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  Citation statistics : Table of Contents
   2016| January-March  | Volume 3 | Issue 1  
    Online since April 13, 2016

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Acute mesenteric ischemia: The what, why, and when?
Edwin Stephen, Ziyab Khan Sarfaraz, Ibrahim Abdelhedy, Khalifa Al Wahaibi
January-March 2016, 3(1):24-28
Acute mesenteric ischemia (AMI) is a complex clinical problem with a high mortality. The mortality associated with AMI has declined steadily over the last three decades. This is due to higher index of suspicion among clinicians, advances in radiographic diagnostic modalities, aggressive surgical approach, endovascular intervention, nutritional supplementation, and better perioperative care. Early diagnosis and prompt, effective treatment are essential to improve the clinical outcome. This article reviews the etiopathogenesis, clinical features, management, and outcomes of AMI.
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Poststab injury subclavian artery pseudoaneurysm excision
Suraj Wasudeo Nagre, KN Bhosle, Ambrish Khatod
January-March 2016, 3(1):31-32
Poststab injury subclavian artery pseudoaneurysm is a rare entity with great significance because of the risk of complications such as thrombosis, rupture, gangrene, or limb loss. It should be repaired early whenever diagnosed. Our case report has a 24-year-old male patient with a history of stab injury to left supraclavicular region followed by pulsatile swelling after 2 days due to subclavian artery pseudoaneurysm. We excised the pseudoaneurysm with vein patch repair of the subclavian artery.
  1 2,359 70
Deep vein thrombosis: An experience of 25 years from north India
Sayyed Ehtesham Hussain Naqvi, Mohammed Azam Haseen, Mohammed Haneef Beg, Eram Ali, Tamkin Khan
January-March 2016, 3(1):2-6
Background and Aim: Unfractionated heparin (UFH) or low-molecular-weight heparin is the treatment for established lower limb deep vein thrombosis (DVT). This study was performed to report our experience of treating the same with UFH. Patients and Methods: This was a retrospective analysis of patients with lower limb DVT managed between 1983 and 2014 at Jawaharlal Medical College, Aligarh, India. Results: This analysis included 83 males and 210 females. Mean age of patients was 34.5 ΁ 11.5 years. Most common age group involved in was 20-30 years (33.79%). Most common symptom was limb swelling (90.8%). Most common risk factor was postpartum period. Among postpartum group, primigravida was most commonly involved group. Left limb involvement was found in 195 patients (65.8%). Proximal DVT was present in 215 (73.33%) patients. In proximal patient group, 74.41% presented with more than 90% block while in distal patient group, 66.67% presented with more than 90% block of the venous system. After 3 weeks of treatment, 29.52% and 15.49% were found to have block of proximal and distal deep veins, respectively, which further declined to 1.78% and 3.45% after 6 months of presentation with continued treatment. Six patients died during the course of treatment. Conclusion: Lower limb DVT respond well to UFH, hence should be used for treatment of same with comparable results. DVT can lead to fatal pulmonary embolism and patients should be admitted till target International Normalized Ratio is achieved.
  1 3,893 215
Brachial artery injury management: Case series
Suraj Wasudeo Nagre
January-March 2016, 3(1):7-10
We performed this retrospective study to analyze our strategies for managing and surgically treating brachial artery injuries. Twenty patients with traumatic brachial artery injuries underwent surgery at our institution, from May 2013 to January 2016. Fifteen patients were male, and five were female (age range, 20-45 years; mean, 30 years). Twelve of the patients had penetrating injuries (two had stab wounds; two had window glass injuries; and eight had industrial accidents); eight had blunt trauma injuries (traffic accidents). Five patients had a peripheral nerve injury. All patients underwent Doppler ultrasonographic examination. The repair involved end-to-end anastomosis for eight injuries, reverse saphenous vein graft interpositional grafts for eight, and primary repair for four. Venous continuity was achieved in 8 of 12 patients who had major venous injuries. Nine of the twenty patients required primary fasciotomy. Follow-up showed that two of the five patients with peripheral nerve injury had apparent disabilities due to nerve injury. There were no deaths. Good results can be achieved in patients with brachial artery injuries by use of careful physical examination, Doppler ultrasonography, and vascular repair and debridement of nonviable tissues. Traumatic neurologic injury addressed expediently with nerve grafting may reduce the subsequent disability.
