Abstract:
PURPOSE:Though the peroneal artery (PA) often remains patent despite disease or occlusion of other infrapopliteal arteries, there is skepticism about using the terminal PA as the outflow tract in distal revascularizations for limb salvage, especially when a patent inframalleolar artery is available. We analyzed our experience of using the distal PA and inframalleolar or pedal branches arteries as outflow tracts in revascularizations for critical limb ischemia. METHODS:Over a decade, among 651 infrapopliteal arterial reconstructions performed in 597 patients, the PA was the outflow vessel in 214, its distal third being involved in 69 vein revascularizations (study group). During the same period, 187 vein bypass grafts were performed to 179 inframalleolar and 8 pedal branches arteries (control group). Patency, limb salvage and survival rates were assessed using Kaplan-Meier life-table analysis. Complete follow-up (range, 0.1-10.2 years; mean, 5.8 years) was obtained in 245 (95.7%) patients (66 were in the study group). RESULTS:The distal PA was chosen as the target vessel: (1) because the proximal, mid-PA was occluded or severely diseased and no other adequate inframalleolar or pedal branches arteries were identified preoperatively (n = 30; 43.5%); (2) because an alternative inframalleolar target vessel was present but severely diseased (n = 9; 13%); (3) because of the length limitations of the available vein (n = 12; 17.4%; or (4) because of the presence of invasive infection or necrosis overlying the dorsalis pedis or posterior tibial arteries (n = 18; 26.1%). The study group was significantly younger than the control group (68 +/- 7 years vs 70 +/- 6 years, P = .039), and included significantly more patients with diabetes mellitus (65.2% vs 50.2%, P = .033) and insulin dependence (52.2% vs 37.9%, P = .041), dialysis-dependent chronic kidney disease (5.8% vs 1.1%, P = .047), and history of smoking (75.3% vs 58.2%, P = .012). None of the patients died in the perioperative period. Although the overall need for minor amputation was statistically higher in the PA group (78.2% vs 63.1%, P = .022), especially as concerns partial calcanectomy (8.7% vs 2.1%, P = .026), the proportion of wounds completely healed during the follow-up and the mean time to wound healing were comparable in the two groups. Kaplan-Meier analysis showed comparable long-term patency, limb salvage, and survival rates in the two groups. CONCLUSIONS:Revascularization to the distal third of the PA can achieve much the same outcome in terms of patency and limb salvage rates, wound healing rate and timing, as when other inframalleolar or pedal branches are used. The skepticism surrounding use of the terminal PA as an outflow vessel appears to be unwarranted.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ballotta E,Da Giau G,Gruppo M,Mazzalai F,Martella Bdoi
10.1016/j.jvs.2008.01.002subject
Has Abstractpub_date
2008-05-01 00:00:00pages
952-9issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(08)00013-Xjournal_volume
47pub_type
杂志文章abstract:OBJECTIVE:Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complicatio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.059
更新日期:2017-04-01 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:OBJECTIVE:The application of thoracic endovascular aortic repair (TEVAR) has changed treatment paradigms for thoracic aortic disease. We sought to better define specific treatment patterns and outcomes for type B aortic dissection treated with TEVAR or open surgical repair (OSR). METHODS:Medicare patients undergoing t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.12.047
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioper...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.04.059
更新日期:2017-11-01 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: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:To examine the outcome of a comprehensive follow-up program for autogenous arteriovenous hemodialysis access (AVF) when performed by the hemodialysis access surgeon. METHODS:Patients with first time AVFs between 2000 and 2005 underwent history and physical examination between the third and sixth postoperativ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.013
更新日期:2007-05-01 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:PURPOSE:Cyclooxygenase, either the cox1 or cox2 isoform, controls synthesis of prostaglandin E2 (PGE2), which regulates expression of matrix metalloprotease-9 (MMP-9). PGE2 and MMP-9 are elevated in aortic aneurysms. The mechanisms and time course of the inhibition of aneurysm expansion with a nonspecific cyclooxygenas...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70216-8
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:Objective scoring systems have been developed for risk stratification of open infrarenal aneurysm repair. To date, none have been applied for the selection of patients who would most benefit from either an open or an endovascular approach. This study assessed the utility of comorbidity-based objective scorin...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.02.036
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:We reviewed the history and preoperative investigations of patients with early postoperative neurologic events after carotid thromboendarterectomy in an attempt to identify risk factors for neurologic complications. METHODS:Patients with neurologic events/complications (S group, n = 14 patients) were compared ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVE:Vascular surgical groin wound infection (VS-GWI) has multiple causes and frequently is manifested as a limb- or life-threatening problem, resulting in significant morbidity and mortality. For patients undergoing operative extirpation, in situ repair, extra-anatomic bypass, or ligation can be used; however, li...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.06.119
