Present Status of Infrainguinal Arterial Bypass Procedures Following an All Autogenous Policy - Long-Term Results of a Single Center

Swiss Surgery ◽  
2002 ◽  
Vol 8 (4) ◽  
pp. 171-175 ◽  
Author(s):  
Eugster ◽  
Stierli ◽  
Guerke ◽  
Obeid ◽  
Hess
Keyword(s):  
Primary Patency ◽  
Long Term Results ◽  
Single Center ◽  
Arterial Reconstruction ◽  
Size Mismatch ◽  
Vein Grafts ◽  
Vein Disease

Objectives: The direction of vein grafts for infrainguinal arterial reconstruction is controversial. Long-term results of a single center following an all autogenous tissue policy in infrainguinal arterial reconstruction are reported with special attention to possible advantages for the in situ and non-reversed bypass using angioscopy. Methods: From 10/88 until 12/00 540 bypasses with autogenous veins were performed on 497 patients. Veins were used in a non-reversed or in-situ direction, valve disruption was performed under angioscopic control. All grafts were prospectively included in our data base and follow-up was scheduled in our vascular lab before discharge and after 3, 6, 9, 12, 24 etc. months. Results: Primary patency of all bypasses after 108 months was 55.2%, primary assisted 76.9% (SE +/- 9.87), survival 58.4% (SE +/- 8.88) and limb salvage 81.3% (SE +/- 9.75). Perioperative mortality was 0.9% (5 pat.). Patency rates (primary assisted patency) after 72 months were 81.7% (98.2%) for supragenicular, 61.5% (79.4%) for infragenicular and 56.6% (78.1%) for tibial anastomoses and for pedal reconstructions after 48 months 49.3% (68.6%). Conclusion: Reviewing the literature neither the in situ and non-reversed nor the reversed grafts yielded better long-term results. Absence of size mismatch may be an advantage in smaller veins. Angioscopy may detect unsuspected vein disease.

Open Surgical versus Minimally Invasive in Situ Femorodistal Bypass: Long-term Results

2003 ◽  
Vol 10 (1) ◽  
pp. 117-120 ◽  
Author(s):  
Nomdo S. Renken ◽  
Cees H.A. Wittens ◽  
Peter M.T. Pattynama ◽  
Nico A.J.J. Du Bois ◽  
Lukas C. van Dijk
Keyword(s):  
Minimally Invasive ◽  
Limb Salvage ◽  
Long Term Results ◽  
Open Technique ◽  
Treatment Groups ◽  
Closed Technique ◽  
Open Versus

Purpose: To compare long-term patency and limb survival rates for the classical in situ surgical bypass procedure versus a minimally invasive technique for femorodistal revascularization. Methods: From May 1992 to June 1994, a prospective multicenter study was undertaken at 4 centers to evaluate the open versus closed technique for femorodistal bypass grafting. Of 97 patients enrolled in the trial, 73 patients (49 men; mean age 71 years) were assigned to the long-term follow-up protocol and prospectively randomized to the open (n = 38) or closed (n = 35) procedure. The classical open technique is characterized by a long incision over the length of the bypass graft, while the minimally invasive procedure involves only two short incisions over each anastomosis site (the side branches are closed with a coaxial embolization catheter system). Graft patency was evaluated with duplex imaging periodically throughout the 4-year observation period. Results: There was no statistically significant difference between the treatment groups with respect to age, sex, hypertension, ischemic heart disease, or smoking. However, the open group had a significantly greater incidence of diabetes (p = 0.037). Over a median 4.7-year follow-up (range 0.3–6.4), 9 (12%) patients (3 open and 6 closed) were lost to follow-up: 2 died and 7 refused the duplex examination. No significant differences in 4-year patency, limb salvage, or survival was demonstrated between the open versus closed treatment groups; 4-year secondary patency was 62% versus 64%, respectively, and limb salvage was 72% versus 86%. Conclusions: The closed technique for femorodistal in situ bypass procedures yields favorable long-term outcomes compared to the traditional open technique.

