Relevant bibliographies by topics / Distal Graft

Academic literature on the topic 'Distal Graft'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Distal Graft"

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Rodriguez, Santiago, Michael R. Mancini, Rafael Kakazu, Matthew R. LeVasseur, Maxwell T. Trudeau, Mark P. Cote, Robert A. Arciero, Patrick J. Denard, and Augustus D. Mazzocca. "Comparison of the Coracoid, Distal Clavicle, and Scapular Spine for Autograft Augmentation of Glenoid Bone Loss: A Radiologic and Cadaveric Assessment." American Journal of Sports Medicine 50, no. 3 (January 20, 2022): 717–24. http://dx.doi.org/10.1177/03635465211065446.

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Background: Glenohumeral instability caused by bone loss requires adequate bony restoration for successful surgical stabilization. Coracoid transfer has been the gold standard bone graft; however, it has high complication rates. Alternative autologous free bone grafts, which include the distal clavicle and scapular spine, have been suggested. Study Design: Controlled laboratory study. Purpose: The purpose of this study was to determine the percentage of glenoid bone loss (GBL) restored via coracoid, distal clavicle, and scapular spine bone grafts using a patient cohort and a cadaveric evaluation. Methods: Autologous bone graft dimensions from a traditional Latarjet, congruent arc Latarjet, distal clavicle, and scapular spine were measured in a 2-part study using 52 computed tomography (CT) scans and 10 unmatched cadaveric specimens. The amount of GBL restored using each graft was calculated by comparing the graft thickness with the glenoid diameter. Results: Using CT measurements, we found the mean percentage of glenoid restoration for each graft was 49.5% ± 6.7% (traditional Latarjet), 45.1% ± 4.9% (congruent arc Latarjet), 42.2% ± 7.7% (distal clavicle), and 26.2% ± 8.1% (scapular spine). Using cadaveric measurements, we found the mean percentage of glenoid restoration for each graft was 40.2% ± 5.0% (traditional Latarjet), 53.4% ± 4.7% (congruent arc Latarjet), 45.6% ± 8.4% (distal clavicle), and 28.2% ± 7.7% (scapular spine). With 10% GBL, 100% of the coracoid and distal clavicle grafts, as well as 88% of scapular spine grafts, could restore the defect ( P < .001). With 20% GBL, 100% of the coracoid and distal clavicle grafts but only 66% of scapular spine grafts could restore the defect ( P < .001). With 30% GBL, 100% of coracoid grafts, 98% of distal clavicle grafts, and 28% of scapular spine grafts could restore the defect ( P < .001). With 40% GBL, a significant difference was identified ( P = .001), as most coracoid grafts still provided adequate restoration (congruent arc Latarjet, 82.7%; traditional Latarjet, 76.9%), but distal clavicle grafts were markedly reduced, with only 51.9% of grafts maintaining sufficient dimensions. Conclusions: The coracoid and distal clavicle grafts reliably restored up to 30% GBL in nearly all patients. The coracoid was the only graft that could reliably restore up to 40% GBL. Clinical Relevance: With “subcritical” GBL (>13.5%), all autologous bone grafts can be used to adequately restore the bony defect. However, with “critical” GBL (≥20%), only the coracoid and distal clavicle can reliably restore the bony defect.
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Prasertcharoensuk, Supatcha, Sopon Jirasiritham, Wiwat Tirapanich, Surasak Leela-Udomlipi, Piyanut Pootracool, Suthas Horsirimanont, Pannuwat Lertsithichai, Chatree Phasit, and Nantawan Lieungthada. "Comparison of Forearm Swelling After Loop Forearm Arteriovenous Graft between Distal Vein Ligation and No Ligation." Journal of the Association for Vascular Access 22, no. 2 (June 1, 2017): 93–97. http://dx.doi.org/10.1016/j.java.2016.12.003.

