We report 3 cases of iatrogenic arterial injuries in relation to saphenous vein stripping. In 2 cases the patients sustained acute severe ischemia and required prompt revascularization. The third patient was seen at a later stage with chronic ischemia and claudication. All 3 patients had their limbs salvaged without severe sequelae. The therapeutic strategies for different situations are discussed.
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http://dx.doi.org/10.1001/archsurg.133.10.1120 | DOI Listing |
Cureus
December 2024
Cardiovascular Surgery, Kansai Electric Power Hospital, Osaka, JPN.
A ruptured popliteal artery aneurysm (PPA) is a life-threatening condition that can mimic deep vein thrombosis and lead to critical limb ischemia. Immediate and accurate diagnosis is essential to save the patient's life and limb. A 73-year-old male presented with acute pain in the posterior aspect of the right knee.
View Article and Find Full Text PDFSci Rep
January 2025
Department of Anaesthesiology, Affiliated Hospital of North Sichuan medical college, Nanchong, Sichuan, China.
The effect of epidural infusion of dexmedetomidine on haemodynamics is unclear. This study aimed to explore the effects of epidural or intravenous infusion of dexmedetomidine on haemodynamics during lower extremity varicose veins surgery (saphenectomy) under epidural anaesthesia. Ninety patients were randomly allocated to three groups: ED group (epidural: 0.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Upper Gastrointestinal Surgery Unit, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
The Arc of Bühler (AoB) is a rare anatomical variant in gastrointestinal vasculature where there is an aberrant anastomotic vessel between coeliac and superior mesenteric arteries. We present a rare case where AoB was noted intraoperatively to have haemodynamically significant flow in the context of coeliac artery stenosis, supplementing arterial supply to the hepatic artery proper via the gastroduodenal artery (GDA). An interpositional jump graft between the aorta and the GDA stump was created using the long saphenous vein, and flow was restored.
View Article and Find Full Text PDFMedicina (Kaunas)
November 2024
Department of Cardiothoracic Surgery, Weill Cornell Medicine, 1300 York Ave., New York, NY 10065, USA.
The saphenous vein graft (SVG) has been a cornerstone of coronary bypass surgery, but its long-term patency is limited by accelerated atherosclerosis. Recent advancements, including the no-touch technique and the use of SVG as a limb of the left internal thoracic artery (LITA), have shown promise in improving outcomes. Both approaches enhance nitric oxide (NO) availability, a key factor in promoting endothelial stability and arterial-like behavior in the SVG.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Fundamental and Applied Research in Vascular Surgery, Pirogov Russian National Research Medical University, 119049 Moscow, Russia.
The great saphenous vein (GSV) has long been recognized as the best conduit for vascular bypass procedures. Concomitant varicose veins disease may be a reason for GSV unavailability either due to dilatation and tortuosity of the vein or due to its destruction during invasive venous treatment. -to assess the rate of varicose vein patients with concomitant lower extremity arterial disease (LEAD) who have previously lost their GSV due to venous ablation.
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