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  • 刊频: Quarterly, 2011-
  • NLM标题: Ann Vasc Dis
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837条结果
  • 机译 改善静脉移植的结果:血管外科医师应否将静脉变成动脉?
    摘要:Autogenous vein grafts remain the gold standard conduit for arterial bypass, particularly for the treatment of critical limb ischemia. Vein graft adaptation to the arterial environment, i.e., adequate dilation and wall thickening, contributes to the superior performance of vein grafts. However, abnormal venous wall remodeling with excessive neointimal hyperplasia commonly causes vein graft failure. Since the PREVENT trials failed to improve vein graft outcomes, new strategies focus on the adaptive response of the venous endothelial cells to the post-surgical arterial environment. Eph-B4, the determinant of venous endothelium during embryonic development, remains expressed and functional in adult venous tissue. After surgery, vein grafts lose their venous identity, with loss of Eph-B4 expression; however, arterial identity is not gained, consistent with loss of all vessel identity. In mouse vein grafts, stimulation of venous Eph-B4 signaling promotes retention of venous identity in endothelial cells and is associated with vein graft walls that are not thickened. Eph-B4 regulates downstream signaling pathways of relevance to vascular biology, including caveolin-1, Akt, and endothelial nitric oxide synthase (eNOS). Regulation of the Eph-B4 signaling pathway may be a novel therapeutic target to prevent vein graft failure.
  • 机译 动脉注射静脉回流引导技术治疗婴儿股静脉的新技术
    摘要:Objectives: Although venography guidance is helpful for central venous catheter placement, it is sometimes difficult to place a peripheral intravenous cannula for enhancement. We designed a new technique for establishing femoral venous access using venography guidance in the return phase of peripheral arteriography. This new technique was named arterial injection venous return guidance. Here we assessed the efficacy and safety of arterial injection venous return guidance.Methods: We reviewed data of 29 infants less than 6 months old undergoing catheter intervention at our institute in 2014. Of the 29 patients, femoral venous cannulation was performed using arterial injection venous return guidance in 5 patients, venography in 20 patients, and the landmark method in 4 patients. The technical success rates and incidence of complications were compared.Results: The overall success rates were 100% in the arterial injection venous return-guided and venography-guided groups. The mean procedure duration and mean contrast material injection time were similar between the groups. The contrast effect on the femoral vein in the arterial injection venous return-guided group was lower than that in the venography-guided group, but adequate for surgery. The overall complication rate was 17%, and obstruction of previously placed intravenous catheters was the most common complication.Conclusions: Therefore, the arterial injection venous return guidance technique was as safe and efficient as venography for establishing venous access.
  • 机译 通过涉及血管内夹紧,血管内置换和开放性腹部减压的综合管理改善破裂性腹主动脉瘤的结果
    摘要:Objective: Endovascular repair has become the treatment of choice for ruptured abdominal aortic aneurysms (RAAAs). To improve surgical outcomes, preoperative management is important. In 2011, we introduced integrated management, which involves endovascular aneurysm repair, stabilization of hemodynamics by endovascular clamping, and open abdominal decompression to address abdominal compartment syndrome (ACS).Methods: To evaluate the efficacy of this management strategy, 62 patients who had undergone emergency surgery for an RAAA were analyzed retrospectively: group A (n=39), where an old strategy was used, and group B (n=23), where integrated management was introduced. Patient characteristics and 30-day mortality rates were compared between the two groups.Results: The average patient age was 67.7 years and 74.7 years for groups A and B, respectively (P=0.032). Group B patients required more frequent use of vasopressors (P=0.035). Other patient characteristics did not differ between the two groups. The duration of surgery was significantly shorter in group B than in group A (P=0.001). The total amount of transfused blood did not differ between the two groups. No patients showed symptoms of ACS. Early mortality rates were 12.8% and 8.7% in groups A and B, respectively. The number of wound infections was significantly fewer in group B than in group A.Conclusion: Although group B patients were significantly older and had a higher rate of vasopressor use, early mortality was improved in both groups. Morbidity was significantly better in group B with respect to the duration of surgery and number of wound infections than in group A.
