Abstract:
PURPOSE:By acutely enhancing the arterial leg inflow, intermittent pneumatic leg compression (IPC) improves the walking ability, arterial hemodynamics, and quality of life of claudicants. We quantified the duration of acute leg inflow enhancement with IPC of the foot (IPC(foot)), calf (IPC(calf)), or both (IPC(foot+calf)) and its amplitude decay in claudicants and controls in relation to the pulsatility index, an estimate of peripheral resistance. These findings are cross-correlated with the features of the three implicated physiologic mechanisms: (1) an increase in the arteriovenous pressure gradient, (2) suspension of peripheral sympathetic autoregulation, and (3) enhanced release of nitric oxide with flow and shear-stress increase. METHODS:Twenty-six limbs of 24 claudicants with superficial femoral artery occlusion or stenoses (>75%) and 24 limbs of 20 healthy controls matched for age and sex, meeting stringent selection criteria, had their popliteal volume flow and pulsating index (peak-to-peak velocity/mean velocity) measured with duplex scanning at rest and upon delivery of IPC. Spectral waveforms were analyzed for 50 seconds after IPC delivery per 5-second segments. The three IPC modes were applied in a true crossover design. Data analysis was performed with the Page, Friedman, Wilcoxon, Mann-Whitney and chi2 tests. RESULTS:The median duration of flow enhancement in claudicants exceeded 50 seconds with IPC(foot), IPC(calf), and IPC(foot+calf) but was shorter (P < .001) in the controls (32.5 to 40 seconds). Among the three IPC modes, the duration of flow enhancement differed (P < .05) only between IPC(foot) and IPC(foot+calf). After reaching its peak within 5 seconds of IPC, flow enhancement decayed at rates decreasing over time (trend, P < .05, Page test), which in both groups were highest at 5 to 20 seconds, moderate at 20 to 35 seconds, and lowest at 35 to 50 seconds (P < .05, Friedman test). Baseline and peak flow with all IPC modes was similar between the two groups. Pulsatility index attenuation in claudicating limbs lasted a median 32.5 seconds with IPC(foot), 37.5 seconds with IPC(calf), and 40 seconds with IPC(foot+calf); duration of pulsatility index attenuation was shorter in the control limbs with IPC(foot) (30 seconds), IPC(calf) (32.5 seconds), or IPC(foot+calf) (35 seconds), yet differences, as well as those among the 3 IPC modes, were not significant. CONCLUSION:Leg inflow enhancement with IPC exceeds 50 seconds in claudicants and lasts 32.5 to 40 seconds in the controls. Peak flow occurs concurrently with maximal pulsatility index attenuation, within 5 seconds of IPC. Irrespective of group or IPC mode, the decay rate (%) of flow enhancement is highest within 5 to 20 seconds of IPC, moderate at 20 to 35 seconds, and lowest at 35 to 50 seconds. Since attenuation in peripheral resistance terminates with the mid time period (20 to 35 seconds) of flow decay, and nitric oxide has a half-life of <7 to 10 seconds, the study's data indicate that all implicated physiologic mechanisms (1, 2, and 3) are likely active immediately after IPC delivery (0 to 20 sec) and all but nitric oxide are effective in the mid time period (20 to 35 seconds). As the pulsatility index has returned to baseline, the late phase of flow enhancement (35 to 50 seconds) could be attributable to the declining arteriovenous pressure gradient alone.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Delis KT,Knaggs ALdoi
10.1016/j.jvs.2005.06.004subject
Has Abstractpub_date
2005-10-01 00:00:00pages
717-25issue
4eissn
0741-5214issn
1097-6809pii
S0741-5214(05)00970-5journal_volume
42pub_type
杂志文章abstract:OBJECTIVE:Randomized trials have shown an initial survival benefit of endovascular over conventional open abdominal aortic aneurysm repair but no long-term difference up to 6 years after repair. Longer follow-up may be required to demonstrate the cumulative negative impact on survival of higher reintervention rates ass...
