Vascular Specialist International最新文献_第7页

Aortic Endograft Infection: Diagnosis and Management. 主动脉内膜感染：诊断和治疗。

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Vascular Specialist International Pub Date : 2023-09-21 DOI: 10.5758/vsi.230071

Young-Wook Kim

{"title":"Aortic Endograft Infection: Diagnosis and Management.","authors":"Young-Wook Kim","doi":"10.5758/vsi.230071","DOIUrl":"https://doi.org/10.5758/vsi.230071","url":null,"abstract":"Aortic endograft infection (AEI) is a rare but life-threatening complication of endovascular aneurysm repair (EVAR). The clinical features of AEI range from generalized weakness and mild fever to fatal aortic rupture or sepsis. The diagnosis of AEI usually depends on clinical manifestations, laboratory tests, and imaging studies. Management of Aortic Graft Infection Collaboration (MAGIC) criteria are often used to diagnose AEI. Surgical removal of the infected endograft, restoration of aortic blood flow, and antimicrobial therapy are the main components of AEI treatment. After removing an infected endograft, in situ aortic reconstruction is often performed instead of an extra-anatomic bypass. Various biological and prosthetic aortic grafts have been used in aortic reconstruction to avoid reinfection, rupture, or occlusion. Each type of graft has its own merits and disadvantages. In patients with an unacceptably high surgical risk and no evidence of an aortic fistula, conservative treatment can be an alternative. Treatment results are determined by bacterial virulence, patient status, including the presence of an aortic fistula, and hospital factors. Considering the severity of this condition, the best strategy is prevention. When encountering a patient with AEI, current practice emphasizes a multidisciplinary team approach to achieve an optimal outcome.","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"26"},"PeriodicalIF":0.9,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c6/45/vsi-39-26.PMC10512004.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endovascular Treatment of a Giant Aneurysm of the Aberrant Right Hepatic Artery in a Patient with Osler-Weber-Rendu Syndrome: A Case Report. 血管内治疗奥斯勒-韦伯-伦度综合征右肝动脉巨动脉瘤1例。

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Vascular Specialist International Pub Date : 2023-09-05 DOI: 10.5758/vsi.230055

Mehmet Burak Çildağ, Mustafa Gök, Tuğba Öztürk, Ömer Faruk Kutsi Köseoğlu

{"title":"Endovascular Treatment of a Giant Aneurysm of the Aberrant Right Hepatic Artery in a Patient with Osler-Weber-Rendu Syndrome: A Case Report.","authors":"Mehmet Burak Çildağ, Mustafa Gök, Tuğba Öztürk, Ömer Faruk Kutsi Köseoğlu","doi":"10.5758/vsi.230055","DOIUrl":"https://doi.org/10.5758/vsi.230055","url":null,"abstract":"Osler-Weber-Rendu syndrome (OWR) is an autosomal dominant disorder characterized by recurrent epistaxis, mucocutaneous or visceral telangiectasias, and arteriovenous malformations in the lungs, liver, brain, and gastrointestinal tract. Hepatic artery aneurysms (HAAs) can also occur in OWR patients. HAAs are the second most common type of visceral artery aneurysm, and mortality rates are high owing to the lack of a tamponade effect. Anatomical variations of the celiacomesenteric vasculature are common, and the most common variation is that of the right hepatic artery originating from the superior mesenteric artery (SMA). We present the endovascular treatment of a patient with OWR and an aberrant right HAA originating from the SMA, with coil embolization and stent grafting. Giant HAAs can be treated endovascularly. However, stent graft placement should be reconsidered because of the need for antithrombotic medication, which may increase the incidence of epistaxis attacks in that patient group.","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"25"},"PeriodicalIF":0.9,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0e/62/vsi-39-25.PMC10480046.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10171227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Technical Tips for Performing Suprahepatic Vena Cava Tumor Thrombectomy in Renal Cell Carcinoma without Using Cardiopulmonary Bypass. 不经体外循环的肾细胞癌肝上腔静脉肿瘤取栓技术提示。

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Vascular Specialist International Pub Date : 2023-09-04 DOI: 10.5758/vsi.230056

