Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_76_22
A. Pandey, Sriram Manchikanti, Neelamjingbha Sun, Aditya Gupta, Shivanesan Pitchai, V. Pillai
Objective: Open surgery for aortic aneurysm is associated with significant morbidity and mortality. Preoperative functional status is one of the key predictors of adverse outcomes in the postoperative period. This study investigated the role of 6-min walk test (6MWT) in predicting the outcomes after open surgery in abdominal aortic aneurysm (AAA). Methods: A prospective cohort study was conducted in patients scheduled to undergo open repair of AAA. The preoperative 6-min walk distance (6MWD) was calculated for patients, followed by postoperative monitoring of all patients who underwent surgery. Walking performance was classified with 300 m as a cutoff, and patients were divided into two groups with 6MWD- <300 m and >300 m. The results of 6MWT were analyzed with respect to cardiopulmonary complications, intensive care unit (ICU) stay, ventilatory or inotropic support, length of hospital stay, and mortality. Results: A total of 52 patients were included in the study, and 49 patients were able to complete the 6MWT. The patients with <300 m 6MWD had a longer stay in the ICU and an increased duration of ventilatory and inotropic support (P < 0.001). The <300-m group had an increased incidence of cardiopulmonary complications (47%, P = 0.001). The <300-m group had a higher duration of hospital stay (10.6 vs. 8.4 days; P = 0.01). All the patients who died in the perioperative period had a 6MWD <300 m (n = 3, P = 0.03). The 6MWD was the only strong predictor of adverse outcomes in the cohort. Conclusion: 6MWT can be safely performed in patients with AAA. A low walking distance correlates directly with increased perioperative morbidity and length of hospital stay. A distance of <300 m in patients with aortic aneurysm is predictive of perioperative morbidity and mortality.
目的:开放手术治疗主动脉瘤具有较高的发病率和死亡率。术前功能状态是术后不良预后的重要预测指标之一。本研究探讨了6分钟步行试验(6MWT)对腹主动脉瘤(AAA)开腹手术后预后的预测作用。方法:前瞻性队列研究计划行AAA开放性修复的患者，计算患者术前6分钟步行距离(6MWD)，并对所有手术患者进行术后监测。步行表现以300米为分界点，以6MWD- 300米分为两组。分析6MWT的结果与心肺并发症、重症监护病房(ICU)住院时间、通气或肌力支持、住院时间和死亡率有关。结果:共纳入52例患者，49例患者能够完成6MWT。6MWD <300 m的患者在ICU的住院时间更长，通气和肌力支持的持续时间也更长(P < 0.001)。<300米组心肺并发症发生率增高(47%，P = 0.001)。<300米组的住院时间更长(10.6天vs. 8.4天;P = 0.01)。围手术期死亡患者6MWD均<300 m (n = 3, P = 0.03)。6MWD是该队列中唯一强有力的不良结果预测因子。结论:6MWT可以安全地用于AAA患者，较低的步行距离与围手术期发病率和住院时间的增加直接相关。主动脉瘤患者距离<300 m可预测围手术期发病率和死亡率。
{"title":"Prognostic value of the pre-procedural six minute walk test in patients undergoing open abdominal aortic aneurysm repair – A prospective observational study","authors":"A. Pandey, Sriram Manchikanti, Neelamjingbha Sun, Aditya Gupta, Shivanesan Pitchai, V. Pillai","doi":"10.4103/ijves.ijves_76_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_76_22","url":null,"abstract":"Objective: Open surgery for aortic aneurysm is associated with significant morbidity and mortality. Preoperative functional status is one of the key predictors of adverse outcomes in the postoperative period. This study investigated the role of 6-min walk test (6MWT) in predicting the outcomes after open surgery in abdominal aortic aneurysm (AAA). Methods: A prospective cohort study was conducted in patients scheduled to undergo open repair of AAA. The preoperative 6-min walk distance (6MWD) was calculated for patients, followed by postoperative monitoring of all patients who underwent surgery. Walking performance was classified with 300 m as a cutoff, and patients were divided into two groups with 6MWD- <300 m and >300 m. The results of 6MWT were analyzed with respect to cardiopulmonary complications, intensive care unit (ICU) stay, ventilatory or inotropic support, length of hospital stay, and mortality. Results: A total of 52 patients were included in the study, and 49 patients were able to complete the 6MWT. The patients with <300 m 6MWD had a longer stay in the ICU and an increased duration of ventilatory and inotropic support (P < 0.001). The <300-m group had an increased incidence of cardiopulmonary complications (47%, P = 0.001). The <300-m group had a higher duration of hospital stay (10.6 vs. 8.4 days; P = 0.01). All the patients who died in the perioperative period had a 6MWD <300 m (n = 3, P = 0.03). The 6MWD was the only strong predictor of adverse outcomes in the cohort. Conclusion: 6MWT can be safely performed in patients with AAA. A low walking distance correlates directly with increased perioperative morbidity and length of hospital stay. A distance of <300 m in patients with aortic aneurysm is predictive of perioperative morbidity and mortality.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"126 - 132"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46537961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_50_23
Tapish Sahu
{"title":"Generational evolution, industry influence and ethical practice","authors":"Tapish Sahu","doi":"10.4103/ijves.ijves_50_23","DOIUrl":"https://doi.org/10.4103/ijves.ijves_50_23","url":null,"abstract":"","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"79 - 81"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43284350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_1_23
