Abstract:
BACKGROUND:Endovascular repair (EVR) is emerging as first-line treatment for patients with superior vena cava (SVC) syndrome of benign etiology, but data on its durability remain scarce. The aims of this study were to assess the efficacy and durability of EVR and compare results of EVR with open surgical reconstruction (OSR). METHODS:Data from 70 consecutive patients undergoing treatment for benign SVC syndrome between November 1983 and November 2006 were retrospectively reviewed. RESULTS:There were 30 males and 40 females (mean age, 41 years; range, 5-75 years). Etiology included indwelling catheters or pacemaker wires in 35 patients, mediastinal fibrosis in 31, idiopathic thrombosis in 2, hypercoagulable disorder in 1, and postsurgical thrombosis in 1. In 42 patients, OSR was done through a median sternotomy: repair was with spiral saphenous vein in 22, expanded polytetrafluoroethylene (ePTFE) in 13, femoral vein grafts in 6, and human allograft in 1. Fifteen OSRs followed failed EVR interventions. EVR was attempted in 32 patients and was successful in 28 (88%): 19 had stenting, 14 had percutaneous transluminal balloon angioplasty (PTA), 2 had thrombolytic therapy with PTA, and 3 had stenting. All four technical failures subsequently underwent OSR. There were no early deaths in either group. Periprocedural morbidity was 19% after OSR and 4% in the EVR group. Six early surgical graft failures were successfully treated with surgical revision; one restenosis after EVR was restented. During a mean follow-up of 4.1 years (range, 0.1-17.5 years) after OSR, 11 patients underwent 18 secondary interventions. Mean follow-up after EVR was 2.2 years (range, 0.2-6.4 years), and nine patients underwent 21 secondary EVR interventions. Primary, assisted primary, and secondary patency rates of surgical bypass grafts were, respectively, 45%, 68%, and 75% at 3 and 5 years. Primary, assisted primary and secondary patency rates after EVR were 44%, 96%, and 96% at 3 years. Assisted primary patency was significantly higher in vein grafts than in ePTFE grafts (P = .05). Assisted primary and secondary patency was significantly higher in patients undergoing stenting compared with PTA (P = .02). At last follow-up, 93% of patients in both OSR and EVR groups had significant relief from symptoms. CONCLUSIONS:OSR of benign SVC syndrome is effective, with durable long-term relief from symptoms. EVR is less invasive but equally effective in the mid-term, albeit at the cost of multiple secondary interventions, and is an appropriate primary treatment for benign SVC syndrome. OSR remains an excellent choice for patients who are not suitable for EVR or in whom the EVR fails.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Rizvi AZ,Kalra M,Bjarnason H,Bower TC,Schleck C,Gloviczki Pdoi
10.1016/j.jvs.2007.09.071subject
Has Abstractpub_date
2008-02-01 00:00:00pages
372-80issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(07)01598-4journal_volume
47pub_type
杂志文章abstract::Extracorporeal shock wave lithotripsy (ESWL) represents the preferred treatment for most upper ureteric and renal calculi. Complication rates associated with ESWL are low, justifying the enthusiasm and acceptance of this treatment modality. As the technique has become more widely available, some deleterious effects on...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104592
更新日期:2000-05-01 00:00:00
abstract:PURPOSE:Although patency data for lower extremity bypass grafts are readily available, few reports have focused on patients' satisfaction after surgical reconstruction for claudication. We reviewed our experience with surgical treatment for claudication, focusing on late outcome from the patients' perspective to furthe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70146-5
更新日期:1996-07-01 00:00:00
abstract:PURPOSE:Thrombosis of popliteal artery aneurysms can produce limb-threatening ischemia. In this setting we have found preoperative thrombolytic therapy to be beneficial. METHODS:Thirty-three patients with 54 popliteal artery aneurysms were studied (mean follow-up 62 months). Twenty-one patients (62%) had bilateral pop...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70121-0
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:The annual number of open abdominal aortic aneurysm (AAA) repairs has decreased dramatically over the last decade, making the search for physician case volume thresholds more important. The purpose of this study was to identify a minimum threshold for annual surgeon case volume in open AAA repair. METHODS:Th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.11.027
更新日期:2019-09-01 00:00:00
abstract::In a series of six patients, a single-bar anterior external fixator was used to treat combined vascular and orthopedic injuries of the leg. This method of external fixation facilitated operative vascular exposure without sacrificing bony stability or alignment. It may be the preferred method of external fixation for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-10-01 00:00:00
abstract::To determine optimal fluid management after elective aortic surgery we compared postoperative administration of 5% dextrose Ringer's lactate solution (102 patients) with 5% dextrose half-normal saline solution (80 patients). For 72 hours after operation, intravenous fluids were titrated to maintain urine output betwee...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0040164
更新日期:1986-08-01 00:00:00
abstract::In this article we describe a method for assembling an endovascular graft within the aorta with a graft and then a stent introduced sequentially over a guidewire as separate components. In the ex vivo study, an endovascular graft that was 25 mm in diameter was introduced through a 9F introducer. In the in vivo study, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115814
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:Aortic arch aneurysmal disease remains a therapeutic challenge. For patients unsuitable for standard open surgery, hybrid repair with debranching of the supra-aortic arteries followed by thoracic endovascular grafting has been shown to be an effective solution. The aim of this study was to report the clinical...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.11.033
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascular...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.01.025
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:This study assessed predictive factors for reintervention after thoracic endovascular aortic repair (TEVAR) for complicated aortic dissection (C-AD). METHODS:An institutional review of consecutive TEVAR for C-AD was performed. RESULTS:Between 2000 and 2011, 41 patients underwent TEVAR for a C-AD involving t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.08.089
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Compression of the left common iliac vein (LCIV) by the right common iliac artery is an anatomic variant that may increase the risk for LCIV thrombosis. The incidence of LCIV compression in patients with abdominal aortic aneurysms (AAA) is unknown, however. The aim of this descriptive anatomic study was to de...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.046
