Journal of vascular surgery
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This study was conducted to determine the results of left subclavian artery (LSA) coverage during thoracic endovascular aortic repair (TEVAR). ⋯ Zone 2 TEVAR with LSA coverage can be accomplished safely in both elective and emergency settings and with and without revascularization (with the exception of a patent LIMA-LAD bypass). Nevertheless, overall stroke rates are higher compared with all-zone TEVAR. Staged LSA revascularization and even urgent revascularization may be necessary but can be performed without long-term detriment to the left arm.
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Fusion of the spine is often performed from an anterior approach requiring mobilization of aorta, iliac artery, and vein. This study describes the preferred techniques and incidence of vascular complications at a spine center. ⋯ Exposure to the lumbar spine can be readily accomplished via a retroperitoneal approach. Minor vascular injuries during exposure, mostly venous, are not uncommon and are easily repaired. They are increased when L4-5 is part of the exposure and are lowest when L5-S1 alone is exposed. Major injuries occur in less than 2% of patients.
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Multicenter Study Controlled Clinical Trial
Pivotal results of the Medtronic Vascular Talent Thoracic Stent Graft System: the VALOR trial.
This report summarizes the 30-day and 12-month results of endovascular treatment using the Medtronic Vascular Talent Thoracic Stent Graft System (Medtronic Vascular, Santa Rosa, Calif) for patients with thoracic aortic aneurysms (TAA) who are considered candidates for open surgical repair. ⋯ The pivotal VALOR 12-month trial results demonstrate that the Medtronic Talent Thoracic Stent Graft System is a safe and effective endovascular therapy as an alternative to open surgery in patients with TAA who were considered candidates for open surgical repair.
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Review Case Reports
Combined thenar and hypothenar hammer syndromes: case report and review of the literature.
Patients who use the palms of their hands as a hammer may cause irreversible damage to the radial or ulnar arteries. Damage to the intima may lead to arterial thrombosis, whereas damage to the media may cause aneurysm formation with embolization to the digital arteries, causing symptoms of ischemia. These patients may have symptoms of Raynaud syndrome, or they may have ischemic ulcerations of their fingers. ⋯ In our review of the literature, we found two reports involving a total of four patients with similar findings. Both conservative and surgical treatments have been used successfully. Avoidance of the precipitating activities is important in long-term management of these patients.
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It has been reported recently that resveratrol preconditioning can protect the brain from ischemia-reperfusion injury. However, it was unclear whether resveratrol administration after stroke was beneficial to the delayed phases after focal cerebral ischemia injury. This study investigated the effects and possible protective mechanism of resveratrol on the delayed phase after focal cerebral ischemia injury in mice. ⋯ Resveratrol administration by gavage provided an important neuroprotective effect on focal cerebral ischemic injury in the delayed phase. The elevated MMP-2 and VEGF levels might be important in the neuroprotective effect of resveratrol administration by inducing angiogenesis.