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Matsumoto Y, Oshikiri Y, Morioka H, Morino Y. Impending rupture of giant iliac artery psedoaneurysm after endovascular repair with coil embolization and stent grafts. Cardiovasc Interv Ther 2024:10.1007/s12928-024-01019-z. [PMID: 38900382 DOI: 10.1007/s12928-024-01019-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/31/2024] [Indexed: 06/21/2024]
Affiliation(s)
- Yuki Matsumoto
- Department of Cardiology Ofunato City, Iwate Prefectural Ofunato Hospital, 10-1, Yamabagoe, Ofunatocho, Ofunato, Iwate Prefecture, Japan.
| | - Yuya Oshikiri
- Department of Cardiology Ofunato City, Iwate Prefectural Ofunato Hospital, 10-1, Yamabagoe, Ofunatocho, Ofunato, Iwate Prefecture, Japan
| | - Hidemi Morioka
- Department of Cardiology Ofunato City, Iwate Prefectural Ofunato Hospital, 10-1, Yamabagoe, Ofunatocho, Ofunato, Iwate Prefecture, Japan
| | - Yoshihiro Morino
- Department of Cardiology, Iwate Medical University, Yahabacho, Japan
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Abou Diwan R, Kaadi L, Hachem S, Smayra T, Slaba S, Chalhoub B, Hachem K. Pseudoaneurysms: Different ultrasound patterns, aetiologies and locations. Australas J Ultrasound Med 2023; 26:258-266. [PMID: 38098621 PMCID: PMC10716566 DOI: 10.1002/ajum.12348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Pseudoaneurysms are frequent vascular anomalies. This review article aims to describe the unique specific aspect of pseudoaneurysm (PSA) that allows to make the diagnosis using different modalities: colour Doppler ultrasound, computed tomographic angiography, magnetic resonance angiography and conventional angiography. It is essential to know the various aetiologies of PSA: iatrogenic, traumatic, dissecting and anastomotic; different locations and the possible complications, information to help clinicians choose the best treatment. Our review is supported by illustrated series of cases.
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Affiliation(s)
- Ralph Abou Diwan
- Medical Imaging Department, Hôtel‐Dieu de FranceAlfred Naccache BoulevardBeirutLebanon
| | - Lea Kaadi
- Medical Imaging Department, Hôtel‐Dieu de FranceAlfred Naccache BoulevardBeirutLebanon
| | - Samir Hachem
- Faculty of MedicineUniversity of Saint JosephBeirutLebanon
| | - Tarek Smayra
- Medical Imaging Department, Hôtel‐Dieu de FranceAlfred Naccache BoulevardBeirutLebanon
| | - Sami Slaba
- Medical Imaging Department, Hôtel‐Dieu de FranceAlfred Naccache BoulevardBeirutLebanon
| | - Berthe Chalhoub
- Laboratory Department, Hôtel‐Dieu de FranceAlfred Naccache BoulevardBeirutLebanon
| | - Kamal Hachem
- Medical Imaging Department, Hôtel‐Dieu de FranceAlfred Naccache BoulevardBeirutLebanon
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Managing infected femoral artery pseudoaneurysm after thoraco-bifemoral bypass with an innovative configuration. J Vasc Surg Cases Innov Tech 2022; 8:583-586. [PMID: 36248387 PMCID: PMC9556622 DOI: 10.1016/j.jvscit.2022.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022] Open
Abstract
An infected femoral artery pseudoaneurysm after aortic reconstruction is a devastating surgical complication associated with the morbidity of limb loss and pelvic ischemia with a reinfection rate of ≤10%. In the present case report, we have described a unique approach for an infected femoral pseudoaneurysm after thoraco-bifemoral bypass using an innovative configuration, in addition to an obturator bypass technique, in a patient with a complex vascular history. This unique approach made use of an existing limb of a thoraco-bifemoral bypass graft to provide inflow to two outflow conduits, the external iliac artery and superficial femoral artery, allowing for preservation of both pelvic and lower extremity perfusion.
