المؤلفون: Ansar Z Vance, Mark P. Mantell, Timothy Clark, J. Redmond, Louis-Xavier Barrette, Kathleen M. Kratz

المصدر: Vascular and Endovascular Surgery. 54:612-617

مصطلحات موضوعية: Male, endocrine system, medicine.medical_specialty, Time Factors, Closure (topology), Hemorrhage, Punctures, Walking, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Femoral access, Catheterization, Peripheral, Humans, Medicine, Vascular closure device, Aged, Retrospective Studies, Aged, 80 and over, Hemostatic Techniques, business.industry, Equipment Design, Recovery of Function, General Medicine, Middle Aged, Surgery, Femoral Artery, Treatment Outcome, Female, Cardiology and Cardiovascular Medicine, business, Vascular Closure Devices

الوصف: Purpose: Vascular closure device (VCD) use following antegrade femoral access may present unique challenges relative to retrograde access. We retrospectively compared safety and efficacy of these devices between antegrade and retrograde patient cohorts undergoing percutaneous intervention. Materials and Methods: Over a 5-year period, a consecutive series of 107 limbs in 84 patients underwent VCD arteriotomy closure following percutaneous revascularization using an antegrade approach (VCD-A). Device deployment success rates, time to ambulation, and complication rates were compared to a contemporaneous control group of 401 limbs in 305 patients who underwent closure following retrograde access (VCD-R) during revascularization or embolization procedures. Results: Closure was attempted in VCD-A using 53 StarClose, 35 Perclose, and 19 Angio-Seal devices. Hemostasis (without supplemental manual compression) was achieved in 86/107 (80.4%) limbs. Closure was attempted in VCD-R using 215 StarClose, 119 Perclose, and 67 Angio-Seal devices with hemostasis in 357/401 (89.0%) limbs. Device deployment failure occurred in 7/107 (6.5%) of VCD-A and 20/401 (5.0%) of VCD-R ( P = .52), independent of specific device type. Femoral pseudoaneurysm developed in 1/107 and 1/401 of VCD-A and VCD-R ( P = .31), and minor hematoma developed in 3/107 and 8/401 of the VCD-A and VCD-R ( P = .61). Mean time to ambulation was 204.1 minutes in VCD-A and 204.8 minutes in VCD-R ( P = .97). Conclusion: Antegrade femoral closure was associated with high rates of technical success and low complications, similar to retrograde closure. Time to ambulation was the same in both groups despite higher heparin doses in the antegrade patients.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::34a297a44b037ca80530988130353b83Test
https://doi.org/10.1177/1538574420941298Test

المؤلفون: Abhishek Kumar, Muhammad Usman Shahid, Aesha Patel, A. Sare, Pratik A. Shukla

المصدر: Vascular and Endovascular Surgery. 54:665-669

مصطلحات موضوعية: Adult, Male, medicine.medical_treatment, Hemorrhage, Punctures, 030204 cardiovascular system & hematology, Radiography, Interventional, 030218 nuclear medicine & medical imaging, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, Catheterization, Peripheral, Urban Health Services, Humans, Medicine, In patient, Center (algebra and category theory), Embolization, Aged, Retrospective Studies, Retrospective review, New Jersey, business.industry, Endovascular Procedures, Hemodynamics, General Medicine, Middle Aged, Vascular System Injuries, medicine.disease, Embolization, Therapeutic, Treatment Outcome, Radial Artery, Feasibility Studies, Female, Stents, Surgery, Medical emergency, Cardiology and Cardiovascular Medicine, business

الوصف: Purpose: To evaluate the efficacy, safety, and feasibility of transradial approach (TRA) for endovascular management of traumatic bleeding. Materials and Methods: A retrospective review was performed at a single level 1 trauma institution from August 2018 to July 2019. Patients presented to the interventional radiology department who were intended to be treating using TRA for the management of trauma-induced bleeding were selected. Demographics, indication for embolization, embolization site, preprocedural labs, hemodynamic stability, technical success, and complications were recorded. Results: Transradial approach was attempted in 29 (74.4%) of the 39 patients identified by operators who prefer TRA. Four patients received treatment using TRA on 2 separate occasions, for a total of 33 procedures completed with a technical success of 97% (32/33). Transradial approach was safely completed in 9 patients (27.3%) with preprocedural hemodynamically unstable status. For the 10 patients who received treatment via a transfemoral approach (TFA), traumatic disfiguration of the left upper extremity, preexisting arterial lines placed by the trauma team, and external iliac artery injuries requiring covered stent placement were the most common indications for TFA over TRA. There were no procedural or access site–related complications. Conclusion: Transradial approach for the endovascular management of bleeding in a trauma setting is safe and effective with a high technical success rate and no complications.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e72f9b5dfa79e53300dc852630391319Test
https://doi.org/10.1177/1538574420940088Test

