scholarly journals Endovascular Instead of Open Surgical Repair of Axillosubclavian Artery Injuries: An Evolving Paradigm Shift

2022 ◽  
Vol 5 (3) ◽  
Author(s):  
Shreya Jalali ◽  
Derek J Roberts ◽  
Megan L Brenner ◽  
Joseph J DuBose ◽  
Laura J Moore ◽  
...  
Keyword(s):  
Paradigm Shift ◽  
Surgical Repair ◽  
Trauma Team ◽  
Hemodynamic Instability ◽  
Postoperative Management ◽  
Vascular Trauma ◽  
Open Surgical Repair ◽  
Team Members ◽  
Lower Complication ◽  
And Control

Axillosubclavian injuries (ASI) comprise a small proportion of vascular injuries, yet their morbidity and mortality is high. This is often attributable to non-compressible bleeding in the apical thorax, hemodynamic instability, and the anatomically challenging location of these vessels making them difficult to access and control quickly. While the traditional management of ASI was with open surgical repair (OSR), recent years have seen an evolution towards less invasive endovascular repair (EVR). In patients with these injuries, EVR may be a safer alternative that achieves similar immediate results with significantly lower complication and mortality rates than the highly morbid open surgical option. In this article, we review and compare the two approaches, providing an overview of patient selection, anatomic considerations, techniques, postoperative management, and outcomes. With the advent of EVTM and more trauma team members capable of endovascular management of vascular trauma, a paradigm shift towards EVR for ASI is taking place.

Open surgical repair versus EVAR: How much is enough?

VASA ◽  
2012 ◽  
Vol 41 (4) ◽  
pp. 239-239 ◽  
Author(s):  
Goodney
Keyword(s):  
Surgical Repair ◽  
Open Surgical Repair

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Comparison of hybrid endovascular and open surgical repair for proximal aortic arch diseases

2016 ◽  
Vol 203 ◽  
pp. 975-979 ◽  
Author(s):  
Woong Chol Kang ◽  
Young-Guk Ko ◽  
Eak Kyun Shin ◽  
Chul-Hyun Park ◽  
Donghoon Choi ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Surgical Repair ◽  
Open Surgical Repair

scholarly journals Renal autotransplantation in open surgical repair of suprarenal abdominal aortic aneurysm

2015 ◽  
Vol 89 (1) ◽  
pp. 48 ◽  
Author(s):  
Eun-Ki Min ◽  
Young Hoon Kim ◽  
Duck Jong Han ◽  
Youngjin Han ◽  
Hyunwook Kwon ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Surgical Repair ◽  
Open Surgical Repair ◽  
Abdominal Aortic ◽  
Renal Autotransplantation

scholarly journals Aggressors and resilient youths in Medellin, Colombia: the need for a paradigm shift in order to overcome violence

2013 ◽  
Vol 29 (11) ◽  
pp. 2208-2216 ◽  
Author(s):  
Luis F. Duque ◽  
Nilton E. Montoya ◽  
Alexandra Restrepo
Keyword(s):  
Public Policy ◽  
Cross Section ◽  
Metropolitan Area ◽  
Paradigm Shift ◽  
Prevention And Control ◽  
High Ratio ◽  
Multi Stage ◽  
Sexually Risky ◽  
And Control ◽  
Resilient Behavior

The objective of this study was to estimate the ratio of resilient youth and compare this to youth with aggressive behavior, and to youth who also exhibit sexually risky behavior and drug use. A cross-section study of a representative sample of people between aged between 12 and 60 who are residents of Medellin, Colombia, and its metropolitan area (N = 4,654) was employed using probabilistic multi-stage sampling. Youth between 14 and 26 years old were selected for the present analysis (n = 1,780). The proportion of resilient youth is 22.9%, of aggressors is 11.3%, and that of youth with other risky conduct is 65.8%. The high ratio of resilient youth calls for a reorientation of public policy toward prevention and control of violence, prioritizing the promotion of resilient behavior instead of continuing with tertiary prevention actions.

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