Cement within Cement Revision Hip Arthroplasty a Minimum 5 Year Follow-Up Study

1998 ◽  
Vol 8 (3) ◽  
pp. 129-137 ◽  
Author(s):  
J.P. Holland ◽  
F.A. Weber
Keyword(s):  
Femoral Stem ◽  
Femoral Shaft ◽  
Complete Removal ◽  
Senior Author ◽  
Long Term Results ◽  
Cemented Stem ◽  
Revision Hip Surgery

Complete removal of femoral shaft cement during revision hip surgery is a difficult task prone to complications. If the cement bone interface is intact however, is there a place for its preservation and re-use with a new cemented stem? The results are reported of 51 cement within cement femoral stem revisions carried out between 1984 and 1991 with a minimum of 5 years’ follow-up, and a mean of 7.8 years. Excluding patients lost or deceased, 39 hips in 38 patients were reviewed clinically and radiologically. Eighty-two percent of these were still functioning in situ, 72% were excellent or good using the HSS scoring system and 97% had no radiological evidence of loosening. Femoral stem failure due to aseptic loosening occurred in 4 cases (10%) between 4 and 12 years after revision. Comparing this series to a previous revision hip series by the senior author, there appears to be no deterioration in long term results using this technique, and a better long term radiological outcome.

scholarly journals Long-Term Results of Universal 2 Total Wrist Arthroplasty

2019 ◽  
Vol 08 (04) ◽  
pp. 317-320 ◽  
Author(s):  
H. J. A. Zijlker ◽  
M. J. P. F. Ritt ◽  
C. B. IJsselstein
Keyword(s):  
Patient Satisfaction ◽  
Long Term Results ◽  
Fourth Generation ◽  
X Rays ◽  
Implant Survival ◽  
Total Wrist Arthroplasty ◽  
Component Loosening

Background The Universal 2 is a widely used total wrist implant that aims to maintain function of the wrist. Purpose Promising mid-term results of the Universal 2 total wrist implant are described in the literature. This study evaluates the long-term results in terms of implant survival and patient satisfaction. Patients and Methods Patients who received a Universal 2 implant between 2004 and 2009 were retrospectively identified through a database search. Clinical outcome and complications of the implant were assessed by examination of the patient's medical records, X-rays, and a questionnaire, consisting of the Patient-Rated Wrist and Hand Evaluation questionnaire (PRWHE) and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaires and additional questions. Results Twenty-five patients (26 wrists) were included in this study. Twenty-one (81%) Universal 2 implants remained in situ after a mean follow-up of 11 years. Moderate PRWHE (44) and QuickDASH (41) scores were found in these cases. Five Universal 2 implants failed and were converted to a total wrist arthrodesis after a mean period of 9.2 years due to distal component loosening (n = 3), recurrent luxation (n = 1), or recurrent synovitis (n = 1). Twenty-three (92%) patients were (very) satisfied with the Universal 2 implant. Conclusion The Universal 2 demonstrates a high (81%) implant survival with a high patient satisfaction after a mean follow-up of 11 years. Prospective studies of the Universal 2 implant are necessary to objectify improvement in wrist function and to provide a better comparison to other fourth generation wrist implants.

Long-Term Results of the Surgical Treatment of Spinal Dermoid and Epidermoid Tumors.

Neurosurgery ◽  
1989 ◽  
Vol 25 (6) ◽  
pp. 860-864 ◽  
Author(s):  
Pierpaolo Lunardi ◽  
Paolo Missori ◽  
Franco M. Gagliardi ◽  
Aldo Fortuna
Keyword(s):  
Surgical Treatment ◽  
Nervous Tissue ◽  
Working Life ◽  
Clinical Findings ◽  
Long Term Results ◽  
Tumor Capsule ◽  
Follow Up Study

Abstract The clinical findings and the results of surgical treatment in 16 patients with spinal dermoid or epidermoid tumors are reported. In 9 patients the tumor capsule adhered so tightly to the nervous tissue that part of it was left in situ. In a follow-up study ranging from 5 to 30 years with a mean of 14.2 years only 1 patient had a recurrence of the tumor and 10 patients resumed a normal working life.

scholarly journals Single-center long-term results of vagus nerve stimulation for epilepsy: A 10–17 year follow-up study

