Perspectives in vascular surgery and endovascular therapy最新文献

{"title":"Use of the Hardman index in predicting mortality in endovascular repair of ruptured abdominal aortic aneurysms.","authors":"Daniel M Conroy,&nbsp;Nishath Altaf,&nbsp;Steve D Goode,&nbsp;Bruce D Braithwaite,&nbsp;Shane T MacSweeney,&nbsp;Toby Richards","doi":"10.1177/1531003511408737","DOIUrl":"https://doi.org/10.1177/1531003511408737","url":null,"abstract":"<p><strong>Purpose: </strong>The Hardman index is a predictor of 30-day mortality after open ruptured abdominal aneurysm repair through the use of preoperative patient factors. The aim of this study was to assess the Hardman index in patients undergoing endovascular repair of ruptured aortic aneurysms.</p><p><strong>Materials and methods: </strong>A retrospective analysis of 95 patients undergoing emergency endovascular repairs of computed tomography-confirmed ruptured aneurysms from 1994 to 2008 in a university hospital was performed. All relevant patient variables, calculations of the Hardman index, and the incidence of 30-day mortality were collected in these patients. Correlation of the relationship between each variable and the overall score with the incidence of 30-day mortality was undertaken.</p><p><strong>Results: </strong>The 24-hour mortality was 16% and 30-day mortality 36%. Increasing scores on the Hardman index showed an increasing mortality rate. Thirty-day mortality in patients with a score of 0 to 2 was 30.5%, and in those with a score of ≥3 was 69.2% (P = .01, risk ratio = 2.26, 95% confidence interval = 0.98 to 5.17). This is lower than predicted in both patient groups based on Hardman index score. Loss of consciousness was the only statistically significant independent predictor of 30-day mortality with a risk ratio of 3.16 (95% confidence interval = 2.00-4.97, P < .001).</p><p><strong>Conclusion: </strong>These data suggest that the Hardman index can predict an increased risk of 30-day mortality from endovascular repairs of ruptured aortic aneurysms. However, mortality from endovascular repair is much lower than would be predicted in open repair and it therefore cannot be used clinically as a tool for exclusion from intervention.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"274-9"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511408737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30050020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for recurrent varicose veins: toward a less-invasive approach?","authors":"Marianne De Maeseneer","doi":"10.1177/1531003511408338","DOIUrl":"https://doi.org/10.1177/1531003511408338","url":null,"abstract":"<p><p>Redo surgery for recurrent varicose veins, involving the saphenofemoral junction (SFJ) or saphenopopliteal junction has a bad reputation because it is a laborious, time-consuming intervention, characterized by a high incidence of postoperative complications. Moreover, outcome is worse than after primary surgery. This is illustrated by long-term (5 years) prospective follow-up of 235 reoperated limbs after redo procedure at the SFJ, all performed at the University Hospital of Antwerp between 1991 and 2009. Such invasive redo procedures will soon belong to the past because, nowadays, many less-invasive alternatives are available: phlebectomies without reopening the groin, focusing on the \"varicose reservoir\"; limited redo surgery with combined with foam sclerotherapy; endovenous ablation of a residual refluxing saphenous trunk; ultrasound-guided foam sclerotherapy; embolization treatment of pelvic vein incompetence; and treatment of an underlying deep-venous obstruction. All these interventions can be performed in an ambulatory setting, without need for general anesthesia.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"244-9"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511408338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30050958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Late gastrointestinal complications of inferior vena cava filter placement: case report and literature review\".","authors":"Marc A Passman","doi":"10.1177/1531003511411727","DOIUrl":"https://doi.org/10.1177/1531003511411727","url":null,"abstract":"","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"265-6"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511411727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30546014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stepwise age-related outcomes of elective endovascular abdominal aortic aneurysm repair: 11-year institutional review.","authors":"Mila H Ju,&nbsp;Mark L Keldahl,&nbsp;William H Pearce,&nbsp;Mark D Morasch,&nbsp;Heron E Rodriguez,&nbsp;Melina R Kibbe,&nbsp;Mark K Eskandari","doi":"10.1177/1531003511430396","DOIUrl":"https://doi.org/10.1177/1531003511430396","url":null,"abstract":"<p><strong>Objective: </strong>Endovascular repair of abdominal aortic aneurysms (EVAR) has largely supplanted open surgery over the past 2 decades. Faced with an aging population, the outcomes of EVAR among various age groups were examined.