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Indian Journal of Vascular and Endovascular Surgery最新文献

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Review article on endovascular management of saccular aneurysm of the aberrant splenic artery: A rare entity 异常脾动脉囊状动脉瘤的血管内治疗:一种罕见的病例
IF 0.1 Pub Date : 2023-04-01 DOI: 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.
异常脾动脉起源于肠系膜上动脉是一种罕见的异常,而表现为异常脾动脉动脉瘤的患者极为罕见。这种动脉瘤的破裂(直径约2厘米)是一个灾难性的事件。我们通过MEDLINE数据库在电子媒体上对异常脾动脉囊状动脉瘤的治疗进行了广泛的研究。从1966年到2020年,我们在英国文献中只发现了38例报告。我们报告一例这样的病例,经过适当的术前计划和术中执行,通过血管内管理成功地获得了成功的结果。
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引用次数: 0
A slice in the right direction – Novel use of directional atherectomy for treatment of upper limb vascular insufficiency and concurrent diagnosis 正确方向的切片-定向动脉粥样硬化切除术治疗上肢血管功能不全及并发诊断的新应用
IF 0.1 Pub Date : 2023-04-01 DOI: 10.4103/ijves.ijves_43_22
Animesh Singla, Y. Cai, Krishna Kotecha, T. Baillie, Daniel Nguyen
Large-vessel vasculitides are well-recognized entities, affecting the aorta, supra-aortic branch vessels, cranial vessels, and less commonly, peripheral arteries. Giant cell arteritis (GCA) is one of the most frequent large-vessel vasculitides affecting elderly patients. Despite diagnostic criteria, the mainstay of definitive diagnosis has been temporal artery biopsies. More recently, adjuvant ultrasound has been used to identify skip lesions before the biopsy. Downstream ischemia affecting branch vessels has traditionally been managed by open revascularization due to patient age and risk of disease recurrence. Experience with endovascular strategies for the management of acute or chronic vasculitides has been steadily increasing. We present an unusual case of acute giant cell vasculitis, diagnosed and treated with the use of an endovascular atherectomy device. The patient was a 74-year-old woman, with prior history of polymyalgia rheumatica, long-standing immunosuppression, and new onset of significant left arm claudication and rest pain. She underwent treatment for a high-grade left axillary artery lesion with directional atherectomy and drug-coated angioplasty. She had a good angiographic result. The intraoperative atherectomy specimen revealed the presence of acute GCA which prompted treatment with an acute vasculitis regimen. She had good patency of the treated segment at 3-month follow-up with complete resolution of her symptoms.
大血管血管炎是公认的实体,影响主动脉、主动脉上支血管、颅内血管,以及不太常见的外周动脉。巨细胞动脉炎(GCA)是影响老年患者最常见的大血管血管炎之一。尽管有诊断标准,但最终诊断的支柱是颞动脉活检。最近,辅助超声已被用于在活检前识别跳过的病变。由于患者年龄和疾病复发的风险,影响分支血管的下游缺血传统上通过开放式血运重建来管理。血管内策略治疗急性或慢性血管炎的经验一直在稳步增加。我们报告了一个不寻常的急性巨细胞血管炎病例,使用血管内斑块切除装置进行诊断和治疗。患者是一名74岁的女性,既往有风湿性多肌痛病史,长期免疫抑制,新发的严重左臂跛行和休息疼痛。她接受了高级别左腋动脉病变的定向腔内斑块切除术和药物涂层血管成形术的治疗。她的血管造影结果很好。术中斑块切除标本显示存在急性GCA,这促使采用急性血管炎方案进行治疗。在3个月的随访中,她治疗段的通畅性良好,症状完全缓解。
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引用次数: 0
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 从军事演习到手术室,一次性物品的安全重复使用,以降低静脉曲张激光消融中光纤和耗材的成本
IF 0.1 Pub Date : 2023-04-01 DOI: 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.
