1
|
Cortes C, Vierge E, Criado E, Martinez-Orgado J, Arruza L. Successful delivery room management of electromechanical dissociation and heart block: is electrocardiogram useless? Pediatr Res 2022; 91:1315-1316. [PMID: 35079112 DOI: 10.1038/s41390-022-01953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/04/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Cristina Cortes
- Division of Neonatology, Instituto del Niño y del Adolescente, Hospital Clinico San Carlos -IdISSC, Madrid, Spain
| | - Eva Vierge
- Division of Neonatology, Instituto del Niño y del Adolescente, Hospital Clinico San Carlos -IdISSC, Madrid, Spain
| | - Enrique Criado
- Division of Neonatology, Instituto del Niño y del Adolescente, Hospital Clinico San Carlos -IdISSC, Madrid, Spain
| | - Jose Martinez-Orgado
- Division of Neonatology, Instituto del Niño y del Adolescente, Hospital Clinico San Carlos -IdISSC, Madrid, Spain
| | - Luis Arruza
- Division of Neonatology, Instituto del Niño y del Adolescente, Hospital Clinico San Carlos -IdISSC, Madrid, Spain.
| |
Collapse
|
2
|
Marín Gabriel MA, Domingo Goneche L, Cuadrado Pérez I, Reyne Vergeli M, Forti Buratti A, Royuela Vicente A, Olabarrieta Arnal I, Sánchez L, Alonso Díaz C, Criado E, Carrizosa Molina T, Caserío Carbonero S, Casas Satre C, Fernández-Cañadas Morillo A. Baby Friendly Hospital Initiative Breastfeeding Outcomes in Mothers with COVID-19 Infection During the First Weeks of the Pandemic in Spain. J Hum Lact 2021; 37:639-648. [PMID: 34374323 DOI: 10.1177/08903344211039182] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Adherence to the Ten Steps of the Baby-Friendly Hospital Initiative has been shown to have a protective role for the initiation and maintenance of breastfeeding. RESEARCH AIMS (1) To determine the breastfeeding rate during the first 6 months of life in children of mothers diagnosed with COVID-19 infection at the time of birth; and (2) to assess the possible influence of being born in a center with Baby-Friendly Hospital Initiative accreditation. METHODS This was a two-group comparative longitudinal observational study of infants born to mothers with COVID-19 at the time of birth, between March 13-May 31, 2020 (the first wave of the pandemic) in Spain. Fourteen Spanish hospitals participated, five (35.7%) were Baby-Friendly Hospital Initiative accredited. Type of feeding was assessed prospectively at discharge, 1, 3, and 6 months of age. A total of 248 newborns were included in the study. RESULTS A total of 117 (47.3%) newborns were born in Baby-Friendly Hospital Initiative (BFHI) accredited centers. These centers applied skin-to-skin contact with greater probability (OR = 1.9; 95% CI [1.18, 3.29]) and separated the newborns from their mothers less frequently (OR = 0.46; 95% CI [0.26, 0.81]) than non-accredited centers. No differences were observed in relation to the presence of a companion at the time of birth. At discharge, 49.1% (n = 57) of newborns born in BFHI-accredited centers received exclusive breastfeeding versus 35.3% (n = 46) in non-accredited centers (p = .03). No differences were observed in breastfeeding rates throughout follow-up. CONCLUSIONS The exclusive breastfeeding rate at discharge in children of mothers with COVID-19 infection at birth was higher in Baby-Friendly Hospital Initiative accredited centers, which most frequently applied skin-to-skin contact at birth as well as rooming-in.
Collapse
Affiliation(s)
| | - Miguel A Marín Gabriel
- Deparment of Neonatology, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain. Pediatric Deparment Associate Professor, Autónoma University, Madrid, Spain
| | - Laura Domingo Goneche
- Deparment of Neonatology, Fuenlabrada University Hospital, Fuenlabrada, Madrid, Spain
| | | | - Mar Reyne Vergeli
- Deparment of Neonatology, Sant Joan de Deu University Hospital, Barcelona, Catalunya, Spain
| | - Azul Forti Buratti
- Deparment of Psychiatry, Puerta de Hierro-Majadahonda University Hospital, Majadahonda, Madrid, Spain
| | - Ana Royuela Vicente
- Biostatistics Unit, Puerta de Hierro Biomedical Research Institute, CIBERESP, Madrid, Spain
| | | | - Laura Sánchez
- Deparment of Neonatology, La Paz University Hospital, Madrid, Spain
| | - Clara Alonso Díaz
- Deparment of Neonatology, 12 de Octubre University Hospital, Madrid, Spain
| | - Enrique Criado
- Deparment of Neonatology, Clínico San Carlos University Hospital, Madrid, Spain
| | | | - Sonia Caserío Carbonero
- Deparment of Neonatology, Río Hortega University Hospital, Valladolid, Castilla y León, Spain
| | - Cristina Casas Satre
- Deparment of Neonatology, Josep Trueta University Hospital, Girona, Catalunya, Spain
| | | | | |
Collapse
|
3
|
Marín Gabriel MA, Cuadrado I, Álvarez Fernández B, González Carrasco E, Alonso Díaz C, Llana Martín I, Sánchez L, Olivas C, Heras S, Criado E, Carrizosa Molina T, Royuela Vicente A, Forti Buratti A, Palanca Maresca I, Dip ME, Martínez Bernat L, Fernández‐Cañadas Morillo A, Domingo Comeche L, Olza I, de Alba Romero C, Olabarrieta I, Caserío Carbonero S, Villar Villar G, Dacosta AI, Rivero I, Reyne M, del Río R, Casas C, Solé L. Multicentre Spanish study found no incidences of viral transmission in infants born to mothers with COVID-19. Acta Paediatr 2020; 109:2302-2308. [PMID: 32649784 PMCID: PMC7404522 DOI: 10.1111/apa.15474] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/18/2022]
Abstract
AIM Our aim was to describe the clinical features of mothers infected with COVID-19 and examine any potential vertical mother to newborn transmission. We also assessed how effective the discharge recommendations were in preventing transmission during the first month of life. METHODS This multicentre descriptive study involved 16 Spanish hospitals. We reviewed the medical records of 42 pregnant women diagnosed with COVID-19 from March 13, 2020, to March 29, 2020, when they were in their third trimester of pregnancy. They and their newborn infants were monitored until the infant was 1 month old. RESULTS Over half (52.4%) of the women had a vaginal delivery. The initial clinical symptoms were coughing (66.6%) and fever (59.5%), and one mother died due to thrombo-embolic events. We admitted 37 newborn infants to the neonatal unit (88%), and 28 were then admitted to intermediate care for organisational virus-related reasons. No infants died, and no vertical transmission was detected during hospitalisation or follow-up. Only six were exclusively breastfed at discharge. CONCLUSION There was no evidence of COVID-19 transmission in any of the infants born to COVID-19 mothers, and the post-discharge advice seemed effective. The measures to avoid transmission appeared to reduce exclusive breastfeeding at discharge.
