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Nakahara Y, Tateishi R, Ono S, Kanemura T. Sutureless repair for vena cava bleeding using an elastomeric sealant in a porcine model. Interdiscip Cardiovasc Thorac Surg 2023; 37:ivad122. [PMID: 37486239 PMCID: PMC10481770 DOI: 10.1093/icvts/ivad122] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/01/2023] [Accepted: 07/21/2023] [Indexed: 07/25/2023]
Abstract
To address the issue of bleeding from the vena cava, a common complication of cardiac and aortic surgeries, we developed a sutureless repair technique using Hydrofit, an elastomeric sealant. In a porcine model, we surgically incised the inferior vena cava and applied the elastomeric sealant with a pericardial patch, achieving complete haemostasis through manual compression. This simple and rapid technique demonstrates effective sutureless haemostasis for the vena cava.
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Affiliation(s)
- Yoshinori Nakahara
- Department of Cardiovascular Surgery, IMS Katsushika Heart Centre, Tokyo, Japan
| | - Retsu Tateishi
- Department of Cardiovascular Surgery, IMS Katsushika Heart Centre, Tokyo, Japan
| | - Shunya Ono
- Department of Cardiovascular Surgery, IMS Katsushika Heart Centre, Tokyo, Japan
| | - Takeyuki Kanemura
- Department of Cardiovascular Surgery, IMS Katsushika Heart Centre, Tokyo, Japan
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Aoki R, Nakajima K, Kobayashi Y, Sakai Y, Kamide H, Yamamoto T, Furugori S, Sawamura S, Terauchi M, Kamiyama K, Ikeda S, Tsuji G, Koyama S, Yoshigi J, Sekikawa Z, Utsunomiya D. Common and uncommon vascular injuries and endovascular treatment associated with pelvic blunt trauma: a real-world experience. Jpn J Radiol 2023; 41:258-265. [PMID: 36350523 PMCID: PMC9974705 DOI: 10.1007/s11604-022-01355-1] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/20/2022] [Indexed: 11/11/2022]
Abstract
Pelvic fractures are common in cases of blunt trauma, which is strongly associated with mortality. Transcatheter arterial embolization is a fundamental treatment strategy for fatal arterial injuries caused by blunt pelvic trauma. However, vascular injuries due to blunt pelvic trauma can show various imaging findings other than arterial hemorrhage. We present a pictorial review of common and uncommon vascular injuries, including active arterial bleeding, pseudoaneurysm, arteriovenous fistula, arterial occlusion, vasospasm, and active venous bleeding. Knowledge of these vascular injuries can help clinicians select the appropriate therapeutic strategy and thus save lives.
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Affiliation(s)
- Ryo Aoki
- Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan. .,Department of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan.
| | - Kento Nakajima
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yusuke Kobayashi
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Yodo Sakai
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Hiroyuki Kamide
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Toh Yamamoto
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Shintaro Furugori
- grid.413045.70000 0004 0467 212XAdvanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Shungo Sawamura
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Miki Terauchi
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Kazutoshi Kamiyama
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Shin Ikeda
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Gengo Tsuji
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Shingo Koyama
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Jun Yoshigi
- grid.417369.e0000 0004 0641 0318Department of Diagnostic Radiology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | - Zenjiro Sekikawa
- grid.413045.70000 0004 0467 212XDepartment of Diagnostic Radiology, Yokohama City University Medical Center, Yokohama, Japan
| | - Daisuke Utsunomiya
- grid.268441.d0000 0001 1033 6139Department of Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Brugada-Bellsolà F, González-Crespo A, Pastor-Cabeza M, Blanco Ibáñez de Opacua A, Remollo S, Anglada-Oliván M, Misis M, Domínguez CJ, Rimbau JM, Rodríguez-Hernández A. Dural Venous Sinus Variations in Idiopathic Subarachnoid Hemorrhage: A New Indicator of the Venous Origin with Diagnostic Usefulness? World Neurosurg 2021; 156:e266-e275. [PMID: 34543731 DOI: 10.1016/j.wneu.2021.09.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 03/17/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Venous hypertension associated with a primitive basal vein of Rosenthal (BVR) has been noted as the most likely cause of idiopathic subarachnoid hemorrhage (iSAH). Other types of venous drainage variations have been scarcely studied but may further explain the cases not associated with a BVR anomaly. Our aim was to investigate if dural venous sinus (DVS) anomalies are related with iSAH. METHODS A total of 76 patients diagnosed with iSAH were identified from a prospectively maintained database and their angiographic findings compared with 76 patients diagnosed with aneurysmal subarachnoid hemorrhage. RESULTS On top of the BVR variations, our data showed a higher prevalence of transverse sinus hypoplasia (47.4% vs. 28.9%; P = 0.019), superior petrosal sinus hypoplasia (32.9% vs. 13.2%; P = 0.003), and clival plexus hyperplasia (65.8% vs. 43.4%; P = 0.005) in patients with iSAH. Analyzing by total number of angiograms, the iSAH group showed also a higher prevalence of inferior petrosal sinus hyperplasia (36.2% vs. 25%; P = 0.003). Of the patients with iSAH without a primitive BVR, 84% harbored ≥1 perimesencephalic DVS variation and the overall number of venous drainage variations was significantly higher in patients with iSAH. CONCLUSIONS In addition to the well-documented BVR anomalies, there seems to be a significant relationship of other DVS variations in patients with iSAH. Transverse sinus hypoplasia, superior petrosal sinus hypoplasia, inferior petrosal sinus hyperplasia, and clival plexus hyperplasia were significantly more frequent in patients with iSAH. The presence of ≥3 of those variations would increase the suspicion of a nonaneurysmatic subarachnoid hemorrhage and could help avoid a second angiogram.
