Perspectives in vascular surgery and endovascular therapy
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Perspect Vasc Surg Endovasc Ther · Dec 2011
Multicenter StudyThe efficiency of pain control using a thigh pad under the elastic stocking in patients following venous stripping: results of a case-control study.
The use of a specific thigh foam pad placed under compression stockings increases interface pressure. The interface pressure obtained under 2 medical compression stockings of 15 to 20 mm Hg at the ankle, is 14 ± 2.2 mm Hg in the middle of the thigh in the horizontal position and rises to 49.2 ± 4.7 mm Hg when an appropriate thigh foam pad is interposed. Thigh compression could be useful in relieving pain after surgery of the great saphenous vein. ⋯ The results of this case-control study show that the addition of a pad at thigh level under the elastic compression stocking significantly reduces pain experienced by patients during the week after stripping surgery by 49%.
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Perspect Vasc Surg Endovasc Ther · Sep 2011
ReviewResults and challenges for the endovascular repair of aortic arch aneurysms.
Endovascular aortic arch reconstruction provides an attractive alternative to treat aortic arch disease in high-risk patients who would otherwise be unsuitable for open repair. Success with multibranched stent grafts in the thoracoabdominal aorta along with recent advances in design such as the precurved inner nitinol cannula have simplified the endovascular reconstruction of aortic arch aneurysms with multibranched stent grafts. These devices allow for greater flexibility in conforming to difficult anatomy and preserving important side branches. ⋯ The method is not suitable for patients with extensive atheromatous involvement of the aortic arch. Careful preoperative planning (preoperative imaging, device construction, and access issues), high endovascular skills, and appropriate imaging equipment are imperative for a successful result. Long-term follow-up is necessary to evaluate the efficacy and safety of these new devices.
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Perspect Vasc Surg Endovasc Ther · Sep 2011
ReviewSpinal cord preservation in thoracoabdominal aneurysm repair.
Spinal cord injury (SCI) stands as one of the most dreadful complications of thoracoabdominal aneurysm repair. Despite the less invasive nature and recent technical advancements of endovascular aortic repair, SCI still remains a significant danger in endovascular approaches. However, as our understanding of the collateral network of spinal cord vasculature has grown, it has become evident that the incidence of paraplegia and paraparesis in conjunction with endovascular procedures can be minimized through the use of many of the same strategies that have proven successful in reducing SCI associated with open surgical repair. This article highlights important aspects of spinal cord protection, which have been derived from the authors' clinical and experimental experience.