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Abstract Purpose: Forearm loop arteriovenous grafts (AVGs) are an effective way to grant permanent vascular access in end-stage renal disease patients undergoing hemodialysis. A common postoperative complication with this procedure is forearm swelling. Distal vein ligation is believed to reduce postoperative venous hypertension and forearm swelling. There have been no previous randomized controlled trials comparing the efficacy of AVGs with and without distal vein ligation. Methods: A pilot study was performed as a randomized controlled trial. End-stage renal disease patients who required AVG construction were recruited and randomly assigned to either the distal vein ligation group or the nondistal vein ligation group. Forearm swelling, graft patency, and graft thrombosis were recorded and compared. Results: The nonligation and ligation groups consisted of 30 and 31 patients, respectively. Forearm swelling at both the proximal and distal areas was nonsignificantly higher in the nonligation group than in the ligation group. The success rate of cannulation of the graft was 77% in both groups. The first cannulation time was somewhat shorter in the ligation group than in the nonligation group (57 vs 63 days; P = .282). There was no difference in graft thrombosis between the 2 groups (8 and 6 patients, respectively, in the nonligation and ligation groups). Conclusions: AVGs can be performed with or without distal vein ligation.
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Kwapisz, Adam, Kelly Fitzpatrick, Jay B. Cook, George S. Athwal, and John M. Tokish. "Distal Clavicular Osteochondral Autograft Augmentation for Glenoid Bone Loss: A Comparison of Radius of Restoration Versus Latarjet Graft." American Journal of Sports Medicine 46, no. 5 (January 30, 2018): 1046–52. http://dx.doi.org/10.1177/0363546517749915.

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Background: Bone loss in shoulder instability is a well-recognized cause of failure after stabilization surgery. Many approaches have been described to address glenoid bone loss, including coracoid transfer. This transfer can be technically difficult and has been associated with high complication rates. An ideal alternative to coracoid transfer would be an autologous source of fresh osteochondral graft with enough surface area to replace significant glenoid bone loss. The distal clavicle potentially provides such a graft source that is readily available and low-cost. Purpose: To evaluate distal clavicular autograft reconstruction for instability-related glenoid bone loss, specifically comparing the width of the clavicular autograft with the width of an ipsilateral coracoid graft as prepared for a Latarjet procedure. Further, we sought to compare the articular cartilage thickness of the distal clavicle graft with that of the native glenoid. Study Design: Controlled laboratory study. Methods: Twenty-seven fresh-frozen cadaver specimens were dissected, and an open distal clavicle excision was performed. The coracoid process in each specimen was prepared as has been described for a classic Latarjet coracoid transfer. In each specimen, the distal clavicle graft was compared with the coracoid graft for size and potential of glenoid articular radius of restoration. The distal clavicle graft was also compared with the native glenoid for cartilage thickness. Results: In all specimens, the distal clavicle grafts provided a greater radius of glenoid restoration than the coracoid grafts ( P < .0001). On average, the clavicular graft was able to reconstruct 44% of the glenoid diameter, compared with 33% for the coracoid graft ( P < .0001). The articular cartilage of the glenoid was significantly thicker (1.4 mm thicker, P < .0001) than that of the distal clavicular autograft (average ± SD, 3.5 ± 0.6 mm vs 2.1 ± 0.8 mm, respectively). When specimens with osteoarthritis were excluded, this difference decreased to 0.97 mm when compared with the clavicular cartilage ( P = .0026). Conclusion: The distal clavicle autograft can restore a significantly greater glenoid bone deficit than the Latarjet procedure and has the additional benefit of restoring articular cartilage to the glenoid. The articular cartilage thickness of the distal clavicle is within 1.4 mm of that of the native glenoid. Clinical Relevance: The distal clavicular autograft may be a suitable option for reconstruction of instability-related glenoid bone loss. This graft provides a structural osteochondral autograft with a broader radius of reconstruction than that of a coracoid graft, is locally available, has minimal donor site morbidity, is anatomic, and provides articular cartilage.
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Chuang, David. "Distal Nerve Transfers: A Perspective on the Future of Reconstructive Microsurgery." Journal of Reconstructive Microsurgery 34, no. 09 (May 16, 2018): 669–71. http://dx.doi.org/10.1055/s-0038-1656719.