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Giant Pseudoaneurysm in Distal Anastomosis of Prosthetic Aorto-Femoral Bypass. COR ET VASA 2021. [DOI: 10.33678/cor.2020.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Manolesou DG, Georgiopoulos G, Lazaris AM, Schizas D, Stamatelopoulos KS, Khir AW, Liakakos T, Papaioannou TG. Experimental Devices Versus Hand-Sewn Anastomosis of the Aorta: A Systematic Review and Meta-Analysis. J Surg Res 2020; 258:200-212. [PMID: 33035743 DOI: 10.1016/j.jss.2020.08.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/27/2020] [Accepted: 08/30/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND To minimize complications associated with the construction of the hand-sewn aortic anastomosis, alternative experimental methods have been pursued. This study aimed to evaluate the efficacy of experimental anastomotic devices in relation to time and point of rupture of the anastomosis in comparison to the conventional technique. MATERIALS AND METHODS An electronic search was performed using MEDLINE, Scopus, Science Direct, and Cochrane Library databases by two independent authors. Our exclusion criteria referred to studies reporting results solely from end-to-side anastomosis, results on vessels other than the aorta, studies that did not involve animal experiments, and non-English publications. The last search date was January 1, 2020. RESULTS The meta-analysis included 22 studies with 34 anastomosis samples and a total of 316 animals. The pooled mean automated anastomosis time was 10.38 min, and the mean point of rupture was 32.7 N. In the subgroup analysis of automated anastomosis time by device category, the anastomotic stenting technique reported significantly lower anastomosis time but also showed significantly lower point of rupture. Comparing the efficacy of experimental devices and the hand-sewn technique, our pooled analysis showed that automated devices significantly decrease the time needed to perform the anastomosis (weighted mean difference -7.24 min). On the other hand, the automated anastomosis is also associated with decreased tensile strength (weighted mean difference -20.68 N). CONCLUSIONS Although experimental devices seem to offer a faster anastomosis, they lack endurance when compared with the hand-sewn technique. Further research is needed for the development of an "ideal" anastomotic technique.
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Affiliation(s)
- Danae G Manolesou
- Biomedical Engineering Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - George Georgiopoulos
- School of Biomedical Engineering and Imaging Sciences, King's College London, London UK
| | - Andreas M Lazaris
- Department of Vascular Surgery, Attikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kimon S Stamatelopoulos
- Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ashraf W Khir
- Brunel Institute for Bioengineering, Brunel University London, London, UK
| | - Theodoros Liakakos
- First Department of Surgery, Laiko Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Theodore G Papaioannou
- Biomedical Engineering Unit, First Department of Cardiology, Hippokration Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Ruptured Superficial Femoral Artery Anastomotic Pseudoaneurysm after 30 Years. Case Rep Vasc Med 2019; 2019:1679214. [PMID: 31428510 PMCID: PMC6679845 DOI: 10.1155/2019/1679214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/27/2019] [Accepted: 07/11/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Anastomotic pseudoaneurysms are a complication of vascular reconstructive surgery with the majority in the femoral region. Although rare, ruptured femoral anastomotic pseudoaneurysms have high mortality and require emergency surgery. Case Presentation A 60-year-old male with a history of a left leg crush injury was treated with a superficial femoral artery interposition vein graft 30 years ago. He presented nowadays with a three-day history of severe pain in his left thigh. CT angiography demonstrated a ruptured anastomotic pseudoaneurysm with contrast extravasation into an intramuscular hematoma. He had significant scarring from his previous surgeries which made the leg hostile for an open repair. Therefore, percutaneous access selectively cannulated the left iliofemoral vasculature. An angiogram showed a distal superficial femoral artery pseudoaneurysm. Subsequently, two 10mmx15cm Viabahn covered stents (Gore & Associates, Flagstaff, AZ) were placed bridging healthy superficial femoral artery. A completion angiogram demonstrated no extravasation into the pseudoaneurysm. The patient recovered and was discharged home two days postoperatively. Conclusion Ruptured femoral anastomotic pseudoaneurysms are traditionally repaired with open pseudoaneurysm excision and arterial reconstruction, although endovascular repair has been reported. Furthermore, most femoral anastomotic pseudoaneurysms form less than 10 years after initial operation. We present a unique case of ruptured superficial femoral artery pseudoaneurysm, 30 years after the initial operation. Endovascular stents offer effective treatment for ruptured anastomotic pseudoaneurysms.
