Outpatient endovascular aortic aneurysm repair: experience in 100 consecutive patients.

Objectives: To present the safety, feasibility, costs, and patient satisfaction of outpatient endovascular aneurysm repair (EVAR).

Background: Our experience in more than 1000 patients indicated that in technically uncomplicated EVAR procedures, the only need for hospitalization was for access vessel complications (bleeding or occlusion) requiring secondary procedures. These complications could always be identified within the first 3 hours after EVAR.

Side-branched modular endograft system for thoracoabdominal aortic aneurysm repair.

Purpose: To describe a side-branched modular endograft system that provides adequate visceral artery perfusion with perfect seal during thoracoabdominal aortic aneurysm (TAAA) repair.

Case Report: A 76-year-old man with a 57-mm TAAA involving the celiac artery was treated with a customized Talent endograft consisting of a 46-mm x 18-cm stented main body and a 6-mm x 30-mm nonstented Dacron side branch. The graft was delivered through a surgical exposure of the left common femoral artery.

Peripheral arterial obstruction: prospective study of treatment with a transluminally placed self-expanding stent-graft. International Trial Study Group.

Purpose: To evaluate the safety and efficacy of an endoluminal prosthesis for treatment of peripheral arterial occlusive disease (PAOD).

Materials And Methods: A self-expanding endoprosthesis with an expanded polytetrafluoroethylene tube inside a nitinol support structure was implanted in 127 patients with symptomatic PAOD in the iliac (61 limbs) and femoral arteries (80 limbs). Clinical category status, ankle-brachial index, and color duplex flow imaging results were recorded before treatment, at discharge, and at 1, 3, 6, and 12 months after treatment.

Carotid surgery under locoregional anaesthesia. Description of technique and results of our first 100 consecutive operations.

In a 28-month-period 100 consecutive carotid operations were performed on 91 patients under locoregional anaesthesia. The indications were 37 TIAs, 16 recovered strokes, 12 cases presenting with amaurosis fugax, eight with vertigo and 27 patients with severe but still asymptomatic stenosis. In 20 cases a shunt had to be used.

A case against immediate revascularisation after uni- or bilateral removal of infected aortobifemoral (end-to-side) prosthetic grafts. Report based on three cases.

More than 75% of the infections of Dacron aortobifemoral grafts occur in the groin. Early removal of the infected limb will enable the vascular surgeon to leave the abdominal part and opposite limb of the graft in place. In aortoiliac occlusive disease and with end-to-side proximal and distal anastomoses, simple removal of the infected graft will not threaten the viability of the limb.

[Approach in the treatment of combined aorto-iliac and femoro-popliteal lesions].

Recognition of the hemodynamic importance of aorto-iliac and femoro-popliteal stenoses or occlusions is essential for correct vascular reconstruction. Non-invasive examinations, arteriography, pressure- and flow-measurements add their value to clinical judgment and surgical experience. Practical guides are given to decide for one-level-reconstruction, concomitant or delayed two-stage-repair, or a combination of balloon-dilation together with arterial reconstruction.

[Contribution of femoral hemodynamics (intra-arterial velocity, pressure) in indications for vascular reconstruction in ischemia of the lower limbs. Preliminary study].

The choice of the best operative procedure in vascular reconstructions for ischemic lower limbs, is mainly guided by clinical experience and by arteriography. Doppler wave analysis and femoral artery pressure measurements are new diagnostic tools. In those difficult cases of multiple-level-disease, the intra-operative measurement of the femoral artery pressure proved to be an important step for the operative decision.

[Membranous obstruction of the inferior vena cava].

A case of idiopathic membranous obstruction of the inferior vena cava (MOVC) is reported. Varicose veins of both lower limbs associated with dermatitis and venous ulceration were the presenting symptoms. Diagnosis was made by cavography after phlebography of both legs had revealed a normal deep system.

[The surgical treatment of pulmonary embolism].

Acute pulmonary embolism with major hemodynamic derangement may be treated by thrombolysis or surgically by direct pulmonary embolectomy under cardiopulmonary bypass or by a transvenous method with a steerable aspiration catheter unit. The key to success in massive pulmonary embolism is a quick and correct diagnosis while the vital haemodynamic parameters are maintained by supportive means.

[Surgical therapy of pheochromocytoma (author's transl)].

Between 1958-1978 a total of 19 patients, 11 men and 8 women, were treated for pheochromocytoma. Their age varied between 9 and 67 years (overage 39 years). In all cases with unilateral tumor located in the adrenal gland a lateral approach was preferred.

Autotransfusion in surgical practice.

The authors have used autotransfusion of intraoperatively collected blood in 58 vascular surgery cases over a period of more than two years. The clinical results confirm the experimental and laboratory studies on the quality of the autotransfused blood. A more liberal use of intraoperative autotransfusion is advocated.

[Bronchussuture (author's transl)].

We describe the method of manual bronchussuture, used from 1968 until new, which gave us complete satisfaction. Many of the important factors are discussed. The results are analysed and concluding we expose the reasons why we found manual bronchussuture better than any automatic stapling device.