Collapse
Affiliation(s)
- Miguel A. Marín Gabriel
- Department of Neonatology Puerta de Hierro‐Majadahonda University Hospital Madrid Spain
- Pediatric Department Autónoma University Madrid Spain
| | - Irene Cuadrado
- Department of Neonatology Getafe University Hospital Getafe Spain
| | | | | | - Clara Alonso Díaz
- Department of Neonatology 12 de Octubre University Hospital Madrid Spain
| | - Isabel Llana Martín
- Department of Neonatology HM Puerta del Sur University Hospital Móstoles Spain
| | - Laura Sánchez
- Department of Neonatology La Paz University Hospital Madrid Spain
| | - Cristina Olivas
- Department of Neonatology Príncipe de Asturias University Hospital Alcalá de Henares Spain
| | - Susana Heras
- Department of Neonatology Fuenlabrada University Hospital Madrid Spain
| | - Enrique Criado
- Department of Neonatology Clínico San Carlos University Hospital Madrid Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Martin T, Munuera CD, Fidalgo JS, Garcia D, Cancio-Villalonga D, Carasa P, Álvarez-Argüelles S, Cortes S, Miguel LGD, Criado E, Matthys L, Horcajadas JA, Munne S. AUTOMATED VITRIFICATION AND WARMING OF OOCYTES MEDIATED BY A NOVEL MICROFLUIDICS DEVICE. Fertil Steril 2020. [DOI: 10.1016/j.fertnstert.2020.08.463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
5
|
Guitart J, Teixidor M, Brun N, López S, Criado E, Romero N. Preoperative giant sacrococcygeal teratoma embolization in a newborn - A case report and a review. Cir Pediatr 2020; 33:95-98. [PMID: 32250074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Sacrococcygeal teratoma (SCT) is the most frequent congenital germ cell tumor. Patients have a higher risk of perinatal complications and death, with bleeding and cardiac decompensation being the most common causes of neonatal mortality. This is the case of a 35-week preterm newborn with a large SCT diagnosed at ultrasound screening in the second trimester. Preoperative selective embolization of the middle sacral artery and total surgical resection were performed postnatally with minimal blood loss. The patient was discharged at 25 days of life with a normal physical examination. Selective embolization prior to giant SCT resection is feasible and appears as a safe and useful technique in the control of perioperative bleeding.
Collapse
Affiliation(s)
- J Guitart
- Corporació Sanitària i Universitària Parc Taulí. Sabadell. Barcelona
| | - M Teixidor
- Corporació Sanitària i Universitària Parc Taulí. Sabadell. Barcelona
| | - N Brun
- Corporació Sanitària i Universitària Parc Taulí. Sabadell. Barcelona
| | - S López
- Corporació Sanitària i Universitària Parc Taulí. Sabadell. Barcelona
| | - E Criado
- Corporació Sanitària i Universitària Parc Taulí. Sabadell. Barcelona
| | - N Romero
- Corporació Sanitària i Universitària Parc Taulí. Sabadell. Barcelona
| |
Collapse
|
6
|
Barata L, Arruza L, Rodríguez MJ, Aleo E, Vierge E, Criado E, Sobrino E, Vargas C, Ceprián M, Gutiérrez-Rodríguez A, Hind W, Martínez-Orgado J. Neuroprotection by cannabidiol and hypothermia in a piglet model of newborn hypoxic-ischemic brain damage. Neuropharmacology 2018; 146:1-11. [PMID: 30468796 DOI: 10.1016/j.neuropharm.2018.11.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 10/31/2018] [Accepted: 11/13/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Hypothermia, the gold standard after a hypoxic-ischemic insult, is not beneficial in all treated newborns. Cannabidiol is neuroprotective in animal models of newborn hypoxic-ischemic encephalopathy. This study compared the relative efficacies of cannabidiol and hypothermia in newborn hypoxic-ischemic piglets and assessed whether addition of cannabidiol augments hypothermic neuroprotection. METHODS One day-old HI (carotid clamp and FiO2 10% for 20 min) piglets were randomized to vehicle or cannabidiol 1 mg/kg i.v. u.i.d. for three doses after being submitted to normothermia or 48 h-long hypothermia with a subsequent rewarming period of 6 h. Non-manipulated piglets (naïve) served as controls. Hemodynamic or respiratory parameters as well as brain activity (aEEG amplitude) were monitored throughout the experiment. Following termination, brains were obtained for histological (TUNEL staining, apoptosis; immunohistochemistry for Iba-1, microglia), biochemical (protein carbonylation, oxidative stress; and TNFα concentration, neuroinflammation) or proton magnetic resonance spectroscopy (Lac/NAA: metabolic derangement; Glu/NAA: excitotoxicity). RESULTS HI led to sustained depressed brain activity and increased microglial activation, which was significantly improved by cannabidiol alone or with hypothermia but not by hypothermia alone. Hypoxic-ischemic-induced increases in Lac/NAA, Glu/NAA, TNFα or apoptosis were not reversed by either hypothermia or cannabidiol alone, but combination of the therapies did. No treatment modified the effects of HI on oxidative stress or astroglial activation. Cannabidiol treatment was well tolerated. CONCLUSIONS cannabidiol administration after hypoxia-ischemia in piglets offers some neuroprotective effects but the combination of cannabidiol and hypothermia shows some additive effect leading to more complete neuroprotection than cannabidiol or hypothermia alone.
Collapse
Affiliation(s)
- Lorena Barata
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Instituto de Investigación Puerta de Hierro Majadahonda, Spain
| | - Luis Arruza
- Servicio de Neonatología, Hospital Clínico San Carlos - IdISSC, Madrid, Spain
| | | | - Esther Aleo
- Servicio de Neonatología, Hospital Clínico San Carlos - IdISSC, Madrid, Spain
| | - Eva Vierge
- Servicio de Neonatología, Hospital Clínico San Carlos - IdISSC, Madrid, Spain
| | - Enrique Criado
- Servicio de Neonatología, Hospital Clínico San Carlos - IdISSC, Madrid, Spain
| | - Elena Sobrino
- Instituto de Investigación Puerta de Hierro Majadahonda, Spain
| | - Carlos Vargas
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain
| | - María Ceprián
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Departamento de Bioquímica y Biología Molecular, CIBERNED, IRICYS. Facultad de Medicina, Universidad Complutense de Madrid, Spain
| | | | | | - José Martínez-Orgado
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Madrid, Spain; Servicio de Neonatología, Hospital Clínico San Carlos - IdISSC, Madrid, Spain.
