The "Wound-QoL": a short questionnaire measuring quality of life in patients with chronic wounds based on three established disease-specific instruments.

The aim of this study was to develop a short questionnaire measuring health-related quality of life (HRQoL) in chronic wounds. Three validated instruments assessing HRQoL in chronic wounds-the Freiburg Life Quality Assessment for wounds, the Cardiff Wound Impact Schedule, and the Würzburg Wound Score-were completed by 154 German leg ulcer patients in a longitudinal study. For implementation in the new, shorter questionnaire Wound-QoL, all of those 92 items that covered the core content of the three questionnaires and showed good psychometric properties were selected.

Homografts and extra-anatomical reconstructions for infected vascular grafts.

Managing graft infections is a challenge in vascular surgery. The incidence of vascular graft infections varies between 2% and 6%. The number of patients treated by means of implantation of artificial prostheses is constantly growing.

Acute ischemia and bypass occlusion: current options.

Aim: Acute limb ischemia (ALI) and bypass occlusion are vascular emergencies and require immediate decisions and therapy. There are a lot of options, and the vascular therapist should be able to provide multiple alternatives. In this article we give on overview over the actual therapeutic options and present the data of a retrospective analysis of bypass occlusions.

Spinal cord ischemia in open and endovascular thoracoabdominal aortic aneurysm repair: new concepts.

For more than half a century ischemic spinal cord injury (SCI) and consecutively permanent paraplegia remained the most devastating complication after open and endovascular thoracoabdominal aortic aneurysm (TAAA) repair. Various neuroprotective strategies (e.g.

Acute aortic syndromes: definition, prognosis and treatment options.

Acute aortic syndromes (AAS) are life-threatening vascular conditions of the thoracic aorta presenting with acute pain as the leading symptom in most cases. The incidence is approximately 3-5/100,000 in western countries with increase during the past decades. Clinical suspicion for AAS requires immediate confirmation with advanced imaging modalities.

Through-and-through wire technique for endovascular damage control in traumatic proximal axillary artery transection.

Repair of blunt shoulder trauma with transection of the subclavian or proximal axillary artery poses a surgical challenge, especially in instable patients. Endovascular treatment for initial damage control in arterial transection has evolved as a promising technique to improve outcome, but technical success can be limited in cases of complete transection as the lesion cannot be passed by a guidewire. This report describes an endovascular approach using a through-and-through brachial-femoral wire to control complete traumatic transection of the proximal axillary artery in a hemodynamically unstable patient.

Latent mycobacterium avium infection causing a mycotic suprarenal aortic aneurysm in a human immunodeficiency virus-positive patient.

Mycobacterium avium complex (MAC) infection occurs in up to 50% of advanced-stage human immunodeficiency 1 (HIV-1) infections when the CD4 counts is <50/mm³. We report the case of a 52-year-old HIV-positive patient who presented with a symptomatic, rapidly growing suprarenal abdominal aortic aneurysm. He had been diagnosed and treated for disseminated MAC infection 3 years earlier.

Addressing persistent false lumen flow in chronic aortic dissection: the knickerbocker technique.

Purpose: To describe an innovative technique to occlude distal backflow into a false lumen aneurysm by controlled rupture of the dissection membrane after stent-graft implantation.

Technique: The "Knickerbocker technique" involves relining the true lumen in the descending aorta with an oversized thoracic tubular endograft, followed by controlled rupture of the dissection membrane using a large compliant balloon within the graft's midsection. This maneuver, which allows expansion of the stent-graft's midsection into the false lumen, was developed in order to occlude the large false lumen distally and thus prevent continued false lumen perfusion through distal abdominal entry tears.

Association of multiple biomarkers and classical risk factors with early carotid atherosclerosis: results from the Gutenberg Health Study.

Background: In the Gutenberg Health Study, a random sample of the population was scanned with vascular ultrasound for early atherosclerosis. A continuous classical risk marker model (waist circumference, HbA1c, LDL/HDL ratio, pack years and pulse pressure) was compared to a model of modern biomarkers (C-reactive protein, troponin I, N-terminal pro B-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin, and asymmetric dimethylarginine) with regard to the ability of ruling out abnormal intima-media thickness (IMT), respectively, carotid plaques.

Methods: Data of the first consecutive 5,000 participants (aged 35-74 years; 2,540 men, 2,460 women) were analyzed.

[Screening of carotid arteries before surgery: when does preoperative duplex ultrasound make sense?].

Carotid artery stenosis is a marker for generalized atherosclerosis with high cerebrovascular and cardiovascular morbidity and mortality rates. There is an estimated increase in prevalence of moderate stenosis for older age and male sex. Asymptomatic carotid artery stenosis is a risk factor for perioperative neurological events during general surgery.

First implantation of Gore Hybrid Vascular Graft in the right vertebral artery for cerebral debranching in a patient with Loeys-Dietz syndrome.

A 53-year-old woman with Loeys-Dietz syndrome developed progressive subclavian artery aneurysm and common carotid artery dissection. She was treated successfully by plugging and coiling of the subclavian aneurysm and its side branches after combined cervical debranching using standard carotid-axillary bypass and Gore Hybrid Vascular Graft for vertebral revascularization. Follow-up control (4 weeks) documented patent debranching, and only minimal residual flow in the subclavian aneurysm.

Distal false lumen occlusion in aortic dissection with a homemade extra-large vascular plug: the candy-plug technique.

Purpose: To report a technique to create an extra-large vascular plug for occlusion of a large distal false lumen in chronic aortic dissection.