  • 机译 霉菌性主动脉瘤的外科治疗
    摘要:Purpose: A mycotic aneurysm is an uncommon disease associated with a high mortality rate when managed surgically. This study reviewed our experiences in the surgical management of mycotic aortic aneurysms.Methods: In total, 26 patients who underwent surgery for a mycotic aneurysm were retrospectively reviewed. The mycotic aneurysms involved the thoracic aorta in 9 patients, the thoracoabdominal aorta in 4 patients, and the abdominal aorta in 13 patients. An overt aortic rupture in the mediastinum or retroperitoneal space was detected in 4 patients. Patients were classified into one of two groups, febrile or afebrile, and background characteristics, surgical intervention, and early and late mortalities were all compared.Results: There were 19 patients who underwent open surgery, and 7 patients underwent endovascular repair. No significant differences in the clinical characteristics were found between the two groups; however, the incidence of postoperative complications was significantly higher in the febrile group than in the afebrile group (P=0.024). Overall mortality was 15.4% (4/26), and 30-day mortality was 7.7% (2/26).Conclusion: Although febrile patients had a higher incidence of postoperative complications, surgical mortality from a mycotic aneurysm was within an acceptable range. Each patient should be thoroughly evaluated and treated on a case-by-case basis, using conventional open repair, endovascular repair, or a combination of both approaches.
  • 机译 使用肾下主动脉延长套囊救治升主动脉假性动脉瘤的血管内支架置入术
    摘要:We report successful thoracic endovascular repair of a pseudoaneurysm rupture in the ascending aorta using infrarenal endovascular devices after an aortic valve replacement. Complete exclusion of the pseudoaneurysm was achieved with no endoleak or postoperative complications. Despite limitations of the current technology, this endovascular technique was a relatively less invasive, feasible lifesaving surgical option for the repair of a pseudoaneurysm of the ascending aorta with a diameter ≤32 mm.
  • 机译 腹主动脉瘤的混合修复:马蹄肾患者血管内动脉瘤修复的分支。
    摘要:Abdominal aortic aneurysm (AAA) with associated horseshoe kidney (HSK) poses a technical challenge when performing conventional open surgical repair because of possible complications including renal infarction, neuralgia, and collecting system disruption. Endovascular aortic repair (EVAR) is considered the first-line treatment for this pathology, allowing for aneurysm repair without isthmus bisection. However, whether to sacrifice commonly presenting aberrant renal arteries during EVAR is a point of controversy. We report a case in which hybrid repair was performed for AAA to preserve aberrant renal vasculature in a patient with HSK.
  • 机译 肢体缺血持续性坐骨动脉瘤:两例报告
    摘要:We report two cases of persistent sciatic artery (PSA) aneurysm with limb ischemia. Physicians who treat peripheral artery disease should be aware that PSA is a very rare congenital malformation of the lower extremities that is potentially hazardous, and that revascularization should be performed when a PSA aneurysm is treated.
  • 机译 Kommerell憩室和右侧主动脉弓的血管内修复
    摘要:A 74-year-old man with hoarseness was diagnosed with a right-sided aortic arch and Kommerell’s diverticulum by computed tomography (CT). The diverticulum had a maximum diameter of 33 mm, and surgical intervention was chosen because of the possibility of rupture. A right common carotid to right subclavian artery bypass was constructed, stent-graft was placed after the branching of the right common carotid artery, and coil embolization of the diverticulum was performed via left brachial artery. No leaks were found on postoperative CT. Symptoms disappeared and the diverticulum became smaller soon after surgery. Thoracic endovascular aortic repair (TEVAR) for Kommerell’s diverticulum was safe and effective.
  • 机译 涤纶移植物修复A型剥离后的纵隔移植物血清
    摘要:Perigraft seromas are uncommon after surgical repair of the thoracic aorta with woven polyester grafts. A 50-year-old woman required redo sternotomy for the treatment of a perigraft seroma 6 months after total arch replacement for acute type A dissection. After removal of a jelly-like mass, a prosthetic graft was covered with fibrin glue, and the bilateral pleurae beside the graft were opened widely for drainage of effusion into the bilateral pleural cavities. Bacterial culture and laboratory and histological examination of the content confirmed the final diagnosis of perigraft seroma. No evidence of recurrence was observed 4 months after drainage.
