Journal of vascular surgery
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Baker's cysts mimicking the symptoms of deep vein thrombosis: diagnosis with venous duplex scanning.
The purpose of this study was to determine the incidence and characteristics of Baker's cysts discovered during venous duplex examinations to rule out deep vein thrombosis (DVT). ⋯ The presentation of DVT and that of a Baker's cyst are similar enough to be difficult to distinguish by clinical examination. Careful examination of the popliteal fossa should be performed during venous duplex examinations regardless of the indication for the study.
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The purpose of this study was to validate the commonly accepted indicators of risk of ischemic stroke that indicate the necessity for cerebral protection during carotid endarterectomy (CEA), and to examine the efficacy of high-dose thiopentone sodium (thiopental) as a cerebral protection method in patients who are at high risk of intraoperative ischemic stroke. ⋯ The absence of neurologic deficit in the study indicated that thiopental protection was effective in preventing ischemic stroke in high-risk patients and safely replaced intraluminal shunting.
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Arterial allografts are used in vascular surgery to solve a major problem: vascular reconstruction in the infected area. To palliate the unavailability and to reduce the risk of viral disease transmission, vascular allografts are currently cryopreserved and stored in tissue banks. In our recent clinical experience, we observed several cases of rupture and degeneration of cryopreserved arterial allografts. All indications are that current cryopreservation protocols are probably the cause for these degenerations.
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We report the case of a patient with Von Recklinghausen's neurofibromatosis in whom two visceral artery aneurysms were diagnosed: a 4 cm aneurysm originating from the common hepatic artery and a smaller aneurysm originating from the superior mesenteric artery. The hepatic artery aneurysm underwent successful embolization. Because of the patient's poor general condition, the superior mesenteric aneurysm was considered inoperable and has been kept under surveillance by ultrasonography. ⋯ Stenotic lesions predominate, with the renal arteries being the site of predilection. Aneurysmal defects are less common, and involvement of the visceral arteries is exceptional. Only three reports of superior mesenteric artery aneurysm in patients with Von Recklinghausen's neurofibromatosis were found in the literature, and hepatic artery aneurysm has never previously been described in this disease.
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The role of complex venous reconstructions (CVRs) in patients with major trauma remains a controversial topic. This study evaluates the patency and clinical outcome of CVRs in a major urban trauma center. ⋯ Patients with CVRs had a 30-day patency rate of 73%. Of this group panel and spiral vein grafts were less successful, exhibiting only a 50% 30-day patency rate, whereas end-to-end and vein patch repairs were successful in 88% and 87% of cases, respectively. Our overall evaluation suggests that use of CVRs results in successful venous repair; however, the postoperative patency of interposition panel and spiral grafts suggests selective use of these techniques.