المؤلفون: Sven Ross Mathisen, Kristofer F. Nilsson, Thomas Larzon

المصدر: Vascular and endovascular surgery. 55(8)

مصطلحات موضوعية: Male, medicine.medical_specialty, Percutaneous, Technical success, Closure (topology), Punctures, 030204 cardiovascular system & hematology, 030230 surgery, Single Center, 03 medical and health sciences, Blood Vessel Prosthesis Implantation, 0302 clinical medicine, Medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Endovascular Procedures, General Medicine, Middle Aged, Surgery, Femoral Artery, Treatment Outcome, Access site, Female, Cardiology and Cardiovascular Medicine, business

الوصف: Purpose: The objective of this study was to evaluate the primary and assisted secondary percutaneous and non-invasive technical success of the ProGlide device on all-comers in a consecutive case series of percutaneous endovascular aortic aneurysm repair (P-EVAR). Method: A single-center consecutive case series where 434 elective and acute P-EVAR procedures were registered prospectively between May 2011 and July 2017. The mean age was 74.5 years ± SD 11.4 years. 82.3% of the patients were male. All patients were pre-planned from CT angiography. Percutaneous access punctures, performed in local anesthesia in the common femoral artery, with a final introducer size between 12-22 Fr OD were included and stratified in 2 groups, 12-16 Fr and 17-22 Fr. Results: By screening 868 access groins 22 groins were excluded. Of the remaining 846 groins, intended to be treated with ProGlide, 9 groins were excluded peri-procedurally and treated with the Fascia Suture Technique or surgical cutdown. The remaining 837 groins had access closure with ProGlide, with a mean value of 2.15 devices per groin with a slight significant difference between the 2 stratification groups. Primary ProGlide technical success was achieved in 68.1% of the groins. Secondary percutaneous or non-invasive technical success was achieved in 96.9%. Here there was no statistically significant difference between the 2 stratification groups. Thirty-one (3.7%) groin complications were registered during 30-day follow-up and 17 required additional treatment. Total mortality was 2.8%. None of these deaths were related to the access site. Conclusion: ProGlide by itself has a significant failure rate in the closure of large-bore access holes on an unselected cohort of patients eligible for P-EVAR. However, together with adjunct percutaneous or non-invasive methods a success rate of 97% can be achieved. The access complication rate was lower than 4% at 30-day follow-up.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a5e759afc7b9d1e6e66de786bd01904fTest
https://pubmed.ncbi.nlm.nih.gov/34105422Test

المؤلفون: Richa Kalsi, Joseph C. Noggle, Ali Khalifeh, Justin K. Nelms, Christine Owen, Besher Tolaymat

المصدر: Vascular and endovascular surgery. 54(4)

مصطلحات موضوعية: Coronary angiography, Male, medicine.medical_specialty, Time Factors, Punctures, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, medicine.artery, Internal medicine, Catheterization, Peripheral, medicine, Humans, Vascular Diseases, Radial artery, Patient comfort, Aged, Retrospective Studies, business.industry, Vascular disease, Endovascular Procedures, Angiography, General Medicine, Middle Aged, medicine.disease, Term (time), Treatment Outcome, Radial Artery, Cardiology, Surgery, Female, Cardiology and Cardiovascular Medicine, business

الوصف: Objectives: Radial artery access is widely utilized in coronary angiography with reported lower rates of vascular complications and better patient comfort. There is limited data in the literature regarding radial access in peripheral endovascular procedures. We hypothesize that radial access is safe and feasible for peripheral endovascular procedures. Methods: A retrospective chart review was performed for all patients who underwent angiography using radial artery access between August 2013 and December 2017. Patient demographics and perioperative data were recorded and analyzed. Patient Selection: The operating surgeon screened patients presenting for elective angiography for possible radial artery access. Ultrasound guidance was used in all cases. Upon cannulation, the sheath was infused with an antispasmodic cocktail, and the patients were systemically anticoagulated. Results: Forty-seven out of 52 patients successfully completed their procedure (90% success rate). The patients were mostly female (60%), elderly (mean age of 71 years), and had several comorbidities. Preoperative diagnoses were variable. Procedures were both diagnostic (58%) and interventional (42%) with maximum sheath size used being 7F and median fluoroscopy time of 7.5 minutes. Only 2 patients experienced perioperative complications, and both of these were minor hematomas that resolved with manual pressure. Conclusions: Transradial arterial access for peripheral vascular angiography and interventions is safe and feasible. With low complication rates and increased patient comfort, transradial access serves as an excellent alternative to transfemoral access for a variety of endovascular procedures.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e770884042223479002f3fb82ec02154Test
https://pubmed.ncbi.nlm.nih.gov/32079500Test

