n 9), minor active bleeding (n 4) or life-threatening hemorrhage (n 3). Underlying causes were local infection, aneurysm/pseudo-aneurysm formation and venous stenosis. Most accesses were preserved. Rescue procedures consisted in excision of skin necrosis in association with aneurysmorrhaphy (n 1, 6.3%), simple closure of the venous breach (n 2, 12.5%) or resection and direct re-anastomosis (n 7, 43.8%). Concomitant endoluminal dilatation of venous outflow was needed in 7 (43.8%) cases. No intraoperative complications were observed. At a median of 13 months (range 1-39), 90% of rescued accesses were still functional. CONCLUSIONS:Skin necrosis/ulceration over vascular access requires prompt surgical intervention ahead the risk of life-threatening hemorrhage. The rescue of a functional access is possible in most patients and provides an efficient dialysis in postoperative period.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Borghese O,Pisani A,Di Centa Idoi
10.1016/j.avsg.2020.11.030subject
Has Abstractpub_date
2020-12-28 00:00:00eissn
0890-5096issn
1615-5947pii
S0890-5096(20)31073-6pub_type
杂志文章abstract：:The aim of this article is to describe a new open surgical technique for revascularization of renal arteries. Several interventions for surgical revascularization of renal arteries have been proposed. We suggest to perform an alternative technique if the described inflow vessels are not suitable because of severe athe...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2015.03.051
更新日期：2015-08-01 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：:Although retrograde vertebral artery flow was described over 100 years ago, its relationship to symptoms remains unclear. We documented 43 patients who were found by duplex scanning to have reverse flow in the vertebral artery. Of this group, seven patients (16%) were found to have symptoms described as typical for th...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1007/BF02015293
更新日期：1991-07-01 00:00:00
abstract：PURPOSE:Our purpose is to analyze the outcomes of endovascular aneurysm repair (EVAR) in patients treated with Excluder endograft (W.L. Gore and Associate, Flagstaff, AZ), comparing second generation, featuring SIM-PULL delivery system (ExSP) and third generation, featuring C3 (ExC3), concerning intraprocedural data an...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2017.03.176
更新日期：2017-10-01 00:00:00
abstract：BACKGROUND:To determine whether patient adherence to follow-up and patient outcomes after endovascular aneurysm repair (EVAR) are affected by the distance between a patient's residence and a tertiary care treatment center. METHODS:A retrospective review of 136 consecutive patients undergoing EVAR at the New Mexico Vet...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2010.05.009
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Iodine contrast medium (ICM) is considered gold standard in endovascular revascularization procedures. However, nephrotoxicity and hypersensitivity to ICM are causes that limit its indiscriminate use. Carbon dioxide (CO2) contrast angiography has been used as an alternative in patients with formal contraindi...
journal_title：Annals of vascular surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.avsg.2014.03.021
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:The natural history of penetrating aortic ulcer (PAU) has been variably described and clear guidelines are lacking. We reviewed our experience with PAUs in a tertiary referral center. METHODS:Imaging reports from January 2010 to December 2017 were retrospectively searched for the diagnosis of "penetrating a...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2018.12.062
更新日期：2019-05-01 00:00:00
abstract：:Acute spontaneous isolated common and external iliac dissection with aneurysm is a very rare entity involving high morbidity and mortality, with only few reports in literature. If not treated promptly, they have high morbidity or mortality in case they rupture. We report a case of similar dissection with aneurysmal fo...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2015.09.009
更新日期：2016-02-01 00:00:00
abstract：BACKGROUND:Carotid endarterectomy (CEA) is the gold standard for treating severe carotid artery stenosis, whereas carotid artery stenting (CAS) represents an endovascular alternative. The objective of this study was to assess the potential neural damage following open or endovascular carotid surgery measured by periphe...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2014.05.006
更新日期：2014-10-01 00:00:00
abstract：:We present a unique case of listeria-infected pseudoaneurysm of the superficial femoral artery. Listeria monocytogenes, a gram positive, intracellular bacterium, is widespread in the environment. The manifestation of infection in humans ranges from mild gastroenteritis to life-threatening listeriosis. The incidence in...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2015.09.013
更新日期：2016-02-01 00:00:00
abstract：:The case being presented is a 35-year-old female with a 3-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventr...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2017.06.033
更新日期：2017-11-01 00:00:00
abstract：:The surgical management of aortic prosthesis infection remains an enormous challenge for the vascular surgeon and a critical issue for the patient's well-being and life. Several techniques for its management have been devised and employed over the years, but none of them has been totally satisfactory. Thus new alterna...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1007/s10016-004-0080-z
更新日期：2004-09-01 00:00:00
abstract：:In 163 carotid reconstructions under peridural anesthesia performed from 1988 to 1991, we routinely measured residual systemic and carotid artery pressure during clamping. Seventy-nine patients (48.5%) were asymptomatic and 84 (51.5%) had a history of neurologic manifestations in the form of transient ischemic attacks...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1007/BF02001887
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:Controversy remains over how to best manage chronic total occlusions of the aortoiliac (AI) system. Uncovered stents are the traditional choice but offer less durability in theory with the risk of stent ingrowth. External iliac artery (EIA) occlusions are challenging due to access difficulty. METHODS:We per...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2018.06.002
更新日期：2018-11-01 00:00:00
abstract：:The middle aortic syndrome (MAS) is an uncommon clinical expression as a result of isolated stenosis or complete occlusion of the descending thoracic and/or abdominal aorta; Takayasu's arteritis (TA) is a rare vasculitis and a recognized etiology of MAS. We herein present the case of a 52-year-old woman with refractor...