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Abstract Background Nerve transfer can be broadly separated into two categories: proximal nerve graft and/or transfer and distal nerve transfer. The superiority of proximal nerve graft/transfer over distal nerve transfer strategy has been debated extensively, but which strategy is the best has not yet been defined. Each technique has its own advantages and disadvantages. However, proximal nerve graft/transfer is still the main reconstructive procedure based on the principle of “no diagnosis, then no treatment.” Proximal nerve transfer can avoid iatrogenic injury where the lesion is still in continuity and neurolysis is the only procedure without further cutting the nerve. Results Our clinical and experimental study show that proximal nerve grafts/transfers yield at least equal or better results compared to distal nerve transfers. Proximal nerve grafts/transfers remain the mainstay of my reconstructive strategy. Proximal nerve graft/transfer offers more accurate diagnosis and proper treatment to restore shoulder and elbow functions simultaneously. Distal nerve transfers can offer more efficient elbow flexion. Conclusion Combined, both strategies in primary nerve reconstruction are especially recommended when there is no healthy or not enough donor nerve available Distal nerve transfers should be considered as a complementary option for proximal nerve grafts/ transfers.
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Mohan, Irwin V., Peter L. Harris, Corine J. van Marrewijk, Robert J. Laheij, and Thien V. How. "Factors and Forces Influencing Stent-Graft Migration after Endovascular Aortic Aneurysm Repair." Journal of Endovascular Therapy 9, no. 6 (December 2002): 748–55. http://dx.doi.org/10.1177/152660280200900606.

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Purpose: To assess and validate the clinical features predisposing to stent-graft migration and to calculate the distal displacement forces exerted at the proximal fixation site following endovascular aortic aneurysm repair (EVAR). Methods: Demographic, anatomical, and graft-related features from 2862 patients were analyzed in a regression model to identify variables associated with stent-graft migration, which was defined as device movement >5 mm or considered significant by the investigator. Using the principles of continuity and momentum, a mathematical model of blood flow was created. The pulse pressure, proximal aortic and distal iliac diameters, and the degree of iliac angulation were varied in the calculations, and the distal displacement force exerted at the proximal fixation site was calculated. Results: Ninety-nine patients developed stent-graft migration, which was clinically relevant in 85 (3.0%). Hypertension (p=0.015), smoking (p=0.009), maximal aortic diameter (p=0.004), and distal transverse aortic diameter (p=0.03) correlated with migration in the univariate analysis, but iliac angulation did not quite achieve significance (p=0.06). On multivariate analysis, current smoking, hypertension, distal transverse aortic diameter, maximum common iliac diameter, and increasing proximal graft size were significantly associated with stent-graft migration. The mathematical model calculated the distal displacement force exerted on the proximal fixation site of the stent-graft and validated the clinical findings. The ratio of graft-diameter change from proximal aorta to distal iliac influenced the greatest increase in the displacement force. Conclusions: The mathematical model validated hypertension, aneurysm morphology, and endograft size as clinical factors significantly associated with stent-graft migration. These findings may have important implications for the choice and design of future stent-grafts.
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Onohara, Toshihiro, Kaoru Kitamura, Thomas E. Arnold, Teruo Matsumoto, and Morris D. Kerstein. "Management of Failed or Failing Infrainguinal Bypasses with Distal Correctable Lesions." American Surgeon 67, no. 10 (October 2001): 935–38. http://dx.doi.org/10.1177/000313480106701005.

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The goal of this study was to assess the management of failed or failing infrainguinal bypasses with distal correctable lesions. A retrospective analysis of 94 procedures was performed for 72 (77%) failed and 22 (23%) failing infrainguinal bypasses with distal correctable lesions in 94 patients. The 94 procedures included 50 (53%) balloon angioplasties and 44 (47%) distal vein graft extensions from the previous graft to the distal artery. Preprocedural thrombolytic therapy was performed in 62 of 94 limbs with a failed graft, and complete thrombolysis was achieved in 30 of 94. The results of thrombolytic therapy (complete or incomplete thrombolysis) or the means of revision procedure (balloon angioplasty or distal vein graft extension) did not affect the patency. Lower patency was observed for women, patients with a secondary bypass, and grafts with multiple episodes of revision. We conclude that the patency of failing infrainguinal bypasses after revision of distal lesions was affected not by means of therapy but by previous vascular procedures, the usual risk factors, and female gender.
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Parada, Stephen A., K. Aaron Shaw, Colleen Moreland, Douglas R. Adams, Mickey S. Chabak, and Matthew T. Provencher. "Variations in the Anatomic Morphology of the Lateral Distal Tibia: Surgical Implications for Distal Tibial Allograft Glenoid Reconstruction." American Journal of Sports Medicine 46, no. 12 (August 31, 2018): 2990–95. http://dx.doi.org/10.1177/0363546518793880.