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Mousa A, Hanbal I, Sharabi A, Nasr MA, Nassar AK, Elkalla MA. Vascular suture line wrapping for Aortoiliac anastomoses following open surgical repair of Infrarenal Behçet's Aortoiliac aneurysms. Orphanet J Rare Dis 2019; 14:81. [PMID: 30987653 PMCID: PMC6466776 DOI: 10.1186/s13023-019-1048-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/12/2019] [Indexed: 02/08/2023] Open
Abstract
Background This study was conducted to evaluate our local experiences of adjunctive mechanical prosthetic wrapping for aortoiliac vascular anastomoses as a prophylactic measure following surgical repair of Behçet’s aortoiliac aneurysms. The goal of prosthetic wrapping to reinforce the vascular anastomoses by mechanical protection to reduce the bleeding complications, and consequently pseudoaneurysm formation. This was aided by the administration of pre- and postoperative immunosuppressive therapy as an adjuvant treatment. Methods A seven-year retrospective study was conducted between January 2006 and December 2012, retrieving data of patients with Behçet’s aortoiliac aneurysms. All patients underwent open surgical repair using a heparin-bonded synthetic Dacron® graft. Data for all patients were retrieved and analyzed for diagnostic procedures, graft selection, as well as, different methods of surgical repair. Graft-related complications such as anastomotic pseudoaneurysms, occlusion, and thrombosis were also reported. Results Sixteen patients were recruited in this study. There were 11 (69%) males and 5 (31%) females with the male to female ratio 2:1. The patients’ age ranged between 25 and 47 years with the mean of 36.4 ± 7.3. All Behçet’s aortic/aortoiliac aneurysms were repaired by the application of heparin-bonded Dacron® tube and bifurcated grafts. The anastomotic wrapping technique was performed for both the proximal and the distal vascular anastomoses. The technical success of aortoiliac aneurysm and wrapping techniques was achieved in 100% of patients. All patients were given pre- and postoperative systemic immunosuppressive therapy. No graft-related complications were reported except for only one anastomotic pseudoaneurysm that developed at one of the right iliac anastomoses, that developed within 24 months after follow up. Conclusions Mechanical prosthetic wrapping for vascular anastomoses in patients with Behçet’s aortic/aortoiliac aneurysms is a feasible, simple, and reliable technique with low morbidity and mortality. It was performed as a prophylactic measure to avoid the development of postoperative anastomotic pseudoaneurysms. It must be performed for all patients with Behçet’s arterial aneurysms whenever possible. Furthermore, the supplemental administration of pre- and postoperative systemic immunosuppressive therapy should be considered as an important factor for the prophylaxis and prevention of anastomotic pseudoaneurysms and other graft-related complications.
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Affiliation(s)
- Ahmed Mousa
- Department of Vascular & Endovascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Darrasa, Cairo, 11675, Egypt. .,Division of Vascular & Endovascular Surgery, Department of Surgery, College of Medicine, King Faisal University, Eastern Province, Al-Ahsa, 31982, Saudi Arabia.
