Journal of vascular surgery
-
Patients with aortic dissection were studied to define (1) anatomic and physiologic derangements in renal artery blood flow, (2) differences in clinically suspected renal malperfusion and true functional malperfusion, and (3) variations in endovascular interventions for the treatment of renal malperfusion. ⋯ Percutaneous aortic fenestration and renal artery stenting are both technically feasible and associated with an acceptable complication rate. Most patients respond well symptomatically, obviating the need for immediate surgical relief of renal artery obstruction and allowing for renal malperfusion recovery.
-
Thrombosis in unusual locations in the lower extremity veins has not been assessed. These veins are not imaged routinely and therefore information about them is lacking. ⋯ The involvement of the studied veins in DVT is extremely rare. Thrombosis in these veins can follow the natural course of thrombosis in the more usual locations and is associated with lethal incidences of PE. Therefore, the association of these veins with all the grave sequelae of thromboembolic disease suggests that inclusion of these veins in routine lower extremity duplex scans would be beneficial.
-
Carotid angioplasty and stenting (CAS) is a percutaneous alternative to carotid endarterectomy (CEA) for treating patients with carotid artery stenosis. This study sought to evaluate whether patients at increased perioperative risk for CEA may be treated with CAS while maintaining equivalent outcomes. ⋯ The data in this study demonstrate that high-risk patients undergoing CAS had comparable outcomes to low-risk patients undergoing CEA. This study supports the use of CAS as a reasonable alternative for patients at increased perioperative risk for CEA.
-
Lower extremity arterial injury is a rare complication following total knee (TKA) or total hip arthroplasty (THA). To date, no multi-institutional study has identified preoperative factors that may portend increased risk for these injuries. We queried a large clinical database for the incidence and predictors of arterial injury and/or compromise following lower extremity arthroplasty. ⋯ Lower extremity arterial injury was exceedingly rare after total knee or total hip arthroplasty. There is an increased incidence in African American patients and those undergoing redo arthroplasty. Among patients who sustain vascular injury, excellent limb salvage rates can be achieved with close postoperative surveillance to achieve early detection and repair of injuries.
-
This study prospectively assessed the diagnostic accuracy of a novel bilateral photoplethysmography toe pulse measurement technique for the detection of significant lower limb peripheral arterial disease. ⋯ This simple-to-use technique could offer significant benefits for the diagnosis of peripheral arterial disease in settings such as primary care where noninvasive, accurate, and diagnostic techniques not requiring specialist training are desirable. Improved diagnosis and screening for peripheral arterial disease has the potential to allow identification and risk factor management for this high-risk group.