Purpose: Failing hemodialysis grafts continue to pose a challenge in the care of patients with end-stage renal disease (ESRD). We review our experience using percutaneous stent-grafts for the treatment of venous outflow stenosis and occlusion in order to assess their efficacy in nonautologous graft salvage.
Methods: This is a retrospective review of patients treated with percutaneous Viabahn® stent-grafts for failing hemodialysis arteriovenous grafts (AVGs), between 6/2006 and 12/2009.
The practice of vascular surgery has been transformed in the last decade. It is now necessary to change the way we train vascular surgeons, to keep pace with this rapidly evolving specialty.
View Article and Find Full Text PDFExposed or infected peripheral vascular grafts pose a significant challenge to the vascular surgeon. Although graft removal and extraanatomic bypass is feasible in selected circumstances, this procedure is generally not applicable for bypass to the pedal vessels. Preservation of patent grafts is almost always required for limb salvage.
View Article and Find Full Text PDFPatients with abdominal aortic aneurysms (AAAs) often have concomitant coronary artery disease. In patients with large or symptomatic AAAs and symptomatic coronary artery disease, it may be necessary to address both problems simultaneously. We report a case series of five patients undergoing simultaneous off-pump coronary artery bypass and abdominal aortic reconstruction.
View Article and Find Full Text PDFPseudoaneurysm of the subclavian-vertebral artery junction (SVJ) is a rare complication of internal jugular vein catheter placement. Because of its retroclavicular location, arterial injury at the SVJ poses a significant therapeutic challenge. A case report and review of the literature are presented.
View Article and Find Full Text PDFIn patients with critical lower extremity ischemia and occlusion of the distal tibial and pedal arteries bypasses to pedal artery branches may offer the only alternative to primary amputation. The results of 22 pedal branch arterial bypasses are reported, and a review of the literature is offered. The charts of 22 patients undergoing pedal branch arterial bypass during a 12-year period were retrospectively reviewed.
View Article and Find Full Text PDFHypothesis: Ultrasound-guided injection of thrombin is the treatment of choice for femoral pseudoaneurysms.
Design: A prospective study of patients undergoing a single form of treatment for femoral pseudoaneurysms.
Setting: Patients were treated at 2 tertiary care, university-affiliated hospitals.