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Background: Distal tibial allograft glenoid augmentation has been introduced as a viable treatment approach for glenoid bone loss in conjunction with shoulder instability. No previous study, however, has assessed the morphologic variation of the distal tibia at the incisura as it relates to graft dimensions for glenoid augmentation. Increased concavity at the lateral distal tibia necessitates removal of the lateral cortex to obtain a flat surface, which may have implications for the strength of surgical fixation. Purpose: To assess the morphologic variation of the distal tibia at the incisura as it relates to graft dimensions for glenoid augmentation. Study Design: Descriptive laboratory study. Methods: Magnetic resonance images of the ankle were reviewed for morphology assessment of the appearance and depth of the distal tibia. A classification system was created reflecting the suitability for glenoid augmentation. Type A tibias contained a flat contour of the lateral tibia at the articular surface, indicative of an ideal graft. Type B tibias had slight concavity with a central depth <5 mm and were deemed acceptable grafts. Type C tibias had deep concavity with a central depth >5 mm and were deemed unacceptable. Statistical analysis was performed via univariate analyses to compare patient demographics against acceptable morphology for glenoid augmentation. Results: Eighty-five study patients met inclusion criteria (53 male, 32 female; mean age ± SD, 35.1 ± 10.3 years). Overall, 12 patients (14.1%) demonstrated type A morphology, with 61 patients (71.8%) having type B morphology for a total of 85.9% of acceptable grafts for glenoid augmentation. The interrater reliability was moderate to strong between observers (kappa value = 0.841). On univariate analysis, sex was the only variable significantly associated with an acceptable graft, with 100% of female patients having acceptable morphology, as compared with 77% of male patients ( P = .004). Conclusion: Variable morphology of the distal tibia at the incisura was found: 14.1% of patients demonstrated an ideal morphology for glenoid augmentation; an additional 71.8% were deemed suitable for graft usage; and 14.1% of tibias had unacceptable morphology. Sex was a significant factor for predicting acceptable grafts. Clinical Relevance: This information will assist surgeons in accepting or rejecting grafts based on the epidemiology of the distal tibial morphology as it relates to glenoid augmentation.
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Dhupa, S., and J. E. Harris. "Treatment of degloving injuries with autogenous full thickness mesh scrotal free grafts." Veterinary and Comparative Orthopaedics and Traumatology 21, no. 04 (2008): 378–81. http://dx.doi.org/10.3415/vcot-07-04-0029.

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SummaryIn this report, we evaluated the effectiveness of scrotal tissue as an autogenous free skin graft to treat cutaneous degloving injuries of the distal limb in dogs. Surgery was performed on two male intact dogs with distal extremity degloving wounds. Dog #1 had a tarsal degloving wound with exposure of the distal tibial and tarsal bones. Dog #2 had a degloving injury over the metacarpals. Wounds were treated with daily wetto- dry bandages in order to develop a healthy bed of granulation tissue at the graft recipient site. Scrotal ablation castration was performed once the recipient site had been prepared. Subcutaneous and adipose tissue were excised from the scrotal graft and mesh slits were created. The graft was applied to the recipient site with monofilament absorbable simple interrupted sutures. Bandaging was performed postoperatively, and bandage changes occurred four, seven, nine and 11 days postoperatively. Follow-up was performed at 30 days. In dog #1, the tarsal degloving injury graft had first intention healing with 100% graft take on day 11. In dog #2, the metacarpal degloving injury graft had 90% graft take on day nine, with second intention healing adjacent to the fifth digit pad. The scrotum is often discarded at the time of scrotal ablation castration. Distal extremity wounds can be successfully treated with free skin grafts. In male dogs, the scrotum is a viable option as a full thickness mesh free graft for distal extremity reconstructive surgery.
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Kaisar, Jeremy, Aaron Chen, Mathew Cheung, Elias Kfoury, Carlos F. Bechara, and Peter H. Lin. "Comparison of propaten heparin-bonded vascular graft with distal anastomotic patch versus autogenous saphenous vein graft in tibial artery bypass." Vascular 26, no. 2 (August 23, 2017): 117–25. http://dx.doi.org/10.1177/1708538117717141.