  • 机译 斯坦福大学B型主动脉夹层合并严重肢体缺血的支架移植后逆行升主动脉夹层
    摘要:We report a rare case of retrograde Stanford type A aortic dissection after endovascular repair for complicated Stanford type B aortic dissection. A 45-year-old man presented with a sudden onset of back pain and was transferred to our hospital. Computed tomography demonstrated acute Stanford type B aortic dissection with lower limb ischemia. Emergency endovascular surgery was planned for repair of the Stanford type B aortic dissection. The patient suddenly developed recurrent chest pain 10 days after the initial procedure. Computed tomography revealed retrograde Stanford type A aortic dissection involving the ascending aorta and aortic arch. The patient underwent a successful emergency total aortic arch replacement.
  • 机译 下肢大静脉畸形成功完成手术切除:一例报告
    摘要:Venous malformations (VMs) are the most common type of vascular malformations, resulting from errors in vascular morphogenesis. Because of the wide variety in their presentations, selecting the appropriate treatment, especially for large VMs, may be challenging. Herein, we report a case of a 59-year-old man with a large VM in the lower extremity who achieved favorable outcomes by complete surgical resection. Even large VMs can be successfully treated with surgery when patients are properly selected. An accurate and careful evaluation is essential for achieving optimal outcome in patients with VMs.
  • 机译 腔内腹主动脉瘤修补术治疗破裂感染性动脉瘤后胸腹主动脉置换:一例报告
    摘要:A 73-year-old man underwent emergency endovascular abdominal aneurysm repair (EVAR) for a ruptured infected abdominal aortic aneurysm. Two years after EVAR, he was admitted with a spiking fever and left lower back pain. Computed tomography scan revealed not only recurrent graft infection with psoas abscess but also infection around the orifice of the superior mesenteric artery. Because conservative medical therapy with antibiotics could not control the infection, we performed complete removal of the infected stent graft, debridement of psoas abscess, and in situ replacement of the thoracoabdominal aorta using rifampicin-soaked prosthetic grafts, followed by the omental flap. He was discharged with no complications.
  • 机译 胸腔内血管主动脉修复后的Supraceliac主动脉Ib型内漏的嫁接植入物插入吻合术
    摘要:Open surgery for a type Ib endoleak after thoracic endovascular aortic repair is associated with some knacks and pitfalls, particularly in cases wherein the distal edge of a stent graft is located at just supraceliac aorta and the renovisceral segment and infrarenal aorta do not require surgical intervention. Here we describe the invaginated graft insertion technique to provide an easy and secure anastomosis in such clinical situations. This procedure may be feasible for anastomosis between a prosthetic vascular graft and a previously deployed stent graft when the location of the anastomosis is distant from the surface of the skin incision with a narrow and limited surgical view.
  • 机译 股骨浅表股动脉远行逆行使用领先者导管冲洗远端股总动脉
    摘要:We present the case of an 81-year-old female with flush occlusion of the superficial femoral artery (SFA) and percutaneous transluminal angioplasty. Initially, the antegrade approach failed due to flush occlusion without stump. Hard, round surfaced, calcific, and eccentric plaque of the ostium of SFA was also present, which involved distal common femoral artery (CFA). Thus, we successfully used a Frontrunner catheter for retrograde reentry at the lower position of the CFA. Various treatment strategies involving Frontrunner and atherectomy devices could make percutaneous procedures possible in femoropopliteal occlusive disease, involving the CFA.
  • 机译 右主动脉弓对科默勒憩室的血管内治疗
    摘要:We report a rare case of type A dissection involving a right-sided aortic arch with an aberrant left subclavian artery originating from Kommerell’s diverticulum in a 76-year-old woman. Endovascular treatment for Kommerell’s diverticulum including intimal tear of the dissection was performed. At the 5-year follow-up, the patient was doing well, with no endoleak or dilatation of the Kommerell’s diverticulum.
