scholarly journals VENOUS OUTFLOW AFTER HARVESTING OF FEMORAL VEIN FOR RECONSTRUCTION OF AORTOILIAC SEGMENT

2016 ◽  
pp. 25-28
Author(s):  
A. A. Lyzikov
Keyword(s):  
Femoral Vein ◽  
Limb Ischemia ◽  
Late Complications ◽  
Additional Treatment ◽  
Point Of View ◽  
Venous Outflow ◽  
Initial Surgery ◽  
Surgery Department ◽  
Aortoiliac Reconstruction ◽  
Vein Harvesting

Objective: to define the state of venous outflow after femoral vein harvesting for aortoiliac reconstruction. Material and methods. The distant results of 22 aortoiliac reconstructions with deep femoral veins performed at Gomel Regional Vascular Surgery Department over 2010-2015 have been studied. 5 patients were operated for late complications (false aneurisms) of previous aorto-femoral bypass, 8 patients were treated for acute prosthetic infection and 9 patients underwent initial surgery for terminal stage of critical limb ischemia. Results and discussion. The group of the patients after initial reconstructions revealed significant edema and lymphorea immediately after the surgery. It was not necessary to perform fasciotomy in all the cases. There were no signs of chronic venous insufficiency in all the patients in the remote postoperational period. Conclusion. The application of femoral vein for aortoiliac bypass is safe from the point of view of venous morbidity. Outflow disturbances were transient in all the cases and no additional treatment was needed.

Abstract 165: Pial Synangiosis in Patients with Moyamoya less than 2 Years of Age

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Eric M Jackson ◽  
Ning Lin ◽  
Lissa Baird ◽  
R. Michael Scott ◽  
Edward R Smith
Keyword(s):  
Late Complications ◽  
High Risk Population ◽  
Consecutive Series ◽  
Ischemic Change ◽  
Initial Surgery ◽  
Long Term Follow Up ◽  
Progression Of Disease ◽  
Long Term Prognosis

Introduction: Moyamoya patients under two years of age represent a therapeutic challenge because of their frequent neurologic instability and concomitant anesthetic risks. We report our experience with pial synangiosis revascularization in this population. Methods: We reviewed the clinical and radiographic records of all patients with moyamoya syndrome in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results: During a 12-year period (1994-2005), thirty-four procedures (15 bilateral, 4 unilateral) were performed in 19 patients under two years of age (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or TIA. Average age at first surgery was 1.4 years (range 6 months to 1.9 years). Unanticipated staged operations occurred in three patients, two due to persistent EEG changes during the initial surgery and one due to brain swelling during the procedure requiring ventriculostomy. There were two perioperative strokes; both patients had post-operative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14). In long term follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures years later for frontal lobe ischemia (2), late infarction (1) and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre and post-operative angiography demonstrated progression of disease. Conclusions: Despite the challenges inherent to this population, the majority of children with moyamoya under 2 years of age have a good long-term prognosis. Our data support the use of pial synangiosis as a safe, effective and durable method for treatment of moyamoya for most children in this potentially high-risk population.

Perioperative complications and quality of life after radical retropubic prostatectomy

1995 ◽  
Vol 62 (1_suppl) ◽  
pp. 19-22
Author(s):  
F. Merlo ◽  
M. Mangano ◽  
P. Checchin ◽  
L. Maccatrozzo ◽  
A. Fandella ◽  
...  
Keyword(s):  
Social Life ◽  
Perioperative Complications ◽  
Intraoperative Complications ◽  
Late Complications ◽  
Pelvic Lymphadenectomy ◽  
Radical Retropubic Prostatectomy ◽  
Point Of View ◽  
Early Complications ◽  
Retropubic Prostatectomy

— The Authors report their experience with perioperative complications in 128 patients after radical retropubic prostatectomy preceding bilateral pelvic lymphadenectomy for prostatic cancer. Patients were classified by anatomo-pathological stage; 25% were stage D1. Data relating to homologous transfusions (22%), intraoperative complications (1.6%), minor (16%) or major (7%) early complications and late complications (0.8%) are analysed. The latest group of patients has also been assessed from a sexual, psychological and social point of view. 84% of patients reported an erectile deficit, but only 4% suffered a psychological worsening reflecting on their social life.

Pysiological Evaluation of Venous Obstruction in the Post-Thrombotic Leg

1989 ◽  
Vol 4 (1) ◽  
pp. 3-14 ◽  
Author(s):  
Henrik Åkesson ◽  
Lars Brudin ◽  
Ragnar Jensen ◽  
Per Ohlin ◽  
Gunnar Plate
Keyword(s):  
Clinical Symptoms ◽  
Femoral Vein ◽  
Venous Pressure ◽  
Reference Method ◽  
Iliac Vein ◽  
Venous Obstruction ◽  
Venous Outflow ◽  
Physiological Importance ◽  
Venous Outflow Obstruction ◽  
Additional Value

