Seminars in Vascular Surgery (SEMIN VASC SURG )


Each issue of Seminars in Vascular Surgery examines the latest thinking on a particular clinical problem and features new diagnostic and operative techniques. The journal allows practitioners to expand their capabilities and to keep pace with the most rapidly evolving areas of surgery.

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  • 5-year impact
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  • Article influence
  • Website
    Seminars in Vascular Surgery website
  • Other titles
    Seminars in vascular surgery (Online), Seminars in vascular surgery
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  • OCLC
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Renal trauma is predominantly secondary to blunt trauma and is predominately managed nonoperatively. Endovascular interventions are reserved for patients recognized early with a significant vascular injury. Renal injuries and uncommon among intra-abdominal injuries and account for a minority of injuries treated by the vascular specialist.
    Seminars in Vascular Surgery 01/2014;
  • Seminars in Vascular Surgery 01/2014; 26(2-3):57-8.
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    ABSTRACT: Nutcracker syndrome is a rare condition of left renal vein entrapment manifesting with hematuria, flank pain and occasionally pelvic congestion in females or varicocele in males. Diagnosis requires a high index of suspicion upon careful history delineation. The gold standard for definite confirmation remains venography with reno-caval pressure gradient. Treatment is mainly guided by the severity of symptoms. For the majority of centers, it appears that surgery remains the first-line therapy; however endovascular alternatives are rapidly evolving into the field with favorable outcomes. This article reviews current concepts on NCS with particular focus on contemporary surgical and endovascular techniques and their outcomes.
    Seminars in Vascular Surgery 01/2014;
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    ABSTRACT: Ex-vivo renal artery repair combined with cold perfusion protection is an operative technique for managing complex renal artery lesions. Most disease of the renal artery is proximal, and is typically treated either medically, by endovascular means, or surgically. When surgery of the main renal artery is required, it can typically be performed with warm renal ischemia times of less than 30 min. However, in more distal disease that may involve the segmental branches a much more complicated surgical reconstruction can be anticipated. This often will necessitate warm ischemia times of >45 minutes, and can thus lead to direct renal nephron damage. In this setting the ex-vivo technique with cold perfusion can allow for lengthy reconstructive times of several hours without any measurable harm to renal function. The technique can be performed with a low morbidity and mortality, with an excellent rate of renal salvage, and with preservation of renal function.
    Seminars in Vascular Surgery 01/2014;
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    ABSTRACT: As the numbers of interventional procedures are rising exponentially, identification of those patients at risk for renal complications has become important. Renal complications have been associated with increased morbidity and mortality following interventions. Risk factors have been studied to help identify those patients at increased risk of developing contrast induced nephropathy (CIN). Hydration and medications have been studied as a protective measure to decrease the risk of renal complications. Preconditioning patients with intravenous hydration has been found to be the most helpful in circumventing post procedural CIN.
    Seminars in Vascular Surgery 01/2014;
  • Seminars in Vascular Surgery 01/2014;
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    ABSTRACT: Renal insufficiency is a risk factor for mortality and morbidity during endovascular aneurysm repair. Multiple changes in practice have occurred to mitigate renal injury and renal dysfunction. Transrenal fixation does carry an increased risk of a decline in renal function in the medium term. Renal stenting for athero-occlusive disease during endovascular aneurysm repair needs careful consideration, as indications have changed and there are unexpected consequences with early vessel occlusion. The growing number of renal interventions during complex endovascular aneurysm repair with the advent of chimney snorkel/periscope techniques and the introduction of fenestrated grafts has shown the resilience of the intervention with relatively low renal issues (approximately 10%), but has also illustrated the need for additional device development.
    Seminars in Vascular Surgery 12/2013; 26(4):189-192.
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    ABSTRACT: Among the most important factors driving morbidity and mortality after aortic surgery is post operative renal insufficiency. The attendant metabolic derangements greatly complicate surgical care, expedite arrhythmias, and can significantly prolong hospital stay and cost. This article seeds to define factors contributory to renal complications after aortic surgery and offers a review of techniques to protect renal mass from post operative declines.
    Seminars in Vascular Surgery 12/2013; 26(4):193-198.
  • Seminars in Vascular Surgery 12/2013; 26(4):133.
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    ABSTRACT: Renal artery stenosis (RAS) is one of the most common causes of severe hypertension (approximately 1-5% of all patients with hypertension). Presently, there is no universally accepted screening test for RAS. However, most clinicians use renal duplex ultrasound (RDU) imaging; while others use magnetic resonance angiography (MRA) or contrast computed tomography angiography in selected patients. This review will highlight various imaging modalities and discuss the pros and cons of each.
    Seminars in Vascular Surgery 12/2013; 26(4):134-143.
  • Seminars in Vascular Surgery 06/2013;
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    ABSTRACT: With the introduction of retrievable inferior vena cava filters, the number being placed for protection from pulmonary embolism is steadily increasing. Despite this increased usage, the true incidence of complications associated with inferior vena cava filters is unknown. This article reviews the known complications associated with these filters and suggests recommendations and techniques for inferior vena cava filter removal.
    Seminars in Vascular Surgery 03/2013; 26(1):23-8.
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    ABSTRACT: Chronic occlusion of the Inferior Vena Cava (IVC) can go unnoticed because of the remarkable compensatory mechanism of the human body. On the other hand, IVC occlusion can have a significant and debilitating effect on an individual's ability to live a normal lifestyle and be an active and productive member of society. With the introduction of endovascular technology, new treatment options have opened for patients with this condition. This article describes the technical aspects of IVC recanalization and briefly discusses follow-up care and limited reports on outcomes from the procedure.
