Journal of vascular surgery
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Although patient preference and outcome data support continued development and use of minimally invasive endovascular therapies, only a few studies have documented radiation exposure to the patient. This report summarizes patient radiation exposure by endovascular procedure at Cleveland Clinic. ⋯ The increasing complexity of endovascular interventions has resulted in increased radiation exposure to all involved, with the highest doses occurring in aneurysm repairs. Future innovations should concentrate on reducing the risk of radiation exposure to all personnel and developing newer imaging techniques.
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Thoracic aortic anomalies are rare and may be associated with pathologic vascular conditions necessitating intervention. We present a case of a patient with a left aortic arch, right descending thoracic aorta, and a Kommerell's diverticulum giving rise to an aberrant right subclavian artery. The Kommerell's diverticulum was successfully managed with a right carotid to subclavian artery bypass and thoracic endograft exclusion.
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Endovascular treatment of traumatic aortic injury (TAI) is an alternative to open repair (OR) in patients with blunt trauma. We report our initial experience after integration of endovascular repair using thoracic devices. ⋯ In this initial experience, the results of TEVAR did not differ from OR. Long-term follow-up is required to determine the effectiveness of this treatment strategy. Adherence to follow-up imaging protocols is challenging in this patient population. Next generation devices will make TEVAR applicable to a wider range of patients.
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Metabolic syndrome (MetS) is rapidly increasing in prevalence and is associated with carotid plaque development and is a risk factor for stroke. The aim of this study is to describe the outcomes for patients with MetS after carotid revascularization (carotid endarterectomy [CEA] and carotid stenting [CAS]). ⋯ MetS is prevalent among patients undergoing carotid revascularization. MetS patients are at a greater risk for perioperative morbidity as well as stroke, MI, and MAE during follow-up when compared to patients without MetS. Long-term stroke prevention is poor in the presence of MetS. MetS should be considered a significant risk factor for patients undergoing carotid revascularization.
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Review Case Reports
Clostridium septicum aortitis: Report of two cases and review of the literature.
Clostridium septicum aortitis is a rare infection that has a strong association with occult colonic malignancy. To our knowledge, we report the 25th and 26th cases of C septicum aortitis in the English literature and make recommendations for its management. The first patient was a 75-year-old man who presented with abdominal pain. ⋯ Both patients were found to have concurrent colon adenocarcinomas. C septicum aortitis is a lethal disease that necessitates prompt surgical intervention and appropriate antibiotic therapy. The strong association of C septicum with occult malignancy should prompt the astute clinician to undertake an exhaustive search for a neoplastic process.