Vascular complication after percutaneous femoral cerclage wire

Abstract. Background: Effectiveness of vascular closure devices during endovascular procedures requiring a direct puncture of a vascular prosthesis placed in the inguinal region is unknown. Patients and methods: The retrospective analysis included 134 patients with a history of polyethylene terephthalate (PETE) graft implantation in the inguinal region. In 20 (15 %) patients, haemostasis was achieved with manual compression, in 21 (16 %) with the StarClose™, and in 93 (69 %) with the AngioSeal™ device. Results: The incidence of vascular complications in the manual compression group was higher (at a threshold of statistical significance) than in the device closure group (45.0 vs. 24.5 %, p = 0.059). The difference was considered statistically significant when manual compression was compared with the AngioSeal™ closure group (45.0 vs. 13.9 %, p < 0.01). The vascular complication rate in the StarClose™ group was significantly higher than in the AngioSeal™ group (71.4 vs. 13.9 %, p < 0.000001). While haematomas were the only vascular complications observed after application of AngioSeal™, both haematomas and pseudoaneurysms were found in the StarClose™ group. Conclusions: The AngioSeal™ vascular closure device provides better local haemostasis than the StarClose™ device or manual compression during endovascular interventions requiring a direct puncture of PETE grafts

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Doppler US Findings of Vascular Complication after Liver Transplantation

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2000.42.2.311 ◽

2000 ◽

Vol 42 (2) ◽

pp. 311

Author(s):

Dong Jin Jung ◽

Pyo Nyun Kim ◽

Hyun Kwon Ha ◽

Mun Gyu Lee ◽

Yong Ho Auh

Keyword(s):

Liver Transplantation ◽

Vascular Complication ◽

Doppler Us ◽

Us Findings

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Does Vitamin K Intake Influence High Phosphate Induced Vascular Pseudo-ossification: An Underappreciated Therapeutic Prospect in General Population?

Current Drug Targets ◽

10.2174/1389450119666181031124430 ◽

2019 ◽

Vol 20 (4) ◽

pp. 421-430

Author(s):

Zar Chi Thent ◽

Gabriele R.A. Froemming ◽

Suhaila Abd Muid

Keyword(s):

Chronic Kidney Disease ◽

Kidney Disease ◽

Vascular Calcification ◽

Vitamin K ◽

Prolonged Exposure ◽

Vascular Complication ◽

Key Factors ◽

The Matrix ◽

Underlying Mechanisms ◽

High Phosphate

Increasing interest in vascular pseudo-ossification has alarmed the modern atherosclerotic society. High phosphate is one of the key factors in vascular pseudo ossification, also known as vascular calcification. The active process of deposition of the phosphate crystals in vascular tissues results in arterial stiffness. High phosphate condition is mainly observed in chronic kidney disease patients. However, prolonged exposure with high phosphate enriched foods such as canned drinks, dietary foods, etc. can be considered as modifiable risk factors for vascular complication in a population regardless of chronic kidney disease. High intake of vitamin K regulates the vascular calcification by exerting its anti-calcification effect. The changes in serum phosphate and vitamin K levels in a normal individual with high phosphate intake are not well investigated. This review summarised the underlying mechanisms of high phosphate induced vascular pseudo ossification such as vascular transdifferentiation, vascular apoptosis and phosphate uptake by sodium-dependent co-transporters. Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google Scholar were searched using the terms ‘vitamin K’, ‘vascular calcification, ‘phosphate’, ‘transdifferentiation’ and ‘vascular pseudoossification’. Vitamin K certainly activates the matrix GIA protein and inhibits vascular transition and apoptosis in vascular pseudo-ossification. The present view highlighted the possible therapeutic linkage between vitamin K and the disease. Understanding the role of vitamin K will be considered as potent prophylaxis agent against the vascular disease in near future.

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Dose approach matter? A meta-analysis of outcomes following transfemoral versus transapical transcatheter aortic valve replacement

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02158-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruikang Guo ◽

Minghui Xie ◽

Wai Yen Yim ◽

Wenconghui Wu ◽

Weiwei Jiang ◽

...

Keyword(s):

Acute Kidney Injury ◽

Aortic Valve ◽

Transcatheter Aortic Valve Replacement ◽

Observational Studies ◽

Meta Analysis ◽

Kidney Injury ◽

Vascular Complication ◽

Permanent Pacemaker ◽

Transcatheter Aortic Valve ◽

Effect Model

Abstract Background Transcatheter aortic valve replacement (TAVR) has gained increasing acceptance for patients with aortic disease. Both transfemoral (TF-TAVR) and transapical (TA-TAVR) approach were widely adopted while their performances are limited to a few studies with controversial results. This meta-analysis aimed to compare the mortality and morbidity of complications between TF- versus TA-TAVR based on the latest data. Methods Electronic databases were searched until April 2021. RCTs and observational studies comparing the outcomes between TF-TAVR versus TA-TAVR patients were included. Heterogeneity assumption was assessed by an I2 test. The pooled odds ratios(OR) or mean differences with corresponding 95% confidence intervals (CI) were used to evaluate the difference for each end point using a fixed-effect model or random-effect model based on I2 test. Results The meta-analysis included 1 RCT and 20 observational studies, enrolling 19,520 patients (TF-TAVR, n = 11,986 and TA-TAVR, n = 7,534). Compared with TA-TAVR, TF-TAVR patients showed significantly lower rate of postoperative in-hospital death (OR = 0.67, 95% CI 0.59–0.77, P < 0.001) and 1-year death (OR = 0.53, 95% CI 0.41–0.69, P < 0.001). Incidence of major bleeding and acute kidney injury were lower and length of hospital stay was shorter, whereas those of permanent pacemaker and major vascular complication were higher in TF-TAVR patients. There were no significant differences between TF-TAVR versus TA-TAVR for stroke and mid-term mortality. Conclusions There were fewer early deaths in patients with transfemoral approach, whereas the number of mid-term deaths and stroke was not significantly different between two approaches. TF-TAVR was associated with lower risk of bleeding, acute kidney injury as well as shorter in-hospital stay, but higher incidence of vascular complication and permanent pacemaker implantation.

