Annals of vascular surgery
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Case Reports
Acute Renal Vein Thrombosis: A Case Report of Successful Treatment with Mechanical Thromboaspiration.
Treatment of renal vein thromboses has previously been limited to conventional anticoagulation. We describe a case of successful treatment of acute native renal vein thrombosis (RVT) in a 61-year-old fit-and-well female using mechanical thromboaspiration without the use of thrombolysis. The report demonstrates the computed tomographic appearances of an acute RVT, the venographic images taken before and after thromboaspiration, and the magnetic resonance imaging of the kidney performed 3 months later, showing complete resolution of the thrombus and normal appearances of the kidney. We believe this case to be the first published case of a safe and successful treatment of acute native RVT using the Penumbra Indigo® mechanical aspiration system, highlighting the importance of access to skilled interventional radiologists for treatment of this rare condition.
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Prior studies have shown that octogenarians have a higher risk of mortality than nonoctogenarians undergoing open aneurysm repair (OAR) and endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). Fenestrated endovascular aneurysm repair (F-EVAR) was approved by the Food and Drug Administration (FDA) in 2012 and has been used as a less invasive approach to treat patients with suboptimal neck anatomy with favorable outcomes compared with traditional OAR. The aim of the study is to compare 30-day outcomes of F-EVAR versus OAR in octogenarians undergoing repair of AAA involving the visceral vessels in the United States. ⋯ In this large national cohort of octogenarians undergoing repair for complex AAA's, we showed that F-EVAR is associated with significantly lower postoperative morbidity and mortality than open repair. One of the main limitations of the study is the lack of anatomical data. However, despite that, our findings support the shifting paradigm toward minimally invasive approach in this frail population for treatment of complex AAA's. Further studies are needed to evaluate the long-term benefit of any repair in octogenarians.
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Comparative Study
Comparison of Measurement and Grading of Carotid Stenosis with Computed Tomography Angiography and Doppler Ultrasound.
Doppler ultrasound (DUS) and computed tomography angiography (CTA) are the most commonly used imaging modalities for carotid disease. The aim of this study was to test the accuracy and reproducibility of CTA-derived measurements of carotid stenosis and compare them with those obtained by DUS. ⋯ CTA tends to underestimate the degree of stenosis when compared with DUS. The semi-automated method of CTA reporting has greater reproducibility and greater agreement with DUS. These findings have practical implications when CTA is used to measure the degree of carotid stenosis in clinical practice.
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Comparative Study
Early and Late Outcomes of Endovascular Aortic Aneurysm Repair versus Open Surgical Repair of an Abdominal Aortic Aneurysm: A Single-Center Study.
The objective of the study was to compare the treatment outcomes and cost of endovascular aortic aneurysm repair (EVAR) and open surgical repair (OSR) in patients with an abdominal aortic aneurysm (AAA) at a single center. ⋯ EVAR has advantages over OSR in terms of short-term mortality, in-hospital length of stay, and rates of perioperative transfusion. However, OSR is associated with better long-term survival, lower reintervention rates, and lower costs.