Journal of vascular surgery
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We have prospectively evaluated the need for serial venous duplex ultrasound examinations in an inpatient population with an initially normal study result. ⋯ Serial follow-up duplex ultrasound evaluation is unnecessary after an initially complete, normal study in patients with symptoms who have suspected pulmonary embolism and nondiagnostic ventilation-perfusion lung scans.
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Review Case Reports
Tuberculous pseudoaneurysm of the descending thoracic aorta: a case report and literature review of surgically treated cases.
Tuberculous aneurysm of the aorta is an extremely rare disease with a high mortality rate. Only 32 patients treated surgically have been reported in the literature. ⋯ We present a case of a tuberculous false aneurysm in the descending thoracic aorta that was successfully treated surgically with an extracorporeal circulation. The hole in the aorta within the false aneurysm was closed with a Dacron patch because the aortic wall appeared to be free of active infection as a result of long-term preoperative antituberculous chemotherapy.
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The Asymptomatic Carotid Atherosclerosis Study (ACAS) indicated significant benefit from endarterectomy compared with medical therapy for patients with 60% to 99% asymptomatic internal carotid artery (ICA) stenoses. To date, optimal selection of patients for vascular laboratory follow-up to determine progression from < 60% to > or = 60% asymptomatic ICA stenosis is unknown. To determine which patients with < 60% asymptomatic ICA stenoses are at greatest risk for short-term progression to > or = 60% without symptoms, we reviewed vascular laboratory results and clinical risk factors of consecutive patients who were prospectively observed in a study of atherosclerosis progression. ⋯ Early progression from < 60% asymptomatic ICA stenoses to > or = 60% asymptomatic ICA stenoses occurs infrequently. Patients who are at the greatest risk of early progression without symptoms to an ACAS-positive lesion can be identified from the ICA PSV at their initial duplex examination. Early vascular laboratory follow-up of asymptomatic ICA stenoses may be limited to a relatively small group.
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Venacavograms are routinely obtained before vena cava filter placement to evaluate cava size, patency, and the presence of thrombus or venous anomalies. The objective of this study was to determine the ability of duplex ultrasonography to adequately evaluate the inferior vena cava (IVC) for size, patency, and the presence of thrombus before Greenfield filter (GF) insertion. ⋯ Duplex ultrasonography is a useful and accurate method for assessment of the IVC before vena cava filter placement.
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This study evaluated perioperative variables to predict death in nonruptured and ruptured abdominal aortic aneurysm (AAA) surgery. ⋯ Prolonged ventilation, perioperative myocardial infarction, a history of peripheral vascular disease, preoperative renal dysfunction, and a history of congestive heart failure are independent predictors of perioperative death in patients with nonruptured AAAs. For patients with ruptured AAAs, mortality rates can be estimated before surgery using age, level of consciousness, and cardiac arrest. For patients who survive the initial surgery for ruptured AAA, subsequent mortality rates can also be predicted.