European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
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Eur J Vasc Endovasc Surg · Nov 2009
ReviewPerioperative blood glucose monitoring and control in major vascular surgery patients.
Diabetes mellitus (DM) is an independent predictor for morbidity and mortality in the general population, which is even more apparent in patients with concomitant cardiovascular risk factors. As the prevalence of DM is increasing, with an ageing general population, it is expected that the number of diabetic patients requiring surgical interventions will increase. Perioperative hyperglycaemia, without known DM, has been identified as a predictor for morbidity and mortality in patients undergoing surgery. ⋯ In addition, concerns on the external validity of some studies are important barriers for widespread recommendation of intensive glucose control in the perioperative setting. We propose that guidelines recommending intensive glucose control should be re-evaluated. In addition, moderate tight glucose control should currently be regarded as the safest and most efficient approach to patients undergoing major vascular surgery.
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Eur J Vasc Endovasc Surg · Nov 2009
Case ReportsSuccessful endovascular repair of acute type B aortic dissection in undiagnosed Ehlers-Danlos syndrome type IV.
A 61-year-old man presented with an acute type B aortic dissection for which a stent-graft was introduced. He remains complication-free 4 years onwards and has since been diagnosed with Ehlers-Danlos syndrome type IV (EDS IV). His particular mutation is predicted to result in lesser levels of normal collagen and may explain his favourable outcome from endovascular intervention. Understanding the genotype-phenotype correlation may influence the choice of therapy offered to patients with EDS IV.
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The collateral function of the external carotid artery (ECA) for cerebral perfusion in cases of atherosclerotic occlusive disease of the internal carotid artery (ICA) is difficult to assess; for this reason, blood flow measurements were taken during carotid endarterectomy (CEA). ⋯ Increased blood flow in the ICA after CEA is accompanied by decreased ECA flow whereupon the absolute amount of this redistribution is relatively limited. A more profound evaluation of these haemodynamic conditions demands further study.
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Eur J Vasc Endovasc Surg · Sep 2009
Multicenter Study Comparative StudyA comparison of the mid-term results following the use of bifurcated and aorto-uni-iliac devices in the treatment of abdominal aortic aneurysms.
To compare the mid-term results following the use of bifurcated (ABIS) and aorto-uniiliac (AUIS) endovascular devices in the treatment of abdominal aortic aneurysms (AAA) in a population of patients deemed to be at high risk for open surgery. ⋯ This study demonstrates that ABIS is associated with better results than AUIS in the management of patients with AAA. Iliac artery occlusive disease was more frequently diagnosed in the AUIS group and this was significantly associated with a higher risk of complications, while the crossover graft itself was not. Nevertheless, the outcomes for both groups are encouraging in this high risk population.
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Eur J Vasc Endovasc Surg · Sep 2009
The endovascular management of penetrating carotid artery injuries: long-term follow-up.
To review a single-centre experience with stent-graft treatment of penetrating carotid artery injuries and long-term follow-up. ⋯ Endovascular management of penetrating carotid artery injuries is safe and the long-term outcomes justify a more liberal application of this technique in selected patients.