Abstract:
BACKGROUND:Early failure (within 6 weeks of construction) of prosthetic arteriovenous access (AVA) is traditionally treated by surgical revision rather than endovascular intervention because it is assumed to be related to technical factors related to the surgery. This premise is not evidence based and our results for surgical thrombectomy have been poor. Based on our previous experience with angiography and thrombolysis in newly constructed autogenous AVAs, we changed our approach to perform endovascular thrombolysis initially, instead of proceeding directly to surgical revision. METHODS:We prospectively studied all patients who had an early failure of new prosthetic AVA from January 2000 to June 2004 to determine the cause of and treat the occlusions by endovascular means. Thrombolysis took place at least 7 days after surgery, allowing sufficient tissue incorporation to prevent puncture site bleeding. No patients were excluded from the study. RESULTS:During the 54 months of the study, 269 prosthetic AVAs were constructed at our center. Twenty patients had early occlusion. The mean time from creation of the prosthetic AVA to occlusion was 15.8 +/- 10.9 (median 13, range 3-41) days and the mean time to intervention was 25.0 +/- 11.6 (median 21, range 9-54) days. Of the 20 patients, 17 underwent successful endovascular thrombolysis. The only patient of the 20 found to have a technical problem related to surgery had this resolved angiographically. There was one complication in a patient with failed endovascular thrombolysis, who had extravasation from the arterial anastomosis that halted the procedure. This patient later had surgical revision in keeping with the angiographic findings. Cumulative patency rates at 6 months and 1 year were 75% and 68%, respectively. CONCLUSIONS:Endovascular thrombolysis for early occlusion of prosthetic AVAs is feasible, safe, and is associated with a good patency rate. It appears to be a better initial approach than surgical revision in these patients because technical-surgical problems related to AVA construction are rare.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Shemesh D,Goldin I,Berelowitz D,Zaghal I,Olsha Odoi
10.1016/j.jvs.2007.10.047subject
Has Abstractpub_date
2008-03-01 00:00:00pages
585-590issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(07)01750-8journal_volume
47pub_type
临床试验,杂志文章abstract:OBJECTIVE:Successful thoracic endovascular aneurysm repair (TEVAR) requires adequate proximal and distal fixation and seal. We report our experience of planned celiac artery coverage during endovascular repair of complex thoracic aortic aneurysms (TAA). METHODS:Since 2004, 228 patients underwent TEVAR under elective (...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.105
更新日期:2010-11-01 00:00:00
abstract::This study tests the hypothesis that reperfusion injury is the principal cause of limb loss after acute arterial occlusion and that this injury is avoidable. Of 61 isolated hindlimbs amputated at the level of the hip joint, 17 were controls (group I), 5 were perfused without ischemia to establish the validity of the m...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVE:We investigated the outcomes of hybrid repair of thoracoabdominal aortic aneurysms and performed meta-analyses and meta-regressions to assess whether the number of stages during hybrid repair is associated with mortality. METHODS:Review methods were according to the Preferred Reporting Items for Systematic R...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2013.04.061
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:The primary purpose of the current study was to evaluate the safety and effectiveness of selective coverage of the left subclavian artery (LSCA) without revascularization during thoracic endovascular aortic repair (TEVAR) in patients with bilateral patent vertebrobasilar junctions. The secondary purpose was t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.110
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the practice patterns of intraoperative completion imaging (CI) for lower extremity bypass (LEB) in the Vascular Quality Initiative (VQI). METHODS:A retrospective review of all LEB procedures in the VQI database from January 2003 to October 2013 was performed. Regions...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.12.046
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:Volume-outcome relationships for open abdominal aortic aneurysm (AAA) repair have received less attention in publicly funded health systems. Furthermore, the roles of surgeon seniority (years of experience) and composite volume (encompassing all major arterial cases) on outcomes after open AAA repair are less...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.050
更新日期:2018-06-01 00:00:00
abstract:PURPOSE:No single method has been identified that accurately and reliably detects patients with impending bowel infarction during aortic reconstruction. Serial sampling of blood gas from the inferior mesenteric vein (IMV) for detecting colonic ischemia was compared with two previously described techniques: laser Dopple...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70141-9
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:Information on outcome of patients with long superficial femoral artery (SFA) obstruction undergoing endovascular treatment is scarce. The present study reports results from a prospective multicenter registry designed to evaluate the safety, effectiveness, and patency of the aSpire self-expanding polytetraflu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2006.08.032
更新日期:2007-01-01 00:00:00
abstract::Von Recklinghausen's Type 1 neurofibromatosis (NF) is a genetic disorder of neuroectodermal tissue. Arterial involvement has also been recognized. Stenotic lesions predominate, but aneurysms have been documented as well. Aortoiliac, visceral, and cervical aneurysms are well represented in the literature. Rarely noted,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.112704
更新日期:2001-05-01 00:00:00
abstract:BACKGROUND:Credentialing of vascular surgeons to perform carotid artery stenting (CAS) continues to be a major issue confronting the specialty of Vascular Surgery. Cannulation of aortic arch branches, and placement of carotid antiembolic devices and stents constitute the major technical challenges to vascular surgeons ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.039
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:The increasing use of aortic endografts predictably will add to the complexity of open abdominal aortic aneurysm (AAA) repair and, therefore, the proportion of surgically treated infrarenal AAAs that are juxtarenal in location (JRA) will grow. This study reviews a single-center experience with JRAs. METHODS:...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.129638
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To retrospectively assess the therapeutic value of endovascular stenting for treatment of the nutcracker syndrome (NCS) in long-term follow-up and to explore the selection of the size of stents in Chinese patients with NCS. METHODS:From January 2004 to August 2010, 30 patients (two women and 28 men) between ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.01.007