Technique: The "candy-plug" technique is demonstrated in a 58-year-old multimorbid man with a history of complicated acute type B aortic dissection and a 9-cm chronic thoracic false lumen aneurysm. The patient underwent a staged repair with a cervical debranching procedure as a first step and a thoracic endovascular aortic repair from the innominate artery to the celiac artery as a second step.

Endovascular vs open repair of renal artery aneurysms: outcomes of repair and long-term renal function.

Background: Endovascular treatment (ER) of renal artery aneurysms (RAA) has been widely used recently due to its assumed lower morbidity and mortality compared with open surgery (OS). The purpose of this study was to investigate the outcomes of OS and ER, and compare long-term renal function.

Study Design: Data from 2000 to 2012 were retrospectively collected to identify patients who were treated for RAA in a single institution.

Antegrade in situ stent-graft fenestration for the renal artery following inadvertent coverage during EVAR.

Purpose: To report the use of antegrade in situ fenestration as a bailout technique to rescue a renal artery after inadvertent coverage during endovascular aneurysm repair (EVAR).

Technique: The technique is demonstrated in a patient with a 6-cm infrarenal abdominal aortic aneurysm (AAA) and a short, angulated proximal neck. A type I endoleak persisted on completion angiography after implantation of a bifurcated Zenith stent-graft despite dilation with a compliant balloon.

[Treatment of abdominal aortic aneurysms].

The treatment of abdominal aortic aneurysms (AAA) has changed significantly since the introduction of endovascular aortic repair (EVAR). In terms of perioperative morbidity and mortality, randomized multicenter trials revealed results in favour of EVAR compared to open reconstruction. However, EVAR is associated with possible late complications caused by endoleaks, stent migration, kinking and/or overstenting of side branches, making life-long follow-up necessary.

Antegrade side branch access in branched aortic arch endografts: a porcine feasibility study.

Purpose: To describe the deployment technique for a single side branch arch endograft in a porcine model and prove the concept of transseptal or transapical antegrade access for catheterization and introduction of the mating stent-graft.

Methods: Six domestic pigs were operated with retrograde delivery of a single side branch arch endograft and antegrade introduction of a mating stent-graft using transseptal access (n=3) and transapical access (n=3). Technical feasibility, operating time, radiation parameters, and hemodynamic changes were studied.

How to calculate the main aortic graft-diameter for a chimney-graft.

Aim: The aim of this paper was to present a mathematical model to calculate the required main aortic graft-diameter for parallel chimney-grafts. Methods: Geometric approximation model, developed to allow for a standardized calculation of the main aortic graft-diameter determined by the aortic diameter and the diameter of the chimney-graft. Results: We propose a mathematical formula using circular segments of the aorta and the chimney-graft and provide a table with recommended main aortic graft-diameters for single chimney-grafts of 6 and 8 mm.

Risk-adjusted strategies in the prevention of early arterial thrombosis following lower extremity arterial reconstruction: a comparison of unfractionated versus low molecular weight heparin.

Aim: In vascular surgery postoperative thrombosis prophylaxis must sufficiently prevent arterial thrombosis. This cohort study examines different therapeutic approaches of unfractionated heparin (UFH) or low molecular weight heparin (LMWH) after vascular reconstruction.

Methods: Four hundred seventy-five patients entered the study between 2005 and 2008.

Alloplastic bypass material below the knee: actual rationale.

Aim: The greater saphenous vein is considered as material of first choice for a below-knee bypass. A high number of below knee synthetic, polytetrafluoroethylene or knitted polyester, bypass grafts in the institution of the senior author formed the basis to analyze factors for outcome of below-knee synthetic grafts.

Methods: A total of 533 patients (327 men, 206 women; age: 71.

[Operative access routes in reconstructive vascular surgery of arteries: Part 2: upper and lower extremities].

Exact anatomical knowledge of the arterial vascular system is the basis for all access routes. This article describes the most important assess routes of the upper and lower extremities in arterial vascular surgery. The access routes presented do not claim to be complete because this would overstretch the limits of this article and the reader is referred to the references listed.

Customized transapical thoracic endovascular repair for acute type A dissection.

A 67-year-old patient with severe comorbidities and acute type A aortic dissection with pericardial tamponade was treated with an endograft introduced through a mini-thoracotomy and puncture of the left ventricular apex. Final angiography showed complete coverage of the dissection. Early and 6-month follow-up computed tomography showed full apposition of the endograft without residual dissection.

[Operative access routes in reconstructive vascular surgery of arteries. Part 1: neck and torso].

Exact knowledge of the topographical anatomy of the arterial vascular system is the basis for all access routes. This article describes the most important assess routes in the neck and torso regions and gives an overview of the basic principles of the surgical technique with respect to suture material, suture technique, anastomotic technique and the atraumatic preparation of the anastomosis region. The article makes no claims to completeness because this would overstretch the limits but refers in particular to the references listed.

[Dabigatran therapy--perioperative management and interpretation of coagulation tests].

Unlabelled: Dabigatran, an oral, reversible direct factor IIa inhibitor, is approved in Europe for stroke prevention in atrial fibrillation and for the prevention of venous thromboembolism after elective hip and knee replacement. In contrast to vitamin K antagonists, a routine coagulation monitoring during the treatment with dabigatran etexilate is not necessary. However, in specific clinical situations such as invasive emergency procedures or serious haemorrhage, the actual anticoagulant status of dabigatran may be of importance for the treating clinician and can be assessed by clotting tests (aPTT, TT, ECT).