N. Sekar, Jithin Jagan, Rahul Sima, Rajan Archana
Background: Infrapopliteal arterial disease is the most common finding in patients presenting with critical limb-threatening ischemia (CLTI) majority of whom also present with tissue loss. Vein bypass has been the gold standard of treatment in these patients. Nowadays, because of high peri-operative mortality and morbidity in these high-risk patients, endovascular treatment is offered first. Vascular restenosis, caused by intimal hyperplasia due to vessel injury during percutaneous transluminal angioplasty (PTA), remains the main limitation of infrapopliteal PTA and bare metal stent with clinical relapse and reinterventions. Drug-eluting stents (DES) are considered a possible solution to the problem of restenosis by reducing neointimal hyperplasia, after promising results in coronary arteries. Materials and Methods: Coronary DES was used as a bail out in patients undergoing below the knee (BTK) angioplasty. Those who developed dissection or recoil were stented with coronary stents. Multiple stents were used in patients with a long segment recoil of the artery. None of the stents were placed 2 or 3 cm beyond the origin of the tibial artery. The primary patency at 6 and 12 months, defined as absence of restenosis (≥50% stenosis) or occlusion based on clinical assessment and duplex scan, limb salvage and time taken to complete wound healing were assessed. Results: A total of 26 patients underwent drug-eluting stenting of the infra-popliteal vessels for CLTI during a period of 32 months. Technical success was possible in 92.3% patients (n = 24), however two patients had on table thrombosis of the stent. These two patients went on to have surgical bypass and their limbs could be salvaged. Wound healing was seen in 13 of 18 (72.2%) patients at 6 months and 11/12 (91.6%) patients at 1 year. Most patients took an average of 5 months to heal. Limb salvage was 11/12 (91.6%) at 1 year. Two patients underwent below-knee amputation for severe worsening sepsis due to uncontrollable foot infection. In both these patients' stents were patent at the time of amputation. Primary patency was 92.3% at 6 months and at 1 year. None of the patients required re-intervention. Mortality was 15.3% at 1 year. Conclusion: Off-label use of cardiac stents in the infra-popliteal segment seems a viable bailout option in patients undergoing revascularization. DES helps to achieve early technical success, longer patency, better wound healing, and improves limb salvage in these patients.
{"title":"Usefulness of off-label use of coronary drug-eluting stents as bailout for patients with critical limb ischemia and infrapopliteal arterial occlusive disease","authors":"N. Sekar, Jithin Jagan, Rahul Sima, Rajan Archana","doi":"10.4103/ijves.ijves_1_23","DOIUrl":"https://doi.org/10.4103/ijves.ijves_1_23","url":null,"abstract":"Background: Infrapopliteal arterial disease is the most common finding in patients presenting with critical limb-threatening ischemia (CLTI) majority of whom also present with tissue loss. Vein bypass has been the gold standard of treatment in these patients. Nowadays, because of high peri-operative mortality and morbidity in these high-risk patients, endovascular treatment is offered first. Vascular restenosis, caused by intimal hyperplasia due to vessel injury during percutaneous transluminal angioplasty (PTA), remains the main limitation of infrapopliteal PTA and bare metal stent with clinical relapse and reinterventions. Drug-eluting stents (DES) are considered a possible solution to the problem of restenosis by reducing neointimal hyperplasia, after promising results in coronary arteries. Materials and Methods: Coronary DES was used as a bail out in patients undergoing below the knee (BTK) angioplasty. Those who developed dissection or recoil were stented with coronary stents. Multiple stents were used in patients with a long segment recoil of the artery. None of the stents were placed 2 or 3 cm beyond the origin of the tibial artery. The primary patency at 6 and 12 months, defined as absence of restenosis (≥50% stenosis) or occlusion based on clinical assessment and duplex scan, limb salvage and time taken to complete wound healing were assessed. Results: A total of 26 patients underwent drug-eluting stenting of the infra-popliteal vessels for CLTI during a period of 32 months. Technical success was possible in 92.3% patients (n = 24), however two patients had on table thrombosis of the stent. These two patients went on to have surgical bypass and their limbs could be salvaged. Wound healing was seen in 13 of 18 (72.2%) patients at 6 months and 11/12 (91.6%) patients at 1 year. Most patients took an average of 5 months to heal. Limb salvage was 11/12 (91.6%) at 1 year. Two patients underwent below-knee amputation for severe worsening sepsis due to uncontrollable foot infection. In both these patients' stents were patent at the time of amputation. Primary patency was 92.3% at 6 months and at 1 year. None of the patients required re-intervention. Mortality was 15.3% at 1 year. Conclusion: Off-label use of cardiac stents in the infra-popliteal segment seems a viable bailout option in patients undergoing revascularization. DES helps to achieve early technical success, longer patency, better wound healing, and improves limb salvage in these patients.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"208 3","pages":"92 - 97"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41311281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_6_23
