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Objective: The objective of this study was to assess outcomes of a hybrid technique for treatment of abdominal aortic aneurysm (AAA) associated with iliac aneurysm without distal neck by combining an AAA endovascular repair approach with open surgery for preservation of the internal iliac artery (IIA).
Methods: The files of 51 patients operated on between 1998 and 2017 in a single vascular surgery department were retrospectively analyzed. Inclusion criteria were patients with AAA associated with uni-iliac or bi-iliac aneurysm without suitable distal sealing zone. Surgery consisted of deployment of an aortouni-iliac stent graft combined with an extra-anatomic crossover prosthetic bypass. With use of a limited retroperitoneal approach, the contralateral proximal common iliac aneurysm was surgically excluded and the IIA revascularized by direct ilioiliac anastomosis or terminal common iliac suture, preserving the iliac bifurcation.
Results: The patients' mean age was 74 years (58-88 years), and 92% were men. The mean follow-up was 5.8 years (0.1-18 years). Twenty-nine patients (57%) had one or more high-risk criteria for open surgery. Nineteen patients (37.3%) had aortouni-iliac aneurysms, 19 (37.3%) aortobi-iliac aneurysms, 5 (10%) isolated iliac aneurysms, and 8 (15.7%) bi-iliac aneurysms without aortic location. Four patients (7.8%) also had IIA aneurysms. Surgery was successful in all cases. Two patients (4%) died during the 30 days after surgery. One surgically preserved IIA occluded within the first month, resulting in buttock claudication. The 5-year IIA primary patency rate was 96%. Type I proximal endoleaks occurred in two patients, requiring additional surgery 3 years and 13 years after the initial surgery, respectively.
Conclusions: This hybrid technique, consisting of AAA endovascular exclusion combined with open IIA revascularization, is safe and effective for preservation of pelvic vascularization. It is associated with long-term patency and low morbidity rates. We have been using this technique since before the advent of branched dedicated devices, allowing preservation of the IIA with good results. This technique should continue to be proposed, especially in patients not eligible for endovascular iliac branch repair because of anatomic contraindications, to avoid pelvic ischemia if the IIA has to be sacrificed.
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http://dx.doi.org/10.1016/j.jvs.2018.03.416 | DOI Listing |
J Orthop Res
December 2024
AutoRSA Research Group, Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.
Anterior shoulder instability with glenoid bone lesion can be treated with the Eden-Hybinette procedure utilizing a tricortical iliac crest bone graft or the Latarjet procedure. This study aimed to evaluate the glenohumeral joint (GHJ) kinematics throughout an external shoulder rotation following the Eden-Hybinette and Latarjet procedures. Nine human specimens were examined with dynamic radiostereometry during a GHJ external rotation with anteriorly directed loads from 0 to 30 N.
View Article and Find Full Text PDFTraumatic abdominal wall hernia (TAWH) is a rare but serious condition resulting from blunt abdominal trauma, characterized by the herniation of bowel or abdominal organs through a disrupted musculature and fascia without skin penetration. This report describes a unique case of a 24-year-old man who sustained a high-velocity blunt abdominal injury from a motorcycle handlebar during a road traffic accident. The clinical presentation, diagnostic challenges, surgical intervention, and postoperative recovery are discussed to emphasize the importance of the early recognition and management of TAWH in trauma patients.
View Article and Find Full Text PDFRadiol Case Rep
February 2025
Rheumatology Department, University Hospital Son Llátzer, Mallorca, Spain.
Osseous sarcoidosis is a rare manifestation of sarcoidosis, often mimicking other conditions like metastatic disease. Skeletal involvement occurs in only 3%-13% of cases (1), making diagnosis challenging. We present the case of a 63-year-old female with a 1-month history of inflammatory bone pain and multiple lytic and blastic lesions.
View Article and Find Full Text PDFFront Med (Lausanne)
December 2024
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
Objective: Retroperitoneal fibrosis (RPF) is a rare disease characterized by the presence of fibroinflammatory tissue that surrounds the abdominal aorta and the iliac arteries and often entraps the ureters. Hydronephrosis is a common complication of RPF, however, its clinical features and outcomes have not been well elucidated.
Methods: A total of 115 RPF-related hydronephrosis patients have been recruited from 9 clinical centers in China since March 2010.
Infect Drug Resist
December 2024
Department of Orthopaedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Purpose: Periprosthetic joint infection (PJI) is a severe complication following joint replacement surgery, and there is a current lack of rapid, accurate, and non-invasive diagnostic methods. This study aims to assess the effectiveness of using dual-energy computed tomography (DECT) to quantify the maximum long and short axes of the external iliac lymph nodes (LNs) as a diagnostic tool for PJI.
Patients And Methods: In this prospective controlled study, 112 patients undergoing total hip or total knee revision surgery were enrolled.
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