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.2017.05.122
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:To determine the clinical and radiological outcomes of patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated with conservative management. METHODS:This retrospective study included 27 consecutive patients who were diagnosed with symptomatic SIDS...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.112
更新日期:2014-02-01 00:00:00
abstract::Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare vascular proliferative disorder, which most commonly involves the skin of the head and neck regions. Noncutaneous localization of this pathology is unusual, and its primary localization in large arteries presenting as a pulsatile mass is extremely rare. We r...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.12.004
更新日期:2008-05-01 00:00:00
abstract::We report the case of a 78-year-old man with coronary artery disease, chronic obstructive pulmonary disease, and chronic renal insufficiency with an enlarging 6.7-cm infrarenal abdominal aortic aneurysm. He also had a 4-cm right common iliac artery aneurysm, and right external iliac artery occlusion. The patient had a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.105
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Existing literature on unplanned reoperation (UR) after vascular surgery is limited. The frequency of 30-day UR and its association with other adverse outcomes was analyzed. METHODS:Patients who underwent vascular procedures in the American College of Surgeons National Surgical Quality Improvement Program (2...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.09.046
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:Guidelines from the Society for Vascular Surgery and the Choosing Wisely campaign recommend that peripheral vascular interventions (PVIs) be limited to claudication patients with lifestyle-limiting symptoms only after a failed trial of medical and exercise therapy. We sought to explore practice patterns and p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.005
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:This study reports our initial experience with the Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) for staged hybrid open renovisceral debranching and endovascular aneurysm repair in patients affected by thoracoabdominal aortic aneurysms and pararenal abdominal aortic aneurysms (PA...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.12.059
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:Abdominal aortic aneurysm (AAA) progression and disease resistance are related to mural cellularity; adventitial macrophages and neocapillaries predominate in larger, advanced aneurysms, whereas smaller AAAs have fewer macrophages and retain more medial smooth muscle cells (SMCs). Expression analysis of mRNA ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.02.027
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to summarize the existing literature on the efficacy of carotid endarterectomy in patients with ipsilateral symptomatic carotid stenosis. METHODS:Database searching, relevance assessment, methodologic quality assessments, and data extraction were all performed in duplicate with ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析
doi:10.1016/s0741-5214(99)70100-x
更新日期:1999-10-01 00:00:00
abstract::A 67-year-old man with previous total gastrectomy and roux-en-Y esophagojejunostomy had hematemesis 4 weeks after esophagectomy performed because of carcinoma of the esophagus. Investigation showed an aortojejunal fistula with a thoracic aortic pseudoaneurysm. Endovascular stent grafting of the pseudoaneurysm, followe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.044
更新日期:2004-12-01 00:00:00
abstract::An infected pseudoaneurysm of the right common femoral artery in a 69-year-old patient receiving methotrexate therapy was confirmed to have been caused by Mycobacterium tuberculosis. After surgical excision of the aneurysm and revascularization using femoral vein, cutaneous manifestations of M tuberculosis infection i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.024
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:The demand for vascular surgeons is expected to far exceed the current supply. In an attempt to decrease the training duration and to address the impending shortage, integrated vascular surgery residencies were approved and have expanded nationally. Meanwhile, vascular fellowships have continued to matriculat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.031
更新日期:2018-05-01 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::One hundred nine percutaneous catheterizations of synthetic vascular grafts in 89 patients who had angiographic procedures were reviewed to determine the risk of major complications. Ninety-six of the catheterizations were inserted into the inguinal portion of aortofemoral grafts. There were no instances of hematoma, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::There has been a longstanding debate about the roles of surgical bypass graft, percutaneous transluminal angioplasty, subintimal angioplasty, and conservative management for femoro-popliteal occlusive disease. Subintimal angioplasty was first described in 1987 as a method of performing an endovascular arterial bypass....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.03.046