المؤلفون: Pratik A. Shukla, Muhammad Sadiq Shahid, Ethan Wajswol, Abhishek Kumar, V. Chandra, Sohail Contractor

المصدر: Vascular and endovascular surgery. 54(3)

مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Time Factors, Band removal, Hemorrhage, Punctures, 030204 cardiovascular system & hematology, Radiography, Interventional, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Catheterization, Peripheral, medicine, Humans, Aged, Retrospective Studies, business.industry, Hemostatic Techniques, General Medicine, Equipment Design, Middle Aged, Surgery, Treatment Outcome, Radial Artery, Female, Cardiology and Cardiovascular Medicine, business

الوصف: Purpose: For transradial interventions, most published studies report an initial Terumo Radial (TR) band placement time of 60 minutes, with gradual deflation over 30 to 90 minutes. We aimed to determine, retrospectively, whether TR band removal time could be expedited to 45 to 60 minutes, without adverse effects via an expedited single-step deflation protocol. Methods: A total of 115 consecutive noncoronary visceral interventions that utilized TR band from September 2017 till February 2019 were retrospectively reviewed. Alternative single-step deflation protocol was utilized where the nursing staff was instructed to deflate the TR band in 1 step between 45 and 60 minutes; 79 patients (43 men, 36 women, mean age of 55.3 ± 13.6 years) underwent 115 transradial interventions. Mean procedure time was 49.8 ± 22.1 minutes, and mean fluoroscopy time was 18.5 ± 10.6 minutes. Data collected included patient demographics, procedure details, and nursing notes on complications including bleeding and reinflation of the TR band. Univariate and Multivariate analyses of independent variables were performed using a binary logistic regression model. All patients were followed up postoperatively before discharge and in clinic upon follow-up. Results: The TR band was deflated at 51.3 ± 14.5 minutes, with successful removal achieved on the first attempt in 103 cases (90.3% primary technical success rate). In 12 cases, bleeding was noted upon initial deflation, secondary technical success was achieved when the band was reinflated for an additional mean time of 37.0 ± 19.1 minutes. There was 1 incidence of radial artery occlusion (0.8%) and 1 incidence of a grade 1 hematoma (0.8%). The only variable predictive of technical outcome upon initial band deflation on univariate binomial logistic regression was initial TR band removal time ( P = .019). Conclusions: A single-step deflation protocol for TR band placement may be safe for nonocclusive patent hemostasis and may translate to even further shorten postprocedural hospital times for patients and cost savings for hospitals.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ced67a2a0fb23364d17c28d3a15ae1cdTest
https://pubmed.ncbi.nlm.nih.gov/31884881Test

المؤلفون: Rohit Gokhale, Michael J. Attubato, Anvar Babaev, Susanna Zavlunova

المصدر: Vascular and Endovascular Surgery. 50:541-546

مصطلحات موضوعية: Male, medicine.medical_specialty, Atherectomy, Time Factors, Percutaneous, Databases, Factual, medicine.medical_treatment, Arterial Occlusive Diseases, Hemorrhage, Constriction, Pathologic, Punctures, Femoral artery, 030204 cardiovascular system & hematology, Balloon, Revascularization, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine.artery, Angioplasty, Catheterization, Peripheral, Occlusion, medicine, Humans, Vascular closure device, 030212 general & internal medicine, Vascular Patency, Aged, Aged, 80 and over, Hemostatic Techniques, business.industry, General Medicine, Middle Aged, Surgery, Femoral Artery, Treatment Outcome, Female, Radiology, Cardiology and Cardiovascular Medicine, Complication, business, Angioplasty, Balloon, Vascular Closure Devices

