Annals of vascular surgery
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Comparative Study
Port-a-Cath complicated by infection or migration not removed by manual traction: usefulness of cardiac pacing leads extraction techniques.
Long-term use of Port-a-Caths (PACs) is related to device-related delayed complications. The aim of this study is to describe the high success rate and safety of cardiac pacing lead extraction techniques used for PACs complicated by infection or migration and not removed by manual traction. ⋯ In experienced centers, cardiac pacing lead extraction techniques may be considered as an additional, efficacious, safe option for extraction of otherwise nonremovable entrapped PACs before surgery.
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Comparative Study
Postoperative cardiac damage after standardized carotid endarterectomy procedures in low- and high-risk patients.
We conducted a comparison of postoperative cardiac damage, defined as cardiac troponin I (cTn-I) elevation, after carotid endarterectomy in low- and high-risk patients. ⋯ Carotid endarterectomy is followed by an increase in cTn-I value>0.5 ng/mL in 14% of all cases, although symptomatic cardiac ischemia is very low. However, high-risk patients as defined by the SAPPHIRE criteria do not show an increased risk of cardiac damage compared to low-risk patients. Larger studies using cTn-I as a marker of postoperative cardiac damage, after carotid endarterectomy or stenting, are needed.
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Hemodialysis patients who have exhausted all of the conventionally used veins for vascular access, including arteriovenous fistula, arteriovenous graft, and traditional catheter access sites, present a challenge to the treating physician. Transhepatic and translumbar inferior vena cava catheters have been used in these patients who have no other access site option. The objective of the study was to examine our experience with translumbar and transhepatic approach for catheter-based hemodialysis access in patients who have exhausted all other options. ⋯ Translumbar and transhepatic venous access is a viable long-term alternative route for catheter-based hemodialysis access in patients who have exhausted conventional options.
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Multicenter Study Comparative Study
Endovascular repair with fenestrated-branched stent grafts improves 30-day outcomes for complex aortic aneurysms compared with open repair.
Endovascular repair is associated with better 30-day outcomes than open surgical repair for patients with infrarenal aortic aneurysms. In patients with complex aortic aneurysms (CAAs) requiring suprarenal or supravisceral aortic cross-clamping during open repair, few data exist directly comparing the real-world outcomes of open repair versus endovascular repair with fenestrated-branched stent grafts (FEVAR). ⋯ This nationwide real-world database suggests that in similar patient populations, repair of CAAs with FEVAR is associated with reduced 30-day morbidity and mortality compared with open repair. Although long-term comparative studies are needed, FEVAR may represent a preferred treatment alternative to open repair for patients with CAAs.
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Review Meta Analysis
Systematic review of randomized controlled trials of new anticoagulants for venous thromboembolism prophylaxis in major orthopedic surgeries, compared with enoxaparin.
In the past 10 years, new anticoagulants (NACs) have been studied for venous thromboembolism (VTE) prophylaxis. ⋯ NACs can be considered alternatives to conventional thromboprophylaxis regimens in patients undergoing elective major orthopedic surgery, depending on clinical characteristics and cost-effectiveness. The knowledge of some differences concerning efficacy or safety profile, pointed out in this systematic review, along with the respective limitations, may be useful in clinical practice.