Journal of vascular surgery
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The impact of risk factors upon perioperative mortality might differ for patients undergoing open vs endovascular repair (EVAR) of abdominal aortic aneurysms (AAA). In order to investigate this, we developed a differential predictive model of perioperative mortality after AAA repair. ⋯ Mortality after AAA repair is predicted by comorbidities, gender, and age, and these predictors have similar effects for both methods of AAA repair. This simple scoring system can predict repair mortality for both treatment options and thus may help guide clinical decisions.
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The depth of veins can discourage surgeons from creating radial-cephalic arteriovenous accesses for hemodialysis in obese patients. Elevation and tunneled transposition are the two techniques that have been described to superficialize these veins and make them accessible for cannulation. Unfortunately, such manipulation of veins has potential drawbacks. We report lipectomy, a new technique that removes subcutaneous fat and does not mobilize the vein. ⋯ Lipectomy is a safe, effective, and durable approach to make deep arterialized forearm veins accessible for routine cannulation for hemodialysis in obese patients. It might even be hypothesized that incident obese dialysis patients will eventually have the highest proportion of radial-cephalic fistulas because they often have distal veins that have been preserved by their fat from previous attempts at cannulation for blood sampling or infusion.
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Case Reports
Symptomatic perforation of a retrievable inferior vena cava filter after a dwell time of 5 years.
Symptomatic caval perforation is a rare complication of inferior vena cava filter placement, and there is little evidence on which to base clinical practice in such circumstances. We report a case of caval wall perforation 5 years after insertion of a retrievable Günther Tulip filter (William Cook Europe, Bjaeverskov, Denmark) and describe the operative procedure involved in its removal. To our knowledge this is the first reported case of symptomatic caval perforation caused by a Günther Tulip filter.
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We performed radiofrequency ablation to treat a symptomatic facial venous malformation of a 24-year-old woman under ultrasound scan-guidance. The 20.25-cm sized original facial venous malformation in her right cheek markedly reduced without any scar formation and was grossly not visible after 1 month of the procedure. In the 3-month follow-up magnetic resonance imaging, original venous malformation reduced in volume to 5.40 cm. Radiofrequency ablation may provide an alternative treatment for facial venous malformations.