| |
Collapse
|
7
|
Iglesias B, Rodrí Guez MAJ, Aleo E, Criado E, Martí Nez-Orgado J, Arruza L. 3-lead electrocardiogram is more reliable than pulse oximetry to detect bradycardia during stabilisation at birth of very preterm infants. Arch Dis Child Fetal Neonatal Ed 2018; 103:F233-F237. [PMID: 28667190 DOI: 10.1136/archdischild-2016-311492] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 05/22/2017] [Accepted: 06/02/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Current neonatal resuscitation guidelines suggest the use of ECG in the delivery room (DR) to assess heart rate (HR). However, reliability of ECG compared with pulse oximetry (PO) in a situation of bradycardia has not been specifically investigated. The objective of the present study was to compare HR monitoring using ECG or PO in a situation of bradycardia (HR <100 beats per minute (bpm)) during preterm stabilisation in the DR. STUDY DESIGN Video recordings of resuscitations of infants <32 weeks of gestation were reviewed. HR readings in a situation of bradycardia (<100 bpm) at any moment during stabilisation were registered with both devices every 5 s from birth. RESULTS A total of 29 episodes of bradycardia registered by the ECG in 39 video recordings were included in the analysis (n=29). PO did not detect the start of these events in 20 cases (69%). PO detected the start and the end of bradycardia later than the ECG (median (IQR): 5 s (0-10) and 5 s (0-7.5), respectively). A decline in PO accuracy was observed as bradycardia progressed so that by the end of the episode PO offered significantly lower HR readings than ECG. CONCLUSIONS PO detects the start and recovery of bradycardia events slower and less accurately than ECG during stabilisation at birth of very preterm infants. ECG use in this scenario may contribute to an earlier initiation of resuscitation manoeuvres and to avoid unnecessary prolongation of resuscitation efforts after recovery.
Collapse
Affiliation(s)
- Beatriz Iglesias
- Division of Neonatology, Instituto del Niño y del Adolescente, Madrid, Spain
| | | | - Esther Aleo
- Division of Neonatology, Instituto del Niño y del Adolescente, Madrid, Spain
| | - Enrique Criado
- Division of Neonatology, Instituto del Niño y del Adolescente, Madrid, Spain
| | | | - Luis Arruza
- Division of Neonatology, Instituto del Niño y del Adolescente, Madrid, Spain
| |
Collapse
|
8
|
Ibeas J, Abreu R, Vallespin J, Alguersuari A, Merino J, Rodriguez-Jornet A, Rioja S, Criado E, Vinuesa X, Iglesias R, Marcet M, Moya C. MP646EARLY FAILURE AND PATENCY IN HEMODIALYSIS FISTULAS: PROGNOSTIC FACTORS. Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx178.mp646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
9
|
Malas MB, Leal J, Kashyap V, Cambria RP, Kwolek CJ, Criado E. Technical aspects of transcarotid artery revascularization using the ENROUTE transcarotid neuroprotection and stent system. J Vasc Surg 2017; 65:916-920. [DOI: 10.1016/j.jvs.2016.11.042] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/21/2016] [Indexed: 10/20/2022]
|
10
|
Eliason JL, Coleman DM, Criado E, Stanley JC. Surgical treatment of abdominal aortic aneurysms in infancy and early childhood. J Vasc Surg 2016; 64:1252-1261. [DOI: 10.1016/j.jvs.2016.04.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/14/2016] [Indexed: 10/21/2022]
|
11
|
Alguersuari A, Mateos A, Falcó J, Criado E, Fortuño J, Guitart J. Percutaneous radiofrequency ablation of renal tumors in high-risk patients: 10 years’ experience. Radiología (English Edition) 2016. [DOI: 10.1016/j.rxeng.2016.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
12
|
Mehta M, Kashyap V, Malas M, Paty P, Cambria R, Kwolek C, Shah R, Criado E, Molnar R. The ROADSTER Investigational Device Exemption Trial Leads to Food and Drug Administration Approval of the First Stent Labeled for Trans-Carotid Artery Revascularization. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
13
|
Abstract
Purpose: Endovascular exclusion of arterial injuries associated with arteriovenous fistulas and pseudoaneurysms has only recently been described using various stent-graft prostheses. This report details a transbrachial technique used to exclude an axillary artery pseudoaneurysm developing at the axillary anastomosis of an axillofemoral graft. Methods and Results: Thin-walled polytetrafluoroethylene was expanded with an angioplasty balloon catheter and used to cover standard Palmaz stents. Two covered stents were delivered under fluoroscopic guidance via open brachial artery access to the site, resulting in complete exclusion of the pseudoaneurysm. Follow-up duplex scanning confirmed aneurysm exclusion 3 months postprocedure. Conclusions: This technique can be applied in arteries of different sizes and lengths, using currently available materials. However, the long-term behavior of these devices in the arterial tree must be determined before their widespread use can be recommended for most indications.
Collapse
Affiliation(s)
- William A. Marston
- Departments of Surgery and Radiology, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA
| | - Enrique Criado
- Departments of Surgery and Radiology, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA
| | - Matthew A. Mauro
- Departments of Surgery and Radiology, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA
| | - Blair A. Keagy
- Departments of Surgery and Radiology, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA
| |
Collapse
|
14
|
Fontcuberta J, Flores A, Langsfeld M, Orgaz A, Cuena R, Criado E, Doblas M. Screening Algorithm for Aortoiliac Occlusive Disease Using Duplex Ultrasonography–Acquired Velocity Spectra from the Distal External Iliac Artery. Vascular 2016; 13:164-72. [PMID: 15996374 DOI: 10.1258/rsmvasc.13.3.164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Aortoiliac duplex scanning can be difficult to perform owing to the deep location of these vessels. We propose a new method to indirectly screen for aortoiliac disease by performing duplex examination of the distal external iliac artery (DEIA). After performing a preliminary study on 21 patients, the parameters of the Doppler waveform that best distinguish normal from diseased arteries were the presence or absence of reverse flow, peak systolic velocity, and resistance index. These values were used in a derived equation, with the value Y ≥ 0.78 predicting normal proximal inflow. We then studied 118 aortoiliac segments in 81 consecutive patients with arteriography and DEIA duplex ultrasonography. To predict moderate to severe stenosis, duplex ultrasonography had a sensitivity of 95.7%, a specificity of 84.1%, a positive predictive value of 80%, and a negative predictive value of 96.8%. Our formula thus predicted significant disease in 55 of the 118 aortoiliac segments (47%), with these segments needing further arteriographic evaluation. The other 63 limbs can be safely considered as having normal aortoiliac inflow. Our method accurately screens for aortoiliac disease and is excellent for predicting normal inflow. This information can be used to better plan the intraoperative diagnostic study and intervention.