</p><p><strong>Method: </strong>Retrospective review of elective EVAR cases was performed at a single institution from 1998 to 2009. Patients were separated into 4 age groups for easy comparison. Perioperative data were analyzed using Fisher's exact test.</p><p><strong>Results: </strong>Demographics were similar among the groups except for sex, BMI, and smoking status. The 30-day morbidity and mortality data were not statistically different among groups. From EVAR to end of the study, there was a 10.9% all-cause mortality rate (with no difference among groups) and an 8.0% reintervention rate (with the oldest age group having a lower reintervention rate; P < .03).</p><p><strong>Conclusions: </strong>EVAR remains a good treatment option for elective aneurysm repair despite advanced age, which alone does not appear to be an independent predictor of outcome.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"280-90"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511430396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30354762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's new in veins?","authors":"Sterre Irene Langendoen,&nbsp;H A Martino Neumann","doi":"10.1177/1531003512442090","DOIUrl":"https://doi.org/10.1177/1531003512442090","url":null,"abstract":"<p><p>Reflux cannot be interpreted without knowledge of the function of the calf muscle pump. The presence or absence of reflux alone has an insufficient predictive value for excellent functional treatment results. Valves are not simple moving slips but have an autonomous 4-step cycle movement that helps the calf muscle pump to be very effective. New calculations of the Starling equilibrium have shown that capillary filtration fraction returns mainly by the lymphatics. All these new findings help the phlebologist design a more precise and thus better treatment plan in phlebology practice.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"229-32"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003512442090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30546013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late gastrointestinal complications of inferior vena cava filter placement: case report and literature review.","authors":"Frank Vandy,&nbsp;John E Rectenwald,&nbsp;Enrique Criado","doi":"10.1177/1531003511409058","DOIUrl":"https://doi.org/10.1177/1531003511409058","url":null,"abstract":"<p><p>In current practice, inferior vena cava (IVC) filters are commonly used in the prevention of pulmonary embolism. Despite their widespread use, periprocedural as well as late complications do occur. Filter penetration of the IVC wall into surrounding structures, including bowel, is a known although rare complication. This complication may manifest with abdominal pain, gastrointestinal bleeding, duodenocaval fistula, or small bowel obstruction. The authors present a case of abdominal pain from duodenal penetration by a Greenfield IVC filter 13 years after insertion. A detailed operative description and pertinent review of the literature is provided.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"261-4"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511409058","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30050018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of varicose veins: does each technique have a formal indication?","authors":"Olivier Pichot,&nbsp;Marianne De Maeseneer","doi":"10.1177/1531003511433337","DOIUrl":"https://doi.org/10.1177/1531003511433337","url":null,"abstract":"<p><p>Nowadays, various surgical and endovenous methods are available to treat varicose veins. Theoretically, every technique is applicable to treat any kind of patient. However, it seems appropriate to consider the specific indications and limitations of each of the techniques. To choose the most appropriate treatment method, several issues have to be taken into account. The patient's reason for consulting and clinical condition will define the aim of the treatment. Anatomical and hemodynamic characterization of the varicose veins by means of duplex ultrasound will define the technical feasibility. Although a definitive algorithm still remains to be developed, some of the most important questions that should be included in a decision tree can already be proposed: Is high ligation necessary or at least justified? Is stripping or ablation necessary or at least justified, and in that case, what is the most appropriate technique to be used? All this should help us define a reasonable \"à la carte\" treatment for each patient.