Abstract:
BACKGROUND:Proximal (ie, buttock, hip) claudication can result from impaired perfusion in the hypogastric area after aortobifemoral bypass (ABF) despite normal femorodistal blood flow provided by the patent bypass. The proportion of patients that experience proximal claudication after ABF is unknown, and arguments for the vascular origin of symptoms specifically at the proximal level have never been reported. METHODS:This was a prospective study set in an institutional practice of ambulatory patients referred for a systematic survey of their previous ABF bypass. Among the 131 eligible patients, 10 refused to participate and 16 were unable to walk on a treadmill. The 105 studied patients (94 men, 11 women) were a mean age of 63 +/- 10 years, and the median delay from surgery was 2 years (range, 4 months to 26 years). We used a modified version of the San Diego Claudication Questionnaire administered both at rest before the treadmill study and again after the treadmill test. Transcutaneous oxygen pressure (TcPO2) at the buttock level was used to evaluate blood flow impairment during exercise at the proximal level, with blood flow impairment defined as buttock minus chest TcPO2 decrease in excess of -15 mm Hg. RESULTS:Thirty patients reported proximal exercise-related pain consistent with vascular criteria by history before exercise. However, 59 patients (56%) reported symptoms compatible with proximal claudication, and TcPO2 values were abnormal on one or both sides in 52. The persistence of at least one (prograde or retrograde) pathway to the hypogastric circulation, determined by review of operative details from the aortobifemoral bypass and angiography, did not significantly decrease the proportion of patients reporting proximal claudication by history (26%) or on treadmill (55%) compared with those with bilateral hypogastric occlusion (33% by history, P = .51 compared with at least one prograde hypogastric pathway and 61% based on treadmill test, P = .65 compared with at least one prograde hypogastric pathway). CONCLUSION:The present study shows that (1) the proportion of ABF patients with a median bypass age of 2 years that report proximal claudication is high (28%), (2) this proportion is significantly higher when claudication is detected by treadmill exercise tests, (3) a vascular origin (or at least contribution) is likely 88% of the proximal symptoms observed on treadmill, (4) the presence of proximal claudication with associated abnormal TcPO(2) results increases the risk of walking impairment in affected patients, and (5) preservation of at least one internal iliac artery to allow prograde or retrograde flow to the hypogastric vascular bed does not decrease the risk of proximal claudication after ABF surgery. A vascular origin of (or at least contribution to) most of the proximal exercise-related symptoms should always be discussed in patients with patent ABF bypass.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Jaquinandi V,Picquet J,Bouyé P,Saumet JL,Leftheriotis G,Abraham Pdoi
10.1016/j.jvs.2006.09.050subject
Has Abstractpub_date
2007-02-01 00:00:00pages
312-8issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(06)01831-3journal_volume
45pub_type
杂志文章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: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
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doi:
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abstract:BACKGROUND:Iodinated contrast during endovascular aneurysm repair (EVAR) is used with caution in patients with chronic kidney disease. Contrast-enhanced ultrasound (CEUS) imaging using nonnephrotoxic sulphur hexafluoride microbubble contrast is a novel imaging modality that accurately identifies and characterizes endol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.08.095
更新日期:2014-12-01 00:00:00
abstract::An institutional experience with 100 consecutive blunt popliteal artery injuries over a 20-year period was reviewed. The overall amputation rate was 15%; however, during the past 7 years this has declined from 23% to 6%. Minimizing delay in the revascularization of ischemic limbs, routine systemic heparinization, prim...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0070736
更新日期:1988-05-01 00:00:00
abstract:OBJECTIVE:Postoperative ischemic colitis (IC) can be a serious complication following infrarenal abdominal aortic aneurysm (AAA) repair. We sought to identify risk factors and outcomes in patients developing IC after open AAA repair and endovascular aneurysm repair (EVAR). METHODS:The American College of Surgeons Nati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.10.064
更新日期:2016-04-01 00:00:00
abstract::The endothelial injury induced by the placement of a synthetic graft has been implicated as a stimulus for the development of MIH. In this study we compared the degree of EC coverage and the early SMC-PR in the arterial segments proximal and distal to 2 mm diameter PTFE grafts that had been placed in rabbit carotid ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050389
更新日期:1987-02-01 00:00:00
abstract::Preferred treatment for thromboembolism when heparin fails or is contraindicated is infrarenal inferior vena cava (IVC) interruption. In the present study suprarenal Greenfield filters were placed in 11 patients in whom routine infrarenal IVC interruption would have been inadequate therapy. As identified by IVC venogr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease is a significant problem worldwide. In developing countries such as India, the increased incidence of smoking and other forms of nicotine intake has resulted in a large proportion of young individuals with Buerger's disease. The results of surgical and endovascular treatment for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.09.005
更新日期:2008-12-01 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::Popliteal artery aneurysms represent a common pathology that vascular surgeons are often confronted with. However, several issues remain incompletely understood, including indications for intervention and optimal methods of treatment. In the following article, our discussants debate the appropriate management of small...