Collapse
Affiliation(s)
- Juan Fontcuberta
- Vascular Surgery Unit, Hospital Virgen de la Salud, Toledo, Spain.
| | | | | | | | | | | | | |
Collapse
|
15
|
Abstract
The haemodynamic approach for the treatment of varicose veins is a minimally invasive, non-ablative procedure that preserves the saphenous vein. The strategic principles for the implementation of this treatment include fragmentation of the venous pressure column, interruption of the venous segments where reflux originates, preservation of the superficial venous outflow channels to allow adequate drainage of the residual superficial system, and excision of the superficial varicose veins that remain undrained. This treatment modality requires a thorough understanding of the haemodynamic and anatomic rationale on which haemodynamic surgery is construed to tailor a treatment plan individually for each patient. The principles for the implementation of this strategy for the treatment of varicose veins are described here and the results are discussed.
Collapse
Affiliation(s)
- J Juan
- Hospital Vall d'Hebron, Barcelona, Spain
| | | | - E Criado
- Division of Vascular Surgery, Department of Surgery, Stony Brook University, New York, USA
| | | |
Collapse
|
16
|
Abstract
The treatment of varicose veins has traditionally been ablative in nature and implemented without intent to improve the haemodynamic condition of the lower extremity veins. Haemodynamic surgery attempts to treat varicose veins by changing the reflux pattern while preserving the most efficient venous drainage channels. To implement this treatment modality it is necessary to have a clear understanding of the physiologic principles and the different reflux patterns that form the basis of haemodynamic surgery. Haemodynamic surgery is an emerging treatment for varicose veins, and has received little attention in the English literature. The rationale, and functional and anatomic basis of haemodynamic surgery for varicose veins are herein described.
Collapse
|
17
|
Iglesias B, Rodríguez M, Aleo E, Criado E, Herranz G, Moro M, Martínez Orgado J, Arruza L. Pulsioximetría frente al monitor de electrocardiograma para la determinación de la frecuencia cardíaca durante la reanimación del recién nacido pretérmino. An Pediatr (Barc) 2016; 84:271-7. [DOI: 10.1016/j.anpedi.2015.08.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Revised: 08/05/2015] [Accepted: 08/14/2015] [Indexed: 11/28/2022] Open
|
18
|
Iglesias B, Rodríguez M, Aleo E, Criado E, Herranz G, Moro M, Martínez Orgado J, Arruza L. Pulse oximetry versus electrocardiogram for heart rate assessment during resuscitation of the preterm infant. An Pediatr (Barc) 2016. [DOI: 10.1016/j.anpede.2015.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
|
19
|
Criado E. Transthoracic Median Arcuate Ligament Release and Mesenteric Revascularization. Ann Vasc Surg 2016; 33:232-6. [PMID: 26965817 DOI: 10.1016/j.avsg.2016.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 02/25/2016] [Indexed: 11/17/2022]
Abstract
Surgical revascularization for chronic or acute mesenteric ischemia is often technically challenging. In many instances, because of the presence of hostile abdominal conditions or the lack of adequate intra-abdominal arterial inflow sources, alternative surgical approaches that avoid the abdomen and use a more proximal source of arterial inflow are necessary. In these situations, a bypass from the descending or ascending thoracic aorta to the mesenteric vessels may be the only viable option. However, the standard thoracoabdominal approach for mesenteric revascularization carries an extensive surgical insult, and in some situations, this approach does not obviate hostile abdominal pathology. We here describe a transthoracic surgical technique that allows antegrade celiac and mesenteric revascularization without a thoracoabdominal incision. This approach facilitates the easy transection of the median arcuate ligament of the diaphragm and, when needed, resection of the celiac autonomic ganglia. The transthoracic mesenteric revascularization is less invasive than a thoracoabdominal approach, whereas allowing a similar antegrade, short bypass to the mesenteric vessels from the descending thoracic aorta equal to that done through a thoracoabdominal exposure. This procedure provides a superb approach for the treatment of median arcuate ligament syndrome, and an excellent alternative for mesenteric revascularization when avoidance of the abdomen is advisable.
Collapse
Affiliation(s)
- Enrique Criado
- Vascular Surgery Service, Mid Michigan Health System, Midland, MI.
| |
Collapse
|
20
|
Monje A, Kramp AR, Criado E, Suárez-López Del Amo F, Garaicoa-Pazmiño C, Gargallo-Albiol J, Wang HL. Effect of periodontal dressing on non-surgical periodontal treatment outcomes: a systematic review. Int J Dent Hyg 2015; 14:161-7. [PMID: 25721470 DOI: 10.1111/idh.12130] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2014] [Indexed: 12/26/2022]
Abstract
BACKGROUND Periodontal dressing has been advocated and showed some positive outcomes for placing over the surgical site after periodontal surgery. However, little is known about its effect on non-surgical therapy. PURPOSE The aim of this review was to assess the clinical effect of periodontal dressing when used after non-surgical therapy. MATERIAL AND METHODS Two examiners performed an electronic search in several databases for relevant articles published in English up to November 2013. Selected studies were randomized human clinical trials (prospective or retrospective trials) with the clear aim of investigating the effect of periodontal dressing placement upon periodontal non-surgical mechanical therapy. Data were extracted from the included articles for analysis. RESULTS Three randomized clinical trials fulfilled the inclusion criteria and thus were included in the data analysis. Statistical analysis could not be carried out due to the lack of clear data of the included studies. However, descriptive analysis showed its effectiveness in improving clinical parameters such as gain of clinical attachment level and reduction of probing pocket depth. CONCLUSION Placement of periodontal dressing right after non-surgical mechanical therapy can be beneficial in improving overall short-term clinical outcomes, although more controlled studies are still needed to validate this finding.
Collapse
Affiliation(s)
- A Monje
- Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | | | - E Criado
- Department of Oral Surgery, International University of Catalonia, Barcelona, Spain
| | - F Suárez-López Del Amo
- Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - C Garaicoa-Pazmiño
- Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.,Department of Stomatology, Catholic University of Santiago de Guayaquil, Guayaquil, Ecuador
| | - J Gargallo-Albiol
- Department of Oral Surgery, International University of Catalonia, Barcelona, Spain
| | - H-L Wang
- Graduate Periodontics, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| |
Collapse
|
21
|
Abstract
OBJECTIVE Spontaneous celiac artery dissection is rare, and its natural history is not well studied. The objective of this study was to review our experience with the evaluation and management of this condition. METHODS During the last 8 years, 19 patients (14 men, five women) presented with the diagnosis of spontaneous celiac artery dissection. Each patient's clinical course was retrospectively reviewed, and patients were contacted for assessment of current symptoms. RESULTS All patients had computed tomography scans documenting a celiac artery dissection without concomitant aortic dissection. Ages ranged from 39 to 76 years. Seven patients presented with abdominal pain, and 12 were diagnosed incidentally. All patients were initially treated with observation because none had threatened end organs. Patients presenting with aspirin or clopidogrel therapy were continued on these medications, but no patients were prescribed any medications due to their dissection. Three patients continued to have abdominal pain and eventually underwent celiac artery stenting. Pain improved after the intervention in all three. One patient with aneurysmal degeneration of the celiac artery underwent surgical repair. No other patients required intervention. Eighteen patients had follow-up within a year of data collection in the clinic or over the phone. The average time from the initial diagnosis to follow-up for the entire cohort was 46 months. None had abdominal or back pain related to the celiac dissection, had lost weight, or had to change their eating habits. CONCLUSIONS Celiac artery dissection can be safely managed initially with observation. If abdominal pain is persistent, endovascular stenting may stabilize or improve the pain, and surgical reconstruction can be done for aneurysmal degeneration or occlusion, both unusual events. Long-term anticoagulation does not appear necessary in these patients.