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Introduction Heparin-bonded expanded polytetrafluoroethylene grafts (Propaten, WL Gore, Flagstaff, AZ, USA) have been shown to have superior patency compared to standard prosthetic grafts in leg bypass. This study analyzed the outcomes of Propaten grafts with distal anastomotic patch versus autogenous saphenous vein grafts in tibial artery bypass. Methods A retrospective analysis of prospective collected data was performed during a recent 15-year period. Sixty-two Propaten bypass grafts with distal anastomotic patch (Propaten group) were compared with 46 saphenous vein graft (vein group). Pertinent clinical variables including graft patency and limb salvage were analyzed. Results Both groups had similar clinical risk factors, bypass indications, and target vessel for tibial artery anastomoses. Decreased trends of operative time (196 ± 34 min vs. 287 ± 65 min, p = 0.07) and length of hospital stay (5.2 ± 2.3 days vs. 7.5 ± 3.6, p = 0.08) were noted in the Propaten group compared to the vein group. Similar primary patency rates were noted at four years between the Propaten and vein groups (85%, 71%, 64%, and 57%, vs. 87%, 78%, 67%, and 61% respectively; p = 0.97). Both groups had comparable secondary patency rates yearly in four years (the Propaten group: 84%, 76%, 74%, and 67%, respectively; the vein group: 88%, 79%, 76%, and 72%, respectively; p = 0.94). The limb salvage rates were equivalent between the Propaten and vein group at four years (84% vs. 92%, p = 0.89). Multivariate analysis showed active tobacco usage and poor run-off score as predictors for graft occlusion. Conclusions Propaten grafts with distal anastomotic patch have similar clinical outcomes compared to the saphenous vein graft in tibial artery bypass. Our data support the use of Propaten graft with distal anastomotic patch as a viable conduit of choice in patients undergoing tibial artery bypass.
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Wayangankar, Siddharth, Jigar Patel, and Thomas A. Hennebry. "Isolated pharmaco-mechanical thrombectomy (IPMT) for the endovascular treatment of acute axillofemoral graft occlusion." Vascular Medicine 18, no. 1 (February 2013): 27–31. http://dx.doi.org/10.1177/1358863x13477233.

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Since the long-term patency of axillofemoral (AXF) grafts is inferior to aorto-bifemoral (ABF) grafts, limb salvage procedures are crucial in this group of patients. Emerging endovascular devices have helped in the successful restoration of flow for acute limb ischemia in both native arteries as well as bypass grafts. One such device, the Trellis™ thrombectomy system is being used more frequently in this setting. The device has previously been used in veins, native arteries, and rarely in aortofemoral grafts. We present its first successful use for the treatment of occluded AXF bypass graft. The use of this device helped to isolate the treatment zone in the occluded graft, which allowed the use of a lower dose of thrombolytics, less systemic release of thrombolytics, and less distal embolization. Resolution of extensive clot burden was achieved and, with subsequent stenting of the graft at the distal anastomotic site, arterial flow to the leg through the AXF graft was restored and a revision surgery was avoided.
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Dissertations / Theses on the topic "Distal Graft"

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Crane, Jeremy Samuel. "Geometry at the Distal Anastomosis of Infra-inguinal vein bypass Grafts." Thesis, Imperial College London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522848.

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Chen, Wei-Yuan, and 陳威元. "Fibrin Degradation Products and D-dimer as Biomarkers of False Lumen Volume Regression and Predictors of Distal Stent Graft Induced Reentry (SINE) after Endovascular Repair with Stainless Steel-Based Stent Graft in Complicated Stanford Type B Aortic Dissection." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/40869687214745397791.

