Annals of vascular surgery
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Review Meta Analysis
The impact of carotid artery stenting on cognitive function in patients with extracranial carotid artery stenosis.
The effect of carotid artery stenting (CAS) on cognitive function in patients with extracranial carotid artery stenosis is equivocal. The aim of this study was to examine the impact of CAS on various domains of cognitive function. ⋯ CAS may be associated with improvement in global cognition, memory, and attention/psychomotor speed. There was no positive effect on executive function, language, and functional ability, but CAS was not associated with a decline in any area of cognitive function. Future studies in larger groups of patients are probably needed to fully investigate the long-term effect of CAS on cognition in patients with carotid artery stenosis.
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Blunt traumatic aortic injury (BTAI) is of very rare occurrence in adolescents. The purpose of our study was to assess the clinical presentation and treatment outcomes of BTAI in this subset of patients. ⋯ The incidence of BTAI is very low in adolescents. Mortality rate is considerable even in young patients and it is associated with high ISS and degree of aortic wall disruption. Young patients with BTAI who survive hospitalization have a lower ISS and are often discharged home rather than to a rehabilitation facility.
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Randomized Controlled Trial
Prospective study of a single treatment strategy for local tumescent anesthesia in Muller phlebectomy.
Ambulatory Muller phlebectomy for varicose veins can be performed under local anesthesia. However, subcutaneous injection of local tumescent anesthetics may cause discomfort because of acidity of the solution. Addition of sodium bicarbonate lowers the acidity of anesthetic solutions, which might cause less pain. The objective of this study was to study whether alkalinization of the local anesthetic solution with sodium bicarbonate 1.4% decreases perioperative pain during Muller phlebectomies. ⋯ Alkalinization of local anesthetic solution with sodium bicarbonate 1.4% significantly improves patient comfort during injection of local tumescent anesthesia.
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Observational Study
The impact of perioperative red blood cell transfusions on postoperative outcomes in vascular surgery patients.
Red blood cell (RBC) transfusions are common in vascular surgery and aim to reduce tissue ischemia. However, the evidence that transfusions are beneficial is contradictory. This study evaluates the impact of perioperative transfusion (transfusion within 3 days of surgery) on 30-day postoperative outcomes in elective vascular surgery patients. ⋯ Perioperative transfusion is associated with a strongly increased risk of both 30-day CV events and mortality in elective vascular surgery patients.
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Case Reports
Limitation of imaging in identifying iatrogenic aortic coarctation following thoracic endovascular aortic repair.
A 21-year-old male suffered blunt trauma from a motor vehicle accident causing thoracic aorta tear. The smallest available stent graft was deployed. Definitive repair was later performed using a 22 × 22 × 116 mm Talent Thoracic Stent Graft. ⋯ This case report demonstrates a need for wider availability and selecting appropriate stent graft in treating traumatic aortic injuries in young patients. It is the first case report of the inability of current imaging modalities in confirming stent collapse. Pressure gradient is a useful tool in confirming stent collapse when clinical scenario does not match CT findings.