Abstract:
BACKGROUND:Carotid artery stenting (CAS) leads to frequent embolic brain lesions; their source has not been clearly identified yet. In order to investigate this phenomenon, we have evaluated embolic brain lesions (BL) after CAS and correlated them with aortic arch (AA) characteristics. METHODS:The AAs of 59 patients undergoing CAS under distal protection were evaluated by angiography and transesophageal echocardiography (TEE). AAs were stratified according to morphology (type I and II "simple" vs type III and bovine "difficult"), atherosclerotic arch lesions (complicated: >5 mm or with mobile debris vs uncomplicated: <5 mm), and tortuosity index (TI; sum of all angles diverging from ideal carotid axis, <150 vs >150). Diffusion weighted imaging (DWI) was performed before and within 24 hours from CAS. New BL were considered ipsilateral (IL) if ipsilateral to the site of CAS and non-ipsilateral (CL) if contralateral to it or bilateral. Normality distribution was by Shapiro-Wilk test (variables reported as medians +/- interquartile range) and statistical significance (P < .05) by Wilcoxon and Fisher's exact test. RESULTS:Difficult arches were present in 17 patients (28.8%), complicated aortic plaque in 21 (35.5%), and TI > 150 in 34 (57.6%). New BL appeared in 34 or 57.6% patients (6 or 18% IL and 28 or 82% CL). The mean number of BL was 5.7 (range, 0 to 20), 4.7 IL, and 5.7 CL, with a median volume of 560.95 +/- 1677.7 mm(3). Type of arch and TI were not correlated with mean number of BL. Mean volume of BL were greater in patients with difficult AA, complicated plaques, and TI > 150 (258 (572) mm(3) vs 15.6 (353) mm(3), P = .2; and 86 (828) mm(3) vs 85.9 (352) mm(3), P = .4 172 (766) mm(3) vs 0 (228) mm(3), P = .06, respectively). In patients with all three AA characteristics, mean number and volume of BL was significantly greater compared with other patients. Specifically, this increase was due mainly to CL (IL 0 (117) mm(3) vs 0 (172) mm(3), P = .9; CL 564 (687) mm(3) vs 0 (133) mm(3), P = .001). None of the technical details considered was correlated with either IL or CL. CONCLUSION:BL are frequent after protected CAS and are correlated with AA characteristics, thus underlining the role of catheterization maneuvers in determining embolic events. TEE may be useful in patient's selection for CAS.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Faggioli G,Ferri M,Rapezzi C,Tonon C,Manzoli L,Stella Adoi
10.1016/j.jvs.2008.08.014subject
Has Abstractpub_date
2009-01-01 00:00:00pages
80-5issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(08)01364-5journal_volume
49pub_type
杂志文章abstract:OBJECTIVE:Surgical treatment of intact thoracoabdominal aortic aneurysm (TAAA) is crucial to prevent rupture but is associated with high perioperative mortality. We tested the hypothesis that provider volume of surgical treatment of TAAA is an important determinant of operative outcome. Patients and methods Clinical in...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00085-5
更新日期:2003-06-01 00:00:00
abstract::Although endothelial cell seeding has been demonstrated to be effective in producing uniform endothelial coverage on prosthetic grafts, no one has demonstrated that the seeded cells are the genetic precursors of the endothelial cells that ultimately line the graft. This study was performed to determine whether seeded ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:PURPOSE:Oxidized lipids are believed to contribute to atherogenesis and may play a role in the development of anastomotic intimal hyperplasia in prosthetic vascular grafts. This study examines the hypothesis that clinically relevant graft material activates monocytes to oxidize low density lipoprotein (LDL). METHODS:L...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(00)70079-6
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:This retrospective study was performed to investigate prolonged postoperative pain in the area of the proximal or distal scar or the bypass tunnel after femoropopliteal bypass surgery to treat symptomatic peripheral arterial disease. PATIENTS AND METHODS:Ninety-three patients with peripheral arterial disease...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.02.003
更新日期:2004-06-01 00:00:00
abstract::During your preoperative visit, a very wealthy patient, Gill Bates, who donated a wing to the large teaching hospital in which you practice, has an unusual request: He does not want any residents involved with his care. He is scheduled for an open infrarenal aneurysmectomy. He explains that his decision is based on th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.099
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Long-term results of the posterior approach (PA) for the treatment of popliteal artery aneurysms are lacking in the literature. We reviewed our experience during a 13-year period in patients with popliteal artery aneurysms, comparing those treated through a PA with those operated on through a standard medial...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.227
更新日期:2015-12-01 00:00:00
abstract::Large veins (superior and inferior vena cava, portal vein) have been replaced successfully with lower extremity deep veins (superficial femoral-popliteal). Femoropopliteal bypass with superficial femoral-popliteal veins has been reported to give excellent long-term results. Nevertheless, this source of autogenous vein...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.31965
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVE:The aim of the study was to provide, by means of computational fluid dynamics, a comparative analysis after carotid endarterectomy (CEA) between patch graft (PG) and primary closure (PC) techniques performed in real carotid geometries to identify disturbed flow conditions potentially involved in the developme...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.08.094
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:This study was conducted to determine the differences in the diameter of the thoracic aorta when measured from electrocardiographic (ECG)-gated and nongated computed tomography (CT) angiography. Another aim was to define the difference in the aortic diameter when it is measured at peak systole and end diastol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.005
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To evaluate our experience with the endovascular treatment of total occlusions of the mesenteric and celiac arteries. METHODS:We performed a retrospective review of endovascular stenting of 27 nonembolic total occlusions of the superior mesenteric artery (SMA) and celiac artery (CA) between July 2004 and Jul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.12.013
更新日期:2012-06-01 00:00:00
abstract::Effort thrombosis of the subclavian vein (Paget-Schroetter syndrome) has long been considered a primary thrombotic process, but recent experience suggests that it may commonly result from repeated mechanical compression. Increased awareness of the pathophysiology of this syndrome can allow timely, improved diagnostic ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.41523