Seizure ◽  
2018 ◽  
Vol 59 ◽  
pp. 41-47 ◽  
Author(s):  
Jan Chrastina ◽  
Zdeněk Novák ◽  
Tomáš Zeman ◽  
Jitka Kočvarová ◽  
Martin Pail ◽  
...  
Keyword(s):  
Vagus Nerve ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Long Term Results ◽  
Single Center ◽  
Follow Up Study

scholarly journals Long-term results of open aorto-femoral reconstructions

2021 ◽  
Vol 180 (1) ◽  
pp. 54-59
Author(s):  
T. B. Rakhmatillaev ◽  
A. V. Gusinskiy ◽  
V. V. Shlomin ◽  
O. V. Fionik ◽  
A. V. Shatravka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Supervision ◽  
Primary Patency ◽  
Long Term Results ◽  
Secondary Patency ◽  
Femoral Arteries ◽  
Reconstructive Operations

The objective was to analyze the long-term results of open aorto-femoral reconstructions in order to optimize the approach to surgical treatment.Methods and materials. The study included 548 patients with reconstructions of the aorto-femoral segment performed between 1999 and 2007. Of these, 293 patients underwent loop endarterectomy of the iliac arteries, 255 – after aorto-femoral bypass with a synthetic prosthesis. All interventions were performed against the critical lower limb ischemia. The superficial femoral arteries remained occluded in all cases. Outflow was carried out only in the deep femoral arteries and collateral vessels. Patients were under clinical supervision for 5 to 20 years. In the long-term period, most patients underwent interventions on the coronary, brachiocephalic arteries, as well as surgery for cancer.Results. Timely correction of concomitant pathology made it possible to increase the survival rate of patients by the 10-year follow-up period to 72 %, and after 20 years this figure reached 63 %. The primary patency of the reconstructed segment after loop endarterectomy was significantly higher than after aorto-femoral bypass surgery. Secondary patency in the groups did not significantly differ and by 20 years of follow-up reached 76 %. A high level of patency of the operated segment was also provided by a large percentage of preserved limbs (80 % after 20 years). A study of the quality of life showed that, despite the persistence of intermittent claudication at the level of 400–800 meters, the vast majority of patients were satisfied with their life. Suppurations in the transplant area and the formation of false aneurysms in the area of anastomoses were found only in the group of aorto-femoral bypass grafts.Conclusion. Open reconstructive operations on the aorto-femoral segment, such as loop endarterectomy and aorto-femoral bypass with adequate postoperative medical examination have good long-term results of survival, patency of the reconstructed segment, percentage of saved limbs and quality of life of patients. Complications in the form of suppuration in the transplant area and the formation of false aneurysms occur only after bypass.

scholarly journals Survival Benefit of Exclusive Use of In Situ Arterial Conduits Over Combined Use of Arterial and Vein Grafts for Multiple Coronary Artery Bypass Grafting

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Hiroshi Nishida ◽  
Yasuko Tomizawa ◽  
Masahiro Endo ◽  
Hiromi Kurosawa
Keyword(s):  
Cardiac Death ◽  
Artery Bypass ◽  
Arterial Grafts ◽  
Vein Grafts ◽  
Combined Use ◽  
Group A ◽  
Group B

Background— The purpose of this study was to evaluate mortality after coronary artery bypass grafting (CABG) comparing the use of only in situ arterial grafts with the use of arterial and venous conduits. Methods and Results— From April 1985 to March 1999, 1159 patients with multivessel disease underwent elective, isolated, primary, multiple CABG with at least one in situ arterial conduit. Patients who were on chronic dialysis, had active malignant disease, or had free arterial conduits were excluded. The long-term results were compared between 532 patients who had CABG using only in situ arterial conduits (group A; mean follow-up, 7.8 years) and 627 patients who underwent CABG using in situ arterial conduits and saphenous vein grafts (group B; mean follow-up, 10.3 years). Actuarial survival and freedom from cardiac death were determined by the Kaplan-Meier method. Propensity score was included in the Cox multivariable regression model for adjustment of selection bias. Survival at 10 years after surgery was 81.4% in group A and 76.9% in group B ( P =0.11). Freedom from cardiac death at 10 years was 93.4% in group A and 90.4% in group B. Hazard ratio for cardiac death was significantly lower in group A (0.61; 95% confidence interval, 0.38 to 1.00; P =0.05). Conclusions— Our data suggest that the exclusive use of in situ arterial grafts in CABG achieves significantly better long-term survival compared with combined use of arterial and vein grafts.

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