Collapse
Affiliation(s)
- Paul D DiMusto
- Section of Vascular Surgery, University of Michigan, Ann Arbor, Mich
| | | | - Enrique Criado
- Section of Vascular Surgery, University of Michigan, Ann Arbor, Mich.
| |
Collapse
|
22
|
van Bogerijen GH, Patel HJ, Eliason JL, Criado E, Williams DM, Knepper J, Yang B, Deeb GM. Evolution in the Management of Aberrant Subclavian Arteries and Associated Kommerell Diverticulum. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.07.074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
DiMusto PD, Oberdoerster MM, Criado E. Management of Spontaneous Isolated Celiac Artery Dissections. J Vasc Surg 2014. [DOI: 10.1016/j.jvs.2014.07.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
24
|
Weber AE, Criado E. Relevance of Bone Anomalies in Patients with Thoracic Outlet Syndrome. Ann Vasc Surg 2014; 28:924-32. [DOI: 10.1016/j.avsg.2013.08.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 08/09/2013] [Accepted: 08/28/2013] [Indexed: 10/25/2022]
|
25
|
Arya S, Coleman DM, Knepper J, Henke PK, Upchurch GR, Rectenwald JE, Criado E, Eliason JL, Gallagher KA. Outcomes After Late Explantation of Aortic Endografts Depend on Indication for Explantation. Ann Vasc Surg 2013; 27:865-73. [DOI: 10.1016/j.avsg.2013.03.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 02/20/2013] [Accepted: 03/02/2013] [Indexed: 10/26/2022]
|
26
|
Coleman DM, Obi A, Criado E, Arya S, Berguer R. Contemporary outcomes after distal vertebral reconstruction. J Vasc Surg 2013; 58:152-7. [DOI: 10.1016/j.jvs.2012.12.067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 11/27/2012] [Accepted: 12/20/2012] [Indexed: 10/27/2022]
|
27
|
Vandy FC, Campbell D, Eliassen A, Rectenwald J, Eliason JL, Criado E, Escobar G, Upchurch GR. Specialized vascular floors after open aortic surgery: cost containment while preserving quality outcomes. Ann Vasc Surg 2013; 27:45-52. [PMID: 23257073 DOI: 10.1016/j.avsg.2012.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 09/01/2012] [Accepted: 09/07/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Postoperative care of open abdominal aortic surgery (OAAS) traditionally involves the intensive care unit (ICU). We hypothesized that in patients without an indication for postoperative ICU admission, admission to a specialized vascular floor unit (hemodynamic monitoring, 2:1 nursing) offers cost savings to both payer and institution without compromising care. METHODS The electronic medical record was used to collect perioperative data for patients who underwent OAAS between July 2007 and July 2011. The university's cost accounting system provided information on revenue, total margin, and professional billing. Patients with ICU indications (spinal drain, Swan-Ganz monitoring, vasopressors, intubation, or blood product resuscitation) were excluded. Comparative cost and outcome analysis was performed on vascular ward and ICU admissions using the Fisher's exact test for dichotomous categorical variables and the Student's t-test for continuous variables. Long-term survival comparison was calculated using Kaplan-Meier survival estimates. RESULTS One hundred thirty of 215 patients were included for analysis (85 excluded, 51 floor, 79 ICU). Perioperative data amongst the floor and ICU cohorts were similar. Day of operation professional billing fees were comparable (ICU $13,365 vs. floor $12,626; P = 0.18); however, postoperative professional fees were significantly higher in the ICU cohort (ICU $3,258 vs. floor $2,101; P = 0.001) primarily because of intensivist billing. The hospital generated an average of 8.7% more revenue from the ICU cohort (ICU $37,770 vs. floor $34,756; P = 0.023). This was offset by greater expenses in the ICU cohort (ICU $30,756 vs. floor $25,144; P = 0.02), yielding a hospital profit margin of 107.5% favoring floor admission (ICU $2,858 vs. floor $5,931; P = 0.19). Duration of stay was similar (ICU 8.0 days vs. floor 7.8 days; P = 0.86). Kaplan-Meier survival analysis was not significantly different between cohorts (ICU 10.1%, median follow-up, 1,070 days vs. floor 0%, median follow-up, 405 days; P = 0.13). CONCLUSIONS Postoperative admission to the ICU is not always necessary after OAAS. Specialized vascular floors offer a financial savings to both payer and institution, which allows for simultaneous cost containment while preserving quality outcomes.
