our preliminary results support the view that infrainguinal bypass grafting can be safely done even in diabetics. Despite increased mortality in this group, liberal indication for reconstructive vascular surgery seems to be justified by favourable patency rates and clinical outcome in selected patients.
The percutaneous transfemoral placement of self-expanding metallic stents is an effective minimally invasive alternative to surgery in the treatment of symptomatic pelvic venous spur.
Objective improvements in technical performance follow intensive workshop training. Participants' perform better, faster, and with an improved end product following the course. Such adjuncts to training play an important part in a focused integrated programme that addresses reduced work hours.
Regional thrombolysis combined with surgical thrombectomy is relatively easy to perform and seems safe. Vein patency and valve function were restored, and post-thrombotic syndrome was prevented. Additional procedures to overcome pelvic vein obstructions were required in 11 of 33 patients (33%). The procedure should be tested against standard anticoagulation therapy in patients with acute iliofemoral thrombosis.
A self-expanding vascular prosthesis was used to treat 20 venous stenoses or occlusions in 13 patients. The lesions were caused by tumor (n = 5), postoperative fibrous scars (n = 2), and chronic hemodialysis fistulas (n = 13). Follow-up ranged between 6 weeks and 53 months (mean follow-up, 14.9 months). Acute occlusion occurred in two stents, one within a tumor stenosis and one in a dialysis shunt after 3 days and 2 days, respectively. Balloon angioplasty, thrombolysis, and aspiration in the first case and balloon angioplasty and thrombolysis in the second case successfully restored patency. Definite occlusion occurred in these two patients after 8 weeks and 5 months, respectively. Ten secondary interventions were performed in three patients with 10 restenoses who had stenotic arm veins in chronic hemodialysis at presentation. Five of seven patients who received treatment for stenoses associated with hemodialysis underwent successful kidney transplantation 5-27 months after placement of vascular stents. Both patients who received treatment for benign strictures had patent stents at follow-up examinations performed at 45 and 53 months, respectively. Four of five stents placed for malignant stenoses were patent at venography (n = 3) or autopsy (n = 1).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.