Background: Reconstruction of the hepatic artery in infants undergoing liver transplantation presents challenging vascular situations. Microvascular techniques ensure arterial blood flow via small caliber vessels but are insufficient when inflow is poor. In these situations, the use of allogeneic grafts to the supraceliac aorta have been advocated. The development of a pseudoaneurysm at the supraceliac aortic suture line requires urgent repair and restoration of arterial flow to the graft.
Methods: Our study was based on case reports and review of the literature.
Results: Definitive diagnosis and successful repair of supraceliac pseudoaneurysm was accomplished in two infants after transplantation.
Conclusion: We advocate a thoracoabdominal retroperitoneal approach, which provides safe control of the aorta and primary repair or patching of the diseased aortic segment, and also provides access for hepatic revascularization via placement of an infrarenal graft. Thrombosis of the artery and subsequent liver necrosis are indications for retransplantation.
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http://dx.doi.org/10.1097/00007890-199911270-00033 | DOI Listing |
J Endovasc Ther
November 2024
Division of Vascular Surgery and Endovascular Therapy, Department of Surgery, Keck Hospital of USC, University of Southern California, Los Angeles, CA, USA.
Purpose: Despite advances in complex endovascular aortic repair techniques, spinal cord ischemia (SCI) remains a devastating complication following endovascular thoracoabdominal aortic repairs. Novel strategies to preserve key intercostal/lumbar arteries have been described. We report our early results of patients who underwent direct intercostal/lumbar artery revascularization using endovascular incorporation of fenestrations/branches or extra-anatomic approaches for fenestrated-branched endovascular aortic repairs (FBEVARs).
View Article and Find Full Text PDFCureus
October 2024
Department of Anesthesiology, Uniformed Services University of the Health Sciences, Bethesda, USA.
Ann Vasc Surg
January 2025
Division of Vascular and Endovascular Surgery, Department of Surgery, University of California, San Francisco, San Francisco, CA. Electronic address:
Background: Nonhome discharge (NHD) to a rehabilitation or skilled nursing facility after vascular surgery is poorly described despite its impact on patients. For home-dwelling patients undergoing elective surgery, the need for postoperative NHD can have meaningful implications on quality of life, long-term outcomes, and health-care spending. Understanding postsurgical NHD risk is essential to preoperative counseling and shared decision making.
View Article and Find Full Text PDFJAMA Surg
September 2024
Bart's Health National Health Service Trust, London, United Kingdom.
Importance: Hemorrhage is the most common cause of preventable death after injury. Most deaths occur early, in the prehospital phase of care.
Objective: To establish whether prehospital zone 1 (supraceliac) partial resuscitative endovascular balloon occlusion of the aorta (Z1 P-REBOA) can be achieved in the resuscitation of adult trauma patients at risk of cardiac arrest and death due to exsanguination.
Ann Vasc Surg
November 2024
Vascular Surgery, Department of Medicine and Surgery, University of Parma, Parma, Italy; Vascular Surgery, Cardio-Thoracic and Vascular Department, University Hospital of Parma, Parma, Italy.
Background: To describe the outcomes of aortic endograft thrombosis (AET) as an indication for open conversion (OC) after endovascular aortic aneurysm repair (EVAR) in a multicenter experience.
Methods: This study retrospectively analyzed cases of OC for AET following EVAR across 12 Italian Vascular Surgery centers from 1997 to September 2022. The end points were as follows: 30-day mortality and major postoperative complications.
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