  1 3,625 119
Acute posttraumatic renal artery dissection treated by primary stenting
Srihari Raavi, Murali Krishnaswami, Francis Gnanaprakasam, Madan Ramachandran
January-March 2016, 3(1):33-35
Blunt renal artery injury is a relatively rare finding. The literature demonstrates an incidence as low as 0.08% of all blunt abdominal traumas, occurring in 1-4% of patients with renal injury. However, the rate of early diagnosis of such injuries is increasing due to increased awareness and the liberal use of contrast-enhanced computed tomography. In this report, we describe an approach to re-vascularization by endovascular stenting that resulted in successful salvage of renal function after blunt trauma.
  - 2,415 85
Aortic diseases in India and their management: An experience from two large centers in South India
Madathipat Unnikrishnan, Ajay Savlania, Prakash Goura, Himanshu Verma, Ramesh K Tripathi
January-March 2016, 3(1):20-23
  - 4,345 243
From the editor-in-chief's desk
Ramesh K Tripathi
January-March 2016, 3(1):1-1
  - 1,651 64
Dr. Thomas J. Fogarty: The real face of minimally invasive vascular surgery
Devender Singh
January-March 2016, 3(1):29-30
  - 2,479 85
Endovascular management of type b dissection flap of common iliac artery
Manzoor Abbas, Ramesh K Tripathi
January-March 2016, 3(1):36-36
  - 1,417 58
Patterns of vascular referrals in 3 months of completion of training at a tertiary care center in North India
Amit Mahajan
January-March 2016, 3(1):37-37
  - 1,414 64
Extra-anatomical transobturator bypass, modifications of the technique 10 cases report and review of literature
Ahmed Reyad Tawfik, Ezz El-Din Abdel Haleem Korashy
January-March 2016, 3(1):11-14
Context: Transobturator bypass may be a good alternative or a good solution in hostile groin either scared or infected with severe sepsis in drug addict patients. Aims: Evaluating the results transobturator bypasses in cases where groin cannot be addressed after 2 years follow-up. Settings and Design: This is a personal experience using transobturator bypass as an alternative management in a patient with either groin infection or scared groin in recurrent occluded grafts. Subjects and Methods: Ten cases in which transobturator bypass was performed; late graft occlusion was the indication in (five cases) while groin infection was the indication in the other (five cases). In all patients, common iliac - popliteal bypass was performed. In drug addict patients; infected groin, the tunnel was fashioned in a plane deep to the adductor muscles to be rather away from the infected areas, while in cases of graft occlusion, the much easier subcutaneous plane was chosen to allow easier surveillance of the graft. Results: Obturator bypass was performed in ten cases; five occluded grafts and five infected groin, four of them were addicts. One of the drug addicts presented with groin mass while three of them presented shocked and rupture infected pseudoaneurysm. One died of fulminant sepsis. Two years follow-up, seven grafts were patent. Only three experienced major amputations. Conclusions: The proper timing of the procedure, use of endarterectomy as well as the proper choice of the plane of the tunnel is considered essential prerequisites for a successful outcome.
  - 4,185 127
Management of innominate artery true aneurysms: A single centre experience
Aasim Khan, Thodur Vasudevan
January-March 2016, 3(1):15-19
Introduction: True aneurysms of the innominate artery are rare and continued controversy exists in literature regarding the best management of these aneurysms. Patients and Methods: The present study reviewed a 5-year experience of managing IA true aneurysms between 2010 and 2015. There were two patients aged 63 and 77 years who were treated successfully by a selective open debranching technique for the exclusion of the aneurysms. The mean follow-up was 2 years. Preoperative information was derived from spiral computed tomography (CT) scanning, magnetic resonance imaging, and color Doppler imaging (CDI). Results: One male and one female were treated successfully. The most common indication for intervention was transient ischemic attack (100%). The 30-day surgical mortality was zero. Graft patency at 6 months as confirmed by CDI was 100%. One patient had graft-related complication at 6 months and subsequently at 24 months which was revised successfully. Conclusion: Exclusion bypass is a satisfactory treatment of these proximal aneurysms and durable. The proximity to the aortic arch makes endovascular treatment challenging and would depend on the dimensions of the arch and ascending aorta. De-branching simplifies the treatment pathway. The natural history of these isolated aneurysms is unknown.
  - 3,986 108