Collapse
Affiliation(s)
- Frank C Vandy
- University of Michigan Cardiovascular Center, Ann Arbor, MI, USA
| | | | | | | | | | | | | | | |
Collapse
|
28
|
McCullough KP, Lok CE, Fluck RJ, Spergel LM, Andreucci VE, Fort J, Krishnan M, Fissell RB, Kawanishi H, Saran R, Port FK, Robinson BM, Pisoni RL, Shinzato T, Shionoya Y, Fukui H, Sasaki M, Miwa M, Toma S, Lin CC, Yang WC, Simone S, Loverre A, Cariello M, Divella C, Castellano G, Gesualdo L, Grandaliano G, Pertosa G, Mattei S, Pignatelli G, Corradini M, Stefani A, Bovino A, Iannuzzella F, Vaglio A, Manari A, Pasquali S, Chan JS, Wu TC, Roy-Chaudhury P, Shih CC, Chen JW, Ponce P, Scholz C, Goncalves P, Grassmann A, Canaud B, Marcelli D, Suzuki S, Shibata K, Kuji T, Kawata S, Koguchi N, Nishihara M, Satta H, Toya Y, Umemura S, Corbett R, Demicheli N, Iori F, Grechy L, Khiroya R, Ellis D, Crane J, Hamady M, Gedroyc W, Duncan N, Vincent P, Caro C, Sarween N, Price A, Powers S, Allen C, Holland M, Gupta I, Baharani J, Parisotto MT, Schoder V, Kaufmann P, Miriunis C, Grassmann A, Marcelli D, Moura A, Madureira J, Alija P, Fernandes J, Oliveira JG, Lopez M, Felgueiras M, Amado L, Sameiro-Faria M, Miranda V, Vieira M, Santos-Silva A, Costa E, David P, Capurro F, Brustia M, De Mauri A, Ruva C, Chiarinotti D, Gravellone L, De Leo M, Turkvatan A, Kirkpantur A, Mandiroglu S, Afsar B, Seloglu B, Alkis M, Erkula S, GURBUZ HG, Serin M, CALIK Y, Mandiroglu F, Balci M, Rikker C, Juhasz E, Tornoci L, Tovarosi S, Greguschik J, Rosivall L, Ibeas J, Valeriano J, Vallespin J, Fortuno J, Rodriguez-Jornet A, Cabre C, Merino J, Vinuesa X, Bolos M, Branera J, Mateos A, Jimeno V, Grau C, Criado E, Moya C, Ramirez J, Gimenez A, Garcia M, Kirmizis D, Kougioumtzidou O, Vakianis P, Bandera A, Veniero P, Brunori G, Dimitrijevic Z, Cvetkovic T, Paunovic K, Stojanovic M, Ljubenovic S, Mitic B, Djordjevic V, Aicha Henriette S, Farideh A, Daniela B, Zafer T, Francois C, Ibeas J, Vallespin J, Fortuno J, Merino J, Vinuesa X, Branera J, Mateos A, Jimeno V, Bolos M, Rodriguez-Jornet A, Gimenez A, Garcia M, Donati G, Scrivo A, Cianciolo G, La Manna G, Panicali L, Rucci P, Marchetti A, Giampalma E, Galaverni M, Golfieri R, Stefoni S, Skornyakov I, Kiselev N, Rozhdestvenskaya A, Stolyar A, Ancarani PPA, Devoto E, Dardano GGD, Coskun yavuz Y, Selcuk NY, Guney I, Altintepe L, Gerasimovska V, Gerasimovska-Kitanovska B, Persic V, Buturovic-Ponikvar J, Arnol M, Ponikvar R, Brustia M, De Mauri A, Conti N, Chiarinotti D, De Leo M, Capurro F, David P, Scrivano J, Pettorini L, Giuliani A, Punzo G, Mene P, Pirozzi N, Balci M, Turkvatan A, Mandiroglu S, Afsar B, Mandiroglu F, Kirkpantur A, Kocyigit I, Unal A, Guney A, Mavili E, Deniz K, Sipahioglu M, Eroglu E, Tokgoz B, Oymak O, Gunal A, Boubaker K, Kaaroud H, Kheder A, Ibeas J, Vidal M, Vallespin J, Amengual MJ, Merino J, Orellana R, Sanfeliu I, Rodriguez-Jornet A, Vinuesa X, Marquina D, Xirinachs M, Sanchez E, Moya C, Ramirez J, Rey M, Gimenez A, Garcia M, Strozecki P, Flisinski M, Kapala A, Manitius J, Gerasimovska V, Gerasimovska-Kitanovska BD, Sikole A, Weber E, Adrych D, Wolyniec W, Liberek T, Rutkowski B, Afsar B, Oguchi K, Nakahara T, Okamoto M, Iwabuchi H, Asano M, Rap O, Ruiz-Valverde M, Rodriguez-Murillo JA, Mallafre-Anduig JM, Zeid MM, Deghady AA, Elshair HS, Elkholy NA, Panagoutsos S, Devetzis V, Roumeliotis A, Kantartzi K, Mourvati E, Vargemezis V, Passadakis P, Kang SH, Jung SY, Lee SH, Cho KH, Park JW, Yoon KW, Do JY. Vascular access. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Coleman DM, Chen H, Eliassen A, Arya S, Criado E, Eliason JL, Rectenwald J, Stanley JC. A Review of the Contemporary and Historical Management of 134 Patients With Splenic Artery Aneurysms. J Vasc Surg 2013. [DOI: 10.1016/j.jvs.2013.02.215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
30
|
Knepper J, Criado E. Surgical treatment of Kommerell's diverticulum and other saccular arch aneurysms. J Vasc Surg 2013; 57:951-4. [PMID: 23332243 DOI: 10.1016/j.jvs.2012.10.094] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 10/16/2012] [Accepted: 10/20/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Saccular aneurysms of the aortic arch are rare, and their surgical repair is challenging with potentially significant morbidity and mortality. METHODS We examined our experience over a 3-year period with nine consecutive patients that include nine hybrid repairs with initial extra-anatomic carotid and/or subclavian bypass and subsequent endovascular exclusion of the saccular arch aneurysm. RESULTS Three patients presented with dysphagia from aberrant right subclavian arteries with aneurysm at the origin of the artery, two had asymptomatic aneurysms at the origin of the left subclavian, and four patients had isolated saccular aneurysms of the arch, three of whom presented with thoracic pain. A total of 16 extra-anatomic bypasses were done in the nine patients. Ten endografts and one nitinol plug were used for exclusion in the nine hybrid cases. There were no perioperative deaths, no strokes, or myocardial infarction events. During follow-up, two patients (22%) were found to have type II endoleaks, but no reinterventions were required. Symptoms resolved in six patients, whereas persistent dysphagia and pain occurred in one. CONCLUSIONS Repair of saccular aneurysms of the aortic arch by hybrid approach can be done with minimal morbidity and mortality and a reasonable rate of symptom resolution.
