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1.
Ann Vasc Surg ; 87: 100-112, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35398194

ABSTRACT

BACKGROUND: An infection-resistant, immediately available conduit for trauma and urgent vascular reconstruction remains a critical need for successful limb salvage. While autologous vein remains the gold standard, vein-limited patients and size mismatch are common issues. The Human Acellular Vessel (HAV) (Humacyte, Inc., Durham, NC) is a bioengineered conduit with off-the-shelf availability and resistance to infection, ideal characteristics for patients with challenging revascularization scenarios. This report describes HAV implantation in patients with complex limb-threatening ischemia and limited conduit options who may have otherwise faced limb loss. METHODS: The Food and Drug Administration (FDA) expanded-access program was used to allow urgent implantation of the HAV for arterial reconstruction. Electronic medical records were reviewed with extraction of relevant data including patient demographics, surgical implantation, patency, infectious complications, and mortality. RESULTS: The HAV was implanted in 8 patients requiring vascular reconstruction. Graft or soft tissue infection was present in 2 patients. One patient with severe penetrating pelvic injury had 4 HAV placed to repair bilateral external iliac artery and vein injuries. There was 1 technical failure due to poor outflow, 2 patients died unrelated to HAV use, and 5 lower extremity bypasses maintained patency at an average of 11.4 months (range: 4-20 months). No HAV infectious complications were identified. CONCLUSIONS: This report is the first United States series describing early outcomes using the HAV under the FDA expanded-access program for urgent vascular reconstruction. The HAV demonstrates resistance to infection, reliable patency, and offers surgeons an immediate option when confronted with complex revascularization scenarios. Assessment of long-term outcomes will be important for future studies.


Subject(s)
Arterial Occlusive Diseases , Blood Vessel Prosthesis Implantation , Peripheral Vascular Diseases , Humans , Blood Vessel Prosthesis Implantation/adverse effects , Treatment Outcome , Limb Salvage , Ischemia/diagnostic imaging , Ischemia/surgery , Lower Extremity/blood supply , Arterial Occlusive Diseases/surgery , Peripheral Vascular Diseases/surgery , Vascular Patency , Retrospective Studies , Blood Vessel Prosthesis
2.
BMJ Case Rep ; 14(11)2021 Nov 30.
Article in English | MEDLINE | ID: mdl-34848428

ABSTRACT

A pituitary abscess is a rare intrasellar infection. Correct identification can be challenging preoperatively given its non-specific symptoms and imaging findings. We report a case of a young woman presenting with secondary amenorrhea, visual field deficits and a 2.6 cm pituitary lesion diagnosed to be a craniopharyngioma. A concomitant unexpected pituitary abscess was diagnosed intraoperatively without associated meningeal symptoms.


Subject(s)
Brain Abscess , Craniopharyngioma , Pituitary Diseases , Pituitary Neoplasms , Brain Abscess/diagnostic imaging , Brain Abscess/surgery , Craniopharyngioma/diagnosis , Craniopharyngioma/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Pituitary Diseases/diagnosis , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/diagnostic imaging
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