M. Hassani, Binazir Khanabadi, M. Tavallaei, M. Mehdizadeh, Farzad Abadi, Fatemeh Sadat Mirabootalebi
Background: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected many patients worldwide. Infection with this virus appears to be associated with a high risk of macrovascular complications. Methods: In this descriptive study, we examined the clinical and demographic information of 67 patients in whom COVID-19 was confirmed in terms of vascular complications. Results: The results of this study showed that 65.6% of COVID-19 patients had venous complications and 34.4% had arterial complications. In the patients who had more severe symptoms caused by COVID-19 such as fever, cough, sore throat, nausea and vomiting, diarrhea, anorexia, shortness of breath, joint pain, and fatigue, they had more severe venous complications. Conclusions: Better and more accurate understanding of the pathophysiological mechanisms causing severe disease of COVID-19, as well as identifying the prevalence of macrovascular complications and possible disorders resulting from them in patients with COVID-19 in different ethnicities and populations to develop new treatment, is needed.
{"title":"Evaluation and identification of macrovascular complications in patients with COVID-19 – Original study","authors":"M. Hassani, Binazir Khanabadi, M. Tavallaei, M. Mehdizadeh, Farzad Abadi, Fatemeh Sadat Mirabootalebi","doi":"10.4103/ijves.ijves_6_23","DOIUrl":"https://doi.org/10.4103/ijves.ijves_6_23","url":null,"abstract":"Background: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected many patients worldwide. Infection with this virus appears to be associated with a high risk of macrovascular complications. Methods: In this descriptive study, we examined the clinical and demographic information of 67 patients in whom COVID-19 was confirmed in terms of vascular complications. Results: The results of this study showed that 65.6% of COVID-19 patients had venous complications and 34.4% had arterial complications. In the patients who had more severe symptoms caused by COVID-19 such as fever, cough, sore throat, nausea and vomiting, diarrhea, anorexia, shortness of breath, joint pain, and fatigue, they had more severe venous complications. Conclusions: Better and more accurate understanding of the pathophysiological mechanisms causing severe disease of COVID-19, as well as identifying the prevalence of macrovascular complications and possible disorders resulting from them in patients with COVID-19 in different ethnicities and populations to develop new treatment, is needed.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"109 - 112"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48036701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_82_22
Ashita Elizabeth Thomas, S. Desai, C. Ramswamy
Background: Hemodialysis patients require a vascular access that is both reliable and long lasting. Several variables, including population changes and comorbidities, have impacted patency rates. This study analyzes multiple parameters and estimates the patency rates and complications of brachioaxillary arteriovenous (AV) prosthetic grafts used for dialysis access in a single center. Materials and Methods: This was a prospective single-center study conducted at the Ramaiah Medical College Hospital in Bengaluru. This study comprised 92 patients with chronic renal failure who had brachioaxillary AV prosthetic graft surgery for dialysis access between 2018 and 2022. We monitored cases for up to 2 years for complications, and the primary and secondary graft patency rates were reported. Results: Seventy-five percent of the participants were male, with a mean age of 60. Diseases including hypertension (72.9% prevalence), diabetes (38.2%), and coronary artery disease (20.7% prevalence) were also very common. The present investigation found that thrombosis was the most frequent problem, followed by stenosis. In this study, the primary graft patency rates after 1 year and 2 years were 60.5% and 48%, respectively, whereas the secondary graft patency rates at 1 year and 2 years were 69% and 58%, respectively. Conclusion: The outcomes of this study regarding graft patency and complication rates compare favorably with other published data. Therefore, the authors consider brachioaxillary AV to be the optimal HD route when no acceptable forearm veins are available for creating AV fistulas.
