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  • SAGE Publications  (3)
  • Lin, Peter H.  (3)
  • 1
    Online Resource
    Online Resource
    Conservatism and New Technology: The Impact on Abdominal Aortic Aneurysm Repair
    SAGE Publications ; 2002
    In:  The American Surgeon Vol. 68, No. 1 ( 2002-01), p. 57-61
    Details
    In: The American Surgeon, SAGE Publications, Vol. 68, No. 1 ( 2002-01), p. 57-61
    Abstract: The last decade has represented a time of fundamental change in the treatment of abdominal aortic aneurysms (AAAs). Potentially, vascular surgeons will either acquire catheter-based skills or relinquish the care for many patients with infrarenal AAA. We investigated AAA referral patterns and method of AAA repair after the establishment of an endovascular AAA program at our institution. We conducted a retrospective review of elective AAA repairs after the initiation of an endovascular AAA program in April 1994. Six vascular surgeons performed all procedures with a clear distinction between the surgeons (n=3) who performed traditional AAA repair only and those (n=3) who managed AAAs by means of either endovascular or traditional treatment. From April 1994 through December 2000, 740 elective AAA repairs were performed. During this time the mean number of AAA repairs has been 106/year ranging from 75 to 155/year. More notable however is the steady increase in the percentage of endovascular AAA repairs from 6 per cent of all AAA repairs in 1994 to 61 per cent in 2000. During this time traditional surgeons have experienced a plateau in total AAA repairs performed per year with their number of open repairs decreasing by 36 per cent. At the same time endovascular surgeons have seen a progressive rise in total AAA cases including an increase of 200 per cent in open repairs and of 1367 per cent in endovascular repairs. Our vascular surgeons who repair AAA utilizing both endovascular and open techniques have experienced an increase in aneurysm referrals since the advent of an endovascular AAA program. Those who have not adopted endovascular skills have seen a decline in their aneurysm practice. The larger question about whether or not to embrace new technology before the availability of long-term follow-up remains unanswered.
    Type of Medium: Online Resource
    ISSN: 0003-1348 , 1555-9823
    URL: Article
    DOI: 10.1177/000313480206800113
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2002
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  • 2
    Online Resource
    Online Resource
    Management of Hand Ischemia in Patients with Hemodialysis Access by Distal Arterial Ligation and Revascularization
    SAGE Publications ; 1999
    In:  Vascular Surgery Vol. 33, No. 5 ( 1999-09), p. 481-488
    Details
    In: Vascular Surgery, SAGE Publications, Vol. 33, No. 5 ( 1999-09), p. 481-488
    Abstract: Hand ischemia due to arterial steal syndrome is an infrequent but potentially serious complication of hemodialysis access procedures. Correction of symptomatic steal syndrome typically involves fistula ligation, arterial banding, or graft lengthening, each of which provides varying degrees of success. The purpose of this study is to evaluate experience in the treatment of dialysis-associated hand ischemia by distal artery ligation and revascularization. A retrospective review was performed on 14 patients over a 6-year period who developed hand ischemia following hemodialysis access construction and underwent distal artery ligation and revascularization. Patient demographic data, operative indications, risk factors, and treatment outcome were noted. There were 10 men and four women, with a mean age of 52 years (range 21 to 73). Hand ischemia occurred in nine patients with arteriovenous grafts and five patients with arteriovenous fistulas. Nine patients developed steal syndrome within 1 month following the hemodialysis access procedure. All 14 patients underwent a surgical procedure for hand ischemia, which included ligation of the artery distal to arteriovenous fistula and arterial bypass, with reverse saphenous vein grafts in 10 patients, reversed cephalic vein grafts in three patients, and polytetrafluoroethylene graft in one patient. One patient with severe digital gangrene also required amputation. There was no perioperative morbidity or mortality. Following operation, all showed immediate improvement of the affected hand and remained free of symptoms. The cumulative patency rates of the hemodialysis access following the corrective procedure at 1, 3, and 5 years were 85.7%, 64.2%, and 42.9%, respectively. All arterial bypasses remained patent during follow-up, which ranged from 1 month to 5 years (mean 35 months). Distal arterial ligation with revascularization is an effective and durable treatment for patients with arterial steal syndrome following hemodialysis access construction. This technique can be performed with minimal morbidity and maintains a continuous access for hemodialysis.
    Type of Medium: Online Resource
    ISSN: 0042-2835
    URL: Article
    DOI: 10.1177/153857449903300506
    Language: English
    Publisher: SAGE Publications
    Publication Date: 1999
    detail.hit.zdb_id: 2095223-5
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  • 3
    Online Resource
    Online Resource
    Endoluminal Stent Placement and Coil Embolization for the Management of Carotid Artery Pseudoaneurysms
    SAGE Publications ; 2001
    In:  Journal of Endovascular Therapy Vol. 8, No. 1 ( 2001-02), p. 53-61
    Details
    In: Journal of Endovascular Therapy, SAGE Publications, Vol. 8, No. 1 ( 2001-02), p. 53-61
    Abstract: To present a series of carotid artery pseudoaneurysms treated successfully using an endovascular approach. Methods: From April 1995 to November 1999, 5 patients with neurological symptoms not explained by computed tomography of the head were identified by carotid angiography as having internal carotid artery (ICA) pseudoaneurysms. Three patients had sustained blunt trauma, and 2 had previous elective carotid endarterectomies for atherosclerotic disease. The time between injury and treatment ranged from 3 days to 10 years. The patients were treated with endovascular stent placement for exclusion of the pseudoaneurysm, followed by filling of the cavity with multiple detachable coils. Patients were maintained on oral antiplatelet agents or anticoagulant therapy after the procedure. Results: Primary technical success was 100%. No patient suffered permanent neurological sequelae. Postprocedure angiography demonstrated a patent ICA in all cases, with complete obliteration of the pseudoaneurysm. At a mean 8.4-month follow-up (range 2–21), all patients remained symptom free; angiograms in 3 patients at a mean 11.7 months demonstrated continued ICA patency. One patient had a 60% focal narrowing of the distal common carotid artery, which was treated successfully with balloon dilation and stenting. Conclusions: Endovascular treatment of carotid artery pseudoaneurysms is a useful alternative to standard surgical repair. This modality avoids the necessity for surgical exposure at the skull base with its inherent morbidity.
    Type of Medium: Online Resource
    ISSN: 1526-6028 , 1545-1550
    URL: Article
    DOI: 10.1177/152660280100800109
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2001
    detail.hit.zdb_id: 2049858-5
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