Abstract:
OBJECTIVE:We report 5 patients in whom a symptomatic perigraft seroma developed within the aortic sac, without vascular endoleak, after open repair of an abdominal aortic aneurysm (AAA) with a polytetrafluoroethylene (PTFE) graft. We also discuss possible relationships of this phenomenon to endovascular repair of AAAs. PATIENTS AND METHODS:Over 18 years, 1156 patients underwent repair of an AAA by one of the authors (B.M.B.). Of these, 1084 underwent open repair, 256 with PTFE grafts. Five patients in the PTFE group (2.3%) returned at a mean of 4.5 years with acute abdominal or back pain and enlargement of the aortic sac. Mean diameter of the aneurysms was 5.9 cm preoperatively and 8.1 cm at readmission. There was no evidence of vascular endoleak on computed tomography scans, but 1 patient had a retroperitoneal hematoma. RESULTS:Laparotomy in 4 patients disclosed a seroma containing firm rubbery gelatinous material under tension, histologically identified as amorphous eosinophilic material containing thrombus and degenerate blood cells in all cases. Rupture of the sac was confirmed in the patient with a retroperitoneal hematoma. The sac contents were evacuated and the integrity of the underlying grafts and anastomoses was confirmed before sac reduction, with imbricating sutures, and closure was performed. One patient died at 8 months of an unrelated cause; the other 3 patients remain well at mean follow-up of 12 months. The fifth patient received conservative treatment and remains asymptomatic 3 years after acute presentation. CONCLUSIONS:These findings of sac enlargement without vascular endoleak after open AAA repair are reminiscent of sac enlargement in the absence of endoleak after endovascular AAA repair. This has been referred to as endotension. The comparatively benign outcome in 5 patients with symptomatic sac enlargement, including 2 patients with rupture, after open AAA repair provides data to support a circumspect approach to endotension, especially in patients with asymptomatic disease, which has been reported as occurring in almost half of patients who received a PTFE Excluder endograft.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Thoo CH,Bourke BM,May Jdoi
10.1016/j.jvs.2004.08.057subject
Has Abstractpub_date
2004-12-01 00:00:00pages
1089-94issue
6eissn
0741-5214issn
1097-6809pii
S0741521404012479journal_volume
40pub_type
杂志文章abstract:INTRODUCTION:Ruptured descending thoracic aortic aneurysm (rDTAA) is associated with high mortality rates. Data supporting endovascular thoracic aortic aneurysm repair (TEVAR) to reduce mortality compared with open repair are limited to small series. We investigated published reports for contemporary outcomes of open a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2009.10.103
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:The optimal role for bare metal stents (BMS) or stent grafts (SG) in femoropopliteal occlusive disease (FPOD) is as of yet undefined. Understanding the clinical consequences of failure can help guide initial treatment decisions. The goal of this study was to define the nature, frequency, and risk factors for ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.094
更新日期:2013-12-01 00:00:00
abstract::A previous article (Part I) described the patient population and operative management of 666 patients who had surgery for nonruptured abdominal aortic aneurysms. This article details the perioperative complications and, by chi-square and logistic regression analysis, identifies the variables that are associated with e...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1067/mva.1989.vs0090437
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Acute kidney injury (AKI) has been identified as a common complication after fenestrated and branched endovascular aneurysm repair (F/BEVAR), occurring in 5% to 29% of patients. Predictors of AKI and its impact on long-term outcomes remain unknown. We sought to identify independent predictors of AKI and its e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.034
更新日期:2020-07-01 00:00:00
abstract::We report a 36-year-old man who presented with unilateral flank pain caused by renal artery occlusion with ischemia and infarction from septic emboli secondary to bacterial endocarditis. We treated the occlusion with a novel rinsing and aspiration device, the Rinspirator Thrombus Removal System (ev3, Plymouth, Minn) a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.01.013
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:Klippel-Trenaunay Syndrome (KTS) is an uncommon congenital disorder of uncertain etiology that comprises the clinical triad of varicose veins, port wine stain, and bony or soft-tissue hypertrophy. The literature suggests that the deep venous system is often under-developed. We propose that duplex venous ul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.01.040
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the clinical value and reproducibility of laser Doppler (LD) versus photoplethysmography (PPG) in the measurement of the systolic toe blood pressure. METHODS:Toe blood pressure was measured in 60 patients in different stages of peripheral vascular disease with simult...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.108009
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the ability of the Pruitt-Inahara shunt to maintain adequate middle cerebral artery velocities during carotid endarterectomy. STUDY DESIGN:Prospectively collected data recorded during 548 carotid endarterectomies performed at a single university hospital were analyzed ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mva.2000.107565
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Endovascular repair of complex abdominal aortic aneurysms has become increasingly common, but reports have mostly been limited to single centers and single devices. METHODS:We studied all endovascular repairs of complex abdominal aortic aneurysms (zone 6 or caudal) from 2014 to 2018 in the Vascular Quality ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.11.021
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The two techniques for carotid endarterectomy (CEA)--conventional (C-CEA) and eversion (E-CEA)--have different effects on blood pressure. This study compared sympathetic activity after C-CEA and E-CEA, as measured by renin and catecholamine levels. METHODS:E-CEA (n = 40) and C-CEA (n = 34) were performed in ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.01.051
更新日期:2012-08-01 00:00:00
abstract:PURPOSE:Although standard heparin has been demonstrated to reduce endothelial cell dysfunction in acute ischemia-reperfusion injury, its mechanism of action remains unknown. We hypothesized that heparin's salutary endothelial effects are independent of its conventional anticoagulant activity and are not caused by nonsp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70290-3
更新日期:1995-03-01 00:00:00