  • 机译 勘误表
    • 作者:
    • 刊名:Annals of Vascular Diseases
    • 2017年第1期
    摘要:
  • 机译 勘误表
    • 作者:
    • 刊名:Annals of Vascular Diseases
    • 2017年第1期
    摘要:
  • 机译 接受静脉内激光和大隐静脉射频消融的患者术后静脉血栓栓塞
    摘要:Objective: Endovenous laser ablation (EVLA) and radiofrequency ablation (RFA) are safe and effective treatments for varicose veins caused by saphenous reflux. Deep venous thrombosis (DVT) and endovenous heat-induced thrombosis (EHIT) are known complications of these procedures. The purpose of this article is to investigate the incidence of postoperative DVT and EHIT in patients undergoing EVLA and RFA.Methods: The patients were assessed by clinical examination and venous duplex ultrasonography before operation and at 24–72 hours, 1 month, and 1 year follow-up after operation. Endovenous ablation (EVA) had been treated for 1026 limbs (835 patients) using an RFA; 1174 limbs (954 patients) using a 1470-nm wavelength diode laser with radial two-ring fiber (1470R); and 6118 limbs (5513 patients) using a 980-nm wavelength diode laser with bare-tip fiber (980B).Results: DVT was detected in 3 legs (0.3%) of RFA, 5 legs (0.4%) of 1470R, and 27 legs (0.4%) of 980B. One patient in three symptomatic DVT treated with 980B developed asymptomatic pulmonary embolus. In all, 31 of the 35 DVTs were confined to the calf veins. The incidence of EHIT classes 2 and 3 was 2.7% following RFA procedure, 6.7% after 1470R, and 7.5% after 980B.Conclusion: The incidence of EHIT following EVA was low, especially the RFA procedure. EHIT resolves within 2–4 weeks in most patients. DVT rates after EVA were compared with those published for saphenous vein stripping. (This is a translation of J Jpn Coll Angiol 2015; 55: 153–161.)
  • 机译 静脉注射口腔细菌的周围血管疾病的实验模型
    摘要:Objective: The purpose of this study was to observe the direct effects of oral bacteria, such as Porphyromonas gingivalis (Pg) and Treponema denticola (Td), on the peripheral vasculature.Materials and Methods: Beagles were directly injected (at various doses) with Pg or Td. Each leg vein was exposed, ligated at proximal and distal sites, and then injected with bacteria diluted with sterile saline. The collected vascular tissue was examined microscopically, and samples of the vascular tissue and blood were cultured and then subjected to the polymerase chain reaction (PCR) in order to detect the bacterial deoxyribonucleic acid (DNA).Results: No genes of the injected bacteria were detected in the Td-inoculated blood or vascular tissue samples collected 2 weeks after the injection. The Pg gene was also not detected in the blood samples collected 4 weeks after the injection although it was detected in the vascular tissue using PCR. Microscopic examinations showed that the inflammatory reactions in the perivascular tissue increased in a bacterial dose-dependent manner, as expected.Conclusion: We observed the direct effects of oral bacteria on vascular tissue. Further studies are needed to investigate the correlations between oral bacteria and systemic diseases. (This article is a translation of Jpn J Phlebol 2015; 26: 41-6.)
  • 机译 用射频装置或1470-nm激光和径向2环光纤加热的血管的形态比较
    摘要:Introduction: Radio waves and lasers can be used as heat sources during endovenous thermal ablation (EVTA) for saphenous vein insufficiency. A morphological comparison of veins that had been treated with EVTA was performed between those treated with an endovenous closure system (a radiofrequency [RF] system) and those treated with a Radial 2Ring fiber connected to a 1470-nm laser generator (2R).Methods: The experiment was conducted in a system that reproduces the physiological conditions found in the saphenous veins during EVTA. The 2R experiment was performed at two different power levels, 60 J/cm (2R-60) and 90 J/cm (2R-90). The heated vessels were morphologically examined in detail, and the detected morphological changes were classified into three groups: low-temperature changes (LTC), mid-temperature changes (MTC), and high-temperature changes (HTC). The thickness of the layers exhibiting each type of change was measured.Results: In the 2R groups, HTC, MTC, and LTC were observed from the superficial to deep layers. In the 2R-60 group, the layers exhibiting LTC, MTC, and HTC were 17 ± 3.2, 42 ± 10.5, and 190 ± 14.6 µm thick, respectively. In the 2R-90 group, these layers were 14 ± 4.0, 105 ± 64.2, and 363 ± 71.3 µm thick, respectively. In the RF group, only LTC were observed (thickness: 251 ± 72.6 µm).Conclusions: The RF device was able to heat the target vessels more efficiently than the laser device. (This article is a translation of Jpn J Phlebol 2015; 26: 23–8.)

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