Abstract:
:Arterial and venous trauma of the cervicothoracic region continues to present challenging problems for the surgeon, despite advances in vascular diagnostics and surgical technique. Whether due to penetrating or blunt mechanisms, overall incidence of these injuries is low, whereas morbidity and mortality remain high. Despite collective experience from busy trauma centers, there still remain controversies regarding diagnostic evaluation, operative approach, and surgical treatment of these potentially devastating injuries. Therefore, this article compares and contrasts recent literature and controversies surrounding the treatment of cervicothoracic trauma. Pros and cons of duplex ultrasonography and angiography in the diagnosis of carotid and vertebral artery injury are highlighted, and selective versus mandatory neck exploration for zone II penetrating injuries are discussed. Increasing awareness of blunt carotid artery injury is emphasized, including management dilemmas that frequently accompany this type of injury. In addition, we review interventional radiological techniques for the management of vertebral artery injury and surgical approaches for aortic arch branch vessel or major cervicothoracic vein injury.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
McIntyre WB,Ballard JLsubject
Has Abstractpub_date
1998-12-01 00:00:00pages
232-42issue
4eissn
0895-7967issn
1558-4518journal_volume
11pub_type
杂志文章,评审abstract::Innovation in medicine is often driven by the observations of imaginative physicians who are blessed with insatiable curiosity, coupled with the inability to accept technical boundaries, the status quo of patient care, or the acceptance of procedural morbidity. Few examples illustrate this truism better than the physi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2018.03.002
更新日期:2018-03-01 00:00:00
abstract::The training of vascular surgeons in Canada has evolved over the past decade. Direct entry into a vascular surgery training program after medical school has been offered since 2012. At some institutions, it is the only option for surgery training. The smaller population of Canada and a single-payer health care system ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2019.01.009
更新日期:2019-01-01 00:00:00
abstract::There is a need for a standardized consistent language in vascular surgery that allows easy flow of information and comparison of results among clinicians. Beginning with current nomenclature, a common language serves as a framework for more detailed efforts. Understanding the outcomes assessment tools available provi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2010.01.002
更新日期:2010-06-01 00:00:00
abstract::Aortic infection is an uncommon but life-threatening condition. Conservative medical treatment is insufficient in many cases because of the high risk of persistent infection, aortic rupture, and death. Conventional open surgical treatment consists of extensive tissue debridement, complete removal of the infected prost...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.10.009
更新日期:2011-12-01 00:00:00
abstract::In the United States, 90% of carotid intervention is being performed for asymptomatic carotid stenosis, even though 90% of patients would be better treated with intensive medical therapy. This is being justified by comparing risks of stroke or death with medical therapy during clinical trials completed decades ago (ap...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2017.04.011
更新日期:2017-03-01 00:00:00
abstract::The increasing availability of and vascular surgeons' familiarity with digital cine-fluoroscopy in the operating room has been facilitated by the advent and growing popularity of endovascular aortoiliac aneurysm repair and other endovascular techniques that are being incorporated into vascular surgical practice. Digit...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2003.08.006
更新日期:2003-12-01 00:00:00
abstract::Patients with end-stage liver disease (ESLD) who develop hepatorenal syndrome (HRS) have very high mortality rates. For patients with HRS type I, median survival without specific therapy is only 2 weeks. Due to worsening clinical condition in such patients secondary to uremia and hepatic disease, some form of renal re...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.semvascsurg.2017.04.001
更新日期:2016-12-01 00:00:00
abstract::Venous hypertension is a significant problem for the patient on chronic hemodialysis. This condition can result in impairment of arteriovenous access function, disabling upper extremity edema with bluish discoloration and pigmentation of the skin, and, in advanced cases, ulceration of the finger tips and neuralgias. V...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2003.11.002
更新日期:2004-03-01 00:00:00
abstract::Thromboembolic vascular diseases remain the main cause of death in Western industrialized societies. Anticoagulants retard the formation, growth, and embolization of thrombi and are effective agents in the prevention and treatment of thromboembolic disease. Anticoagulants in venous thromboembolism have been investigat...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2002.36261
更新日期:2002-12-01 00:00:00
abstract::In recent years, vascular surgery fellowships have changed substantially to meet the requirements for interventional as well as open surgical training. Data from the Residency Review Committee for Surgery indicate that the average vascular fellow performed fewer than 15 interventional procedures in 2000, but that this...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2006.08.005
更新日期:2006-12-01 00:00:00
abstract::Ischemia-reperfusion injury is a continuing challenge to vascular surgeons. Microvascular factors and mechanisms underlying edema and compartment syndrome provide a useful end point for analysis and planning of therapy. We review the pivotal role of endothelium-leukocyte interactions and of cytokines in the genesis of...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract::Our understanding of cerebrovascular disease in women is hampered by a paucity of studies that include adequate numbers of female patients. Most studies are heavily biased toward men. Although women have fewer strokes than men and have a better long-term prognosis after strokes or TIAs, cerebrovascular disease still a...
