The work was aimed at determining and comparing sensitivity and specificity of various methods of radiodiagnosis of anastomotic pseudoaneurysms after reconstructive operations on the aortic-iliac-femoral segment. The authors identified and analysed the findings of examination of 87 patients presenting with anastomotic false aneurysms following the above-mentioned interventions (with the incidence rate amounting to 5.9%), having diagnosed a total of 105 cases of the formation of false aneurysms of proximal and distal anastomoses. The diagnosis was made using of the following methods: ultrasonographic duplex scanning (USDS), selective contrast- enhanced angiography (CEA), spiral and multispiral CT angiography (SCTA and MSCTA), and magnetic resonance angiography (MRA). Sensitivity and specificity of the methods employed were determined in relation not only to their ability to detect anastomotic pseudoaneurysms but also to identify different characteristics thereof with due regard for the number of the true positive (TPR), true negative (TNR), false positive (FPR), and false negative (FNR) results. Comparing the findings of the comprehensive examination of the patients demonstrated that all methods of the study, except for selective angiography (sensitivity of 85.7%) yielded high sensitivities and specificities in diagnosis of false aneurysms.
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Ann Surg Oncol
January 2025
Department of HPB Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris (AP-HP), Université de Paris-Cité, Clichy, France.
Background: Locally advanced pancreatic adenocarcinomas (LA-PDAC) are more frequently operated now than in the past because of new regimen chemotherapy and improvement in surgical technique. Resection of the coeliac trunk (CT) during pancreatoduodenectomy (PD) or total pancreatectomy (TP) is not routinely done owing to the risk of liver and gastric ischaemia. In this video, a patient with LA-PDAC underwent TP with CT resection and retrograde gastric revascularization through the distal splenic artery.
View Article and Find Full Text PDFBiomedicines
November 2024
Department of General Surgery, Vascular Surgery, Angiology and Phlebology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 45-47 Ziołowa Street, 40-635 Katowice, Poland.
Peripheral arterial disease (PAD) is becoming an increasingly prevalent clinical issue, leading to a growing number of patients requiring surgical interventions. Consequently, there is an increasing occurrence of para-anastomotic aneurysms as late complications following primary treatment for PAD. These aneurysms typically arise at the sites of graft implantation and necessitate individualized management strategies based on factors such as location, size, and the patient's overall condition.
View Article and Find Full Text PDFMorphologie
January 2025
Department of Digestive Surgery, Amiens Picardy University Hospital, 1, rondpoint du Pr-Cabrol, 80054 Amiens, France; Simplifying Care for Complex Patients, UR-UPJV 7518 SSPC, Clinical Research Unit, University of Picardie Jules-Verne, Amiens, France.
Introduction: The duodeno-pancreatic region is a highly vascularized area. The superior and posterior pancreaticoduodenal artery is a vessel primarily originating from the gastroduodenal artery. It exhibits rare anatomical variations, such as its emergence from the right branch of the hepatic artery, which we fortuitously identified during a cadaver dissection.
View Article and Find Full Text PDFKyobu Geka
December 2024
Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan.
A 61-year-old female underwent ascending aortic replacement (resecting the primary entry in the ascending aorta) for Stanford type A acute aortic dissection 1 year and 8 months before. Her postoperative course was uneventful, and the patient was discharged on 17 days later. Follow-up recent computed tomography (CT) scans, however, revealed dissecting aortic aneurysm of the distal aortic arch due to a new entry at the distal anastomosis of the ascending replacement.
View Article and Find Full Text PDFA 69-year-old man underwent liver transplantation with a deceased donor for cirrhosis secondary to steatohepatitis. The arterial anastomosis was performed between the celiac trunk of the donor and the hepatic artery of the recipient. In the second postoperative month, he developed abdominal pain and abnormal liver function tests.
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