{"title":"Arteriovenous grafts: Still a viable option? A 5-year study","authors":"Ashita Elizabeth Thomas, S. Desai, C. Ramswamy","doi":"10.4103/ijves.ijves_82_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_82_22","url":null,"abstract":"Background: Hemodialysis patients require a vascular access that is both reliable and long lasting. Several variables, including population changes and comorbidities, have impacted patency rates. This study analyzes multiple parameters and estimates the patency rates and complications of brachioaxillary arteriovenous (AV) prosthetic grafts used for dialysis access in a single center. Materials and Methods: This was a prospective single-center study conducted at the Ramaiah Medical College Hospital in Bengaluru. This study comprised 92 patients with chronic renal failure who had brachioaxillary AV prosthetic graft surgery for dialysis access between 2018 and 2022. We monitored cases for up to 2 years for complications, and the primary and secondary graft patency rates were reported. Results: Seventy-five percent of the participants were male, with a mean age of 60. Diseases including hypertension (72.9% prevalence), diabetes (38.2%), and coronary artery disease (20.7% prevalence) were also very common. The present investigation found that thrombosis was the most frequent problem, followed by stenosis. In this study, the primary graft patency rates after 1 year and 2 years were 60.5% and 48%, respectively, whereas the secondary graft patency rates at 1 year and 2 years were 69% and 58%, respectively. Conclusion: The outcomes of this study regarding graft patency and complication rates compare favorably with other published data. Therefore, the authors consider brachioaxillary AV to be the optimal HD route when no acceptable forearm veins are available for creating AV fistulas.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"87 - 91"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45021645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_24_23
Devender Singh, M. Praveena, S. Aryala
{"title":"Origin of carotid endarterectomy: The contribution, claims, and credits","authors":"Devender Singh, M. Praveena, S. Aryala","doi":"10.4103/ijves.ijves_24_23","DOIUrl":"https://doi.org/10.4103/ijves.ijves_24_23","url":null,"abstract":"","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"140 - 141"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45134013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_69_22
Neelamjingbha Sun, A. Pandey, Sriram Manchikanti, Aditya Gupta, Shivanesan Pitchai
Autogenous AV access are preferred in all CKD patients due to good patency rates and lower risks of infection. Radiocephalic fistulas (RCF) are the first preferred access, but most patients have diseased and small diameter radial arteries. We would like to describe a technique of creating a forearm loop fistula, utilising a good forearm vein in patients with diseased radial arteries and failed RCF.
{"title":"Operative technique of autogenous forearm loop fistula","authors":"Neelamjingbha Sun, A. Pandey, Sriram Manchikanti, Aditya Gupta, Shivanesan Pitchai","doi":"10.4103/ijves.ijves_69_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_69_22","url":null,"abstract":"Autogenous AV access are preferred in all CKD patients due to good patency rates and lower risks of infection. Radiocephalic fistulas (RCF) are the first preferred access, but most patients have diseased and small diameter radial arteries. We would like to describe a technique of creating a forearm loop fistula, utilising a good forearm vein in patients with diseased radial arteries and failed RCF.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"142 - 144"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41656116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_52_22
Gagandeep Reddy Komatreddy, P. Venkat
Neurological deficits with peripheral venous aneurysm are extremely rare. We report this rare event in an elderly female presenting with difficulty in walk for 2 months, a swelling in the right popliteal fossa, and inability to dorsiflex the right foot. She was successfully managed with surgical intervention.
{"title":"An intriguing case of popliteal vein aneurysm presenting as foot drop","authors":"Gagandeep Reddy Komatreddy, P. Venkat","doi":"10.4103/ijves.ijves_52_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_52_22","url":null,"abstract":"Neurological deficits with peripheral venous aneurysm are extremely rare. We report this rare event in an elderly female presenting with difficulty in walk for 2 months, a swelling in the right popliteal fossa, and inability to dorsiflex the right foot. She was successfully managed with surgical intervention.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"158 - 160"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49015819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_24_22
Srikanth Raju Siddpuram
The aberrant splenic artery arising from the superior mesenteric artery is a rare anomaly, and patients presenting with an aneurysm of the aberrant splenic artery are extremely rare. The rupture of such aneurysms (>2 cm) is a catastrophic event. We have conducted extensive research on electronic media through the MEDLINE database on the management of saccular aneurysm of the aberrant splenic artery. We could find only 38 cases reported in the English literature since 1966–2020. We report one such case which was managed successfully through endovascular management after proper preoperative planning and intraoperative execution leading to a successful outcome.