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the fate of aneurysmal iliac arteries managed during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). METHODS:We analyzed data from the Cook Zenith trial. Follow-up was at 1 month, 6 months, 12 months, and then annually for 5 years. Patients w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.062
更新日期:2011-02-01 00:00:00
abstract:INTRODUCTION:Although autogenous brachial-basilic upper arm transpositions (BVT) have been extensively utilized, there has been significant disparity in published patency rates. Very little is known about the efficacy of autogenous brachial-cephalic upper arm transpositions (CVT). We evaluated our experience with trans...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.02.057
更新日期:2007-07-01 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:PURPOSE:The purpose of this study was to assess the short-term and mid-term results of endovascular aneurysm repair with the Zenith stent graft in a single-center prospective study. METHOD:Between October 1998 and July 2001, we used the Zenith stent graft for elective endovascular aneurysm repair in 116 patients, six ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.125032
更新日期:2002-08-01 00:00:00
abstract::Chronic wounds such as venous stasis ulcers have become a socioeconomic problem. Even with successful initial management, the recurrence rate approaches 70%. With the advent of new wound healing agents, nonoperative attempts to heal these wounds appear indicated. This study reports a prospective randomized evaluator-b...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.1992.37086
更新日期:1992-08-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate prospectively the results of the bifurcated Vanguard endovascular graft for abdominal aortic aneurysm (AAA) repair. METHODS:Seventy-five patients, with a median age of 69.6 years (range, 48 to 88 years) and asymptomatic AAAs, were recruited in 14 French vascular instit...
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)70130-8
更新日期:1999-08-01 00:00:00
abstract::A prospective, randomized study was conducted to compare the retroperitoneal versus transperitoneal approach for elective aortic reconstruction. One hundred thirteen patients (transperitoneal = 59, retroperitoneal = 54) were randomized between March 1987 and October 1988. In addition, to assess the changing course of ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.1990.17353
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:This study validated duplex ultrasound measurement of brachial artery volume flow (VF) as predictor of dialysis access flow maturation and successful hemodialysis. METHODS:Duplex ultrasound was used to image upper extremity dialysis access anatomy and estimate access VF within 1 to 2 weeks of the procedure. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.01.036
更新日期:2015-06-01 00:00:00
abstract::Ascending aortic pseudoaneurysm following prior cardiac or aortic surgery is a rare entity that requires reoperation. Surgical repair is a complex procedure associated with high operative mortality. We report the case of a 76-year-old male patient with an ascending aortic pseudoaneurysm developing from distal anastomo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.092
更新日期:2010-03-01 00:00:00
abstract::Increasing evidence points toward local production of renin and angiotensinogen in the artery wall. Because angiotensin converting enzyme (ACE) inhibitors have been shown to block intimal hyperplasia after arterial injury in the rat, it has been suggested that angiotensin II is an important mediator of the proliferati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine the retrievability of the Greenfield filter, to characterize fixation, and to evaluate the mechanical function of a new retrieval unit. METHODS:Stainless steel, titanium, and two prototype Greenfield filters (n = 82) were placed in 15 sheep at multiple sites and retri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70162-8
更新日期:1994-11-01 00:00:00
abstract::Vascular grafts in canines exhibit similar healing patterns to humans in that the graft surface forms a pseudointima over time but endothelializes only near the anastomotic sites. Thus the pseudointima at the midportion of the graft may represent a nidus for persistent platelet activation. The purpose of this investig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:The clinical impact of peripheral arterial disease (PAD) is well characterized and is associated with significant morbidity and mortality. Health care-related expenditures among individuals with PAD, particularly for patients, are not well described. METHODS:Health care-related expenditure data from the 2011...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.102
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Because vein graft neointimal hyperplasia engenders vein graft failure, and because most vein graft neointimal cells derive from outside the vein graft, we sought to determine whether vein graft neointimal hyperplasia is affected by activity of the CXC chemokine receptor-4 (CXCR4), which is important for bone...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.254
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVES:Increasing evidence points to the inflammatory character of atherosclerosis, and several parameters of inflammation have been proposed as cardiovascular risk markers. We analyzed associations among serum high-sensitivity C-reactive protein (hs-CRP) concentrations, carotid plaque structure, and immunocytology...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00709-2
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Hybrid procedures have gained momentum as less invasive operations that can potentially improve outcomes for patients. However, there is a paucity of data comparing hybrid procedures with traditional bypass. This study compares the perioperative outcomes of hybrid and bypass surgery for femoropopliteal (FP) r...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.01.058
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVE:Cryopreserved human arterial allografts are a recognized acceptable alternative for vascular reconstruction when other traditional conduits are either unavailable or contraindicated. We reviewed our experience using cryopreserved arterial allografts for peripheral artery reconstructions in contaminated and in...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.111
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:Favorable outcomes of thoracic endovascular aortic repair (TEVAR) compared with open repair for descending thoracic aortic aneurysms (DTAs) have led to increasing TEVAR use. We evaluated the effect of case volume and hospital teaching status on clinical outcomes of intact DTA repair. METHODS:The Medicare Pro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.01.035
更新日期:2013-08-01 00:00:00
abstract:PURPOSE:This study was undertaken to evaluate in vivo the effect of recombinant hirudin (r-hirudin [HBW 023]), a potent thrombin inhibitor, on the process of microvascular thrombus formation and recanalization. METHODS:Thrombosis was induced photochemically in distinct arterioles (n = 25) and venules (n = 30) of the e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70136-3
更新日期:1998-09-01 00:00:00