Jun Gyo Gwon, Yong-Pil Cho, Youngjin Han, Jungyo Suh, Seung-Kee Min

{"title":"Technical Tips for Performing Suprahepatic Vena Cava Tumor Thrombectomy in Renal Cell Carcinoma without Using Cardiopulmonary Bypass.","authors":"Jun Gyo Gwon, Yong-Pil Cho, Youngjin Han, Jungyo Suh, Seung-Kee Min","doi":"10.5758/vsi.230056","DOIUrl":"https://doi.org/10.5758/vsi.230056","url":null,"abstract":"Radical nephrectomy with tumor thrombectomy for advanced renal cell carcinoma is an oncologically relevant approach that can achieve long-term survival even in the presence of distant metastases. However, the surgical techniques pose significant challenges. The objective of this clinical review was to present technical recommendations for tumor thrombectomy in the vena cava to facilitate surgical treatment. Transesophageal echocardiography is required to prepare for this procedure. Cardiopulmonary bypass should be considered when the tumor thrombus has invaded the cardiac chamber and clamping is not feasible because of the inability to milk the intracardiac chamber thrombus in the caudal direction. Prior to performing a cavotomy, it is crucial to clamp the contralateral renal vein and infrarenal and suprahepatic inferior vena cava (IVC). If the suprahepatic IVC is separated from the surrounding tissue, it can be gently pulled down toward the patient's leg until the lower margin of the atrium becomes visible. Subsequently, the tumor thrombus should be carefully pulled downward to a position where it can be clamped. Implementing the Pringle maneuver to reduce blood flow from the hepatic veins to the IVC during IVC cavotomy is simpler than clamping the hepatic veins. Sequential clamping is a two-stage method of dividing thrombectomy by clamping the IVC twice, first suprahepatically and then midretrohepatically. This sequential clamping technique helps minimize hypotension status and the Pringle maneuver time compared to single clamping. Additionally, a spiral cavotomy can decrease the degree of primary closure narrowing. The oncological prognoses of patients can be improved by incorporating these technical recommendations.","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"23"},"PeriodicalIF":0.9,"publicationDate":"2023-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/32/3e/vsi-39-23.PMC10480049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10171225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ectopic Variceal Bleeding from the Hepaticojejunostomy due to Extrahepatic Portal Vein Occlusion: How to Treat? 肝外门静脉阻塞致肝空肠吻合术出血:如何治疗?

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Vascular Specialist International Pub Date : 2023-09-04 DOI: 10.5758/vsi.230053

Ahram Han, Seung-Kee Min

引用次数: 0

Spontaneous Celiac Artery Dissection with Splenic Infarction: A Report of Two Cases. 自发性腹腔动脉夹层合并脾梗死2例报告。

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Vascular Specialist International Pub Date : 2023-09-04 DOI: 10.5758/vsi.230067

Suh Min Kim, Hyunmin Ko

引用次数: 0

Surgical Considerations for the Management of an Ectopic Main Renal Artery Originating from an Abdominal Aortic Aneurysm. 源自腹主动脉瘤的肾主动脉异位的外科治疗。

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Vascular Specialist International Pub Date : 2023-07-26 DOI: 10.5758/vsi.230029

Thomas Kotsis, Ourania Preza, Panagitsa Christoforou

引用次数: 0

Bilateral Isolated Common and Internal Iliac Artery Aneurysms Treated with Iliac Branch Endoprostheses Using the Gluteal Arteries as Distal Landing Zones. 以臀动脉为远端着陆区髂支假体治疗双侧孤立髂总动脉和髂内动脉瘤。

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Vascular Specialist International Pub Date : 2023-07-21 DOI: 10.5758/vsi.230048

Nikolaos Kontopodis, Konstantinos Tzirakis, Nikolaos Galanakis, Christos V Ioannou