الوصف: Objective: We describe a novel approach for the endovascular treatment of femoral artery occlusion as a result of Angio-Seal closure device deployment. Background: Angio-Seal is the most commonly used vascular closure device following percutaneous coronary and peripheral catheterizations worldwide. A rare complication of Angio-Seal deployment is an occlusion of the femoral artery leading to limb ischemia requiring revascularization. Given its unique ability to cut both atherosclerotic plaque and the Angio-Seal anchor with a collagen plug at operator-directed planes, TurboHawk/HawkOne atherectomy device can be a fast and effective approach to treat Angio-Seal-associated femoral artery occlusions. Methods: We studied 13 consecutive patients who developed Angio-Seal-associated femoral artery occlusions that occurred from 3 hours to several weeks after catheterization. These patients were successfully treated with TurboHawk/HawkOne directional atherectomy followed by balloon angioplasty with no complications. During a mean follow-up period of 20.4 ± 17.3 months, 12 patients remained claudication free with no evidence of obstructive arterial disease of the treated segment on imaging studies. One patient developed restenosis that was treated with repeat atherectomy and balloon angioplasty following which he was asymptomatic at follow-up. Conclusion: The use of directional atherectomy followed by balloon angioplasty is a quick, safe, and effective endovascular approach to treating Angio-Seal-associated femoral artery occlusions. It is associated with an excellent success rate, no complications, and good midterm outcomes.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a4a81c1f5c2aec04e51735c8a48634baTest
https://doi.org/10.1177/1538574416679520Test

المؤلفون: Patrick A. Stone, David Masinter, Brent Hanson, Stephanie Thompson

المصدر: Vascular and Endovascular Surgery. 50:217-220

مصطلحات موضوعية: Male, Reoperation, Cardiac Catheterization, medicine.medical_specialty, Time Factors, Bypass grafting, Iatrogenic Disease, Punctures, 030204 cardiovascular system & hematology, 03 medical and health sciences, Pseudoaneurysm, 0302 clinical medicine, Patient information, Catheterization, Peripheral, Pressure, medicine, Electronic Health Records, Humans, In patient, cardiovascular diseases, 030212 general & internal medicine, Coronary Artery Bypass, Watchful Waiting, Aged, Retrospective Studies, Ultrasonography, Doppler, Duplex, business.industry, Medical record, Thrombin, Anticoagulants, Mean age, General Medicine, Middle Aged, Vascular System Injuries, medicine.disease, Surgery, Femoral Artery, Treatment Outcome, medicine.anatomical_structure, Injections, Intra-Arterial, Female, Cardiology and Cardiovascular Medicine, business, Aneurysm, False, Artery

الوصف: Objective: A plethora of papers have been written regarding postcatheterization femoral pseudoaneurysms. However, literature is lacking on pseudoaneurysmal management in patients undergoing coronary artery bypass grafting (CABG). Thus, we examined if pseudoaneurysms with subsequent CABG can be managed with the same strategies as those not exposed to the intense anticoagulation accompanying CABGs. Methods: During a 14-year study period, we retrospectively examined femoral iatrogenic pseudoaneurysms (IPSAs) diagnosed postheart catheterization in patients having a subsequent CABG. Patient information was obtained from electronic medical records and included pseudoaneurysm characteristics, treatment, and resolution. Outcomes of interest included the occurrence of IPSA treatment failures and complications. Results: In the 66 patients (mean age, 66 ± 11 years, 46% male) meeting inclusion criteria, mean dose of heparin received during the CABG procedure was 34 000 ± 23 000 units. The IPSA size distribution was the following: 17% of IPSAs measured 3 cm. Pseudoaneurysms were managed with compression, duplex-guided thrombin injection, and surgical repair (1%, 27%, and 26% of cases, respectively). Thrombin injection and surgical repair were 100% effective at treating pseudoaneurysms, with 1 patient experiencing a surgical site infection postsurgical repair. Observation-only management was employed in 30 (45%) patients. Nine of 30 patients with no intervention beyond observation had duplex documented resolution/thrombosis during follow-up. One patient initially managed by observation required readmission and surgical repair of an enlarging pseudoaneurysm (6 cm growth) following CABG. Conclusion: Management of pseudoaneurysms in patients prior to CABG should be similar to those patients not undergoing intense anticoagulation. In appropriate cases, small aneurysms can be safely observed, while thrombin injections are effective and safe as well. Thus, routine open surgical repair is not routinely required in patients with femoral pseudoaneurysms at time of CABG.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::55f318df895f05e06eaef19e2ea590b1Test
https://doi.org/10.1177/1538574416637448Test

المؤلفون: Klara Belaj, Marianne Brodmann, Gerald Hackl, Philipp Eller, Franz Hafner, Thomas Gary