Collapse
Affiliation(s)
- Jordan Knepper
- Department of Surgery, Section of Vascular Surgery, University of Michigan, Ann Arbor, MI 48109-5867, USA
| | | |
Collapse
|
31
|
Coleman DM, Eliason JL, Knepper JP, Criado E, Upchurch GR, Rectenwald JE. Rate of Malignancy Detected on Postendovascular Aneurysm Repair Surveillance Computed Tomography Angiogram. J Vasc Surg 2012. [DOI: 10.1016/j.jvs.2012.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
32
|
Leal I, Orgaz A, Flores Á, Gil J, Rodríguez R, Peinado J, Criado E, Doblas M. A diffusion-weighted magnetic resonance imaging-based study of transcervical carotid stenting with flow reversal versus transfemoral filter protection. J Vasc Surg 2012; 56:1585-90. [PMID: 22960021 DOI: 10.1016/j.jvs.2012.05.107] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 05/30/2012] [Accepted: 05/31/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND Transfemoral carotid artery stenting (CAS) has been associated with a high incidence of embolic phenomena and silent brain infarction. The goal of this study was to compare the incidence of new ischemic cerebral lesions on diffusion-perfusion magnetic resonance imaging (MRI) sequences after transcervical CAS performed with carotid flow reversal vs stenting via transfemoral approach with distal filter protection. METHODS During a 26-month period, 64 consecutive patients diagnosed with significant carotid stenosis by ultrasound imaging were assigned to transcervical CAS with carotid flow reversal or a transfemoral approach with a distal filter. The Rankin stroke scale was administered by an independent neurologist, and diffusion-weighted MRI (DW-MRI) studies were performed ≤24 hours before and ≤24 to 48 hours after the procedure. DW-MRI studies were compared by two neuroradiologists not involved in the study and blinded for time, clinical status, and treatment option. Hyperintense DW-MRI signals found after the procedure were interpreted as postoperative ischemic infarcts. All patients were assessed at 1, 6, and 12 months after the intervention. RESULTS The distribution of demographic and pathologic variables was similar in both groups. All procedures were technically successful, with a mean carotid flow reversal time of 22 minutes. Twenty-one (70%) and 23 patients (69.69%) were symptomatic in the transcervical and transfemoral groups, respectively (P=.869). After intervention, new postprocedural DW-MRI ischemic infarcts were found in four transcervical (12.9%) and in 11 transfemoral (33.3%) patients (P=.03), without new neurologic symptoms. No major adverse events occurred at 30 days after the intervention. All patients remained neurologically intact, without an increase in stroke scale scoring. All stents remained patent, and all patients remained stroke-free during follow-up. In multivariate analysis, age (relative risk [RR], 1.022; P<.001), symptomatic status (RR, 4.109; P<.001), and open-cell vs closed-cell stent design (RR, 2.01; P<.001) were associated with a higher risk of embolization in the transfemoral group but not in the transcervical group. CONCLUSIONS These data suggest that transcervical carotid stenting with carotid flow reversal carries a significantly lower incidence of new ischemic brain infarcts than that resulting from transfemoral CAS with a distal filter. The transcervical approach with carotid flow reversal may improve the safety of CAS and has the potential to improve results in especially vulnerable patients such as the elderly and symptomatic.
Collapse
Affiliation(s)
- Ignacio Leal
- Vascular Surgery Section, Complejo Hospitalario de Toledo, Toledo, Spain.
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Hurie J, Patel HJ, Criado E, Eliason JL, Deeb GM, Upchurch GR. Postoperative fluid collection after hybrid debranching and endovascular repair of thoracoabdominal aortic aneurysms. J Vasc Surg 2011; 54:1623-8. [DOI: 10.1016/j.jvs.2011.05.098] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 05/24/2011] [Accepted: 05/26/2011] [Indexed: 11/24/2022]
|
34
|
Vandy F, Rectenwald JE, Criado E. Late Gastrointestinal Complications of Inferior Vena Cava Filter Placement: Case Report and Literature Review. ACTA ACUST UNITED AC 2011; 23:261-4. [DOI: 10.1177/1531003511409058] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
35
|
|
36
|
|
37
|
Baudín C, Criado E, Bakali J, Pena P. Dynamic corrosion of Al2O3–ZrO2–SiO2 and Cr2O3-containing refractories by molten frits. Part I: Macroscopic analysis. Ann Ital Chir 2011. [DOI: 10.1016/j.jeurceramsoc.2010.11.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
38
|
Knipp BS, Escobar GA, English S, Upchurch GR, Criado E. Endovascular repair of ruptured aortic aneurysms using carbon dioxide contrast angiography. Ann Vasc Surg 2011; 24:845-50. [PMID: 20831984 DOI: 10.1016/j.avsg.2010.05.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2010] [Revised: 04/30/2010] [Accepted: 05/16/2010] [Indexed: 12/23/2022]
Abstract
BACKGROUND Endovascular aneurysm repair (EVAR) has become a common approach to the management of ruptured abdominal aortic aneurysms (rAAA). The use of iodinated contrast during EVAR for rAAA has several disadvantages, including contrast nephropathy, potential allergic response, and the need for high-pressure injection. We evaluated the use of carbon dioxide (CO(2)) as the primary contrast agent for endovascular repair of ruptured aortic aneurysms. METHODS Between December 2007 and July 2009, we retrospectively reviewed our experience with patients undergoing endovascular repair of rAAA, with CO(2)as the principal contrast agent, and compared them with patients who underwent EVAR using iodinated contrast. RESULTS Four patients underwent endovascular repair of rAAA with CO(2) angiography (group 1) and seven with iodinated contrast (group 2). The mean age of the patients was not different between groups (p = 0.353). Patients in group 1 received a mean of 443 ± 99 mL of CO(2) and 4.3 ± 8.5 mL of iodinated contrast. Patients in group 2 received 110.2 ± 37.6 mL of iodinated contrast (p < 0.001). Overall mortality was not different between group 1 (0.0%) and group 2 (28.6%, p = 0.491). In patients who survived to discharge, the change in creatinine between admission and discharge was greater in group 2 although not statistically significant (0.25 ± 0.19 mg/dL for group 1 vs. 0.58 ± 0.25 mg/dL for group 2, p = 0.066). There was no significant difference in length of stay between group 1 (intensive care unit, 1.00 ± 0.82 days; hospital, 4.25 ± 0.96 days) and group 2 (intensive care unit, 3.60 ± 3.44 days; hospital, 9.00 ± 6.60 days). CONCLUSIONS Endovascular repair of rAAA using CO(2) as a contrast agent is technically feasible and safe. The potential benefits of CO(2) angiography support the continued use of CO(2) in cases of ruptured aneurysms. Further studies are necessary to determine whether CO(2) improves survival and limits the progression of renal dysfunction after endovascular repair of rAAA.
