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1.
Methodist Debakey Cardiovasc J ; 20(1): 49-53, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38882594

RESUMO

This paper reports a case of an internal jugular venous malformation (IJVM) and route of treatment in a patient with limited symptoms. After history and imaging studies, a determination of surgical excision was made to rule out possible malignancy and future problems such as thrombosis. The mass was resected, and part of the IJVM was ligated. The mass had no identifiable malignancy, and the patient recovered fully with no complications. The paper highlights the importance of identifying venous malformations and highlights the reasoning behind the course of action.


Assuntos
Veias Jugulares , Malformações Vasculares , Humanos , Veias Jugulares/cirurgia , Veias Jugulares/anormalidades , Veias Jugulares/diagnóstico por imagem , Malformações Vasculares/cirurgia , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Malformações Vasculares/complicações , Resultado do Tratamento , Ligadura , Flebografia , Feminino , Masculino , Procedimentos Cirúrgicos Vasculares , Adulto
2.
J Vasc Surg ; 79(3): 671-678.e2, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37956959

RESUMO

OBJECTIVE: The aim of this study was to investigate the 2-year outcomes of extensive revisions aimed at simultaneously addressing arteriovenous fistula (AVF) aneurysms, outflow stenosis, and/or high flow volumes. METHODS: This was a retrospective cohort study in a tertiary referral center. The study population comprised hemodialysis patients with aneurysmal AVFs requiring revision. Subjects were eligible if they were ≥18 years of age and had aneurysm repair associated with inflow revision or treatment of outflow lesions. Patients were followed-up for a minimum of 2 years, and the primary outcome measure was cumulative patency. RESULTS: Our cohort comprised 93 patients with a mean age of 56 ± 12 years. The most frequent access type was brachiocephalic fistula (61%), and the median access age at the time of revision was 66 months (interquartile range, 46-93 months). The median access flow volume was 2300 ml/min (interquartile range, 1281-2900), and 31 subjects (33%) presented aneurysms associated with both high flow and venous obstruction. Aneurysm repair consisted of aneurysmorraphy in the overwhelming majority (95%). Inflow revision was performed in a total of 49 cases (53%), and outflow tract obstruction was treated in 71 patients (72%), with 27 patients (29%) receiving a simultaneous 3-component revision. At 2 years, the primary, primary assisted, and cumulative patencies were 60% ± 1%, 91% ± 3%, and 94% ± 3%, respectively. The most frequent indication for first-time reinterventions was outflow tract stenosis (24%). Aneurysm recurrence was observed in 13 subjects (14%) during the entire follow-up and was responsible for reinterventions in seven of them (8%), with a 2-year freedom from aneurysm-related reintervention rate of 95% ± 3%. CONCLUSIONS: Extensive AVF revision with simultaneous aneurysm repair, inflow revision, and outflow tract revascularization is feasible, safe, and associated with favorable 2-year patency rates.


Assuntos
Aneurisma , Fístula Arteriovenosa , Derivação Arteriovenosa Cirúrgica , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Pré-Escolar , Criança , Derivação Arteriovenosa Cirúrgica/efeitos adversos , Estudos Retrospectivos , Constrição Patológica/etiologia , Grau de Desobstrução Vascular , Aneurisma/diagnóstico por imagem , Aneurisma/cirurgia , Aneurisma/etiologia , Diálise Renal/efeitos adversos , Resultado do Tratamento , Fístula Arteriovenosa/etiologia
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