Annals of vascular surgery
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Review Case Reports
Hybrid repair of ruptured type B aortic dissection extending into an aberrant right subclavian artery in a patient with Turner's syndrome.
Turner's syndrome (TS) has been documented as the most common cause of aortic dissection in young women. However, little attention from vascular surgery has been paid to these patients. ⋯ Left carotid to subclavian artery bypass, thoracic endovascular aortic repair, and coil embolization of the aberrant right subclavian and left subclavian arteries were performed in an emergency setting. Literature on epidemiology, causes, and management options of acute aortic dissection in TS patients are reviewed and discussed.
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Case Reports
Salmonella mycotic thoracoabdominal aortic aneurysm associated with chronic lymphocytic leukemia.
Non-typhoidal Salmonella infections typically cause self-limiting gastroenteritis. However, extraintestinal focal infections, including mycotic aneurysms of the aorta, can also occur. ⋯ This case illustrates the need to consider the possibility of an immune defect, even in CLL patients with normal leukocyte counts. The underlying mechanisms are unclear, but are likely to involve defects in cell-mediated immunity, thought to be of particular importance in invasive infections with intracellular pathogens such as Salmonella spp.
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Blunt thoracic aortic injury (BTAI) is associated with high mortality. Recent Society for Vascular Surgery (SVS) guidelines recommend repair of all but SVS grade I injuries. This study's objective was to retrospectively determine guideline adherence at the authors' trauma center, and its impact on mortality. ⋯ Minor deviation (9.6%) from guidelines did not result in additional morbidity/mortality. However, a high rate of loss to follow-up limits conclusions. The mortality reduction seen with endovascular repair for grade 3 injury is inflated by patients who die before repair is considered in the nonoperative group. Larger prospective studies with appropriate inclusion and exclusion criteria and improved follow-up are needed to determine the consequences of selective nonoperative management of these injuries.
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Review Meta Analysis
Fenestrated endovascular repair for pararenal abdominal aortic aneurysms: a systematic review and meta-analysis.
The development of endovascular technology has led to the introduction of fenestrated endovascular repair (f-EVAR) to treat pararenal abdominal aortic aneurysms (PRAAAs) that have been deemed unsuitable for standard endovascular repair. We performed a systematic review and meta-analysis of data from the literature to determine the outcomes of the fenestrated technology. ⋯ This study revealed that f-EVAR treatment for PRAAAs has acceptable early and mid-term outcomes.
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Multicenter Study Comparative Study
Comparison of graft patency, limb salvage, and antithrombotic therapy between prosthetic and autogenous below-knee bypass for critical limb ischemia.
The autogenous vein is the preferred conduit in below-knee vascular reconstructions. However, many argue that prosthetic grafts can perform well in crural bypass with adjunctive antithrombotic therapy. We therefore compared outcomes of below-knee prosthetic versus autologous vein bypass grafts for critical limb ischemia and the use of adjunctive antithrombotic therapy in both settings. ⋯ Although limited in size, our study demonstrates that, with appropriate patient selection and antithrombotic therapy, 1-year outcomes for below-knee prosthetic bypass grafting can be comparable to those for greater saphenous vein conduit.