Abstract:
OBJECTIVE:Wounding patterns, methods of repair, and outcomes from femoropopliteal injury have been documented in recent civilian literature. In Operation Iraqi Freedom, as in past conflicts, these injuries continue to be a therapeutic challenge. Therefore, the objective of the current study is to document the pattern of femoropopliteal injuries, methods of repair, and early outcomes during the current military campaign in Iraq. METHODS:From September 1, 2004, to April 30, 2007, all vascular injuries arriving at the Air Force Theater Hospital (the central echelon III medical facility in Iraq; equivalent to a civilian level I trauma center), Balad Air Base, Iraq were prospectively entered into a registry. From this, injuries involving the lower extremities were reviewed. RESULTS:During the 32-month study period, 9289 battle-related casualties were assessed. Of these, 488 (5.3%) were diagnosed with 513 vascular injuries, and 142 casualties sustained 145 injuries in the femoropopliteal domain. Femoral level injury was present in 100, and popliteal level injury occurred in 45. Injuries consisted of 59 isolated arterial, 11 isolated venous, and 75 combined. Fifty-eight casualties were evacuated from forward locations. Temporary arterial shunts were placed in 43, of which 40 (93%) were patent on arrival at our facility. Our group used shunts for early reperfusion before orthopedic fixation, during mass casualty care, or autogenous vein harvest in 11 cases. Arterial repair was accomplished with autogenous vein in 118 (88%), primary means in nine (7%), or ligation in seven (5%). Venous injury was repaired in 62 (72%). Associated fracture was present in 55 (38%), and nerve injury was noted in 19 (13%). Early limb loss due to femoropopliteal penetrating injury occurred in 10 (6.9%). Early mortality was 3.5% (n = 5). CONCLUSIONS:Femoropopliteal vascular injury remains a significant reality in modern warfare. Femoral injuries appear more prevalent than those in the popliteal region. Early results of in-theater repair are comparable with contemporary civilian reports and are improved from the Vietnam era. Rapid evacuation and damage control maneuvers such as temporary shunting and early fasciotomy assist timely definitive repair and appear effective.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Woodward EB,Clouse WD,Eliason JL,Peck MA,Bowser AN,Cox MW,Jones WT,Rasmussen TEdoi
10.1016/j.jvs.2008.01.052subject
Has Abstractpub_date
2008-06-01 00:00:00pages
1259-64; discussion 1264-5issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(08)00190-0journal_volume
47pub_type
杂志文章abstract:OBJECTIVE:The purpose of our study was to investigate the effect of adipose-derived stem cells (ASCs), endothelial-differentiated ASCs (EC/ASCs), and various conditioned media (CM) on wound healing in a diabetic swine model. We hypothesized that ASC-based therapies would accelerate wound healing. METHODS:Diabetes was ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.01.065
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:This study assessed the clinical outcome, morphologic changes, and behavior of acute and chronic type B aortic dissections after endovascular repair and evaluated the extent of dissection and diameter changes in the true (TL), false (FL), and whole lumen (WL) during follow-up. METHODS:From May 2000 to Septembe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.01.022
更新日期:2008-06-01 00:00:00
abstract:PURPOSE:Magnetic resonance angiography (MRA) is a developing technique that provides arteriograms without the risks associated with iodinated contrast and arterial puncture or the expense of hospitalization. Prior reports have demonstrated the accuracy of peripheral vessel MRA for evaluation of the aorta through pedal ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90222-4
更新日期:1994-12-01 00:00:00
abstract:BACKGROUND:High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.01.071
更新日期:2018-02-01 00:00:00
abstract::A retrospective review was undertaken of a random sample (N = 73) comprising 50% of carotid endarterectomies performed during 1986 to evaluate the necessity of routine postoperative intensive care unit (ICU) admission after carotid endarterectomy. Severity of illness was determined with use of the Acute Physiology Sco...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.33418
更新日期:1991-12-01 00:00:00
abstract::The burgeoning field of vascular tissue engineering holds promise for the creation of a practical and successful small-diameter arterial bypass graft. Many creative combinations of autologous cells and scaffolds exist along with an equally long list of microenvironmental cues used to create a functional arterial condu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.02.046
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the cardiopulmonary morbidity and mortality rates after endovascular abdominal aortic aneurysm (EAAA) repair with local anesthesia (LA) with intravenous sedation versus general anesthesia (GA). METHODS:Data from patients who underwent elective infrarenal EAAA repair bet...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.128314
更新日期:2002-11-01 00:00:00
abstract::Several different modes of achieving a bloodless operating field by proximal and distal occlusion of blood vessels have been described. Vascular clamps, vessel loops, intraluminal occluding devices, and tourniquets have been used to control the tibial and pedal vessels but may cause injury or fail to control heavily c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.03.055
更新日期:2005-07-01 00:00:00
abstract:INTRODUCTION:Although lower-extremity bypass grafting has been the gold standard for infrainguinal revascularization, endovascular therapies have been increasingly applied to avoid operative morbidities. This study addresses the initial results of an implementation of infrainguinal percutaneous transluminal angioplasty...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.06.024
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.12.123
更新日期:2017-06-01 00:00:00
abstract::The cause of hypertension in the immediate postoperative period after carotid endarterectomy is unknown. In order to elucidate the etiology of hypertension following carotid endarterectomy, blood samples were drawn intraoperatively from internal jugular vein and external carotid artery prior to and subsequent to carot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-09-01 00:00:00