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:We undertook a quantitative systematic review of randomized controlled trials (RCTs) and observational studies to determine the effectiveness of cerebrospinal fluid (CSF) drainage to prevent paraplegia in thoracic aneurysm (TA) and thoracoabdominal aortic aneurysm (TAAA) surgery. METHODS:We included RCTs an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2004.03.017
更新日期:2004-07-01 00:00:00
abstract:OBJECTIVE:We have previously shown that arteriovenous fistulas (AVFs) are more expensive to create and to maintain than arteriovenous grafts (AVGs) in patients undergoing their first access. Because those for whom this first access fails may be a more disadvantaged group, we hypothesized that the cost of a second acces...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.03.419
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:The composition and mechanical properties of abdominal aortic aneurysms (AAAs) were studied. METHODS:Stereologic study was used to measure volume fractions of the components of the aortic wall. Histochemical methods with picrosirus red and safranin O were developed to differentiate collagen from ground substan...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90169-4
更新日期:1994-07-01 00:00:00
abstract::A knitted Dacron velour externally supported prosthesis was broken in two pieces at the supported portion 3 years after femoroposterior tibial bypass grafting. This type of graft problem has never been reported. Details of the clinical course, angiogram, CT scan, and scanning electron micrograph of a portion of the gr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.19861
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Varicose veins and other vascular abnormalities are common clinical entities. Treatment options include vein stripping, sclerotherapy, and endovenous laser treatment, but all involve some degree of invasive intervention. The purpose of this study was to determine ex vivo the effectiveness of a novel hand-hel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.10.049
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Induction of collateral development to improve tissue perfusion is a promising approach for the treatment of arterial occlusive diseases. Several growth factors and cells have been reported to increase collateral circulation; however, the appropriate site for the delivery of these factors and cells is unclea...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.02.004
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether calf muscle hemoglobin oxygen saturation (Sto2) obtained during a standardized treadmill test is associated with ambulatory function and health-related quality of life (HRQoL) in patients with symptomatic peripheral artery disease (PAD). We hypothesized tha...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.057
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Matrix metalloproteinases (MMPs) likely contribute to the degradation of medial elastin in abdominal aortic aneurysms (AAAs), and tetracycline antibiotics exhibit MMP-inhibiting properties. The purpose of this study was to compare the effects of doxycycline and several non-antibiotic chemically modified tetr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70035-7
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE AND METHOD:In this retrospective review, we report the surgical results of infected aortic aneurysms treated at a single center over 5 years. RESULTS:From October 1996 to October 2001, 19 patients with infected aortic aneurysm were treated with surgery, nine with suprarenal infections (four proximal descendi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126557
更新日期:2002-10-01 00:00:00
abstract::Albeit uncommon, delayed renal dysfunction after endovascular abdominal aortic aneurysm repair (EVAR) can be attributed to proximal stent graft migration or unrecognized partial renal artery coverage. We report two patients who were found to have renal artery occlusion 1 week after EVAR with Zenith (Cook, Bloomington,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.019
更新日期:2008-02-01 00:00:00
abstract::Ibuprofen reduces early occlusion and surface thrombogenicity of small-diameter polytetrafluoroethylene (PTFE) grafts in sheep. The following experiments were designed to determine the effects of cyclooxygenase inhibition by ibuprofen on long-term patency and arterial wall and graft neointima prostaglandin synthesis. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVE:Adequate proximal neck length is important for proper endovascular treatment of abdominal aortic aneurysms (AAAs). Placement of endografts in AAAs with relatively short proximal necks may require covering the origin of accessory renal arteries. Exclusion of these arteries carries the theoretical concern of re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.118814
更新日期:2001-11-01 00:00:00
abstract:OBJECTIVE:Lower extremity arterial injury may result in limb loss after blunt or penetrating trauma. This study examined outcomes of civilian lower extremity arterial trauma and predictors of delayed amputation. METHODS:The records of patients presenting to a major level I trauma center from 2004 to 2014 with infraing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.04.052
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Although endovascular abdominal aortic aneurysm (AAA) repair (EVAR) is widely accepted for elective surgery, the uptake of emergency EVAR for ruptured AAA (REVAR) has trailed behind. This study was intended to identify the barriers to widespread application of REVAR in Australia and New Zealand. METHODS:A cr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.01.037
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:Despite vast improvement in the field of vascular surgery, elective abdominal aortic aneurysm (AAA) repair still leads to perioperative death. Patients with asymptomatic AAAs, therefore, would benefit from an individual risk assessment to help with decisions regarding operative intervention. The purpose of th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.07.103
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Integrity of the abdominal aortic aneurysm (AAA) neck is crucial for the long-term success of endovascular AAA repair (EVAR). However, suitable tools for reliable assessment of changes in small aortic volumes are lacking. The purpose of this study was to assess the intraobserver and interobserver variability...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.10.004
更新日期:2007-02-01 00:00:00
abstract::Untreated traumatic arteriovenous fistulae (AVF) have been associated with aneurysmal dilatation of the involved artery and vein, congestive heart failure, and limb ischemia. Open surgical repair of these lesions can be challenging due to the elevated venous pressure and surrounding inflammation. This case report desc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.11.080
更新日期:2010-05-01 00:00:00
abstract:PURPOSE:The antiproliferative and antisecretory effects of somatostatin have many potential uses in the clinical setting. Retroviral gene transfer of somatostatin to endothelium is a potential means of local delivery of this peptide to specific vascular beds. This investigation was designed to determine whether transdu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70278-2
更新日期:1998-05-01 00:00:00