{"title":"Bilateral Isolated Common and Internal Iliac Artery Aneurysms Treated with Iliac Branch Endoprostheses Using the Gluteal Arteries as Distal Landing Zones.","authors":"Nikolaos Kontopodis, Konstantinos Tzirakis, Nikolaos Galanakis, Christos V Ioannou","doi":"10.5758/vsi.230048","DOIUrl":"https://doi.org/10.5758/vsi.230048","url":null,"abstract":"A 52-year-old male presented with bilateral isolated type III, 45-mm common and internal iliac artery (CIA and IIA) aneurysms (Fig. 1, 2) [1]. Both the CIAs exhibited an adequate proximal non-aneurysmatic segment, whereas the IIAs were aneurysmatic throughout their length (Fig. 3, 4). The patient underwent percutaneous endovascular treatment using iliac branch endoprosthesis (IBE) systems bilaterally (W. L. Gore and Associates, Inc.). The right superior and left inferior gluteal arteries were used as distal landing zones, as these presented lesser tortuosity than did the right inferior and left superior gluteal arteries, which were embolized before IBE deployment with 7-mm coils. Initially, self-expandable covered stents (Viabahn 9×100 mm; W. L. Gore & Associates, Inc.) were placed distally within the target vessels to better conform their anatomy. Subsequently, these stents were connected to the internal iliac leg of the IBE with balloon-expandable covered stents (VBX 11×79 mm; W. L. Gore & Associates, Inc.). The patient’s postoperative course was uneventful, with immediate mobilization Im ge of Vacular Srgery Bilateral Isolated Common and Internal Iliac Artery Aneurysms Treated with Iliac Branch Endoprostheses Using the Gluteal Arteries as Distal Landing Zones","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"20"},"PeriodicalIF":0.9,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/4f/vsi-39-20.PMC10359765.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair. 血管内动脉瘤修复术中髂内动脉中断的临床结果。

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Vascular Specialist International Pub Date : 2023-07-21 DOI: 10.5758/vsi.230032

Hyeon Ju Kim, Deokbi Hwang, Hyung-Kee Kim, Seung Huh, Woo-Sung Yun

{"title":"Clinical Outcomes of Internal Iliac Artery Interruption during Endovascular Aneurysm Repair.","authors":"Hyeon Ju Kim, Deokbi Hwang, Hyung-Kee Kim, Seung Huh, Woo-Sung Yun","doi":"10.5758/vsi.230032","DOIUrl":"10.5758/vsi.230032","url":null,"abstract":"Purpose: This study aimed to investigate the clinical outcomes of internal iliac artery (IIA) interruption during endovascular aneurysm repair (EVAR) and to identify the risk factors for ischemic complications.Materials and methods: Endovascular treatment was performed in 316 patients with aneurysms or pseudoaneurysms of the abdominal aorta or iliac arteries between March 2006 and January 2022. Medical records and radiological imaging studies were retrospectively reviewed. The incidences of buttock claudication, ischemic colitis, and spinal cord ischemia after IIA interruption were investigated as clinical outcomes. Binary logistic regression analysis were performed to identify the risk factors.Results: IIA embolization was performed in 78 patients. Among the 42 patients who underwent IIA flow preservation procedures, the one-month computed tomography detected early failure in five patients. The origin of the IIA was covered with an endograft in ten patients who did not undergo embolization. Eventually, interruption of the IIA by EVAR was observed in 93 patients. Considering preoperative IIA occlusion, there was a total of six patients who did not have at least one IIA patency. Buttock claudication occurred in 32.6% of the patients, and none of the patients had ischemic colitis or spinal cord ischemia. In multivariable analysis, age ≤80 years and isolated iliac artery aneurysm were associated with the development of postoperative buttock claudication.Conclusion: The most common complication after IIA interruption is buttock claudication; however, critical complications such as ischemic colitis or spinal cord ischemia are rare, even in bilateral IIA occlusion. Adjunctive procedures to preserve bilateral IIA perfusion should be adopted selectively.","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"19"},"PeriodicalIF":0.9,"publicationDate":"2023-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c8/ad/vsi-39-19.PMC10359766.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endovascular Aneurysm Repair Using the ALTO Endograft in a Patient with a Very Tight 10-mm Aortic Bifurcation. 应用ALTO血管内移植物修复10毫米主动脉分叉狭窄患者的血管内动脉瘤。

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Vascular Specialist International Pub Date : 2023-06-30 DOI: 10.5758/vsi.230037

