Journal of vascular surgery
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We report the case of a 51-year-old woman who underwent kyphoplasty with polymethylmethacrylate for painful compression fracture of the third lumbar vertebra. Infiltration of cement into the inferior vena cava, noted intraoperatively, was confirmed with postoperative CT scan. ⋯ Endovascular technique was used to retrieve it to the common femoral vein with subsequent successful removal of the crescent-like fragment with operative exploration. Patient was asymptomatic at four-week follow-up visit.
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We investigated the outcomes of reinforcing anastomotic sites using (1) nonbiodegradable polytetrafluoroethylene (PTFE) felt, (2) biodegradable polyglycolic acid (PGA) felt, and (3) PGA felt with basic fibroblast growth factor (bFGF) in a canine descending thoracic aortic replacement model. ⋯ Reinforcement of the experimental aortic wall with PTFE felt resulted in thinning of the media and adventitia and fewer vessels at the anastomotic site. These histologic changes were not observed when biodegradable felt was used. The bFGF failed to augment the modification of the aortic wall with the exception of increased adventitial vessel number. Biomechanical strength of the anastomosis along the longitudinal axis was comparable in all four groups; however, local vascular compliance was better in the biodegradable PGA felt group.
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Comment Letter Historical Article
Why is the last name of William Stewart Halsted misspelled as "Halstead"?
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Multicenter Study
Factors associated with death 1 year after lower extremity bypass in Northern New England.
Using 30-day operative mortality reported with lower extremity bypass (LEB) in preoperative decision making may underestimate the actual death rate encountered before patients have truly recovered from surgery, especially in elderly, debilitated patients with significant tissue loss. Therefore, we examined preoperative, patient-level risk factors that predict survival within the first year following LEB. ⋯ Preoperative risk factors allow surgeons to predict survival in the first year following LEB, and to more precisely inform patients about their operative risk with LEB. Additionally, our model facilitates benchmarking comparison of risk-adjusted outcomes across our region. We believe quality improvement measures such as these will allow surgeons to identify best practices and thereby improve outcomes with LEB across centers.