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"250-4"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511433337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of stenting for postthrombotic venous obstructive lesions.","authors":"Olivier Hartung","doi":"10.1177/1531003512438407","DOIUrl":"https://doi.org/10.1177/1531003512438407","url":null,"abstract":"<p><p>Venous obstructive lesions represent a therapeutic challenge. Postthrombotic lesions are the most complex and very prone to rethrombosis. Technical success can be achieved in more than 85% of the cases (100% when recanalization with thrombolysis is not needed) with a low rate of periprocedural complications and no mortality. The overall rate of thrombotic events after stenting is around 5%. Patency rates depend on multiple criteria, including the need for thrombolysis and the involvement of the common femoral vein and of the inferior vena cava. Primary, assisted-primary, and secondary patency rates were 67%, 89%, and 93%, respectively, at 6 years in the study by Neglén and 66%, 70%, and 77%, respectively, in the intention-to-treat European multicentric study, at 5 and 10 years. Stenting is a minimally invasive and safe technique with good long-term clinical results and patency rates. It represents the method of choice for the treatment of postthrombotic iliofemoral venous obstructions.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":" ","pages":"255-60"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003512438407","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40144525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficiency of pain control using a thigh pad under the elastic stocking in patients following venous stripping: results of a case-control study.","authors":"J P Benigni,&nbsp;F A Allaert,&nbsp;P Desoutter,&nbsp;G Cohen-Solal,&nbsp;X Stalnikiewicz","doi":"10.1177/1531003511431737","DOIUrl":"https://doi.org/10.1177/1531003511431737","url":null,"abstract":"<p><strong>Background: </strong>The use of a specific thigh foam pad placed under compression stockings increases interface pressure. The interface pressure obtained under 2 medical compression stockings of 15 to 20 mm Hg at the ankle, is 14 ± 2.2 mm Hg in the middle of the thigh in the horizontal position and rises to 49.2 ± 4.7 mm Hg when an appropriate thigh foam pad is interposed. Thigh compression could be useful in relieving pain after surgery of the great saphenous vein.</p><p><strong>Objective: </strong>The aim of this study was to compare pain intensity on day 1 and day 7 and global mean pain during the week after stripping of the great saphenous vein between patients to whom a pad has been added at the thigh level under the compression stocking (case) and patients wearing a compression stocking only (control).</p><p><strong>Methods: </strong>Case-control study conducted in daily surgical practice by patients having undergone surgical stripping. Main criteria: pain self-evaluation on visual analogue scale from day 1 to day 7 adjusted for analgesic consumption. No pain evaluation was conducted on Day 0 because of the fact that the elastic compression was applied in the operating room on a patient still under anesthesia. Results. A total of 53 patients were included in the study: 36 in the pad group and 17 in the control group. Patients were similar in respect of age, sex ratio, body mass index, professional status, and CEAP (clinical, etiologic, anatomic, and pathophysiologic) classification. On day 1, pain was 40.8 ± 20.8 in the control group and 27.4 ± 24.2 in the pad group (P = .05). On day 7, pain was 15.3 ± 13.4 in the control group and 3.7 ± 5.5 in the pad group (P < .0001). Global mean pain during the week after stripping surgery was 156.5 ± 80.6 in the control group and 80.1 ± 82.01 in the pad group (P < .0001).</p><p><strong>Conclusion: </strong>The results of this case-control study show that the addition of a pad at thigh level under the elastic compression stocking significantly reduces pain experienced by patients during the week after stripping surgery by 49%.</p>","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"238-43"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511431737","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30380213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Late gastrointestinal complications of inferior vena cava filter placement: case report and literature review\".","authors":"David L Gillespie","doi":"10.1177/1531003511429157","DOIUrl":"https://doi.org/10.1177/1531003511429157","url":null,"abstract":"","PeriodicalId":87201,"journal":{"name":"Perspectives in vascular surgery and endovascular therapy","volume":"23 4","pages":"267"},"PeriodicalIF":0.0,"publicationDate":"2011-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1531003511429157","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30294982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}