1,721,220 research outputs found
Chirurgia endovascolare per patologia dell'aorta toracica: fattori predittivi per le complicanze postoperatorie e di follow-up.
No full textmissin
Preoperative pleural effusion in acute type B aortic dissections: simple, fast ... but not enough
No full text'Ulcer-like projection' in uncomplicated acute type B intramural haematoma: might we prevent or protect from an unexpected event?
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Comparison between aorto-bifemoral bypass and aorto-iliac kissing stent in patients with complex aorto-iliac obstructive disease
No full textTo retrospectively compare early and late results of aorto-bifemoral bypass
and endovascular recanalization with the kissing stent technique in
the management of TASC II C and D lesions in the aorto-iliac district in a
multicentric study
Materials/ Methods: F rom January 2006 to December 2013, 293 open and endovascular interventions
for TASC-II class C and D aorto-iliac obstructive lesions were
performed at three Italian teaching hospitals. In 210 patients the intervention
was performed for aortic and bilateral iliac involvement: an
aorto-bifemoral bypass was performed in 82 patients (Group 1) while in
the remaining 128 an endovascular recanalization with the kissing stent
technique (Group 2). Early results in the two groups were compared with
X2 test. Follow-up results were analyzed with Kaplan-Meyer curves and
compared with log rank test
Results: There were no differences between the two groups in terms of demographic
data, comorbidities, risk factors for atherosclerosis, except for
an higher percentage of females and of diabetic patients in group 2.
Critical limb ischemia was present in 29 patients in group 1 (35.5%) and
in 31 patients in group 2 (24%, p=0.07). Technical success in group 2 was
98.5%; two patients required immediate conversion to open surgery for
iliac rupture. There was one perioperative death in group 1 (mortality rate
1.2%, p=0.2 in comparison with group 2). Four perioperative thromboses
occurred, two in group 1 and two in group 2 (in one case requiring conversion
to open surgical intervention) and no amputations at 30 days were
recorded. Postoperative local and systemic complications occurred in 20
patients in group 1 (24%) and in 13 patients in group 2 (10% p=0.006).
Mean duration of follow-up was 39 months (range 1-108 months). Survival
rates at 6 years were 65% (SE 0.07) in group 1 and 82% (SE 0.05) in group
2 (p=0.07). At the same time interval, primary, assisted primary and secondary
patency rates were similar; reintervention rates were 6% in group
1 (SE 0.05) and 11% in group 2 (SE 0.04; p=0.2).
Conclusion: Endovascular repair of complex lesions of aorto-iliac district with the
kissing stent-technique provided in this multicentric experience similar
satisfactory early and late results to those obtained with open surgery,
however with a lower rate of perioperative complications and a trend
towards better long-term survival
Incidence of vascular injuries following the use of the Angio-Seal closure device following endovascular procedures in a single Center
No full textINTRODUCTION: Percutaneous closure devices have been used to obtain rapid hemostasis and early mobilization of the patient after arterial catheterization. However, we observed challenging problems with the sealing procedure that require further surgical intervention. The present report is a retrospective analysis of the patterns of injury and the final outcome of four cases of femoral artery injury following the use of Angio-Seal.
METHODS: During the last 24 months, in a group of 175 patients (131 men, 44 women; median age 68.4 years, range 47-81 years) underwent percutaneous closure after diagnostic (n = 53) or therapeutic (n = 122) endovascular procedures. Among them we observed four patients (three men, one woman; median age 65.2 +/- 10.8 years, range 47-75 years) who developed severe limiting claudication and required vascular repair of an iatrogenic vascular injury following deployment of the Angio-Seal. They had a femoral thrombosis due to narrowing/severe intimal dissection.
RESULTS: All patients required operative intervention with removal of the device. We performed femoropopliteal thrombectomy and common femoral endarterectomy with patch angioplasty (n = 2), resection of the femoral bifurcation and reimplantation of the deep femoral artery (n = 1), and femoral bifurcation endarterectomy with direct arterial suture (n = 1). The median hospital stay was 6.5 +/- 3.8 days (range 4-12 days). Limb salvage was achieved in all of the surviving patients at a mean follow-up of 7 months (range 1-12 months).
CONCLUSIONS: Vascular injuries are uncommon after use of the hemostasis closure device. When they occur, however, they are likely to require challenging surgical correction
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