Journal of vascular surgery
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Endovascular treatment of traumatic aortic injury (TAI) is an alternative to open repair (OR) in patients with blunt trauma. We report our initial experience after integration of endovascular repair using thoracic devices. ⋯ In this initial experience, the results of TEVAR did not differ from OR. Long-term follow-up is required to determine the effectiveness of this treatment strategy. Adherence to follow-up imaging protocols is challenging in this patient population. Next generation devices will make TEVAR applicable to a wider range of patients.
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Review Meta Analysis
Neurological complications after left subclavian artery coverage during thoracic endovascular aortic repair: a systematic review and meta-analysis.
Recent studies suggest an increased risk of neurologic complications after coverage of the left subclavian artery (LSA) during thoracic endovascular aortic repair (TEVAR). The preventative role of preoperative revascularization of the LSA using carotid-subclavian bypass or transposition remains controversial. We assessed this increased risk and the role of revascularization by undertaking a systematic review and meta-analysis of the literature. ⋯ The risk of neurologic complications is increased after coverage of the LSA during TEVAR. Preemptive revascularization offers no protection against CVA, perhaps indicating a heterogeneous etiology. Revascularization may reduce the risk of SCI, although limited data tempers this conclusion. Improved or perhaps compulsory reporting to registries of a minimum data set may help further assess the exact etiology of these complications and identify a higher-risk subset of patients in whom revascularization might prove protective.
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Review Case Reports
Vertebral artery stent graft for a chronic symptomatic vertebrojugular arteriovenous fistula.
A patient with a chronic, symptomatic V2 segment vertebrojugular fistula was successfully treated with a vertebral artery stent graft, with immediate tinnitus resolution. No early or late complications were observed, and at 45 months of follow-up, the patient remains asymptomatic with a patent stent graft. The existing literature on stent graft treatment of vertebrojugular fistula is reviewed.
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Comparative Study
Inferior outcomes of autogenous infrainguinal bypass in Hispanics: an analysis of ethnicity, graft function, and limb salvage.
Recent evidence suggests disparities exist among racial groups with peripheral arterial disease (PAD). Hispanics (HI) are the fastest growing demographic in the United States, but little outcome data is available for this population. Therefore, we undertook this study to compare the results of autogenous infrainguinal bypass grafting in HI to Caucasians (CA) and African Americans (AA). ⋯ Autogenous infrainguinal bypass surgery in HI is associated with primary patency and limb salvage inferior to that of CA and similar to that of AA, despite HI rates of CLI equivalent to CA and HI comorbidities less severe than AA. HI ethnicity was an independent predictor of limb loss. Our data provides evidence of outcome disparities in HI treated aggressively for their PAD. Further investigation with regard to biologic and social factors is required to delineate the reasons for these inferior outcomes in HI patients.