Collapse
Affiliation(s)
- Brian S Knipp
- Section of Vascular Surgery, Department of Surgery, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | | | | | | | | |
Collapse
|
39
|
Criado E, Berguer R, Greenfield L. The spectrum of arterial compression at the thoracic outlet. J Vasc Surg 2010; 52:406-11. [DOI: 10.1016/j.jvs.2010.03.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2009] [Revised: 03/04/2010] [Accepted: 03/05/2010] [Indexed: 11/17/2022]
|
40
|
Leal J, Orgaz A, Fontcuberta J, Flores A, Doblas M, Garcia-Benassi J, Lane B, Loh C, Criado E. A Prospective Evaluation of Cerebral Infarction following Transcervical Carotid Stenting with Carotid Flow Reversal. J Vasc Surg 2010. [DOI: 10.1016/j.jvs.2010.04.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
41
|
Patel HJ, Upchurch GR, Eliason JL, Criado E, Rectenwald J, Williams DM, Deeb GM. Hybrid Debranching With Endovascular Repair for Thoracoabdominal Aneurysms: A Comparison With Open Repair. Ann Thorac Surg 2010; 89:1475-81. [DOI: 10.1016/j.athoracsur.2010.01.062] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 01/25/2010] [Accepted: 01/29/2010] [Indexed: 10/19/2022]
|
42
|
Kabbani LS, Criado E, Upchurch GR, Patel HJ, Eliason JL, Rectenwald J, Berguer R. Hybrid Repair of Aortic Aneurysms Involving the Visceral and Renal Vessels. Ann Vasc Surg 2010; 24:219-24. [DOI: 10.1016/j.avsg.2009.08.007] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2009] [Revised: 07/21/2009] [Accepted: 08/18/2009] [Indexed: 11/17/2022]
|
43
|
Flores A, Doblas M, Criado E. Transcervical carotid artery stenting with flow reversal eliminates emboli during stenting: why does it work and what are the advantages with this approach. J Cardiovasc Surg (Torino) 2009; 50:745-749. [PMID: 19935605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Carotid artery stenting (CAS) remains under scrutiny because of the controversial results of major trials that compared it with carotid endarterectomy. However, the question of how the results of carotid stenting are influenced by the access technique and cerebral protection methods has not been properly addressed in any trial. Most unresolved technical weaknesses of transfemoral carotid stenting are related to instrumentation of the arch and proximal supra-aortic trunks, crossing of the carotid lesion without protection, and use of distal filter protection devices of unproven benefit. All these problems can be avoided by using a transcervical approach with carotid flow reversal for protection. The potential advantage of transcervical carotid artery stenting (CAS) is demonstrated by the fact that it can be done in octogenarians without increased morbidity, produces a lower incidence of middle cerebral artery transcranial Doppler (TCD)-detected embolic signals during the procedure, carries a significant reduction in the incidence of ischemic brain infarcts as detected by diffusion weighted magnetic resonance imaging (MRI), when compared to transfemoral stenting with distal filter protection, and can be done with a remarkably low incidence of major adverse events.
Collapse
Affiliation(s)
- A Flores
- Vascular Surgery Section, Complejo Hospitalario de Toledo, Toledo, Spain
| | | | | |
Collapse
|
44
|
Izquierdo L, Criado E, Leiva L, Aguinaco A, Zotta R, Solares JIF. Triple-wire: a variation of the "Preclose" technique. Ann Vasc Surg 2009; 23:713-5. [PMID: 19631500 DOI: 10.1016/j.avsg.2009.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2009] [Revised: 05/10/2009] [Accepted: 05/14/2009] [Indexed: 10/20/2022]
Abstract
We describe a technical modification of the "Preclose" technique that changes the cross-pattern sutures created with the Prostar XL as in a previously described variation using the Proglide device for longitudinal interrupted sutures. This technique was used in 19 femoral arteries, with satisfactory hemostasis achieved in 17. The variation we describe creates a percutaneous longitudinal interrupted suture that closely resembles a surgical interrupted suture. It adds minimal operative time, no additional technical demands, and no significant material cost. Additionally, it allows better control over suture placement and insertion of a balloon catheter for better proximal bleeding control.
Collapse
Affiliation(s)
- Luis Izquierdo
- Vascular and Endovascular Surgery Service, Instituto Vascular Internacional-Hospital Universitario Madrid Montepríncipe, Madrid, Spain.
| | | | | | | | | | | |
Collapse
|
45
|
Upchurch GR, Eliason JL, Rectenwald JE, Escobar G, Kabbani L, Criado E. Endovascular Abdominal Aortic Aneurysm Repair Versus Open Repair: Why and Why Not? ACTA ACUST UNITED AC 2009; 21:48-53. [DOI: 10.1177/1531003509333363] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
46
|
Izquierdo L, Criado E, Leiva L, Vázquez E, Solares I, Zotta R. Giant Renal Vein Aneurysm and Arteriovenous Fistula Secondary to Renal Artery Aneurysm. Eur J Vasc Endovasc Surg 2009. [DOI: 10.1016/j.ejvs.2008.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
Vandy F, Criado E, Upchurch GR, Williams DM, Rectenwald J, Eliason J. Transluminal hypogastric artery occlusion with an Amplatzer vascular plug during endovascular aortic aneurysm repair. J Vasc Surg 2008; 48:1121-4. [PMID: 18692350 DOI: 10.1016/j.jvs.2008.06.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2008] [Revised: 05/15/2008] [Accepted: 06/01/2008] [Indexed: 11/26/2022]
|
48
|
Criado E, Kabbani L, Cho K. Catheter-less angiography for endovascular aortic aneurysm repair: a new application of carbon dioxide as a contrast agent. J Vasc Surg 2008; 48:527-34. [PMID: 18632243 DOI: 10.1016/j.jvs.2008.04.061] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Revised: 04/28/2008] [Accepted: 04/28/2008] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Avoidance of nephrotoxic contrast agents during endovascular repair of abdominal aortic aneurysms (EVAR) may reduce the incidence of renal dysfunction following the procedure. Carbon dioxide (CO(2)) angiography is a safe alternative to iodinated contrast media vastly under-utilized by vascular surgeons. We herein describe our experience with a simple angiographic technique using CO(2) for EVAR guidance that does not require a separate angiographic catheter. METHODS Eighteen patients underwent EVAR using angiography with CO(2) delivered through the endograft sheath. The renal and hypogastric arteries were localized for endograft deployment exclusively with CO(2) in all patients. Completion angiography was done with CO(2) in all patients and an additional angiogram with iodinated media was done in 13 cases. RESULTS All endograft deployments were done successfully with CO(2) angiography injected through the endograft delivery systems and femoral access sheaths. Additional iodinated media completion angiography did not modify the procedure in any case. All patients were discharged within two days after surgery. There were no ischemic or systemic complications related to CO(2) administration. Follow-up CT-scan revealed well positioned endografts with the expected patent renal and hypogastric arteries in all patients, and no additional endoleaks. No significant deterioration in renal function occurred in any case. CONCLUSION Carbon dioxide angiography conducted through the endograft delivery sheath is reliable for endograft deployment, safe, non-toxic and inexpensive. In addition, it may expedite EVAR by eliminating a number of angiographic catheter placements and exchanges during the procedure. This favorable experience warrants further utilization of this technique.
Collapse
Affiliation(s)
- Enrique Criado
- Cardiovascular Center, Sections of Vascular Surgery, University of Michigan School of Medicine, Ann Arbor, Michigan, USA.
| | | | | |
Collapse
|
49
|
Vandy F, Izquierdo L, Liu J, Criado E. Angiolymphoid hyperplasia involving large arteries. J Vasc Surg 2008; 47:1086-9. [DOI: 10.1016/j.jvs.2007.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2007] [Revised: 11/27/2007] [Accepted: 12/01/2007] [Indexed: 10/22/2022]
|
50
|
Criado E, Fontcuberta J, Orgaz A, Flores A, Doblas M. Transcervical carotid stenting with carotid artery flow reversal: 3-year follow-up of 103 stents. J Vasc Surg 2007; 46:864-9. [DOI: 10.1016/j.jvs.2007.07.028] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Revised: 07/03/2007] [Accepted: 07/18/2007] [Indexed: 11/30/2022]
|