Background: Of the many antimicrobial agents available, iodophore-based formulations such as povidone iodine have remained popular after decades of use for antisepsis and wound healing applications due to their favorable efficacy and tolerability. Povidone iodine's broad spectrum of activity, ability to penetrate biofilms, lack of associated resistance, anti-inflammatory properties, low cytotoxicity and good tolerability have been cited as important factors, and no negative effect on wound healing has been observed in clinical practice. Over the past few decades, numerous reports on the use of povidone iodine have been published, however, many of these studies are of differing design, endpoints, and quality.
View Article and Find Full Text PDFPatients with ruptured abdominal aortic aneurysms (RAAAs) benefit from treatment in high-volume facilities. This study explored the effect of patient transfer on outcomes and the relationship between hemodynamic status and mortality. We performed a retrospective review of 83 consecutive patients who had open repair for RAAA at a single tertiary facility.
View Article and Find Full Text PDFEndovascular repair is increasingly used for ruptured abdominal aortic aneurysms (RAAAs). This study estimated the mortality rate for this approach. A review of 307 publications in English was performed.
View Article and Find Full Text PDFBackground: Recent studies have described the importance of renal glomerular filtration rate (GFR) as a determinant of perioperative mortality in patients with aneurysms that involve the thoracoabdominal and abdominal aorta. We studied the impact of GFR on mortality following repair of ascending and arch aneurysms.
Methods: Between February 1991 and August 2006, we performed 994 repairs of the ascending and transverse aortic arch.
Objective: Renal dysfunction is among the most commonly occurring morbidities following descending thoracic and thoracoabdominal aortic repair. We hypothesized that myoglobin nephrotoxicity might arise from leg ischemia caused by femoral artery cannulation, which is required for distal aortic perfusion. Lacking complete historical laboratory data on myoglobinemia, we studied somatosensory evoked potential (SSEP) changes in the leg (a functional marker of leg ischemia), as a surrogate predictor of acute postoperative renal failure.
View Article and Find Full Text PDFBackground: Concerned with the associated risks of proximal reoperation, some have proposed an aggressive approach of aortic root replacement during emergent repair of acute type A aortic dissection. Because few data exist regarding late reoperations, we report outcomes of proximal reoperation after repaired type A aortic dissection.
Methods: Between January 1991 and March 2006, 63 patients underwent reoperation after previous repair for acute type A aortic dissection.
A 28-year-old woman in the first trimester of a twin pregnancy presented with a symptomatic descending thoracic aortic aneurysm. We report our experience in managing a descending thoracic aortic aneurysm in this patient.
View Article and Find Full Text PDFBackground: Aneurysms of the aortic arch seldom occur alone. They usually involve the ascending aorta. Occasionally, the aneurysm also involves the descending thoracic or thoracoabdominal aorta.
View Article and Find Full Text PDFBackground: The management of combined arterial and musculoskeletal injuries to the lower extremity remains controversial, particularly with regard to the initial order of intervention and the use of intravascular shunting. In this study, we review the contemporary management and outcome of patients treated for acute traumatic distal femoropopliteal arterial injuries.
Methods: From January 2001 to January 2006, we repaired 57 acute traumatic lower-extremity arterial injuries in a level 1 trauma center.
Background: Clinically evident renal disease (dialysis, history of renal insufficiency, or serum creatinine >2.0 mg/dL) is a known risk factor for mortality after thoracoabdominal aortic aneurysm repair. We extended this concept to the questions of whether subclinical renal disease is also a risk factor and how best to identify subclinical disease.
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