journal_title:Seminars in vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验,评审
doi:
更新日期:1995-12-01 00:00:00
abstract::The decision to operate on a patient with an aortic aneurysm is based on the risk of aneurysm rupture versus the risk of aneurysm repair, within the context of the patient's overall life expectancy. Risk of rupture is still primarily based on the maximum aneurysm diameter, with some allowances made for factors that mo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.04.001
更新日期:2007-06-01 00:00:00
abstract::Over the last decade, more than 25,000 endovascular stent grafts have been used to treat aortic aneurysms. Although results have been promising thus far, problems with endoleaks, material failure, device migration, and aneurysm rupture continue to be reported. Improvements in device material and design have contribute...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0895-7967(03)00006-1
更新日期:2003-06-01 00:00:00
abstract::For generations, the use of techniques to defer skin pressure and protect the lower-extremity wound has been a cardinal goal to achieve therapeutic success and healing. Choosing the appropriate postoperative offloading device or shoe is often difficult, as it is challenging to merge optimal mechanical protection with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.10.002
更新日期:2014-03-01 00:00:00
abstract::In this article, the use of prosthetic grafts for above-the-knee femoral-popliteal arterial bypass reconstruction is discussed. The issue as to whether prostheses should be used preferentially, selectively, or not at all, remains both topical and controversial in vascular surgical circles. The debate has been heighten...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract::Early detection of abdominal aortic aneurysms potentially can save many lives by preventing aneurysm rupture. Screening programs, however, have yet to be proven as an efficient means of accomplishing this goal and improving overall life expectancy. Until more information is available, selective high-risk screening may...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.25491
更新日期:2001-09-01 00:00:00
abstract::Constructing vascular access for hemodialysis causes changes in blood flow to the extremity, which can lead to distal ischemia. Ischemic steal syndrome is manifested by pain; weakness; pallor; and, in severe cases, ulceration and tissue loss. Severe ischemia, requiring reintervention, has an incidence of 4%, although ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.07.009
更新日期:2007-09-01 00:00:00
abstract::Elimination of the embolic potential of existing thrombus, restoration of unobstructed flow, prevention of further thrombosis, and preservation of venous valve function are the ideal goals of therapy for acute deep vein thrombosis (DVT). Meeting these goals will not only prevent pulmonary embolus, but will also minimi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2010.10.002
更新日期:2010-12-01 00:00:00
abstract::Duplex ultrasound testing has evolved to be a clinically useful modality for the evaluation of chronic mesenteric ischemia (CMI) due to visceral artery origin atherosclerosis. Patients with known or suspected CMI can be scanned to identify stenosis or occlusion of the celiac, superior mesenteric, and inferior mesenter...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2013.11.005
更新日期:2013-06-01 00:00:00
abstract::Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2010.05.001
更新日期:2010-09-01 00:00:00
abstract::Acute limb ischemia is one of the most potentially devastating but treatable diseases faced by the vascular surgeon. It is crucial to identify the ischemic process early, as the outcomes of early intervention can lead to limb salvage, whereas late recognition places the patient at risk for limb loss and potential mort...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.12.004
更新日期:2009-03-01 00:00:00
abstract::While open or endovascular techniques for treatment of the superficial femoral artery continue to dominate the care of most patients, there are clearly patients who benefit from a combination of these approaches. Typically these patients require treatment of more than a single level of disease. In these cases, endovas...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.11.006
更新日期:2008-12-01 00:00:00
abstract::Thrombembolic complications frequently occur during and after endovascular procedures because of associated arterial injury and thrombotic characteristics of implanted devices such as stents. New strategies in platelet aggregation inhibition are now available blocking the final and common pathway of platelet aggregati...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.23171
更新日期:2001-06-01 00:00:00
abstract::Chronic venous disease includes a spectrum of clinical presentations ranging from varicose veins through chronic lower extremity pain and edema to venous skin changes and ulceration. Such manifestations may result from primary venous insufficiency or be secondary to other disorders, primarily acute deep venous thrombo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract::Renal artery stenting remains an important adjuvant treatment for true-resistant hypertension, although recent disappointing randomized trials highlight the importance of careful patient selection. Safe and successful renal interventions begin with critical core knowledge regarding renal artery anatomy and understandi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.06.002
更新日期:2013-12-01 00:00:00
abstract::Nutcracker syndrome is one of the abdominal venous entrapments, caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Occasionally a retro-aortic left renal vein is compressed between the aorta and the vertebral body (posterior nutcracker syndrome). The renal vein...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2013.04.006
更新日期:2013-03-01 00:00:00
abstract::The evolution of vascular surgery during the past five decades has established what was once controversial to be mandate, what was never dreamed of as debatable, and the vast body of knowledge yet to be unraveled--but requiring clinical application--as currently controversial. Controversy results when dissimilar thera...
journal_title:Seminars in vascular surgery
pub_type: 历史文章,杂志文章
doi:
更新日期:1999-03-01 00:00:00
abstract::Because endovascular procedures represent an ever-increasing portion of many vascular surgery practices, many surgeons are faced with difficult choices. Endovascular procedures often require open surgery, and open surgical techniques increasingly require fluoroscopic imaging. Without good intraoperative imaging, endov...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1999-12-01 00:00:00
abstract::The obturator bypass is a useful method for revascularizing the lower extremity in the presence of a hazardous groin dissection. The most common indication for employing this method of reestablishing arterial continuity is in circumventing infected vascular prostheses. One- and 5-year patency rates of 72.7% and 56.9% ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00