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pub_type: 杂志文章
doi:10.1016/j.jvs.2011.02.001
更新日期:2011-04-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.03.066
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:Vascular surgery training has evolved from a single clinical year after general surgery training to a multi-year training program to encompass such entities as noninvasive vascular laboratory, office-based procedures, and endovascular techniques. Simultaneously, members of the vascular surgery community have...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.10.109
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:This study aimed to determine predictors and outcomes associated with bleeding or anemia requiring transfusion (BAT) after fenestrated or branched endovascular aneurysm repair (FB-EVAR). METHODS:Health insurance claims data of Germany's third largest insurance provider, DAK-Gesundheit, were used to investiga...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.02.059
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:Increased utilization of computed tomography angiography (CTA) has increased the radiologic diagnosis of penetrating atherosclerotic ulcers (PAUs), which are defined as the ulceration of atherosclerotic plaque through the internal elastic lamina into the aortic media. However, the presentation, treatment ind...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.005
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Percutaneous intervention for symptomatic renal artery atherosclerosis is rapidly replacing surgery in many centers. This study evaluated the anatomic and functional outcomes of endovascular therapy for atherosclerotic renal artery stenosis on a combined vascular surgery and interventional radiology service a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2003.09.024
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:Deep venous arterialization (DVA) is a technique aimed at providing an option for chronic limb-threatening ischemia patients with no options except amputation. In patients with no outflow distal targets permitting bypass, DVA involves creating a connection between a proximal arterial inflow and a distal venou...
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pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2019.10.085
更新日期:2020-06-01 00:00:00
abstract::Iatrogenic aortic injuries after spinal surgery have been described, but are rare. We describe a case of a 77-year-old woman who underwent surgical correction of a debilitating spinal deformity at an outside institution. Postoperative thoracic spine radiographs and computed tomography scans revealed a misplaced pedicl...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2003.10.056
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:Outcomes of infrainguinal bypass surgery (IBS) in patients with renal transplants are largely undescribed. This study evaluated perioperative and long-term outcomes of IBS using autogenous and prosthetic conduits in a large population-based cohort of renal transplantation patients. METHODS:A retrospective re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.086
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.08.228
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Duplex ultrasound (DUS) imaging for vein bypass graft (VBG) surveillance is confounded by technical and physiologic factors that reduce the sensitivity for detecting impending graft failure. In contrast, three-dimensional computed tomography angiography (CTA) offers high-fidelity anatomic characterization of ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.220
更新日期:2015-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jvs.2011.03.262
更新日期:2011-09-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 评论,杂志文章
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更新日期:2001-04-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1067/mva.2002.121572
更新日期:2002-04-01 00:00:00
abstract::We report the vascular surgical strategies and results in 13 patients with heparin-associated thrombocytopenia and describe useful in vitro techniques for the evaluation of anticoagulant therapy. Thirteen of 40 patients with heparin-associated thrombocytopenia had 18 cardiovascular procedures done to save life or limb...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:This study investigated the diameter of internal iliac artery (IIA) aneurysms (IIAAs) at the time of rupture to evaluate whether the current threshold diameter for elective repair of 3 cm is reasonable. The prevalence of concomitant aneurysms and results of surgical treatment were also investigated. METHODS:...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2016.06.109
更新日期:2017-01-01 00:00:00
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journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.12.014
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Arteriovenous fistula (AVF) is the preferred access for hemodialysis. Percutaneous transluminal angioplasty(PTA) has become a choice for AVF stenosis and ultrasound has been used in PTA more frequently. METHODS:This single-center retrospective cohort study analyzed 129 patients who underwent PTA in the First...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.11.041
更新日期:2020-12-16 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: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:PURPOSE:To assess primary success and safety of percutaneous transluminal angioplasty (PTA) and/or stenting of ostial/proximal common carotid artery lesions (pCCA) and to compare its 30-day stroke/mortality level with the literature data for surgical options. METHODS:A total of 147 patients (153 stenoses, 6 recurrent)...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.008
更新日期:2008-07-01 00:00:00