引言:将手术室设置为进行类似于军事的外科演习,再加上一次性物品的安全重复使用,能否降低静脉内激光消融(EVLA)耗材的成本?方法:EVLA的手术路径包括患者的清洁和覆盖(步骤1)、进入受影响的静脉和肿胀局部麻醉浸润(步骤2)、静脉内消融(步骤3)、超声引导的微泡沫硬化治疗(步骤4)和耗材的化学灭菌(步骤5)。EVLA的专用手术室名单被安排在预先安排的手术室中,每次治疗几名患者。当对第一个患者完成步骤5时,对下一个患者使用无菌光纤(OF)作为循环执行步骤1,同时最小化患者转换时间。记录并分析每次of治疗的患者数量以及步骤1至步骤4所花费的时间。结果:在2019年12月至2022年12月期间,共有140名患者使用8种OFs进行治疗。接受单次of和单次纤维治疗的患者平均人数分别为17.5(9-23)和4.2(3-7)。第1步平均耗时7.83分钟,第2步平均耗时7.95分钟,第3步平均耗时1.57分钟,第4步平均耗时6.36分钟。所有手术均使用四根化学重新灭菌的导丝和鞘管进行。结论:将手术室串联起来进行类似于军事演习的EVLA手术,可以优化OFs和耗材的利用。
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引用次数: 0
Endovascular treatment of superficial femoral artery ostial occlusions and outcomes of unexpected postprocedural deep femoral artery occlusion 股浅动脉口闭塞的血管内治疗及术后意外股深动脉闭塞的结果
IF 0.1 Pub Date : 2023-01-01 DOI: 10.4103/ijves.ijves_96_22
Behlul Igus, A. Firat
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引用次数: 0
Origin and Evolution of Sclerotherapy for Varicose Veins 静脉曲张硬化疗法的起源与发展
Pub Date : 2023-01-01 DOI: 10.4103/ijves.ijves_82_23
M K Ayyappan, Jithin Jagan Sebastian
Sclerotherapy is a simple and common method used to treat telangiectasia, reticular veins, and varicose veins, especially when no other option is available. It has become a part of primary and secondary treatments offered for varicose veins. It has several alternate uses in vascular surgery (malformations), as well as being commonly used in other disciplines such as dermatology due to its simplicity and efficacy. It has a quick learning curve, is easily practiced, and has thus undergone several historical modifications by several authors. There are two main events which led to the development of modern-day sclerotherapy. The first important aspect of the technique is gaining intravenous access. The invention required for this is a syringe, hence most progress in sclerotherapy came after and alongside designs and improvements made to syringes. The second problem encountered was a high rate of complication due to the nature of early sclerosants used and a poor understanding of their mechanisms of action in varicose veins. This paved the way for phlebologists experimenting with several different substances and describing safety techniques which eventually led to modern-day safe sclerotherapy. The first methods of intravenous access were rudimentary. Sir Christopher Wren and Robert Boyle in 1656 used a goose quill attached to an animal bladder as the first syringe.[1] This allowed them to perform the first intravenous access in a dog. The experiment consisted of using this device to inject wine and alcohol into the leg vein of a dog and success was noted when the dog was found to be drunk. The syringe used was primitive but served its purpose and was presented in the first meetings of the Royal Society of London.[2] This apparatus was modified and used by Johann Sigismund Elsholtz who administered the first injection of sclerotherapy in 1665. Elsholtz was a state physician to Frederick William of Brandenburg, the Duke of Prussia (Germany before the First World War), which gave him an opportunity to experiment and write extensively.[3] One of these experiments, documented in the “Clysmatica Nova” in 1665 in Berlin, describes the first use of sclerotherapy [Figure 1].[4] Elsholtz was a botanist and the sclerosant he used was a plant alkaloid which he injected into the leg vein of the duke’s bodyguard who had a venous ulcer. The puncture was carried out by open access to the vein with a lancet, along with proximal compression to enlarge the vein, making it easy to observe and cannulate.[4] The needle used was a hollowed out chicken bone fitted with a pigeon’s bladder as a syringe. Although the instrument used was archaic, this was the first successfully recorded attempt at sclerotherapy.[5] Elsholtz intention at the time was to find different uses of a clyster (enema syringe) and unintentionally used it in a patient with a venous ulcer to perform the first recorded sclerotherapy.[4] The outcome was never reported.Figure 1: Picture demonstrating the firs