The accuracy and value of occlusion plethysmography (OP) in assessing post-thrombotic iliac and femoral vein obstruction was determined in 45 patients (85 legs) six months after an acute iliofemoral venous thromboses using contrast phlebography (CP) as reference method. The additional value of femoral venous pressure (FVP) measurements in assessing the physiological importance of iliac vein obstructions was determined in 34 of these patients (60 legs). The sensitivity and specificity of OP in detecting femoral and iliac vein obstructions was 79% and 84% respectively. OP was unable to distinguish femoral from iliac lesions and stenosis from obstructions. A maximum venous outflow (MVO) <30 ml·100 ml−1 ·min−1 was greatly associated with venous obstruction which was very uncommon if the MVO >50 ml·100 ml−1 ·min−1. Resting FVPs were of little value in assessing iliac venous outflow. Exercise pressures and comparison with normal contralateral veins improved the association with anatomical obstruction. A difference in FVP change with exercise exceeding l mmHg as compared to the contralateral leg was most predictive of an iliac vein obstruction. Patients with obvious clinical symptoms of venous outflow obstruction (venous claudication) all had iliac vein obstruction, abnormal OP and an FVP change with exercise exceeding 5 mmHg. This demonstrates the ability of OP and FVP to reflect physiological rather than morphological post-thrombotic venous obstruction.

Novel treatment of a totally occluded venous outflow tract of an arteriovenous graft

2018 ◽  
Vol 20 (3) ◽  
pp. 333-336
Author(s):  
Crystal A Farrington ◽  
Ahmed K Abdel-Aal ◽  
Ammar Almehmi
Keyword(s):  
Blood Flow ◽  
Chronic Total Occlusion ◽  
Femoral Vein ◽  
Chronic Hemodialysis ◽  
Outflow Tract ◽  
Arteriovenous Graft ◽  
Initial Attempt ◽  
Venous Outflow ◽  
Total Occlusion ◽  
Vein Access

Introduction: Conventional guidewire techniques are not always sufficient to restore arteriovenous graft patency in patients with challenging vascular scenarios. We discuss a novel approach to the treatment of chronic total occlusion of the venous outflow tract to enable successful arteriovenous graft thrombectomy. Case presentation: A 28-year-old female with end-stage renal disease on chronic hemodialysis and recurrent arteriovenous graft thromboses presented with a clotted thigh graft. An existing ipsilateral common femoral vein stent was found to be chronically occluded, causing persistent venous outflow obstruction and rendering an initial attempt at thrombectomy unsuccessful due to wire buckling and the inability to navigate through the stent chronic total occlusion. Results: After establishing femoral vein access, a vibrational recanalization device was used to cross the occluded stent. The device was then removed, permitting routine angioplasty. Post-angioplasty angiogram revealed persistent intra-stent stenosis, so a covered stent was deployed with good angiographic results. Routine pharmaco-mechanical thrombectomy of the arteriovenous graft was then performed. Two additional stents were placed due to stenotic recoil in the venous limb of the graft. Angioplasty was also performed at the arteriovenous graft arterial anastomosis. Repeat imaging demonstrated marked improvement in the graft blood flow. Discussion: Total occlusion of the venous outflow tract prevents adequate blood flow through an arteriovenous graft and undermines successful thrombectomy. We describe the use of the Crosser vibrational recanalization device for the safe and effective treatment of a chronic total occlusion of the venous outflow tract, thus extending the life of the patient’s vascular access for hemodialysis.

scholarly journals Surgical techniques for hemostasis in penetrating trauma to femoral artery

2016 ◽  
Vol 12 (1) ◽  
Author(s):  
Nazir Ahmad ◽  
Ashfaq Ahmad ◽  
Syed Tahir Ahmad Shah
Keyword(s):  
Femoral Artery ◽  
Vein Graft ◽  
Femoral Vein ◽  
Penetrating Trauma ◽  
Limb Ischemia ◽  
Arterial Injury ◽  
Skin Damage ◽  
Ischemia Time ◽  
Study Results ◽  
Femoral Vessels

Objectives: To analyse the efficacy of various operative procedures and factors affecting the outcome especially the effect of limb ischemia time in penetrating trauma to the femoral artery. Study Design: Prospective. Setting: Study was conducted at West Surgical Ward, Mayo Hospital Lahore. Duration: August 2001 to July 2004. Materials and Methods: All the patients >12 years of age referred from periphery as well as directly admitted with penetrating trauma to the femoral vessels alone or associated with other organ injuries having hard/soft physical signs of an arterial injury were included in the study. Results: 39(97.5%) patients were male, age ranged from 14-53 years with the mean limb ischemia time of 7.8 hours in the series. 35(87.5%) patients sustained firearm injuries. Superficial femoral artery was injured in 23(57.5%) followed by vein in 12(30%) and major vessels were found intact in 4(10%) patients. Lateral arteriorrhaphy was performed in 4(10%) & venorrhaphy in 3(7.5%) patients with 100 % succ ess rate, resection and primary anastomosis in 18(45%) patients with pseudo aneurysm formation in 1(2.5%) patient. Reverse great saphenous vein graft was interposed in 9(22.5%) patients with graft failure rate of 5% (2 patients). Femoral vein was ligated in 12(30%) patients with development of deep vein thrombosis in 2(5%) patients. There were 3(7.5%) deaths. No synthetic graft was used in the series. Conclusion: Exsanguination, prolonged injury duration, associated organ injuries and extensive soft tissue and skin damage of the extremities were the major factors responsible for increased morbidity particularly limb loss and mortality. Proximity of injury to the femoral vessels was a poor predictor of an arterial injury in the study. Arteriorrhaphy and primary end-to-end anastomosis are the main stays for an arterial injury repair, next comes the use of autogenous vein graft, in our setup. Moreover ligation of femoral vein is not associated with leg amputation.

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