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:Although peripheral arterial occlusive disease (PAOD) is a public health issue in the elderly population, limited population-based data are available on use of interventional procedures in Canada. We describe trends in use of interventional procedures to treat PAOD in Ontario over the past decade. METHODS:A re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00273-8
更新日期:2003-08-01 00:00:00
abstract::Fifty-five patients with 72 aneurysms of the iliac vessels were evaluated retrospectively during a 12-year period (1972 to 1985). Atherosclerotic vascular disease was found in all aneurysms. Marked male predominance (5:1) and advanced age (mean 74.6 years) characterized this population group. Two thirds of them harbor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:This study was performed to determine the effectiveness of recombinant P-selectin glycoprotein ligand Ig (rPSGL-Ig) pretreatment to decrease thrombosis and inflammation in experimental venous thrombosis. rPSGL-Ig, a unique mucin-like glycoprotein, has a high affinity for P-selectin. METHODS:Twelve juvenile b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(00)90162-9
更新日期:2000-02-01 00:00:00
abstract::A 38-year-old woman with neurofibromatosis type 1 was referred for massive swelling of the left thigh, pain, and anemia. Angiography demonstrated three saccular aneurysms of the femoropopliteal artery. The largest measured 3 cm in diameter. Resection of the aneurysms and femoropopliteal interposition grafting using re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.05.034
更新日期:2007-10-01 00:00:00
abstract:PURPOSE:We sought to analyze the results of lower limb arterial injury (LLAI) management in a busy metropolitan vascular unit and to identify risk factors associated with limb loss. PATIENTS AND METHODS:Between 1987 and 1997, prospectively collected data on 550 patients with 641 lower limb arterial injuries were analy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2001.113982
更新日期:2001-06-01 00:00:00
abstract::As CT scanning has evolved as a reliable clinical tool, the use of angiography in the diagnosis of aortic aneurysmal disease has diminished. Fewer than 25% of patients with aortic aneurysmal disease undergo aortic angiographic evaluation at our institution. A prospective clinical study was undertaken to assess the val...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:This investigation describes the perioperative and early follow-up results associated with transcarotid artery revascularization (TCAR) in patients not participating in the Safety and Efficacy Study for Reverse Flow Used During Carotid Artery Stenting Procedure II (ROADSTER-2) registry using the ENROUTE neuro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.06.222
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:Conventional end-to-side anastomosis to establish venous outflow for prosthetic arteriovenous grafts often requires operative patch angioplasty within 1 year because of venous stenosis. Rather than conventional venous anastomosis, a modified end-to-side anastomosis at a 15-degree angle with a flow diffuser wa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.187
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:Dementia has been associated with increased complications and mortality in orthopedics and other surgical specialties, but has received limited attention in vascular surgery. Therefore, we evaluated the association of dementia with surgical outcomes for elderly patients with Medicare who underwent a variety o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.07.087
更新日期:2020-05-01 00:00:00
abstract:INTRODUCTION:Fenestrated endovascular aneurysm repair (FEVAR) is the highest radiation dose procedure performed by vascular surgeons. We sought to characterize the radiation dose to patients and staff during FEVAR procedures with different premanufactured devices. METHODS:A single-center prospective study of FEVARs wa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.031
更新日期:2018-11-01 00:00:00
abstract::Carotid endarterectomy was performed in 152 patients during a 27-month period. The first 82 patients had primary closure of the arteriotomy, whereas the subsequent 70 patients underwent closure with Dacron patch angioplasty. Duplex scanning was undertaken postoperatively in 102 of these patients with a mean follow-up ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:This study was conducted to determine the outcomes and predictive factors for success during percutaneous endovascular aneurysm repair (PEVAR) using vascular closure devices (VCDs). METHODS:The clinical data of patients who underwent PEVAR between 2005 and 2012 were retrospectively reviewed. Patient demograp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.028
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:Data regarding the cardiac abnormalities associated with Stanford type B aortic dissection (TBAD) and whether these abnormalities are related to outcomes are limited. We describe the prevalence of cardiac abnormalities in patients with TBAD as detected by echocardiography. METHODS:This retrospective review i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.09.050
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:Endovascular aneurysm repair (EVAR) has increasingly been used as the primary treatment approach for abdominal aortic aneurysm (AAA). This study examined the hypothesis that EVAR leads to an increased risk of abdominal cancer within the radiation field compared with open AAA repair. METHODS:The nationwide En...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.09.058
更新日期:2019-06-01 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