Annals of vascular surgery
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Migration of the iliac limb after endovascular abdominal aortic aneurysm repair (EVAR) can result in type 1b and 3 endoleaks, which are relatively common causes of reintervention after EVAR. The aim of the present study was to investigate the factors influencing migration of the iliac limb and methods of treatment. ⋯ Migration of the iliac limb after EVAR was influenced by a complex combination of several factors including a large aneurysm (>60 mm in diameter), dilated or aneurysmal CIA (>18 mm in diameter), short length of fixation (<70%), lower degree of iliac limb oversizing (<10-20%), and bell-bottom of the iliac limb. Patients with these factors require more vigorous surveillance after EVAR. The implantation of an additional stent graft is effective and is the most common reintervention procedure.
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The aim of this study is to examine the efficacy and safety of AngioJet rheolytic thrombectomy for the treatment of subacute deep venous thrombosis (DVT) in lower limbs. ⋯ It is safe and feasible to use the AngioJet rheolytic thrombectomy in the treatment of subacute DVT in lower limbs. In patients without high risk of bleeding, combination of AngioJet thrombectomy and CDT is an effective treatment to reduce the thrombus volume.
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Observational Study
Consistency of Proximal-to-Distal Tapering of Descending Thoracic Aortic Diameter: Quantification Using a Novel Computer Tomography-based Assessment.
Successful endovascular repair of thoracic aorta for type B aortic dissection requires correct stent-graft sizing, particularly of distal landing zone which is mainly based on operator experience. The present study aimed to quantitatively define proximal-to-distal tapering of descending thoracic aortic diameter and its consistency. ⋯ The maximal diameter of descending thoracic aorta decreases gradually and consistently among individuals free of aortic diseases.
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Vascular surgeons have a central role in managing peripheral artery disease (PAD). This study assessed their knowledge, attitudes, and behaviors regarding pharmacologic risk reduction in PAD and results were compared to a similar 2004 survey conducted by our group. ⋯ Significant knowledge and action gaps exist among Canadian vascular surgeons with regards to pharmacologic cardiovascular risk reduction in PAD. Although there is recognition that vascular surgeons are central to the medical management of patients with PAD, few routinely evaluate risk factors and prescribe medications. There is little evidence of sufficient improvement since 2004. New educational and clinical strategies are needed to improve PAD risk reduction pharmacotherapy among Canadian vascular surgeons.
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Hypothenar hammer syndrome (HHS) is an uncommon vascular syndrome of upper extremity. HHS should be considered in patients who are presented with digital ischemia. Distal ulnar artery compression at the level of Guyon's canal with trauma results in thrombus or aneurysm. It may be observed after repetitive chronic trauma or acute blunt trauma to hypothenar eminence. Middle-aged male laborers, smokers, and dominant hands are affected frequently. Hand pain, discoloration or ulceration of digits, cold intolerance, hypothenar pulsatile mass, hypothenar weakness, and numbness are significant clinical findings. ⋯ She was diagnosed as HHS secondary to intense needlework. A calcium channel blocker and low-dose aspirin were prescribed to her, and avoidance of hand traumas was suggested. These interventions relieved digital ischemia symptoms on her hand.