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Splanchnic Vein Thrombosis in Acute Pancreatitis and Its Consequences

Clinical and Applied Thrombosis/Hemostasis ◽

10.1177/10760296211010260 ◽

2021 ◽

Vol 27 ◽

pp. 107602962110102

Author(s):

Łukasz Nawacki ◽

Jarosław Matykiewicz ◽

Ewa Stochmal ◽

Stanisław Głuszek

Keyword(s):

Acute Pancreatitis ◽

Severe Disease ◽

Vascular Complication ◽

Strong Positive Correlation ◽

Splanchnic Vein Thrombosis ◽

Vein Thrombosis ◽

Computed Tomography Scans ◽

Negative Effect ◽

Medical Histories ◽

The Impact

Splanchnic vein thrombosis (SVT) is a serious vascular complication that can occur in patients with acute pancreatitis. We assessed the incidence of SVT and its relationship with acute pancreatitis (AP) and associated complications. We carried out a retrospective analysis of medical histories from patients hospitalized with AP in a single surgical center. Histories were acquired from patients with abdominal and pelvic computed tomography scans performed between the 2nd and 3rd day of hospitalization. We assessed the impact and extent of thrombosis over the disease course. We found a strong positive correlation (Cramer’s V coefficient = 0.34) between SVT and disease severity. Mortality in the study group was 7.2% (8 patients) of which 5 patients (62.5%) were diagnosed with SVT. We observed an increased incidence of death among patients with thrombosis, with results approaching significance ( P = 0.056). In our study, we found that SVT has a negative effect on the course of AP and is associated with more severe disease and increased mortality.

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Augmented cerclage wire improves the fixation strength of a two-screw construct for humerus split type greater tuberosity fracture: a biomechanical study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04215-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Chao-Jui Chang ◽

Wei-Ren Su ◽

Kai-Lan Hsu ◽

Chih-Kai Hong ◽

Fa-Chuan Kuan ◽

...

Keyword(s):

Screw Fixation ◽

Biomechanical Study ◽

Fixation Strength ◽

Myotendinous Junction ◽

Steel Cable ◽

Simple Modification ◽

Greater Tuberosity ◽

Cerclage Wire ◽

Group A ◽

Group B

Abstract Background Poor functional outcome can result from humeral greater tuberosity (GT) fracture if not treated appropriately. A two-screw construct is commonly used for the surgical treatment of such injury. However, loss of reduction is still a major concern after surgery. To improve the biomechanical strength of screw fixation in GT fractures, we made a simple modification of the two-screw construct by adding a cerclage wire to the two-screw construct. The purpose of this biomechanical study was to analyze the effect of this modification for the fixation of GT fractures. Materials and methods Sixteen fresh-frozen human cadaveric shoulders were used in this study. The fracture models were arbitrarily assigned to one of two fixation methods. Group A (n = 8) was fixed with two threaded cancellous screws with washers. In group B (n = 8), all screws were set using methods identical to group A, with the addition of a cerclage wire. Horizontal traction was applied via a stainless steel cable fixed directly to the myotendinous junction of the supraspinatus muscle. Displacement of the fracture fixation under a pulling force of 100 N/200 N and loading force to construct failure were measured. Results The mean displacements under 100 N and 200 N traction force were both significantly decreased in group B than in group A. (100 N: 1.06 ± 0.12 mm vs. 2.26 ± 0.24 mm, p < 0.001; 200 N: 2.21 ± 0.25 mm vs. 4.94 ± 0.30 mm, p < 0.001) Moreover, the failure load was significantly higher in group B compared with group A. (415 ± 52 N vs.335 ± 47 N, p = 0.01), Conclusions The current biomechanical cadaveric study demonstrated that the two-screw fixation construct augmented with a cerclage wire has higher mechanical performance than the conventional two-screw configuration for the fixation of humeral GT fractures. Trial registration Retrospectively registered.

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Pancreatic Pseudoaneurysm from a Gastroduodenal Artery

Case Reports in Gastroenterology ◽

10.1159/000503895 ◽

2019 ◽

Vol 13 (3) ◽

pp. 450-455 ◽

Cited By ~ 1

Author(s):

Dhineshreddy Gurala ◽

Abhishek Datta Polavarapu ◽

Pretty Sara Idiculla ◽

Magda Daoud ◽

Vivek Gumaste

Keyword(s):

Acute Pancreatitis ◽

Gastric Bypass ◽

Coil Embolization ◽

Bypass Surgery ◽

Gastric Bypass Surgery ◽

Vascular Complication ◽

Gastroduodenal Artery ◽

Unique Case ◽

Fatal Complications

Pancreatic pseudoaneurysm is a rare vascular complication of pancreatitis, resulting from erosion of the pancreatic or peripancreatic artery into a pseudocyst. However, it may happen after pancreatic or gastric bypass surgery or trauma. It may lead to fatal complications if left untreated. Herein, we report a unique case of pseudoaneurysm from a gastroduodenal artery in a patient with recurrent episodes of acute pancreatitis, which was managed successfully with coil embolization.

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