Comparison of 30 Day Stroke and Death in Hybrid Intervention and Open Surgical Reconstruction for the Treatment of Tandem Carotid Bifurcation and Supra-aortic Trunk Disease

Composites of plaster of Paris (PP) and hydroxylapatite (HA) particles are being applied for the surgical reconstruction of craniofacial bone defects and for cosmetic surgery. Two types of HA particles are being employed, the dense sintered ceramic (DHA) and the porous, coralline hydroxylapatite (PHA) particles. Excess water is expressed out of the moistened HA/PP mixture prior to implantation and setting by pressing it in a non-tapered syringe against a glass plate. This results in implants with faster setting times and greater mechanical strengths. It was therefore of interest to compare samples of the compressed versus noncompressed mixtures to see whether or not any changes in their microstructure after setting could be related to these different properties.USG Medical Grade Calcium Sulfate Hemihydrate (which has the lowest mortar consistency of any known plaster) was mixed with an equal weight of Interpore 200 particles (a commercial form of PHA). After moistening with a minimum amount of water, disc-shaped noncompressed samples were made by filling small holes (0.339 in. diameter x 0.053 in. deep) in polypropylene molds with a microspatula.

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589: Tissue Engineered Tubularized Urethra for Surgical Reconstruction: A Pre-Clinical Study

The Journal of Urology ◽

10.1016/s0022-5347(18)30829-2 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 197-197 ◽

Cited By ~ 2

Author(s):

Hazem O. Orabi ◽

Tamer A. Aboushwareb ◽

Yuan Yuan Zhang ◽

James J. Yoo ◽

Anthony Atala

Keyword(s):

Clinical Study ◽

Surgical Reconstruction

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Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽

10.1024/0301-1526/a000151 ◽

2011 ◽

Vol 40 (6) ◽

pp. 474-481 ◽

Cited By ~ 1

Author(s):

Radak ◽

Babic ◽

Ilijevski ◽

Jocic ◽

Aleksic ◽

...

Keyword(s):

Diabetes Mellitus ◽

Limb Salvage ◽

Iliac Artery ◽

Graft Patency ◽

Long Term Results ◽

Surgical Reconstruction ◽

Safe Procedure ◽

Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

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Current concepts of the interventional treatment of proximal supraaortic vessel stenosis

VASA ◽

10.1024/0301-1526/a000216 ◽

2012 ◽

Vol 41 (5) ◽

pp. 313-318 ◽

Cited By ~ 5

Author(s):

Ernemann ◽

Bender ◽

Melms ◽

Brechtel ◽

Kobba ◽

...

Keyword(s):

Treatment Strategies ◽

Carotid Bifurcation ◽

Current Treatment ◽

Long Term Results ◽

Clinical Indication ◽

Interventional Treatment ◽

Special Focus ◽

Brachiocephalic Artery ◽

Treatment Concepts ◽

Angioplasty And Stenting

Interventional therapies using angioplasty and stenting of symptomatic stenosis of the proximal supraaortic vessels have evolved as safe and effective treatment strategies. The aim of this paper is to summarize the current treatment concepts for stenosis in the subclavian and brachiocephalic artery with regard to clinical indication, interventional technique including selection of the appropriate vascular approach and type of stent, angiographic and clinical short-term and long-term results and follow-up. The role of hybrid interventions for tandem stenoses of the carotid bifurcation and brachiocephalic artery is analysed. A systematic review of data for angioplasty and stenting of symptomatic extracranial vertebral artery stenosis is discussed with a special focus on restenosis rate.

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A carotid bifurcation pseudoaneurysm treated endovascularly in a patient with irradiated neck

VASA ◽

10.1024/0301-1526/a000748 ◽

2019 ◽

Vol 48 (2) ◽

pp. 193-195

Author(s):

Christiana Anastasiadou ◽

Chrisostomos Maltezos ◽

George Galyfos ◽

Sotirios Giannakakis ◽

Nikos Zannes ◽

...