{"title":"Review article on endovascular management of saccular aneurysm of the aberrant splenic artery: A rare entity","authors":"Srikanth Raju Siddpuram","doi":"10.4103/ijves.ijves_24_22","DOIUrl":"https://doi.org/10.4103/ijves.ijves_24_22","url":null,"abstract":"The aberrant splenic artery arising from the superior mesenteric artery is a rare anomaly, and patients presenting with an aneurysm of the aberrant splenic artery are extremely rare. The rupture of such aneurysms (>2 cm) is a catastrophic event. We have conducted extensive research on electronic media through the MEDLINE database on the management of saccular aneurysm of the aberrant splenic artery. We could find only 38 cases reported in the English literature since 1966–2020. We report one such case which was managed successfully through endovascular management after proper preoperative planning and intraoperative execution leading to a successful outcome.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"82 - 86"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46453306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/ijves.ijves_14_23
K. Rajapaksha
Introduction: Can the tandem arrangement of operating theater setup to perform a surgical drill similar to military, together with safe reuse of single-use items combat the cost of consumables of endovenous laser ablation (EVLA)? Methods: Operation pathway of EVLA consisted of cleaning and draping of patient (step 1), access to the affected vein and infiltration of tumescent local anesthesia (step 2), endovenous ablation (step 3), ultrasound-guided microfoam sclerotherapy (step 4), and chemical sterilization of consumables (step 5). Dedicated theater lists for EVLA were arranged to treat several patients per session in a prearranged operating theater. When the step 5 is completed on the first patient, the step 1 on the next patient was performed using sterilized optical fiber (OF) as a cycle while minimizing patient changeover time. Number of patients treated with each session of OF and time taken for step 1 to step 4 was recorded and analyzed. Results: A total of 140 patients treated using eight OFs during December 2019 to December 2022. Average number of patients treated with a single OF and during a single session of fiber is 17.5 (9–23) and 4.2 (3–7), respectively. Average time taken for step 1 was 7.83 min, step 2 was 7.95 min, step 3 was 1.57 min, and step 4 was 6.36 min. All the procedures were performed using four chemically re-sterilized guidewires and introducer sheaths. Conclusion: Tandem arrangement of operating theater to perform EVLA procedure similar to military drill can optimize the utilization of OFs and consumables.
{"title":"Drill from military to operating theater and safe reuse of single-use items to combat the cost of optical fibers and consumables in endovenous laser ablation of varicose veins","authors":"K. Rajapaksha","doi":"10.4103/ijves.ijves_14_23","DOIUrl":"https://doi.org/10.4103/ijves.ijves_14_23","url":null,"abstract":"Introduction: Can the tandem arrangement of operating theater setup to perform a surgical drill similar to military, together with safe reuse of single-use items combat the cost of consumables of endovenous laser ablation (EVLA)? Methods: Operation pathway of EVLA consisted of cleaning and draping of patient (step 1), access to the affected vein and infiltration of tumescent local anesthesia (step 2), endovenous ablation (step 3), ultrasound-guided microfoam sclerotherapy (step 4), and chemical sterilization of consumables (step 5). Dedicated theater lists for EVLA were arranged to treat several patients per session in a prearranged operating theater. When the step 5 is completed on the first patient, the step 1 on the next patient was performed using sterilized optical fiber (OF) as a cycle while minimizing patient changeover time. Number of patients treated with each session of OF and time taken for step 1 to step 4 was recorded and analyzed. Results: A total of 140 patients treated using eight OFs during December 2019 to December 2022. Average number of patients treated with a single OF and during a single session of fiber is 17.5 (9–23) and 4.2 (3–7), respectively. Average time taken for step 1 was 7.83 min, step 2 was 7.95 min, step 3 was 1.57 min, and step 4 was 6.36 min. All the procedures were performed using four chemically re-sterilized guidewires and introducer sheaths. Conclusion: Tandem arrangement of operating theater to perform EVLA procedure similar to military drill can optimize the utilization of OFs and consumables.","PeriodicalId":13375,"journal":{"name":"Indian Journal of Vascular and Endovascular Surgery","volume":"10 1","pages":"113 - 117"},"PeriodicalIF":0.1,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45194373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：