硬化疗法是治疗毛细血管扩张、网状静脉和静脉曲张的一种简单而常用的方法,特别是在没有其他选择的情况下。它已经成为静脉曲张初级和二级治疗的一部分。它在血管外科(畸形)中有几种替代用途,并且由于其简单和有效,通常用于其他学科,如皮肤病学。它有一个快速的学习曲线,很容易实践,因此经历了几个作者的几次历史修改。有两个主要事件导致了现代硬化症疗法的发展。这项技术的第一个重要方面是获得静脉注射。为此所需要的发明是一种注射器,因此硬化疗法的大多数进展都是在注射器的设计和改进之后出现的。遇到的第二个问题是由于早期使用的硬化剂的性质以及对其在静脉曲张中的作用机制的了解不足,并发症的发生率很高。这为血液学家试验几种不同的物质和描述安全技术铺平了道路,最终导致了现代安全的硬化疗法。最初的静脉注射方法还很简陋。克里斯托弗·雷恩爵士和罗伯特·波义耳在1656年使用了一根连接在动物膀胱上的鹅毛笔作为第一个注射器。[1]这使他们能够在狗身上进行第一次静脉注射。实验包括使用这个装置将酒和酒精注射到狗的腿部静脉中,当发现狗喝醉时,就说明成功了。使用的注射器很原始,但却达到了它的目的,并在伦敦皇家学会的第一次会议上提出。[2]1665年,约翰·西吉斯蒙德·埃尔肖尔兹(Johann Sigismund Elsholtz)进行了第一次硬化症治疗注射,并对该装置进行了改进和使用。埃尔肖尔茨是普鲁士公爵勃兰登堡的弗雷德里克·威廉(一战前的德国)的御医,这给了他一个实验和广泛写作的机会。[3]其中一项实验记录在1665年柏林的“Clysmatica Nova”中,描述了第一次使用硬化疗法[图1]。[4]埃尔肖尔兹是一名植物学家,他使用的硬化剂是一种植物生物碱,他将这种硬化剂注射到公爵患有静脉溃疡的保镖的腿部静脉中。穿刺是通过用刺胳针打开静脉进行的,同时近端压迫以扩大静脉,使其易于观察和插管。[4]使用的针头是一根挖空的鸡骨头,配以鸽子的膀胱作为注射器。虽然使用的仪器是古老的,但这是第一次成功记录硬化症治疗的尝试。[5]Elsholtz当时的意图是寻找灌肠注射器的不同用途,并无意中将其用于静脉溃疡患者进行第一次有记录的硬化治疗。[4]结果从未被报道过。图1:1665年柏林“Clysmatica Nova”中的Sigismund Johann Elsholtz首次将硬化疗法应用于腿部和手臂静脉的图片[2]据说瑞士的Daniel Zollikofer在1682年向静脉注射了一种酸,但在这方面没有找到支持的证据[6]。尽管这些最初的无意尝试,硬化疗法只有在现代注射器的发明和对静脉曲张背后病理的理解取得进展后才进一步发展。约瑟夫·霍奇森(Joseph Hodgson, 1815年)在《关于动脉和静脉疾病的论文》(a treatise on The diseases of动脉和静脉疾病)中首次提出了对硬化疗法如何起作用的理解。他的理论是浅表静脉血栓形成,临床观察为大隐静脉血栓性静脉炎,导致静脉曲张得到治疗。[5]这种认识导致用硬化疗法来治疗静脉曲张,而不是早期通过放血来减压血栓形成的浅静脉。[7]1835年,亚历山大·伍德(爱丁堡)和查尔斯·加布里埃尔·普拉瓦兹(里昂)分别发明了现代注射器。他们使用不同类型的材料来制造注射器。虽然伍德用他的发明注射吗啡来治疗神经痛,但普拉瓦兹用注射器先将硬化剂(氯化铁)注射到动脉中,然后注射到静脉中,试图阻塞它们以缓解症状。[8]这与对血栓形成治疗静脉曲张的理解一起导致了硬化疗法的广泛使用,特别是在里昂和巴黎。当时,这种新疗法在法国非常流行。Petrequin, Soquet, Desgranges, Valette, Barrier和Guillermand使用不同的硬化剂(氯化铁,碘单宁和醋酸)试图阻塞静脉,据报道其中一种比另一种更好。
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引用次数: 0
Is Patient Care Losing its Personal Touch? Exploring the Paradigm Shift in Health-care Systems 病人护理正在失去人性化?探索卫生保健系统的范式转变
Pub Date : 2023-01-01 DOI: 10.4103/ijves.ijves_67_23
Edwin Stephen, Darpanarayan Hazra
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引用次数: 0
Anthology-15 Anthology-15
Pub Date : 2023-01-01 DOI: 10.4103/0972-0820.388301
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引用次数: 0
Self-evaluation of manuscript according to reporting guidelines 根据报告准则对稿件进行自我评价
IF 0.1 Pub Date : 2023-01-01 DOI: 10.4103/ijves.ijves_9_23
Himel Mondal, Shaikat Mondal
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引用次数: 0
Carotid body tumor presentation, management, and outcome an institutional experience – 12-year experience 颈动脉体肿瘤的表现、处理和结果:一个机构经验- 12年的经验
IF 0.1 Pub Date : 2023-01-01 DOI: 10.4103/ijves.ijves_85_22
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引用次数: 0
Indian VenaSeal™ experience study extension: outcomes of nonthermal, nontumescent endovenous ablation (VenaSeal™) for the treatment of truncal reflux in varicose vein disease – An Indian perspective with 2-year follow-up 印度VenaSeal™经验研究扩展:非热、非肿胀静脉内消融(VenaSeal™)治疗静脉曲张疾病的截尾反流的结果——印度2年随访的视角
IF 0.1 Pub Date : 2023-01-01 DOI: 10.4103/ijves.ijves_86_22
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引用次数: 0
期刊
Indian Journal of Vascular and Endovascular Surgery
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