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碩士
國立陽明大學
臨床醫學研究所
100
Objective The gold standard of treating Stanford type B aortic dissection is medical management, and the surgical intervention is only reserved for complicated dissections. Instead of traditional open surgery, the endovascular stent graft repair becomes more popular, but this population of patients requires frequent computed tomography (CT) follow-up for the aortic remodeling after procedure. In this study, we analyzed these patients’ outcome, and proposed to identify any existing biomarkers which could be applied to predict the remodeling of false lumen regression of dissecting aorta after endovascular repair with stent graft, eliminating the expensive CT scan burden of patients. Methods From November 2006 to June 2011, 64 patients with complicated type B aortic dissection underwent stainless steel-based stent graft repair in Taipei VGH. Clinical and laboratory data were collected before and after procedure, and then at intervals of 1, 3, 6, 12 months and annually thereafter. Serial contrast-enhanced spiral computed tomography scans were performed during these examinations, and the images were transferred to a workstation (Aquarius iNtutition, version 4.4.68, TeraRecon Inc., San Mateo, CA) for calculation of parameters, including volume of true and false lumen of dissected aorta. Data were analyzed with SPSS software (version 17.0; SPSS, Inc., Chicago, ILL). Results Stent grafts were successfully implanted in all patients (100%). Two surgical mortalities were documented, and cumulative survival rate was 84.4% in a mean follow-up period of 26.7 ± 17.2 months. Fifty three enrolled patients had completed one year follow-up, and were divided into two groups according to total regression of false lumen (n=9) or not (n=44). Biochemical data and coagulatory factor examined between two groups showed that fibrin degradation products (FDP) and D-dimer had statistically significant difference (P < .05). For further quantitative analysis, patients with complete or partial regression of false lumen were selected, excluding endoleak or late distal SINE. The false lumen volume on the computed tomography scan was calculated by the workstation, and then correlated with FDP or D-dimer data during the follow-up periods. Total 27 sets of data met the selective criteria, and linear regression showed positive correlation (FDP: R2 = .464, P < .001; D-dimer: R2 = .469, P < .001). Another twenty patients suffered from distal SINE during the follow-up periods. The mean detection time after procedure was 52.5 ± 36.9 weeks. The biochemical data at the event of distal SINE was compared with previous data. FDP level elevated from 11.95 ± 4.37 μg/mL to 17.47 ± 8.84 μg/mL (P = .014), and D-dimer level elevated from 5.10 ± 2.38 μg/mL to 7.41 ± 4.16 μg/mL (P = .026), both showed significantly increased. Conclusion Fibrin degradation products (FDP) and D-dimer have good correlation with false lumen volume regression after endovascular repair with stainless steel-based stent graft in complicated Stanford type B aortic dissection. Besides, these two parameters are proposed as good predictors for detecting the distal SINE episode during the aortic remodeling process.
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Books on the topic "Distal Graft"

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Walsh, Michael Thomas. Design of a distal graft/artery junction to increase the patency rates of peripheral bypass surgery. 2001.

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Agarwal, Anil, Neil Borley, and Greg McLatchie. Vascular surgery. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199608911.003.0008.

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This chapter covers vascular operations. Treatments described for varicose veins are high tie and multiple avulsions, radio-frequency ablation, and foam sclerotherapy. Repair of elective and ruptured abdominal aortic aneurysm and endovascular repair are described. Operations like aortobifemoral bypass, femoral popliteal above- and below-knee bypass graft, and femoro-distal bypass are included. Urgent operations like femoral and brachial embolectomy, lower limb fasciotomy are also described. In addition, above- and below-knee amputations and vascular access are included.
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Kahn, S. Lowell. Reverse Deployment of the Gore Excluder Contralateral Iliac Limbs for Aortoiliac Interventions. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0009.

