In-Hospital Outcomes in Autogenous Vein vs Synthetic Graft Interposition for Traumatic Arterial Injury

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
David P. Stonko ◽  
Richard D. Betzold ◽  
Hossam Abdou ◽  
Joseph Edwards ◽  
Faris K. Azar ◽  
...  
Keyword(s):  
Arterial Injury ◽  
Synthetic Graft ◽  
Hospital Outcomes ◽  
Autogenous Vein ◽  
Graft Interposition

scholarly journals Pseudoaneurysm formation following a traumatic wrist laceration

CJEM ◽  
2011 ◽  
Vol 13 (01) ◽  
pp. 48-52 ◽  
Author(s):  
Naveen Poonai ◽  
Rodrick Lim ◽  
Tim Lynch
Keyword(s):  
Early Recognition ◽  
Arterial Injury ◽  
Penetrating Injury ◽  
Motor Deficits ◽  
Ulnar Nerve Compression ◽  
Pseudoaneurysm Formation ◽  
Pulsatile Mass ◽  
Definitive Therapy ◽  
High Index Of Suspicion ◽  
Graft Interposition

ABSTRACT Pseudoaneurysms occur secondary to partial disruption of the arterial wall. They are a commonly described complication of arterial injury, with penetrating injury and iatrogenic arterial catheterization being the most common etiologies in children. Many present weeks to months after the injury, and the initial vascular injury is often missed. The complications of pseudoaneurysm, which include thromboembolism, neurapraxia, and compartment syndrome, underscore the importance of early recognition and management. Definitive therapy consists of ultrasound-guided compression or resection and possible graft interposition. We describe a case of pseudoaneurysm formation in the radial artery of an adolescent girl 6weeks following a penetrating injury. The patient’s injury was complicated by sensory and motor deficits consistent with ulnar nerve compression. This case attests to the importance of adequately ruling out arterial injury in penetrating injury and close followup if the history is suggestive. In addition, a high index of suspicion is warranted to facilitate imaging of a pulsatile mass to avoid confusion of a thrombosed artery with an abscess.

scholarly journals Axillary Artery Injuries Surgical experience review in a single vascular trauma center

2020 ◽  
Vol 16 (1) ◽  
pp. 4-9
Author(s):  
Bahaa I. Hamza
Keyword(s):  
Axillary Artery ◽  
Arterial Injury ◽  
Cross Sectional Study ◽  
Vascular Trauma ◽  
Delayed Presentation ◽  
Management Options ◽  
Cross Sectional ◽  
The Third ◽  
Trauma Surgeons ◽  
Graft Interposition

Background: Injuries to blood vessels are among the most dramatic challenges facing trauma surgeons because repair is often urgent, the surgeon has to decide between management options (open or endovascular), and gaining control and reconstructing a major arterial injury can be technically demanding .Objective:,To analyze the cause of injury, surgical approach, outcome and complications of axillary artery injuries.Methods A descriptive cross-sectional study on fifty patients at Ibn-Alnafees hospital in Baghdad from January 2005 to December 2010Results Males were more commonly affected than female with ratio of 6.1:1. Most injuries were caused by bullet and shell (84%), followed by stab wounds (10%) and blunt trauma (6%). Patients were divided into three groups according to the involved part of the axillary artery: the first part, the second part and the third part. The second part represents most of the cases (48%), the third part account for (30%), while the least is the first part (22%). Resection and end to end anastomosis was done in 80% of the cases, lateral repair in 8%, graft interposition in 8 % and ligation in 4%.Conclusion: The outcome of the injury in this study was in general good. The morbidity of the patients due to nerve injury and wound infection still problem. Mortality due to associated injury and delayed presentation was 4% which is acceptable as compared with other studies.

scholarly journals Current results of arterial injuries seen at femoral and popliteal arteries in civil society

2020 ◽  
Vol 7 (7) ◽  
pp. 2082
Author(s):  
Metin O. Beyaz ◽  
Ibrahim Demir ◽  
Emin C. Ata
Keyword(s):  
Early Intervention ◽  
Saphenous Vein Graft ◽  
Arterial Injury ◽  
University Hospital ◽  
Bleeding Control ◽  
Critical Importance ◽  
Ischemic Time ◽  
Loss Of Life ◽  
Arterial Injuries ◽  
Graft Interposition