Nikolaos Kontopodis, Nikolaos Galanakis, Christos V Ioannou

{"title":"Endovascular Aneurysm Repair Using the ALTO Endograft in a Patient with a Very Tight 10-mm Aortic Bifurcation.","authors":"Nikolaos Kontopodis, Nikolaos Galanakis, Christos V Ioannou","doi":"10.5758/vsi.230037","DOIUrl":"https://doi.org/10.5758/vsi.230037","url":null,"abstract":"Endovascular aneurysm repair (EVAR) is the primary treatment modality for abdominal aortic aneurysms; however, a suitable anatomy is a prerequisite for optimal outcomes. Proximal neck anatomic configuration, including length followed by size and angulation, is the main morphometric characteristic that determines EVAR suitability. Iliac landing zone and access vessels’ adequacy should also be considered [1]. Another characteristic that may affect EVAR feasibility but has received less attention is the presence of a narrow aortic bifurcation (NAB). Data on EVAR outcomes in patients with NAB are scarce and heterogeneous. Overall, EVAR in patients with NAB has been reported to present outcomes similar to those in patients with a standard aortic bifurcation at the expense of considerably more iliac limb stentings and overall adjunctive manipulations during the primary procedure [2,3]. Regarding the definition of NAB, most relevant studies have used a threshold of <20 mm, although <18 mm and <16 mm thresholds have also been used [3]. We report a patient with a very tight 10-mm aortic bifurcation who was successfully treated with an ALTO (Endologix Inc.) endograft (Fig. 1, 2). In this case, simultaneous deployment of the iliac limbs was performed, in contrast to the standard technique in which the contralateral limb is deployed first. Specifically, the","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"18"},"PeriodicalIF":0.9,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1a/5e/vsi-39-18.PMC10318495.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9752040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Below-Knee Prosthetic Bypass Is a Viable Option for Limb Salvage in Patients with Extensive Femoropopliteal Occlusive Disease. 膝下假体旁路是广泛股腘动脉闭塞性疾病患者保肢的可行选择。

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Vascular Specialist International Pub Date : 2023-06-29 DOI: 10.5758/vsi.230028

Younghye Kim, Ji Hyun Jung, Deokbi Hwang, Woo-Sung Yun, Seung Huh, Hyung-Kee Kim

{"title":"Below-Knee Prosthetic Bypass Is a Viable Option for Limb Salvage in Patients with Extensive Femoropopliteal Occlusive Disease.","authors":"Younghye Kim, Ji Hyun Jung, Deokbi Hwang, Woo-Sung Yun, Seung Huh, Hyung-Kee Kim","doi":"10.5758/vsi.230028","DOIUrl":"https://doi.org/10.5758/vsi.230028","url":null,"abstract":"Purpose: This study aimed to (1) evaluate the outcomes of below-knee prosthetic bypass (BKPB) in the absence of the great saphenous vein, and (2) identify risk factors associated with these outcomes.Materials and methods: This study included 37 consecutive patients who underwent BKPB with or without distal modification between 2010 and 2022. We further assessed the following treatment outcomes: primary patency (PP), secondary patency (SP), limb salvage (LS), and amputation-free survival (AFS) rates. The risk factors for PP were also examined.Results: Most patients (n=31) were male. In 32 (86.5%) patients, BKPBs were performed for chronic limb-threatening ischemia. At the time of initial admission, two (5.4%) early deaths and three (8.1%) major amputations were noted. At 1 year after BKPB, the overall PP, SP, LS, and AFS rates were 78%, 85%, 85%, and 70%, respectively; at 3 years, they were 58%, 70%, 80%, and 52%, respectively; and at 5 years, they were 35%, 58%, 62%, and 29%, respectively. Notably, PP was significantly lower in limbs with ≤1 patent tibial arteries than in limbs with ≥2 patent artery (hazard ratio [HR], 3.80; 95% confidence interval [CI], 1.14-12.69 for overall; and HR, 12.97; 95% CI, 2.15-78.08 for distal anastomosis to below-knee popliteal artery). However, the PP was unaffected by the distal modification.Conclusion: BKPB is a viable option for LS in patients with extensive femoropopliteal disease. Tibial runoff was significantly correlated with patency; therefore, decision-making for BKPB and follow-up must involve careful evaluation of the outflow arteries.","PeriodicalId":52311,"journal":{"name":"Vascular Specialist International","volume":"39 ","pages":"16"},"PeriodicalIF":0.9,"publicationDate":"2023-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/ed/vsi-39-16.PMC10308069.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9731878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0