SPLENECTOMY WITH PROXIMAL SPLENIC ARTERY LIGATION AND ESOPHAGOGASTRIC DEVASCULARIZATION ■ The indications for this procedure include patients with a life-threatening complication from portal hypertension and complex mesenteric veno-occlusive disease or poor…
■ Once the history, physical examination, and noninvasive testing are complete, the surgeon must determine the next step in imaging, which may be both diagnostic and therapeutic. The patient’s functional status,…
■ Computed tomographic arteriography (CTA): CTA has assumed an increasing role in guiding peripheral vascular intervention, particularly in regard to choosing appropriate devices and optimal interventional approach (e.g., ipsilateral antegrade vs….
■ Access to a three-dimensional (3-D) workstation/program and familiarity with reconstruction software by the implanting surgeon for manipulation of the images and creating centerline pathways should be mandatory to most accurately…
■ A 65-cm 4-Fr angled catheter (e.g., Kumpe®) is advanced through the sheath and, under digital subtraction roadmapping guidance, directs the hydrophilic guidewire into the ipsilateral internal iliac artery (FIG 2)….
■ Arterial thoracic outlet syndrome (aTOS) is the least common presentation of thoracic outlet syndrome and most often involves subclavian artery compression leading to extrinsic compression, poststenotic dilatation, aneurysmal degeneration, and…
■ Computed tomography (CT) arteriography of the abdomen and pelvis, with arterial and venous pelvis, may provide additional useful information regarding the extent of aortic disease and other associated abdominal pathology…
DIFFERENTIAL DIAGNOSIS ■ Neurogenic claudication is frequently confused for arterial claudication. Neurogenic claudication is variable—some good days, some bad—whereas arterial claudication is very consistent. Neurogenic claudication can be relieved by the…
■ Details of prior upper and lower gastrointestinal (GI) bleed, findings of upper GI endoscopy to exclude other causes of nonvariceal upper GI bleeding, history of prior endoscopic management of bleeding…
■ The risk of AAA rupture increases with progressive diameter enlargement.2 Rupture and subsequent aneurysm-related mortality may be prevented by elective surgical repair, either by open interposition grafting or endovascular aneurysm…