Background: Lower extremity arterial injuries caused by penetrating or fired-gun trauma may result in limb or loss of life. Early intervention has critical importance. The aim of this study was to investigate the importance of early intervention and outcomes.Methods: We retrospectively reviewed the data on 144 patients (18 females, 126 males) who were treated in Istanbul Medipol University Hospital between January 2016 to 2018. All patients had an arterial injury at level of femoral and popliteal arteries. Standard statistical methods were used for data analysis.Results: Revascularization was performed to all 144 (18 females, 126 males) patients. Autologous saphenous vein graft interposition was performed in 96 patients. End-to-end repair was performed in 39 patients. 9 patients underwent a polytetrafluoroethylene graft (8 mm ringed) interposition.Conclusions: All viable limbs should be revascularized rapidly. The primary goal is to provide bleeding control rapidly and to prevent the prolongation of ischemic time. It should be kept in mind that in addition to surgical technique, fasciotomy may be required in arterial injuries with ischemic time of more than 6-8 hours.

The Effect of Oxidized Cholesterol on the Aorta of Rabbits- Scanning Electron Microscopic Observations

1982 ◽  
Vol 40 ◽  
pp. 340-341
Author(s):  
S. K. Pena ◽  
C. B. Taylor ◽  
J. Hill ◽  
J. Safarik
Keyword(s):  
Cholesterol Biosynthesis ◽  
Cholesterol Content ◽  
Arterial Injury ◽  
Electron Microscopic ◽  
Aortic Smooth Muscle ◽  
Oxidized Cholesterol ◽  
Initial Event ◽  
Membrane Structure And Function ◽  
Scanning Electron Microscopic ◽  
And Function

Introduction: Oxidized cholesterol derivatives have been demonstrated in various cell cultures to be very potent inhibitors of 3-hvdroxy-3- methylglutaryl Coenzyme A reductase which is a principle regulator of cholesterol biosynthesis in the cell. The cholesterol content in the cells exposed to oxidized cholesterol was found to be markedly decreased. In aortic smooth muscle cells, the potency of this effect was closely related to the cytotoxicity of each derivative. Furthermore, due to the similarity of their molecular structure to that of cholesterol, these oxidized cholesterol derivatives might insert themselves into the cell membrane, alter membrane structure and function and eventually cause cell death. Arterial injury has been shown to be the initial event of atherosclerosis.

Control of Autogenous Vein Grafts Prior to Reimplantation, By Electron Microscopy

1972 ◽  
Vol 30 ◽  
pp. 106-107
Author(s):  
John H. L. Watson ◽  
John L. Swedo ◽  
M. Vrandecic
Keyword(s):  
Electron Microscopy ◽  
Light And Electron Microscopy ◽  
Physiological Saline ◽  
Experimental Conditions ◽  
Vein Grafts ◽  
Arterial Blood ◽  
Saphenous Veins ◽  
Autogenous Vein ◽  
Control Of Parameters ◽  
Post Implantation

The ambient temperature and the nature of the storage fluids may well have significant effects upon the post-implantation behavior of venus autografts. A first step in the investigation of such effects is reported here. Experimental conditions have been set which approximate actual operating room procedures. Saphenous veins from dogs have been used as models in the experiments. After removal from the dogs the veins were kept for two hours under four different experimental conditions, viz at either 4°C or 23°C in either physiological saline or whole canine arterial blood. At the end of the two hours they were prepared for light and electron microscopy. Since no obvious changes or damage could be seen in the veins by light microscopy, even with the advantage of tissue specific stains, it was essential that the control of parameters for successful grafts be set by electron microscopy.

Multidisciplinary team decision is rare and decreasing in percutaneous vascular interventions despite positive impact on in-hospital outcomes

VASA ◽  
2019 ◽  
Vol 48 (3) ◽  
pp. 262-269 ◽  
Author(s):  
Christian-Alexander Behrendt ◽  
Tilo Kölbel ◽  
Thea Schwaneberg ◽  
Holger Diener ◽  
Ralf Hohnhold ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Positive Impact ◽  
Cross Sectional Study ◽  
Invasive Treatment ◽  
Cross Sectional ◽  
Hospital Outcomes ◽  
Vascular Intervention ◽  
Medical Specialties ◽  
Team Decision ◽  
The Impact