更新日期:2020-07-21 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:OBJECTIVE:To explore the therapeutic potential of endothelial progenitor cells (EPCs) transfected with vascular endothelial growth factor A (VEGFA) and heme oxygenase-1 (HO-1) on rat hindlimb ischemia model. METHODS:Eukaryotic expression vectors encoding VEGFA or HO-1 were constructed and introduced into EPCs isolated...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.11.096
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:This is a review of 100 consecutive supraaortic trunk reconstructions (SAT) performed over 16 years. METHODS:There were eight innominate endarterectomies and 92 bypass procedures based on the thoracic aorta (n = 86) or proximal innominate artery (n = 6) in 98 patients 24 to 79 years of age. Indications include...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70289-7
更新日期:1998-01-01 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: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:PURPOSE:The purpose of this study was to define the relationship between left ventricular diastolic function and survival after renal revascularization. METHODS:Seventy-six adult patients (49 women, 27 men; mean age: 63 ± 13 years) with preoperative echocardiography who underwent renal revascularization for atheroscle...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.05.091
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the incidence, severity, and etiologic factors of the development of colon ischemia after endovascular aortoiliac aneurysm repair (EVAR). METHODS:During the last 9 years we performed 278 elective EVARs using a variety of grafts. To facilitate these repairs, one hypoga...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.119241
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:Endovascular aneurysm repair (EVAR) has reduced early adverse outcomes from abdominal aortic aneurysm (AAA) repair. Preferential use of EVAR may have altered the profile of patients who undergo open repair. The validity of scoring systems such as the Glasgow Aneurysm Score (GAS), devised when open surgery was...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2011.01.029
更新日期:2011-08-01 00:00:00
abstract::Popliteal artery aneurysms rarely rupture. We treated a 91-year-old man who presented with a deep venous thrombosis and anemia; rupture of a popliteal artery aneurysm was suspected only after compartment syndrome isolated to the thigh developed as the result of bleeding. Although fasciotomy was required on the basis o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70251-4
更新日期:1998-04-01 00:00:00
abstract::Endovascular infections after percutaneous transluminal renal angioplasty with stenting (PTRAS) are rarely reported. Because strict longitudinal follow-up of patients undergoing PTRAS is lacking, the true incidence of such complications remains obscure. We report the first case of a patient with an infected renal arte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70170-3
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVE:Lower extremity bypass grafts that develop stenoses are commonly treated with either open surgical or endovascular revision. Vein graft stenoses with unfavorable lesions (multiple lesions, lesions >2 cm in length, lesions in grafts <3 months old, lesions in grafts <3 mm in diameter) fare worse than those with...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.08.065
更新日期:2016-01-01 00:00:00
abstract::Two hundred forty-three bypasses to paramalleolar arteries were performed in 224 extremities of 208 patients since 1971; 166 were implanted in men (68%) and 77 in women (32%). The median age was 73 years. Gangrene (61%), nonhealing ulcer (15%), rest pain (22%), and trauma (2%) were the indications for bypass. Usual ri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0070785
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:We developed a novel method using anatomic markers along the thoracic aorta to accurately quantify longitudinal and circumferential cyclic strain in nondiseased thoracic aortas during the cardiac cycle and to compute age-related changes of the human thoracic aorta. METHODS:Changes in thoracic aorta cyclic st...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.11.056
更新日期:2009-04-01 00:00:00
abstract::Thirty-nine reoperations in 38 patients with recurrent symptoms of neurogenic thoracic outlet syndrome were performed by the supraclavicular approach. Scarring around the brachial plexus was the primary cause in 59% of procedure, whereas in 41% of reoperations residual osseous and soft tissue anomalies were identified...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70027-3
更新日期:1994-04-01 00:00:00
abstract::The need for quality assurance in vascular surgery can be deduced from the variability in unruptured abdominal aneurysm operative death rates in a group of patients large enough that factors influencing mortality rates other than quality of care can be controlled. Operative mortality rate for 3570 patients undergoing ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract::Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of sy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract::Despite the proven experimental success of endothelial cell seeding of prosthetic vascular grafts, the process has not been widely accepted for clinical use because of its complexity and the need for a relatively large length of autologous vein to provide the requisite number of cells. Using autologous endothelial cel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030264
更新日期:1986-02-01 00:00:00
abstract::The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.047
更新日期:2009-05-01 00:00:00