    Seminars in Vascular Surgery 03/2013; 26(1):29-34.
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    ABSTRACT: Vascular malformations result from an arrest of development of a normal vascular structure or from abnormal growth of a vascular structure. Treatment continues to be a challenge. We sought to study the outcomes of sclerotherapy and embolization for vascular malformations. We reviewed clinical data of all patients treated with sclerotherapy or embolization for arteriovenous or venous malformations between 2006 and 2010 at Mayo Clinic. Follow-up information was obtained from clinical charts and a questionnaire sent to all patients. Overall, 60 patients (24 male and 36 female; mean age 31.7 years; range, 5.6 to 72.4 years) had 163 unique sclerotherapy or embolization procedures for lesions involving the lower extremity (55%), upper extremity (18.3%), pelvis (11.7%), abdomen (5%), chest (5%), back (3.3%), and multiple locations (1.7%). Thirty-one patients had low-flow venous malformations and 29 patients had high-flow arteriovenous malformations. Twenty-four patients required more than three sessions. The most common indication for intervention was pain (57 of 60 [95%]). Sixteen patients (27%) had documented or patient-reported complications. There was no significant difference in complication rates or lesion size between patients with low-flow or high-flow lesions. There were no procedural deaths. Mean available follow-up was 2.0 ± 1.3 years (range, 0.5 to 5.0 years). Median pain scores at most recent follow-up decreased significantly (P<.001). Eighty-three percent of the responders (24 of 29) would recommend treatment to others. With appropriate patient selection, sclerotherapy and embolization can decrease the pain of patients with arteriovenous and venous malformations. Multiple interventions might be necessary. Practitioners should be aware of the potential complications and counsel their patients about these risks.
    Seminars in Vascular Surgery 03/2013; 26(1):48-54.
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    ABSTRACT: Recent sequencing of the human genome has opened up new areas of investigation for genetic aberrations responsible for the pathogenesis of many human diseases. To date, there have been no studies that have investigated the entire human genome for the genetic underpinnings of chronic venous insufficiency (CVI). Utilizing Gene Chip Arrays we analyzed the relative expression levels of more than 47,000 transcripts and variants and approximately 38,500 well-characterized genes from each of 20 patients (N (CVI)=10; N (Control Group)=10). Relative gene expression profiles significantly differed between patients with CVI and patients unaffected by CVI. Regulatory genes of mediators of the inflammatory reaction and collagen production were up-regulated and down-regulated, respectively in CVI patients. DNA microarray analysis also showed that relative gene expression of multiple genes which function remains to be elucidated was significantly different in CVI patients. Fundamental advancements in our knowledge of the human genome and understanding of the genetic basis of CVI represents an opportunity to develop new diagnostic, prognostic, preventive and therapeutic modalities in the management of CVI.
    Seminars in Vascular Surgery 03/2013; 26(1):2-13.
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    ABSTRACT: Stent migration and dislodgment is a potential complication after endovenous stenting of the left renal vein (LRV) for nutcracker syndrome. Our purpose is to describe the technique for endovenous removal of such a dislodged stent that was used in a 36-year-old woman with nutcracker syndrome initially treated with renal vein transposition. Recurrent renal vein compression and symptoms developed and a 14 × 20-mm self-expanding stent was placed in the LRV and was noted to be dislodged into the inferior vena cava on the first post-procedure day. Through right internal jugular access, the stent was stabilized by cannulating a cell of the stent using a guide wire and an angled angiographic catheter. A 20Fr sheath was then placed via right femoral vein access into the inferior vena cava. The stent lumen was cannulated from femoral approach and the stent straightened with a stiff wire. An 18-mm angioplasty balloon was then used to capture the stent. The stent was then compressed with two 25-mm loop snares while simultaneously deflating the balloon as it was pulled into the 20Fr sheath and removed. The LRV was restented with an 18 × 40-mm self-expanding stent. Stenting of LRV for nutcracker syndrome can result in stent migration. Endovenous removal of such a dislodged self-expanding stent is feasible. Our technique emphasizes stent stabilization with cell cannulation and capture over a larger diameter balloon.
    Seminars in Vascular Surgery 03/2013; 26(1):43-7.
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    ABSTRACT: Nutcracker syndrome is one of the abdominal venous entrapments, caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Occasionally a retro-aortic left renal vein is compressed between the aorta and the vertebral body (posterior nutcracker syndrome). The renal vein distal to the compression is dilated and renal venous flow can be diverted toward the pelvis through an incompetent, refluxing, left ovarian or spermatic vein, in addition to drainage through retroperitoneal venous collaterals. In this article, we describe the different surgical and endovascular techniques that are used to treat this syndrome.
    Seminars in Vascular Surgery 03/2013; 26(1):35-42.
  • Seminars in Vascular Surgery 03/2013; 26(1):1.
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    ABSTRACT: Intraoperative assessment of arterial repairs can be performed using angiography or ultrasound techniques. Duplex ultrasound is an accurate technique to image and assess the hemodynamics of repaired arteries using color and pulsed Doppler velocity spectra recordings. Procedure-specific interpretation criteria should be used to determine the technical adequacy of carotid artery endarterectomy, renal/visceral arterial repairs, and infrainguinal limb arterial bypass. The interpretation pathway for intraoperative assessment is detailed, focusing on transducer selection, imaging technique, and velocity spectra criteria for residual stenosis.
    Seminars in Vascular Surgery 01/2013; 26(2-3):105-110.