Annals of vascular surgery
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Patients undergoing open aortoiliac surgery constitute a high-risk subgroup. The aim of this study was to evaluate the relationship between postoperative troponin T (TnT) elevation with the associated postoperative mortality, and mean hospital stay. ⋯ TnT level in the immediate postoperative period is a highly relevant indicator of prognosis in patients undergoing major vascular surgery.
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The purpose of this study was to evaluate the effectiveness of a standardized preoperative cardiac assessment in reducing the rate of perioperative cardiac complications in patients undergoing aortic surgery, paying particular attention to the analysis of the factors affecting perioperative cardiac outcomes. ⋯ In our experience, the use of a routine preoperative cardiac assessment allowed us to obtain satisfactory perioperative results in patients undergoing abdominal aortic surgery. Very few patients, however, require cardiac revascularization before abdominal aortic surgery. Patients with positive stress test may benefit from an endovascular treatment if anatomically feasible.
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We describe a simple method to avoid favored passage of the wire into the profunda femoral artery (PFA) after antegrade puncture of the common femoral artery. ⋯ When a repeated passage of the guidewire down the PFA is experienced despite conventional manipulation of the wire or needle, the barrier technique is an easy alternative approach for the catheterization of the superficial femoral artery.
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Spinal cord injury is a major complication of thoracoabdominal aortic operations. We aimed to investigate neuroprotective role of olmesartan administered to rats before ischemia against ischemia-reperfusion (I-R) injury. ⋯ Olmesartan may protect the spinal cord from I-R injury and reduce the incidence of associated neurological dysfunction after temporary aortic occlusion.
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Endovascular repair of thoracic aortic disease continues to evolve since FDA approval of the first thoracic endograft in the United States in March 2005. Certain anatomic characteristics, including adequacy of arterial access, remain a significant limiting factor in thoracic endovascular repair. In clinical trials evaluating thoracic endografts, vascular access complications occurred in >20% of cases. The purpose of this study is to evaluate the arterial access and the selective use of the ascending aorta for thoracic endograft placement. ⋯ Access selection is an important part of the preoperative planning of endovascular procedures. Choosing the most appropriate access for a patient will decrease the access-associated complication rate. In addition, selected patients with poor aortoiliac access and those that require debranching or elephant trunk procedures may benefit from antegrade access.