Annals of vascular surgery
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Bacillus Calmette-Guerin (BCG) is a live, attenuated strain of Mycobacterium bovis commonly used for the treatment of superficial bladder carcinoma. Intravesical BCG is well tolerated despite side effects that range from hematuria to sepsis syndrome. ⋯ These are challenging to diagnose because of their scarcity, nontraditional culture media, slow growth, and are often lethal. We report the first successful repair of a symptomatic, multifocal TAAA secondary to M bovis manifesting 17 months after intravesical BCG therapy and review the literature.
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Review Case Reports
Bier spots are an under-recognized cutaneous manifestation of lower extremity lymphedema: a case series and brief review of the literature.
Bier spots represent a benign vascular mottling characterized by multiple irregular white macules along the extensor surfaces of the arms and legs. They have been reported in a variety of diverse conditions with no consistent disease association. ⋯ The thighs were affected as well in 2 morbidly obese subjects. We suspect that these lesions are not uncommon in lymphedema but are simply under-recognized.
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Review Meta Analysis
The influence of study design on the evaluation of ruptured abdominal aortic aneurysm treatment.
The best strategy in the treatment for ruptured abdominal aortic aneurysm (RAAA) is an ongoing matter of debate. Differently from several retrospective studies, recent randomized controlled trials (RCTs) failed to demonstrate the superiority of endovascular repair (EVAR) over open repair (OPEN). The aim of the present study was to compare 30-day mortality of EVAR and OPEN in RAAA according to different study designs through a systematic review and meta-analysis. ⋯ Only few studies are available to compare EVAR and OPEN in an "unbiased" cohort, with no significant differences between the 2 treatments. However, after the introduction of EVAR and OPEN protocols, the overall mortality for RAAA was reduced compared with the only OPEN option, suggesting a beneficial effect of EVAR in selected cases.
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Review Case Reports
Posttraumatic axillary false aneurysm after luxatio erecta of the shoulder: case report and literature review.
Vascular complications after dislocation of the shoulder are rare. We report a case of glenohumeral inferior dislocation (luxatio erecta) responsible for an acute ischemia of the upper limb. Endovascular treatment with a covered stent associated with the evacuation of the compressive hematoma was privileged. ⋯ The conventional surgical treatment remains the standard treatment. Hybrid techniques with endovascular clamping can be useful in the presence of proximal arterial lesions. Endovascular treatment is an interesting therapeutic alternative in the urgency and in selected cases but its mid- and long-term results should still be evaluated.
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The elderly represent a large percentage of patients seen in departments of vascular surgery. Delirium is a frequent perioperative complication in this population and contributes to increased morbidity and mortality. ⋯ The aging of our population implies management of increasing numbers of older patients who often have concomitant pathologies and, consequently, polypharmacy. Optimization of their management rests on collaboration between surgeons, anesthetists, and geriatrists.