المصدر: Vascular and Endovascular Surgery. 49:160-165

مصطلحات موضوعية: Male, medicine.medical_specialty, Time Factors, Blood Pressure, Hemorrhage, Punctures, Femoral artery, Risk Assessment, Peripheral Arterial Disease, Risk Factors, medicine.artery, Odds Ratio, Pressure, medicine, Humans, Blood Coagulation, Aged, Retrospective Studies, Prothrombin time, medicine.diagnostic_test, business.industry, Endovascular Procedures, Age Factors, Angiography, Digital Subtraction, Retrospective cohort study, General Medicine, Odds ratio, Blood Coagulation Disorders, Middle Aged, Protective Factors, Peripheral, Surgery, Femoral Artery, Logistic Models, Treatment Outcome, Blood pressure, Hypertension, Female, Cardiology and Cardiovascular Medicine, business, Risk assessment, Body mass index

الوصف: Objective: To compare femoral access site closure techniques and to highlight risk factors for puncture site complications after lower extremity endovascular procedures. Methods: This retrospective study included 787 patients. Procedures were performed according to a standardized protocol. Puncture site complications within 24 hours were regarded as study end points. Results: Ninety (11.5%) puncture site complications were registered. Conventional manual compression (n = 87, 11.1%) was significantly associated with puncture site complications (odds ratio [OR] 2.08, P = .03). Body mass index > 25 kg/m2 (OR 0.54, P = .01) and prothrombin time > 70% (OR 0.38, P = .04) were protective. All bleeding occurred in procedures >45 minutes. Blood pressure >200 mm Hg and below the knee (BTK) procedures were strong predictors for access site complications (OR 4.21, P = .01 and OR 3.33, P = .02). Conclusions: We observed an inferiority of conventional manual compression. Age, procedure duration > 45 minutes, BTK procedures, uncontrolled hypertension, and impaired coagulation were risk factors.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::36951223ae76d0a3b1e13b245967d69bTest
https://doi.org/10.1177/1538574415608268Test

المؤلفون: Owen Mogabgab, Elias B. Hanna, Hassan Baydoun

المصدر: Vascular and endovascular surgery. 52(6)

مصطلحات موضوعية: Male, medicine.medical_specialty, Lumen (anatomy), Femoral artery, Punctures, 030204 cardiovascular system & hematology, Radiography, Interventional, Iliac Artery, 03 medical and health sciences, Peripheral Arterial Disease, 0302 clinical medicine, Femoral access, medicine.artery, Occlusion, Catheterization, Peripheral, medicine, Humans, In patient, 030212 general & internal medicine, Radial artery, Vascular Calcification, Vascular Patency, Aged, medicine.diagnostic_test, business.industry, Endovascular Procedures, Rendezvous, Angiography, General Medicine, Middle Aged, Surgery, Femoral Artery, Treatment Outcome, Radial Artery, Cardiology and Cardiovascular Medicine, business

الوصف: We present cases of complex, calcified iliac occlusive disease revascularized via a combined radial-femoral access strategy. Through a 6-French, 125-cm transradial guiding catheter, antegrade guidewires and catheters are advanced into the iliac occlusion, while retrograde devices are advanced transfemorally. The transradial and transfemoral channels communicate, allowing the devices to cross the occlusion into the true lumen (radial-femoral antegrade–retrograde rendezvous).

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0fc4eb28e6ced192aa8dc535c27a7b1fTest
https://pubmed.ncbi.nlm.nih.gov/29554860Test

المؤلفون: Bashar A Ababneh, Amit N Amin, Elias B. Hanna

المصدر: Vascular and endovascular surgery. 52(2)

مصطلحات موضوعية: Male, medicine.medical_specialty, Atherectomy, Time Factors, medicine.medical_treatment, Femoral artery, Constriction, Pathologic, Punctures, 030204 cardiovascular system & hematology, Single Center, Endovascular therapy, 03 medical and health sciences, Peripheral Arterial Disease, 0302 clinical medicine, medicine.artery, Angioplasty, medicine, Humans, 030212 general & internal medicine, Radial artery, business.industry, Superficial femoral artery, New Orleans, General Medicine, Middle Aged, Surgery, Femoral Artery, Treatment Outcome, Radial Artery, Feasibility Studies, Female, Cardiology and Cardiovascular Medicine, business, Stepwise approach, Angioplasty, Balloon

الوصف: Objective: We describe our experience in transradial recanalization of the superficial femoral artery (SFA), and we provide a stepwise approach accounting for the patient’s height and optimizing the yield of currently available devices. Methods and Results: Fifteen patients with simple SFA disease, including 4 patients with total SFA occlusions Conclusion: In patients with simple SFA disease, transradial recanalization appears feasible and safe but currently limited to balloon angioplasty ± orbital atherectomy. Proximal SFA stenting may be feasible in patients

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bbe5cd63ec85d8f6db1a733e5a3abc16Test
https://pubmed.ncbi.nlm.nih.gov/29179651Test