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Arterial disease in women will become a major issue in the near future. METHODS:A systemic review of existing literature was retrospectively conducted to collect information on the three most common entities of vascular disease: carotid atherosclerotic, abdominal aortic aneurismal, and lower extremity arter...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.07.057
更新日期:2007-12-01 00:00:00
abstract::A case is reported of a woman with an ischemic arm as a result of damage to the subclavian artery by the clavicular anomaly associated with cleidocranial dysostasis. Only one similar case has been reported previously. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70105-8
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:The optimal strategy for revascularization in chronic limb-threatening ischemia (CLTI) is not yet completely known and is still under debate. Endovascular treatment methods predominate despite limited evidence for their advantage. In this concurrent, prospective observational cohort study, we investigated ou...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.03.029
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:This study investigated the prevalence and distribution of deep vein thrombosis (DVT) in patients with symptomatic pulmonary embolism (PE) to establish a screening protocol to reduce unnecessary venous duplex scanning using different D-dimer level rather than single cutoff point of 0.5 microg/mL in patients w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.05.026
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVE:Quality metrics were developed to improve outcomes after carotid artery revascularization; however, few studies have evaluated regional differences in perioperative outcomes. This study aimed to evaluate regional variation in mortality and perioperative outcomes after carotid endarterectomy (CEA) and carotid ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.11.080
更新日期:2018-09-01 00:00:00
abstract::Lower extremity paraplegia or paraparesis is an extremely rare event after operative repair of infrarenal abdominal aortic aneurysms (AAAS). We report two such cases that occurred after endovascular repair or attempted endovascular repair of routine AAAS. To our knowledge, these are the first two cases reported specif...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111801
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:Few studies have examined factors that influence an individual's decision to enter an academic medical career after residency training. We sought to evaluate whether sex, ethnicity, child care issues, and debt burden influenced residents' choice for a career in academic vascular surgery. METHODS:A 39-item We...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.141
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:Infrapopliteal angioplasty (percutaneous transluminal angioplasty [PTA]) is routinely used to treat critical limb ischemia (CLI) despite limited data on long-term outcomes. METHODS:We reviewed all patients undergoing infrapopliteal PTA for CLI from 2004 to 2012 stratified by TransAtlantic Inter-Society Conse...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.109
更新日期:2013-06-01 00:00:00
abstract:PURPOSE:Recent studies have recommended unilateral venous duplex scanning for the diagnosis of deep venous thrombosis (DVT) in patients who are unilaterally symptomatic. Vascular laboratory accreditation standards, however, imply that bilateral leg scanning should be performed. We examined whether actual practice patte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70206-5
更新日期:1999-05-01 00:00:00
abstract::A nonrandomized prospective clinical study was undertaken to evaluate the technique and efficacy of in vitro endothelial cell lining of synthetic grafts. Twenty-six patients (10 men and 16 women with a mean age of 68.4 years; range, 49 to 80 years) with end stage chronic peripheral vascular disease requiring reoperati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract::We report four consecutive cases of Kommerell's aneurysm of an aberrant left subclavian artery in patients with a right-sided aortic arch and the results of a systematic review of the literature. In our cohort of patients, three had an aneurysm limited to the origin of the aberrant subclavian artery, causing dysphagia...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2003.07.021
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVE:The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2016.10.099
更新日期:2017-04-01 00:00:00
abstract::Renal cell carcinoma extends into the lumen of the inferior vena cava in approximately 4% of patients at the time of diagnosis. Surgical removal of the intracaval tumor thrombus with radical nephrectomy is the preferred treatment for this malignancy. From January 1977 to June 1990, 31 such patients were examined for c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.29912
更新日期:1991-09-01 00:00:00
abstract::The diagnosis-related groups have encouraged physicians to become more efficient in the care of their patients; often, however, raising the question of safety. For 3 years all patients undergoing carotid endarterectomy at our institution were monitored in the intensive care unit for 24 hours and the majority were disc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(92)90056-e
更新日期:1992-12-01 00:00:00
abstract::Antithrombin (AT III), a major circulating anticoagulant, may be influenced by ischemia-induced changes in microvascular integrity and contribute to localized hypercoagulability. In a nonheparinized intact canine hindlimb model we determined AT III activity by chromogenic substrate assay (S-2238); coagulation changes ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.vs0090740
更新日期:1989-05-01 00:00:00
abstract::Revascularization of the lower extremities may require an axillofemoral bypass when an aortobifemoral bypass is contraindicated. Thirty-one patients underwent axillounifemoral and 59 had an axillobifemoral bypass, with a mortality rate of 9%. The indication for operation was limb salvage in 67%, intra-abdominal sepsis...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:This study was conducted to evaluate and compare the rates of postoperative infectious complications and death after elective vascular surgery, define vascular procedures with the greatest risk of developing nosocomial infections, and assess the effect of infection on health care resource utilization. METHOD...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.006
更新日期:2010-01-01 00:00:00
abstract::When proximal arterial control cannot be obtained by standard methods, it may be achieved safely and bloodlessly by intraluminal routes with balloon catheters, hemostatic sheaths, and catheter-guide wire techniques. This method was used successfully in 20 patients to achieve proximal arterial control without complicat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70338-6
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVE:This investigation describes the perioperative and early follow-up results associated with transcarotid artery revascularization (TCAR) in patients not participating in the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure II (ROADSTER-2) registry using the ENROUTE neuro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.06.222
更新日期:2019-03-01 00:00:00