Endovascular Repair of Inflammatory Abdominal Aortic Aneurysms with Special Reference to Concomitant Ureteric Obstruction

AbstractObjectives: to study the technical feasibility and results of endovascular treatment of inflammatory abdominal aortic aneurysms (AAA).Design: prospective study.Material and methods: seven patients underwent endovascular repair of an inflammatory AAA. Five patients (8 ureters) were treated with ureteric stents CT scans were obtained one year.Results: the early technical success rate was 100%. Four ureters remained entrapped at one year. Partial regression of periaortic fibrosis was documented in three patients, while four patients showed no regression.Conclusion: endovascular reconstruction of inflammatory abdominal aneurysms is technically feasible. Further study is warranted with regard to the evolution of the periaortic fibrosis and the possible benefits for patients with concomitant hydronephrosis

The Outcome of the Axillofemoral Bypass: A Retrospective Analysis of 45 Patients

Purpose This study was designed to retrospectively analyze outcomes of axillofemoral bypass (AxFB) operations performed in patients with severe comorbidities. Methods All patients (n = 45) who received an AxFB between 1990 and 2005 for aortoiliac occlusive disease (AIOD, n = 35) or infectious aortic disease (IAD, n = 10) were included. Information on patency of the bypass and mortality was retrieved from patient records. A Kaplan-Meier survival analysis was performed to illustrate survival rates, limb salvage, and primary and secondary patency. Results Included patients had several comorbidities and a high operative risk. In this group, a 30-day mortality rate of 20% was found: 17% for the AIOD group, and 30% for the IAD group. During 5-year follow-up 20 patients died, of which 15 during the first year after operation. Survival rates were at 64 and 41% at 1 and 5 years and limb salvage rates were 84% for both these years. Primary patency rates at 1 and 5 years were 72 and 58%, respectively, and secondary patency rates were 86% at both time points. Conclusions High mortality rates were found in AIOD or IAD patients who received an AxFB. However, for high-risk patients with an already reduced life expectancy, the AxFB remains an alternative with acceptable patency rate

Inflammatory aneurysms: are they a good indication for endovascular reconstruction?

edition: 1ststatus: publishe

Nephrotoxic effects of thermal decomposition mixtures of type C hydraulic fluids.

A survey was conducted to check the toxicological impact of ethylene glycol present in a thermal decomposition mixture of type C hydraulic fluid on laboratory animals submitted to an inhalation test. The target organs, i.e. kidneys, of exposed rats were evaluated histologically and oxalic acid--the ethylene glycol metabolite thought to cause renal failure--was quantified in urine samples. The results show that the low ethylene glycol concentrations present in the inhalation chamber produce only a temporarily increased oxalic acid excretion, at levels that are not significant. These findings are supported by the histological evaluation of the kidneys showing no calcium oxalate deposits or other abnormalities

Long-term Results of Totally Laparoscopic Aortobifemoral Bypass

OBJECTIVES: The aim was to estimate the long-term results and patency rates of totally laparoscopic aortobifemoral bypass in aorto-iliac occlusive disease (AIOD). METHODS: All 87 patients who received a laparoscopic aortobifemoral bypass for AIOD on an intention to treat basis between October 2003 and October 2013 were identified. All operations were performed by the same surgical team using a totally laparoscopic technique. Demographic, pre-operative, peri-operative, and follow up variables were collected and analyzed. Patients were followed up at 1 month post-operatively and annually thereafter. Patency rates were calculated in accordance with published patency reporting standards. RESULTS: The median age was 57 years (range 40-78 years). The conversion rate was 20.6% overall. The thirty-day post-operative mortality was 1.1%. Six patients required early re-intervention. There were no graft infections. The median length hospital stay was 6 days (range 4-39 days). The mean follow up was 58.0 months (range 1-133 months). Graft limb based primary, primary assisted, and secondary patency rates were respectively 96.1%, 98.1% and 99.4% at 1 year, and 83.0%, 92.0% and 97.0% at 5 years. CONCLUSION: Totally laparoscopic aortobifemoral bypass is a safe alternative to open surgery in selected patients, with excellent long-term patency rates, albeit at the cost of a steep learning curve.status: publishe