abstract::Primary portal venous aneurysms are rare; however, they are the most common visceral venous aneurysms, and their pathogenesis is not fully understood. Complications include thrombosis, rupture, and mass effect on adjacent structures. The optimal management of these patients is not known. We describe a patient whose la...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.07.063
更新日期:2011-01-01 00:00:00
abstract::A retrospective review was undertaken of a random sample (N = 73) comprising 50% of carotid endarterectomies performed during 1986 to evaluate the necessity of routine postoperative intensive care unit (ICU) admission after carotid endarterectomy. Severity of illness was determined with use of the Acute Physiology Sco...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.33418
更新日期:1991-12-01 00:00:00
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 exp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.01.002
更新日期:2008-05-01 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:BACKGROUND:Obesity is recognized as an independent predictor of coronary artery disease; however, its importance in peripheral arterial disease is less clear. The aim of this study was to assess the association between obesity and the severity and outcome of intermittent claudication. METHODS:This study was a prospect...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.09.006
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Endovascular stent-graft placement is replacing traditional surgery in type B aortic dissection. Usually stent-graft implantation is performed under fluoroscopic and angiographic guidance, but this relatively new procedure is still burdened with some complications. We investigated the value of a developed alg...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.041
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:Whereas uncomplicated acute type B aortic dissections are often medically managed with good outcomes, a subset develop subacute or chronic aneurysmal dilation. We hypothesized that computational fluid dynamics (CFD) simulations may be useful in identifying patients at risk for this complication. METHODS:Pati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.02.048
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Prior studies have suggested improved wound complication rates but decreased primary patency in lower extremity bypasses performed with endoscopic vein harvest (EVH) vs open vein harvest (OVH). We hypothesize that the inferior patency reflects the initial learning curve for EVH and that improved patency can b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.02.043
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:Embolization of the internal iliac artery (IIA) may be performed during endovascular abdominal aortic aneurysm (AAA) repair if aneurysmal disease of the common iliac artery precludes graft placement proximal to the IIA orifice. The IIA may also be unintentionally occluded because of iliac trauma or coverage b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.109750
更新日期:2000-10-01 00:00:00
abstract::When proximal arterial control cannot be obtained by standard methods, it may be achieved safely and bloodlessly by intraluminal routes with balloon catheters, hemostatic sheaths, and catheter-guide wire techniques. This method was used successfully in 20 patients to achieve proximal arterial control without complicat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70338-6
更新日期:1998-03-01 00:00:00
abstract::We report the fifth case of a graft appendiceal fistula. The four previously reported cases are reviewed. This is the first report of the utility of the tagged red blood cell study in the evaluation of a patient with a graft appendiceal fistula. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0070814
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:During endovascular aneurysm repair (EVAR), severely tortuous aortoiliac anatomy can alter the deployment and conformability of the endograft. The accuracy of treatment length measurements is commonly recognized to be affected by severe tortuosity. However, the exact mechanism of the postintervention length d...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.09.041
更新日期:2017-05-01 00:00:00
abstract::A 53-year-old woman with Loeys-Dietz syndrome developed progressive subclavian artery aneurysm and common carotid artery dissection. She was treated successfully by plugging and coiling of the subclavian aneurysm and its side branches after combined cervical debranching using standard carotid-axillary bypass and Gore ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.09.031
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To assess the effects of magnetic resonance imaging (MRI) on stainless-steel Z-stent-based abdominal aortic prostheses. METHODS:From June 1996 to December 2005, 550 patients underwent endovascular repair of an infrarenal abdominal aortic aneurysm at a single academic institution by using a stainless-steel Z-...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.11.031
更新日期:2007-03-01 00:00:00
abstract::The successful treatment of a brachial artery occlusion caused by a chronic embolizing aneurysm of the anterior humeral circumflex artery is described. In the case of embolizing axillary artery aneurysms, the best therapy is resection of the aneurysm followed by distal thromboembolectomy and vascular reconstruction by...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.25235
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:The use of cross-sectional area (CSA) measurements obtained from computed tomographic angiography (CTA) for the calculation of carotid artery stenosis has been suggested but not yet validated in a large population. The objective of this study was to determine whether CTA-derived CSA measurements were able to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.031
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:Studies have shown that a sizable percentage of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is performed outside the instructions for use (IFU). We report our long-term outcomes after EVAR with respect to device-specific IFU. METHODS:Computed tomography angiography data from a c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.01.034
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:Technical proficiency in carotid artery stent (CAS) procedures is paramount to ensure patient safety. If virtual reality (VR) simulation is to be used as a valid means for credentialing physicians for CAS procedures, the assessment parameters must be able to evaluate the performance during CAS and to differe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.06.028
更新日期:2007-11-01 00:00:00
abstract:BACKGROUND:Black patients have a higher mortality rate than nonblacks after abdominal aortic aneurysm repair. We sought to understand the factors responsible for this racial disparity in the mortality rate after aneurysm repair. METHODS:The Medicare database (2001-2006) was used to identify 160,785 patients undergoing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.05.020
更新日期:2009-10-01 00:00:00