ABSTRACT
Vascular compression syndromes (VCS) are rare diseases, but they may cause significant symptoms interfering with the quality of life (QoL) of patients who are often in their younger age. Given their infrequent occurrence, multiform clinical and anatomical presentation, and absence of dedicated guidelines from scientific societies, further knowledge of these conditions is required to investigate and treat them using modern imaging and surgical (open or endovascular) techniques. This consensus document will focus on known VCS, affecting the arterial and venous system. The position paper, written by members of International Union of Angiology (IUA) Youth Committee and senior experts, will show an overview of pathophysiology, diagnostic, and therapeutical approaches for patients with VCS. Furthermore, this document will provide also unresolved issues that require more research that need to be addressed in the future.
ABSTRACT
This position paper, written by members of International Union of Angiology (IUA) Youth Committee and senior experts, shows an overview of therapeutical approaches for patients with chronic limb-threatening ischemia (CLTI) and absence of 'standard' solutions for revascularization. The aim was to demonstrate the accurate management of the 'no-option' CLTI patient including the wound treatment and the rehabilitation, considering always the goal of the increase of quality of life of the patients.
Subject(s)
Cardiology , Peripheral Arterial Disease , Adolescent , Humans , Amputation, Surgical , Chronic Disease , Chronic Limb-Threatening Ischemia , Ischemia/diagnosis , Ischemia/therapy , Limb Salvage , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/therapy , Quality of Life , Retrospective Studies , Risk Factors , Treatment OutcomeABSTRACT
This position paper, written by members of International Union of Angiology (IUA) Youth Committee, shows an overview of coagulation system and laboratory tests, analysis of medical therapies (older and newer), medication discontinuation/restart recommendations, bridging therapy recommendations, and an overview of hemostatic agents used in the operating room.
Subject(s)
Cardiology , Hemostatics , Adolescent , Humans , Hemostasis , Vascular Surgical Procedures/adverse effectsABSTRACT
BACKGROUND: Patients with lower limb arterial disease have a high risk for complications related with surgical wounds. The endoscopic extraction of the great saphenous vein (GSV) is a less invasive alternative to the conventional surgical extraction. METHODS: A clinical and ultrasonographic follow-up was carried out on the lower limb bypass with GSV performed in our institution between years 2007 and 2012. Patients were selected for open or endoscopic harvesting depending on the surgeon assigned (endoscopic or open surgeon). Follow-up was performed at 1, 3, 6, and 12 months after surgery and annually thereafter. All the GSV endoscopic harvestings (GSVEH) were performed by the same surgeon. Data for primary, assisted, and secondary patency and amputation-free survival were analyzed. Anatomopathalogic analysis were performed on pares of samples of the same vein dissected surgically and endoscopically from the same patient. RESULTS: Sixty bypass surgery has been performed on 60 patients (54 men and 6 women), 30 with GSVEH (50%), and 30 with GSV open harvesting (GSVOH). All patients were intervened for critical limb ischemia (Rutherford cathegory 4, 5, and 6). Significant differences were found between both groups for suture dehiscence (GSVEH 0%, GSVOH 20%, P = 0.01) and infection (GSVEH 3%, GSVOH 30% P, 0.006). No significant differences were found between both groups regarding to primary patency, assisted primary patency, or amputation-free survival. An anatomopathologic comparison of segments of veins extracted surgically and endoscopically of the same patients did not show any significant differences. CONCLUSIONS: Although no statistically significant differences were found between GSVOH and GSVEH bypass for lower limb revascularization, there is a trend toward poorer patency rates for the endoscopic technique. GSVEH lowers the risks for infection and dehiscence of surgical wounds.
Subject(s)
Endoscopy , Ischemia/surgery , Lower Extremity/blood supply , Peripheral Vascular Diseases/surgery , Saphenous Vein/transplantation , Tissue and Organ Harvesting/methods , Amputation, Surgical , Critical Illness , Disease-Free Survival , Endoscopy/adverse effects , Female , Graft Occlusion, Vascular/etiology , Graft Occlusion, Vascular/physiopathology , Graft Occlusion, Vascular/surgery , Humans , Ischemia/diagnosis , Ischemia/physiopathology , Kaplan-Meier Estimate , Length of Stay , Limb Salvage , Male , Operative Time , Peripheral Vascular Diseases/diagnosis , Peripheral Vascular Diseases/physiopathology , Prospective Studies , Reoperation , Risk Factors , Saphenous Vein/diagnostic imaging , Saphenous Vein/physiopathology , Surgical Wound Dehiscence , Surgical Wound Infection/microbiology , Surgical Wound Infection/prevention & control , Time Factors , Tissue and Organ Harvesting/adverse effects , Treatment Outcome , Ultrasonography , Vascular PatencyABSTRACT
Intraluminal aortic malignant masses are extremely rare. Clinical symptoms of these tumors include locally occlusive aortic disease, peripheral emboli, or mesenteric emboli. Eventually, general symptoms, such as fatigue, weight loss, or fever, will occur. Nevertheless, the diagnosis is most often made after surgery or autopsy, when histologic data can be examined. Few cases of intraaortic masses treated endovascularly have been reported, most of them related to intraluminal blood clot formation. We present a case of intraaortic malignant tumor formation with distal embolization to the legs, in which the diagnosis of malignant disease was reached after analysis of the material obtained during embolectomy. Endovascular exclusion was performed as a transient treatment to avoid new embolic events.