Abstract. Background: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. Methods: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014. Results: MTD prior to PVI was associated with lower odds of early unsuccessful termination of the procedures (Odds Ratio 0.662, p < 0.001). The proportion of MTD decreased over the study period (30.9 % until 2009 vs. 16.6 % from 2010, p < 0.001) while rates of critical limb-threatening ischemia (34.5 % vs. 42.1 %), patients´ age (70 vs. 72 years), PVI below-the-knee (BTK) (13.2 % vs. 22.4 %), and rates of severe TASC C/D lesions BTK (43.2 % vs. 54.2 %) increased (all p < 0.001). Utilization of MTD was different between medical specialties with lowest frequency in procedures performed by internists when compared to other medical specialties (7.1 % vs. 25.7 %, p < 0.001). Conclusions: MTD prior to PVI is associated with technical success of the procedure. Nonetheless, rates of MTD prior to PVI are decreasing during the study period. Future studies should address the impact of multidisciplinary vascular teams on long-term outcomes.

Inhibition of Leucocyte and Platelet Adhesion Reduces Neointimal Hyperplasia after Arterial Injury

1997 ◽  
Vol 77 (04) ◽  
pp. 783-788 ◽  
Author(s):  
Paolo Golino ◽  
Giuseppe Ambrosio ◽  
Massimo Ragni ◽  
Plinio Cirillo ◽  
Nicolino Esposito ◽  
...  
Keyword(s):  
Coronary Angioplasty ◽  
Neointimal Hyperplasia ◽  
Rabbit Model ◽  
Arterial Injury ◽  
Platelet Glycoprotein ◽  
Beneficial Effects ◽  
Von Willebrand ◽  
Willebrand Factor ◽  
Factor Interaction ◽  
Adhesion Complex

SummaryRestenosis following coronary angioplasty is thought to result from migration and proliferation of medial smooth muscle cells. However, the factors that initiate this proliferation are still unknown. In a rabbit model of carotid artery injury, we tested the hypothesis that activated platelets and leucocytes might contribute to the development of neointimal hyperplasia. Following arterial injury, rabbits received either no treatment, R15.7, a monoclonal antibody against the leucocyte CD ll/CD 18 adhesion complex, aurintricarboxylic acid (ATA), a sub stance that inhibits platelet glycoprotein Ib-von Willebrand factor interaction, or the combination of R15.7 and ATA. After 21 days, the extent of neointimal hyperplasia was evaluated by planimetry on histological arterial sections. The area of neointima averaged 0.51 ±0.07 mm2 in control animals and it was significantly reduced by administrationof either R15.7 or ATA alone to 0.12 ± 0.05 and 0.20 ±0.01 mm2, respectively (p <0.05 vs controls for both groups). The animals that received the combination of R15.7 and ATA showed a further reduction in neointimal hyperplasia, as compared to animals that received ATA alone (p <0.05 vs ATA alone). These data indicate that platelets and leucocytes play animportant role in the pathophysi ology of neointimal hyperplasia in this experimental model. Interven tions that reduce platelet and leucocyte adhesion to vessel wall might have beneficial effects in reducing restenosis following coronary angioplasty.

Increased Plasma Fibrinogen and Platelet-Aggregates in Type II Hyperlipoproteinaemia

1979 ◽  
Vol 42 (05) ◽  
pp. 1503-1507 ◽  
Author(s):  
G D O Lowe ◽  
Maureen M Drummond ◽  
Jane L H C Third ◽  
W F Bremner ◽  
C D Forbes ◽  
...  
Keyword(s):  
Plasma Lipids ◽  
Young Patients ◽  
Adult Life ◽  
Arterial Disease ◽  
Arterial Injury ◽  
Plasma Fibrinogen ◽  
Type Ii ◽  
Familial Type ◽  
Platelet Aggregate ◽  
Platelet Aggregates

SummaryPlasma fibrinogen and platelet-aggregates (method of Wu and Hoak) were measured in 21 patients with familial Type II hyperlipoproteinaemia and 21 matched control subjects. Patients with hyperlipoproteinaemia had increased levels of fibrinogen and platelet- aggregates (p<0.01). Young patients with hyperlipoproteinaemia had prematurely high fibrinogen levels, and the normal rise in fibrinogen during adult life was abolished. There were no statistically significant correlations within the patient group between fibrinogen, platelet-aggregates, and plasma lipids. High fibrinogen and platelet-aggregate levels may play a part in the development of the premature arterial disease associated with Type II hyperlipoproteinaemia, or may be markers of arterial injury.

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