journal_title：Annals of vascular surgery
pub_type：
doi：10.1016/j.avsg.2020.05.064
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:Surgical site infections (SSIs) are a significant burden to patients and health care systems. This retrospective study evaluates the observed rates of SSI after our institution implemented chlorhexidine gluconate-impregnated (CHG) cloth as a preoperative antiseptic preparation in elective vascular surgery. ...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2016.11.011
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND:Crossed-fused renal ectopia is a rare anomaly that poses a therapeutic challenge in the management of abdominal aortic aneurysms (AAAs). Such challenges include preservation of renal blood flow in the setting of multiple aberrant renal arteries and ureteral anomalies. Several surgical approaches to this dile...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2011.05.016
更新日期：2011-10-01 00:00:00
abstract：:We describe a case of gluteal compartment syndrome (GCS) after a 4-vessel fenestrated endovascular abdominal aortic aneurysm repair. The case highlights the need for a high index of suspicion for GCS as a differential diagnosis for spinal cord ischemia in patients developing perioperative lower limb neurologic deficit...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2015.07.029
更新日期：2016-01-01 00:00:00
abstract：:Performance of carotid endarterectomy for asymptomatic carotid stenosis has been restricted during recent years because of concern of reported complications in as high as 10-15% of patients, as well as limited long-term data on stroke protection. During the last 10 years, we have studied immediate and long-term result...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1007/BF02016741
更新日期：1991-03-01 00:00:00
abstract：BACKGROUND:To determine whether direct open repair of thoracoabdominal aortic aneurysms after previous abdominal aortic surgery is a safe option. METHODS:Ten patients were operated between January 2006 and January 2012. Mean age was 70 years (62-78 years). Four aneurysms (Crawford type III) were treated by firstly per...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2014.04.002
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:An aggressive surgical approach to locally advanced malignancy is being increasingly used in the absence of distant metastatic disease. This includes resection and reconstruction of major venous structures. We investigated the results of using a multidisciplinary surgical approach in these instances. METHOD...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2015.01.012
更新日期：2015-07-01 00:00:00
abstract：:Hybrid repair involves both open and endovascular interventions. This technique has been increasingly used in treating complex aortic aneurysms as an alternative to conventional open repairs, mainly because of the avoidance of aortic cross-clamping and the associated increased ischemia time to the viscera. We report a...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2018.12.076
更新日期：2019-07-01 00:00:00
abstract：BACKGROUND:Renal artery aneurysms (RAAs) represent a rare vascular pathology with an estimated incidence of <1%. Although an endovascular approach is being increasingly used to treat RAAs, we hypothesized that open surgical repair of RAA, specifically via aneurysmectomy with arterial reconstruction (AAR), is a safe, ef...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2009.07.030
更新日期：2010-05-01 00:00:00
abstract：:Injection drug users frequently present with abscess, cellulitis, and endocarditis. The development of arterial mycotic pseudoaneurysm (AMP) as a sequela of injection drug use, however, is much less frequently reported. We undertook a study to determine the prevalence and presenting clinical characteristics of AMP, ut...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1007/s10016-001-0124-6
更新日期：2002-09-01 00:00:00
abstract：:We describe the technique using high-volume three-dimensional coils to "augment" an insufficient stent-graft landing zone. This was performed to preserve hypogastric artery perfusion in the case of common iliac artery aneurysm which resides next to the internal iliac artery. ...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2017.03.191
更新日期：2017-08-01 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:Starting in December 2013, the Hospital Inpatient Quality Reporting Program included Clostridium difficile infection (CDI) rates as a new publically reported quality measure. Our goal was to review the trend, hospital variability in CDI rates, and associated risk factors and costs in vascular surgery. METHO...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2014.10.031
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:The optimal management of type B aortic dissection (TBAD) remains controversial in the era of endovascular therapies. This study reports the outcomes and complication rates of different treatment paradigms for TBAD. METHODS:A retrospective review was undertaken of all patients with TBAD from June 2006 to Ju...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2016.03.015
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:In this single-center study, we assessed the clinical outcomes of fenestrated endovascular aortic repair (f-EVAR) and branched EVAR on morbidity and mortality during total endovascular aortic repair for thoracoabdominal aortic aneurysms (TAAAs). METHODS:Between July 2006 and June 2015, elective f-EVAR and m...
journal_title：Annals of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.avsg.2017.04.025
更新日期：2017-10-01 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