abstract:PURPOSE:The North American and the European Symptomatic Carotid Endarterectomy Trial investigators reported a conclusive benefit of carotid endarterectomy for patients with symptomatic 70% to 99% internal carotid artery (ICA) stenosis. However, it has been suggested that plaque structure may be an even more important f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90014-0
更新日期:1994-08-01 00:00:00
abstract:PURPOSE:Endothelin-1 (ET-1) has been implicated in a variety of vascular pathologic conditions, although there is considerable controversy as to whether such effects are mediated by the ET-(A) or ET-(B) receptor. This study investigated whether inhibition of big ET-1 processing by inhibition of endothelin-converting en...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115960
更新日期:2001-09-01 00:00:00
abstract::This study evaluated the role of duplex scanning in the management of patients with normal or minimally diseases carotid arteries. Carotid duplex scans were interpreted according to previously established criteria and considered normal when pulsed Doppler spectral waveforms showed laminar flow or only minor flow distu...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:PURPOSE:Prognostic information about graft outcome, obtained by using a new method for intraoperative measurement of vascular impedance, was evaluated. METHODS:Hydraulic impedance was measured in 136 infrainguinal bypass grafts that were entered into a multicenter trial. Seventy femoropopliteal and 66 femorocrural pol...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0741-5214(99)70141-2
更新日期:1999-08-01 00:00:00
abstract:PURPOSE:Mesenteric arterial reconstruction in patients with acute or chronic intestinal ischemia is associated with significant morbidity and mortality rates. Reperfusion of ischemic bowel in animals leads to release of multiple factors that cause organ dysfunction. Similar phenomena potentially occur in human beings a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.48586
更新日期:1993-09-01 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:We performed a systematic review and meta-analysis aiming to assess the mortality and morbidity of all published case series on thoracoabdominal aortic aneurysms (TAAAs) in experienced centers treated with open repair. METHODS:A systematic search of the literature published until April 2017 was performed acc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2018.03.410
更新日期:2018-08-01 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::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::Surgical repair of proximal right subclavian artery aneurysms can be difficult. They typically require a combined mediastinal exposure to control the innominate and right common carotid arteries and a supra- or infraclavicular exposure for distal control, with either a segmental resection and bypass or a bifurcated re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.07.050
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:This study explored the long-term outcomes of arteriovenous fistulas treated with vonapanitase (recombinant human elastase) at the time of surgical creation. METHODS:This was a randomized, double-blind, placebo-controlled trial of 151 patients undergoing radiocephalic or brachiocephalic arteriovenous fistula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2016.08.101
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess functional status, well-being, and symptom relief of patients after infrainguinal revascularization for severe peripheral vascular disease. METHODS:Two questionnaires were used to assess symptoms, functional status, and well-being before operation and 6 months after oper...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70242-3
更新日期:1995-01-01 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::The treatment of unilateral iliac occlusion remains controversial. We report our experience with femorofemoral bypass (FF) and iliofemoral bypass (IF). One hundred sixty-two FFs and 82 IFs were performed during a 25-year period. Demographic characteristics of the two groups were similar. Operative indications included...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-12-01 00:00:00
abstract:PURPOSE:Fifty-one consecutive patients with premature lower extremity atherosclerosis were prospectively evaluated for atherogenic risk factors and primary or acquired hypercoagulability, which might contribute to early ischemia and revascularization failure. METHODS:Laboratory tests included plasma assays of (1) natu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(05)80033-3
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:Creating a diverse workforce is paramount to the success of the surgical field. A diverse workforce allows us to meet the health needs of an increasingly diverse population and to bring new ideas to spur technical innovation. The purpose of this study was to assess trends in workforce diversity within vascul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.12.063
更新日期:2020-12-18 00:00:00
abstract:PURPOSE:The early and late outcomes of carotid endarterectomy (CEA) following a rigid protocol of patch angioplasty or occasionally interposition bypass grafting, when the arteriotomy required to obtain a complete internal carotid end point extended distal to the bulb segment, and primary closure, when it was limited t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104591
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:Failure of prior endovascular (EV) interventions for chronic limb ischemia has been reported to negatively affect patency and limb salvage after subsequent revascularization procedures. The goal of our study was to compare the clinical presentation of patients who failed infrainguinal EV and open revasculariz...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.12.076
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:Based on the significant number of unfilled vascular fellowship positions in the 2004 National Residency Matching Program (NRMP) and the perception of program directors that the quality of candidates is deteriorating, the Issues Committee of the Association of Program Directors in Vascular Surgery (APDVS) exp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.05.011
更新日期:2005-09-01 00:00:00