Journal of vascular surgery
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Review Meta Analysis
Meta-analysis of open versus endovascular repair for ruptured descending thoracic aortic aneurysm.
Ruptured descending thoracic aortic aneurysm (rDTAA) is associated with high mortality rates. Data supporting endovascular thoracic aortic aneurysm repair (TEVAR) to reduce mortality compared with open repair are limited to small series. We investigated published reports for contemporary outcomes of open and endovascular repair of rDTAA. ⋯ Endovascular repair of rDTAA is associated with a significantly lower 30-day mortality rate compared with open surgical repair. TEVAR was associated with a considerable number of aneurysm-related deaths during follow-up.
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Review Case Reports
Successful repair of a ruptured Stanford type B aortic dissection during pregnancy.
We present our experience with an acute Stanford type B aortic dissection in a 25-year-old, 26-week gravid patient without a known connective tissue disorder and discuss a literature-based treatment strategy. After failed conservative treatment manifest by aneurysm rupture, emergency cesarean section delivery and immediate repair of her thoracic aorta was performed. ⋯ During pregnancy, thoracic aortic dissection occurs from physiologic and hemodynamic changes. Emergency cesarean delivery, followed by immediate aortic repair, is the treatment choice if malperfusion syndrome, rupture, uncontrolled hypertension, or unremitting pain occurs.
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Varicose veins are a frequent burden, also in the small saphenous system. Yet its basic anatomy is not described consistently. We therefore investigated the fascial and neural relationships of the small saphenous vein (SSV) as well as the frequency and position of valves and the different junctional patterns, also considering the thigh extension. ⋯ Two fascial points or regions can be described in the SSVs' course and its own saphenous fascia is demonstrated macroscopically in almost all cases. The neural topography is highly individual. The SPJ is highly individual where we found hitherto unclassified patterns in a remarkable number of veins. Venous valves are not as frequent as we supposed them to be. Furthermore, not all most proximal valves seem to be terminal valves.
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This study evaluated virtual reality (VR) simulation for endovascular training of medical students to determine whether innate perceptual, visuospatial, and psychomotor aptitude (VSA) can predict initial and plateau phase of technical endovascular skills acquisition. ⋯ Simulator-based training in endovascular skills improved performance in medical students. There were significant correlations between initial endovascular skill and fine motor dexterity as well as with image recall at end of the training period. In addition to current recruitment strategies, VSA may be a useful tool for predictive validity studies.
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To determine diversity in the membership and analyze representation of private practitioners and ethnic and racial minorities/women in senior leadership roles in a regional vascular society. ⋯ Ethnic and racial minorities and women are under represented in the membership compared with the general population, medical school graduates, and faculty. PPs and non-white male academics are under represented in senior leadership positions. With changing demographics, a predicted shortage of vascular surgeons, the need for role models in leadership positions and a push to culturally competent care, regional and national societies must change course and promote a more diverse membership and representative senior leadership.