| | - Ibrahim Hanbal
- Department of Vascular & Endovascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Darrasa, Cairo, 11675, Egypt
| | - Alaa Sharabi
- Department of Vascular & Endovascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Darrasa, Cairo, 11675, Egypt
| | - Mohammed A Nasr
- Division of Vascular & Endovascular Surgery, Department of Surgery, Faculty of Medicine, Al-Azhar University, Assiut Branch, Assiut, Egypt
| | - Abdelfattah K Nassar
- Department of Rheumatology and Rehabilitation, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt
| | - Mai A Elkalla
- Medical Student, Faculty of Medicine, Helwan University, Cairo, Egypt
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Manolesou D, Papaioannou TG, Georgiopoulos G, Schizas D, Lazaris A, Stamatelopoulos K, Dimakakos E, Stergiopulos N, Stefanadis C, Liakakos T, Tousoulis D. Α systematic review and meta-analysis of the efficacy of aortic anastomotic devices. J Vasc Surg 2019; 69:598-613.e7. [PMID: 30683205 DOI: 10.1016/j.jvs.2018.08.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/09/2018] [Indexed: 01/16/2023]
Abstract
OBJECTIVE One of the factors contributing to complications related to open repair of the aorta is the construction of a hand-sewn anastomosis. Aortic anastomotic devices (AADs), such as the intraluminal ringed graft (IRG), and the anastomotic stenting technique have been developed to perform a sutureless and less complicated anastomosis. This study performed a systematic review and meta-analysis of the literature reporting clinical use of AADs and aimed to assess, primarily, the effect of each device on 30-day overall and operation-related mortality and aortic cross-clamping time and, secondarily, the rate of successful two-sided application of the IRG device and the operation-related morbidity for each device. METHODS An electronic search was performed using MEDLINE, Scopus, ScienceDirect, and Cochrane Library by two independent authors. Our exclusion criteria included studies incorporating fewer than three patients and studies reporting results solely from animals or in vitro testing, results solely from end-to-side anastomosis, and results solely from endarterectomy procedures. The last search date was February 1, 2018. RESULTS A total of 41 studies were identified that reported outcomes for the use of three different device types: IRG, anastomotic stenting technique, and surgical staplers. The last two types were classified together as the non-IRG group. The meta-analysis included 27 studies with 50 cohorts incorporating 1260 patients. The median age of the incorporated patients was 61.4 years (range, 51-73 years), and 68.9% were male. The operations were performed for the treatment of acute aortic dissection in 82.3%. The pooled overall 30-day mortality rate varied by device type; IRG devices had a mean rate of all-cause mortality of 9.71%, whereas non-IRG devices were associated with a significantly (I2 = 15.78%; P for Cochrane Q test < .19) lower rate of death (1.47%). The pooled mean aortic cross-clamping time was 35.83 minutes. Metaregression showed that the performance of two-sided anastomosis with the IRG device significantly decreased the aortic cross-clamping time. However, a successful two-sided ringed anastomosis was performed in approximately half of the cases. CONCLUSIONS Taking into account that the majority of operations were performed for the treatment of acute aortic dissection, AADs had a relatively low rate of 30-day mortality. Despite the observed heterogeneity in study protocols and the small sample size in the non-IRG group, the non-IRG group presented with the lowest 30-day mortality rate. Specific device-related complications between the different device types need further investigation.
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Affiliation(s)
- Danae Manolesou
- Biomedical Engineering Unit, First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
| | - Theodore G Papaioannou
- Biomedical Engineering Unit, First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Georgiopoulos
- Vascular Laboratory, Department of Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Andreas Lazaris
- Department of Vascular Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Kimonas Stamatelopoulos
- Vascular Laboratory, Department of Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Dimakakos
- Vascular Unit, 3rd Internal Medicine Clinic, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Stergiopulos
- Laboratory of Hemodynamics and Cardiovascular Technology, Institute of Biotechnology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | - Theodoros Liakakos
- First Department of Surgery, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Tousoulis
- Biomedical Engineering Unit, First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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“In situ” endografting in the treatment of arterial and graft infections. J Vasc Surg 2017; 65:1824-1829. [DOI: 10.1016/j.jvs.2016.12.134] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 12/13/2016] [Indexed: 12/27/2022]
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Ruffino MA, Rabbia C. Endovascular Repair of Peripheral and Visceral Aneurysms With the Cardiatis Multilayer Flow Modulator:One-Year Results From the Italian Multicenter Registry. J Endovasc Ther 2012; 19:599-610. [DOI: 10.1583/jevt-12-3930mr2.1] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Orimoto Y, van Keulen JW, Waasdorp EJ, Moll FL, van Herwaarden JA. Treatment of a recurrent false aneurysm of the femoral artery by stent--graft placement from the brachial artery. Ann Vasc Surg 2011; 25:841.e1-4. [PMID: 21620657 DOI: 10.1016/j.avsg.2011.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Revised: 01/21/2011] [Accepted: 01/24/2011] [Indexed: 11/28/2022]
Abstract
An anastomotic false aneurysm is a well known complication after femoral artery surgery. Open surgical repair is the treatment of choice for anastomotic femoral aneurysms, but this can be challenging, unsuccessful, or even impossible. Endovascular repair is an alternative in these cases, but the delivery of a stent--graft in the femoral artery can be difficult. We report the case of a patient with a recurrent left femoral artery anastomotic false aneurysm, treated twice by open exclusion, and finally excluded successfully by a stent--graft that was inserted through the left brachial artery.