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Aortoiliac occlusive disease and aneurysmal disease are common pathologies encountered by the interventionalist. There are a multitude of commercially available bifurcated grafts for use in aortoiliac disease, but these devices are costly and require at least a 14 Fr femoral access for deployment. This chapter describes a simple and safe method for reversing deployment of the Excluder contralateral limb. This has great utility not only for aortoiliac interventions but also for central venous stenoses/occlusions. Reversal of the limb allows a proximal diameter of 12–27 mm with a fixed distal diameter of 16 mm. The technique requires use of a 12–15 Fr sheath, most commonly a 12 Fr sheath.
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Coleman, Deirdre. Imperial Commerce, Gender, and Slavery. Oxford University Press, 2018. http://dx.doi.org/10.1093/oso/9780199574803.003.0024.

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This chapter explores the twinned emergence in the British novel of a critique of plantation slavery and commercial imperialism with a proto-feminist questioning of the ‘commerce of the sexes’. The discourses of racial and sexual oppression resonate with one another, helping to establish connections between inequalities at home and the sufferings of distant others. It has been argued that novelistic representations of violence and suffering are central to an ‘imagined empathy’ which in turn assisted the development in the eighteenth century of humanitarian sentiment. While it might be charged that the mid-eighteenth-century novel failed to grant full humanity to the enslaved and that it was somewhat instrumentalist in its handling of slavery reform, it can be demonstrated that the versatility of the figure of slavery enabled fuller characterization of the colonized and enslaved, as well as the more explicit imagining of colonial violence.
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Astarci, Parla, Laurent de Kerchove, and Gébrine el Khoury. Aortic emergencies. Oxford University Press, 2015. http://dx.doi.org/10.1093/med/9780199687039.003.0061.

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Acute aortic dissections account for the leading and most feared of aortic emergencies. Acute dissections are associated with a dreadful mortality rate; therefore, an accurate diagnosis and immediate treatment are mandatory. The key point of a lifesaving management strategy is the distinction between acute type A dissection, uncomplicated type B dissection, and complicated type B dissection, and those including contained ruptured aorta (severe pleural effusion) and/or malperfusion syndrome (by end-organ ischaemia: paraplegia, intestinal ischaemia, renal insufficiency, limb ischaemia). Type A generally requires urgent surgery; uncomplicated type B dissections are treated conservatively, while complicated type B dissections are currently managed by means of minimally invasive endovascular techniques, eventually associated with a tight surgical time (e.g. in the case of limb ischaemia). Surgical repair of type A dissection consists of the replacement of the ascending aorta. The repair is extended proximally towards the aortic root and valve, and distally towards the aortic arch, in function of the lesions found and the clinical presentation of the patient (haemodynamic status, age, comorbidities). The emergence of endovascular techniques and the contribution of thoracic endovascular aortic repair, with thoracic stent-grafts deployed from the proximal descending aorta to reopen the true lumen and to seal the entry tear in type B dissections, have revolutionized the surgical treatment algorithm in this pathology, and thus the patient’s immediate and medium-term survival. In the same group of acute aortic syndromes, traumatic aortic isthmic ruptures are also life-threatening conditions and account for one of the main causes of death at the time of traumatic accidents. As in the case of complicated type B dissections, the introduction of aortic stent-grafts has changed the outcome of these patients.
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Book chapters on the topic "Distal Graft"

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Kitabata, Hironori, and Takashi Akasaka. "Percutaneous Coronary Intervention for Distal Anastomotic Lesions." In Coronary Graft Failure, 655–60. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-26515-5_58.

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Provencher, Matthew T., Andrew R. Hsu, Neil S. Ghodadra, and Anthony A. Romeo. "Iliac-Crest Graft and Distal Tibia Allograft Procedure." In Shoulder Instability, 117–46. Milano: Springer Milan, 2011. http://dx.doi.org/10.1007/978-88-470-2035-1_6.

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Kabinejadian, F., L. P. Chua, D. N. Ghista, and Y. S. Tan. "A New Coronary Artery Bypass Graft (CABG) Distal Anastomosis Design." In IFMBE Proceedings, 491–94. Berlin, Heidelberg: Springer Berlin Heidelberg, 2009. http://dx.doi.org/10.1007/978-3-642-03882-2_130.

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Papatheodorou, Loukia K., and Dean G. Sotereanos. "Dorsal Capsular-Based Vascularized Distal Radius Graft for Scaphoid Nonunion." In Scaphoid Fractures and Nonunions, 157–66. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18977-2_14.