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Affiliation(s)
- Ferran Brugada-Bellsolà
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Antonio González-Crespo
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Marta Pastor-Cabeza
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain
| | | | - Sebastian Remollo
- Department of Neuroscience, Interventional Neuroradiology Unit, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Mireia Anglada-Oliván
- Department of Intensive Care, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Maite Misis
- Department of Intensive Care, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Carlos J Domínguez
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Jordi M Rimbau
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain
| | - Ana Rodríguez-Hernández
- Department of Neurological Surgery, Germans Trias i Pujol University Hospital, Badalona, Spain.
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Charcos IB, Wong TW, Larsen BR, Azurdia AR, Gridley DG, Vail SJ, Hollingworth AK, Lettieri SC, Feiz-Erfan I. Location of Traumatic Cranial Epidural Hematoma Correlates with the Source of Hemorrhage: A 12-Year Surgical Review. World Neurosurg 2021; 152:e138-e143. [PMID: 34033954 DOI: 10.1016/j.wneu.2021.05.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/01/2021] [Revised: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Epidural hematoma (EDH) can result in a catastrophic outcome of traumatic brain injury. Current management guidelines do not consider the source of hemorrhage in decision making. The purpose of this study was to examine the relationship between EDH location and the source of hemorrhage. METHODS We report retrospectively reviewed, prospectively obtained surgical data of patients with acute traumatic cranial EDH treated between 2007 and 2018. Computed tomography (CT) scans were used to categorize EDH location as lateral or medial. The source of hemorrhage was identified intraoperatively by a single surgeon. RESULTS Overall, of 92 evacuated EDHs (in 87 patients), 71 (77.2%) were in the lateral location. Arterial bleeding was the cause of EDH in 63.4% of the lateral EDHs and 9.2% of the medial EDHs (P < 0.0001). In the cases where surgery was done primarily to treat EDH, 65.3% had an arterial bleed source (P < 0.0001). In those treated for primary reasons other than EDH evacuation, 75% had a venous bleed source (P = 0.002). CONCLUSIONS The location of EDH correlates with the source of hemorrhage. The decision to operate on EDH may be influenced by this factor.
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Affiliation(s)
- Iris B Charcos
- Department of Surgery, Division of Neurosurgery, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA
| | - Tina W Wong
- Department of Surgery, Division of Neurosurgery, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA
| | - Brett R Larsen
- Department of Radiology, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Adrienne R Azurdia
- Emergency Medicine, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Department of Emergency Medicine, HonorHealth Scottsdale, Scottsdale, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Daniel G Gridley
- Department of Radiology, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Sydney J Vail
- Division of Trauma, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Alexzandra K Hollingworth
- Division of Trauma, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Department of Surgery and Anesthesia, Midwestern University, Glendale, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Salvatore C Lettieri
- Division of Plastic Surgery, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Division of Plastic Surgery, Mayo Clinic, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA
| | - Iman Feiz-Erfan
- Department of Surgery, Division of Neurosurgery, Creighton University, School of Medicine Phoenix, Phoenix, Arizona, USA; Valleywise Health Medical Center, Phoenix, Arizona, USA; The University of Arizona, College of Medicine Phoenix, Phoenix, Arizona, USA.
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Val-Jordán E, Seral-Moral P, Novo-González B. Remote cerebellar hemorrhage caused by undetected dural tear after lumbar spinal surgery. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017; 62:228-230. [PMID: 28882465 DOI: 10.1016/j.recot.2017.06.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/08/2017] [Accepted: 06/21/2017] [Indexed: 12/01/2022] Open
Abstract
Remote cerebellar haemorrhage is a rare but serious complication after spinal surgery. Although the mechanism is not well known, it always occurs after loss of cerebrospinal fluid due to dural tear, not always identified, which produces remote venous bleeding. Prognosis depends largely on the severity of this bleeding. We report a case of 67-year-old female who suffered a cerebellar and subarachnoid haemorrhage and subdural haematoma after elective lumbar fusion surgery and eventually required decompressive craniectomy.
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Affiliation(s)
- Estela Val-Jordán
- Servicio de Medicina Intensiva, Hospital Universitario Miguel Servet, Zaragoza, España.
| | - Pilar Seral-Moral
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España
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