Keyword(s):

Carotid Artery ◽

Endovascular Treatment ◽

Carotid Bifurcation ◽

Rare Entity ◽

Artery Pseudoaneurysm

Abstract. A carotid artery pseudoaneurysm in an irradiated neck is a rare entity with possible devastating results and management should be multidisciplinary. We present a successful endovascular treatment of a late carotid artery pseudoaneurysm following patch endarterectomy and cervical radiotherapy.

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Achilles Tenorrhaphy in Five Dogs: A Modified Surgical Technique and Evaluation of a Cranial Half Cast

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632549 ◽

1998 ◽

Vol 11 (04) ◽

pp. 205-210 ◽

Cited By ~ 13

Author(s):

H. Burbidge ◽

E. Firth ◽

S. Fox ◽

S. Guerin

Keyword(s):

Soft Tissue ◽

Surgical Technique ◽

Surgical Procedure ◽

Normal Function ◽

Surgical Reconstruction ◽

Bone Apposition ◽

Cast Material ◽

Bilateral Lesions ◽

Bone Tunnels

SummaryAchilles mechanism rupture in four of five dogs was treated with tenorrhaphy using a modified surgical technique designed to optimise accurate apposition of tendon to bone. Two bone tunnels were drilled in the calcaneal tuber from a plantomedial - dorsolateral, and plantolateral – dorsomedial direction respectively. The distal ends of the tendons were sutured to the calcaneal tuber using a Krachow suture pattern. The remaining dog had a mid-tendon Achilles mechanism rupture. A resinous half cast was placed on the cranial aspect of the tarsocrural joint of all five dogs, for a minimum of six weeks, in order to provide limited post operative support. Du e to insufficient cast material two of the support splints failed and one of these cases also required a second surgical procedure. A varying amount of soft tissue irritation was noted in each case. All of the five Achilles mechanisms healed, and all of the dogs returned to normal function.Five dogs with surgical reconstruction of the Achilles mechanism were stabilised postoperatively with a resinous half cast placed on the cranial aspect of the tarsocrural joint for a minimum of six weeks. Two of these casts failed at the tarsocrural joint when six folds of casting material were used; all subsequent cases had eight folds applied. Variable soft tissue irration was observed under the cast in each case. A modified surgical technique using a Krachow suture pattern allowed good tendon-bone apposition. All five Achilles mechanisms healed, and all dogs returned to normal function. Bilateral lesions were identified in 3 of the 4 dogs examined.

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Apolipoprotein(a), Fibrinopeptide A and Carotid Atherosclerosis in Middle-Aged Men

Thrombosis and Haemostasis ◽

10.1055/s-0038-1648915 ◽

1994 ◽

Vol 72 (04) ◽

pp. 563-566 ◽

Cited By ~ 16

Author(s):

Tuomo Rankinen ◽

Sari Väisänen ◽

Michele Mercuri ◽

Rainer Rauramaa

Keyword(s):

Risk Factors ◽

Cardiovascular Diseases ◽

Carotid Atherosclerosis ◽

Intima Media Thickness ◽

Carotid Bifurcation ◽

Carotid Intima Media Thickness ◽

Fibrinopeptide A ◽

Carotid Imt ◽

Apolipoprotein A ◽

The Difference

SummaryThe association between apolipoprotein(a) [apo(a)], fibrinogen, fibrinopeptide A (FPA) and carotid intima-media thickness (IMT) was analyzed in Eastern Finnish men aged 50 to 60 years. Apo(a) correlated directly with carotid bifurcation (r = 0.26, p = 0.001), but not with common carotid IMT. Men in the lowest quartile of apo(a) had thinner (p = 0.013) IMT in bifurcation [1.59 mm (95% Cl 1.49; 1.68)] compared to the men in the highest [1.91 mm (95% Cl 1.73; 2.09)] apo(a) quartile. The difference remained (p=0.038) after adjusting for confounders. Plasma fibrinogen was not related to carotid IMT, whereas FPA correlated with common carotid (r = 0.21, p = 0.016) and carotid bifurcation (r = 0.21, p = 0.018) IMT. These associations abolished after adjusting for the confounders. The data suggest that apo(a) associate with carotid atherosclerosis independent of other risk factors for ischemic cardiovascular diseases.

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