Blowout of Carotid Venous Patch Angioplasty

Abstract

for the Vascular Quality Initiative, Rochester and Minneapolis, Minnesota; Salt Lake City, Utah; Boston and Worcester, Massachusetts; Ann Arbor, Michigan; and Hanover, New HampshireBackground: Blood transfusions are associated with adverse events. We examined perioperative transfusion practices and associated complications following open vascular procedures nationwide in the Vascular Quality Initiative (VQI). Methods: Adults undergoing open abdominal aortic aneurysm repair (OAR) and lower extremity arterial bypass (Bypass) within VQI (2003e2016) were identified. All emergent cases, patients with preoperative hemoglobin <7 g/dL, preoperative hospitalization >1 day, or a return to operating room during the index hospitalization were excluded. Units of red blood cells transfused were the primary outcome. Secondary outcomes were postoperative myocardial infarction (MI) and death. Patient, center, and procedural factors were evaluated. Multivariable mixed effects negative binomial regression and multivariable logistic regression were performed. Results: We identified 24,131 procedures (OAR 3885, 16.1%; Bypass 20,246, 83.9%) among 22,532 patients (10.1% had >1 procedure). Overall, 37.5% of OAR and 19.5% of Bypass were transfused. Transfusion rates varied across estimated blood loss quartiles and across various preoperative hemoglobin levels. The overall rate of postoperative MI and death was 4.0% and 1.8% for OAR, and 2.2% and 0.7% for Bypass, respectively. In univariate and multivariable

Resistência tensional do pericárdio bovino fixado em glutaraldeído comparada com a da veia safena magna

“…Embora as veias fossem livres de refluxo, alterações estruturais clinicamente não-evidentes podem ter diminuído a resistência tensional desses segmentos venosos. Tal correlação entre a presença de varizes e a ocorrência de ruptura por fraqueza da parede venosa foi ressaltada por Van Damme et al 34 . Mesmo quando comparamos a tensão de ruptura média entre as veias dos dois estudos, notamos que uma grande diferença entre os dois grupos (4,8 versus 13,22 Mpa).…”

Selective Patch Angioplasty and Intraoperative Shunting in Carotid Endarterectomy: A Single-Center Review of 141 Procedures

“…Autologous vein and synthetic patches are most commonly used during CEA’s [ 15 ], though increased cross-clamp time for vein harvesting, most commonly of the saphenous vein [ 15 ], is associated with the use of an autologous graft. Harvesting a vein also requires a second incision and the incidence of rupture (reported as 0.5-4%) of the saphenous vein patch is higher than that of synthetic grafts [ 16 - 18 ]. Patch rupture or bleeding, though rare, requires further intervention with incremental time, morbidity, and cost, although vein patches do provide a lower risk of infection and bleeding through the suture hole and are more resistant to thrombosis by providing an endothelial cell surface [ 15 ].…”

Estudo experimental comparativo da resistência tensional da safena magna no tornozelo e na região inguinal

“…O uso de remendos em endarterectomia de carótida já foi extensamente estudado e é frequentemente relacionado a melhores resultados tanto precoces como tardios 5,6 , apesar de alguns relatos favorecerem o fechamento primário 7,8 . No entanto, o uso de remendos pode apresentar complicações específicas, entre elas infecção 9,10 e ruptura [11][12][13][14] . A ruptura de um remendo de safena magna após endarterectomia é uma complicação grave, com altos índices de sequelas neurológicas e elevadas taxas de óbito 15 .…”