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Affiliation(s)
- Yuki Orimoto
- Department of Vascular Surgery, University Medical Center, Utrecht, The Netherlands
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Kim SD, Won YS, Yun SS, Park SC, Kim JI, Moon IS, Koh YB. Aortic transection and diverting bypass as treatment of repetitive recurrent abdominal aortic false aneurysm rupture in a patient with Behcet's disease. Ann Vasc Surg 2010; 25:267.e1-5. [PMID: 20932713 DOI: 10.1016/j.avsg.2010.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2010] [Revised: 04/08/2010] [Accepted: 07/19/2010] [Indexed: 11/17/2022]
Abstract
Abdominal aortic false aneurysms in patients with Behcet's disease have been reported frequently and repaired successfully by various procedures; however, anastomotic false aneurysms have often been reported to occur after the operation. In this article, we report a case of four-time repetitive, recurrent suprarenal abdominal aortic false aneurysm ruptures that lasted for 7 years. The location of this aneurysm was not easy to repair not only by open surgical procedures but by endovascular stent because the aortic defect was too close to the visceral arterial branches. The last operation consisted of primary repair of aortic defect, transection of abdominal aorta at the level of supraceliac aorta with end closure, and a thoracic aorta to abdominal aorta bypass with Dacron graft. An 8-year follow-up revealed no more abdominal aortic aneurysm recurrence.
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Affiliation(s)
- Sang-Dong Kim
- Department of Surgery, The Catholic University Medical Center, Seoul, Korea
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Kapoor BS, Haddad HL, Saddekni S, Lockhart ME. Diagnosis and management of pseudoaneurysms: an update. Curr Probl Diagn Radiol 2009; 38:170-88. [PMID: 19464587 DOI: 10.1067/j.cpradiol.2008.11.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
"Pseudoaneurysm" is a term that describes disruption of an artery with patent flow in a defined space beyond the confines of the vessels. A pseudoaneurysm can involve any vascular bed and is usually associated with direct arterial injury or erosion of an artery by an adjacent tumor or inflammation. In this article, we discuss different clinical settings and various imaging modalities such as ultrasound, computerized tomography, magnetic resonance imaging, as well as conventional angiography used for the diagnosis of pseudoaneurysms. We also describe the role of newer endovascular, percutaneous, and traditional surgical approaches for the treatment of visceral and peripheral pseudoaneurysms in different clinical circumstances.
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Affiliation(s)
- Baljendra S Kapoor
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL 35249-6830, USA.
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Klonaris C, Katsargyris A, Vasileiou I, Markatis F, Liapis CD, Bastounis E. Hybrid repair of ruptured infected anastomotic femoral pseudoaneurysms: Emergent stent-graft implantation and secondary surgical debridement. J Vasc Surg 2009; 49:938-45. [DOI: 10.1016/j.jvs.2008.10.063] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2008] [Revised: 10/28/2008] [Accepted: 10/30/2008] [Indexed: 10/21/2022]
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Functional Assessment at the Buttock Level of the Effect of Aortobifemoral Bypass Surgery. Ann Surg 2008; 247:869-76. [DOI: 10.1097/sla.0b013e31816bcd75] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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