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Papatheodorou, Loukia K., and Dean G. Sotereanos. "Proximal Pole Scaphoid Nonunion: Capsular-Based Vascularized Distal Radius Graft." In Wrist and Elbow Arthroscopy with Selected Open Procedures, 561–66. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-78881-0_45.

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Spiegelenberg, S. R., A. J. C. Mackaay, H. Kroes, and M. R. Sobotka. "The use of externally supported dacron graft in femoro-distal reconstruction." In Femorokrurale Arterienverschlüsse, 111–15. Heidelberg: Steinkopff, 1991. http://dx.doi.org/10.1007/978-3-642-72466-4_14.

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Lin, Michael, and Tamara D. Rozental. "Scaphoid Nonunion Open Treatment with Distal Radius Bone Graft via Mini Dorsal Approach." In Scaphoid Fractures and Nonunions, 87–93. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-18977-2_8.

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Esato, Kensuke, Nobuya Zempo, Masaki O-hara, Kentaroh Fujioka, Takayuki Kuga, and Hiroaki Takenaka. "Effects of Morphology of Distal Anastomosis Immediately After Surgery on Intimal Hyperplasia in Femoropopliteal Bypass Graft." In Modern Vascular Surgery, 314–21. New York, NY: Springer New York, 1992. http://dx.doi.org/10.1007/978-1-4612-2946-9_26.

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Koja, Kageharu, Yukio Kuniyoshi, Kazufumi Miyagi, Mitsuyoshi Shimoji, Touru Uezu, Katsuya Arakaki, Kazuo Taira, and Katsuhito Mabuni. "Impact of Segmental Aortic Clamp and Distal Aortic Perfusion on Postoperative Paraplegia During Thoracoabdominal Aortic Graft Replacement." In Cardio-aortic and Aortic Surgery, 225. Tokyo: Springer Japan, 2001. http://dx.doi.org/10.1007/978-4-431-65934-1_34.

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Kitamura, Siro, Junichi Ooida, Yoshinori Inoue, and Takehisa Iwai. "Numerical Simulations of Blood Flow at the Distal Anastomosis between a Prosthetic Graft and a Native Popliteal Artery." In Computational Fluid Dynamics 2002, 185–90. Berlin, Heidelberg: Springer Berlin Heidelberg, 2003. http://dx.doi.org/10.1007/978-3-642-59334-5_25.

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Conference papers on the topic "Distal Graft"

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Vardoulis, Orestis, Eline Coppens, Bryn Martin, Philippe Reymond, and Nikos Stergiopulos. "Assessment of Aortic Graft Impact on Hemodynamics." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53245.

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In vivo studies have revealed that aortic grafts augment heart load and alter blood pressure and flow waveforms [1]. A one-dimensional model of the arterial tree was developed in order to analyze the different mechanisms by which proximal and distal aortic grafts affect hemodynamics. Graft compliance and properties were based on in vitro tests. Predicted pressures at the aortic root were compared for the control, proximal and distal graft case. Pulse pressure increased by 21% and 10% in presence of a proximal and distal graft, respectively. The distal graft resulted in a wave reflection coefficient of 0.62 while for the proximal graft the wave reflection coefficient was 0.46. The physiological mechanism behind the rise of pressure is dual and it is critically affected by the graft’s compliance and position. In case of a proximal graft, the primary reason for aortic pressure increase is the augmentation of aortic characteristic impedance, which augments the forward running pressure wave, while for the distal graft the wave reflections are major contributors to the total pressure wave. Overall, the proximal graft altered hemodynamics to a greater extent than a distal aortic graft.
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Ballyk, Peter D., Matadial Ojha, and Colin Walsh. "Vein Cuffs May Improve Anastomotic Patency by Reducing Suture-Line Intramural Stresses." In ASME 1997 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1997. http://dx.doi.org/10.1115/imece1997-0258.

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Abstract Intimal hyperplasia (IH) is an important complication of arterial bypass surgery which can ultimately lead to graft failure. The pathogenesis of IH involves the migration of smooth muscle cells from the media to the intima where they proliferate and secrete extracellular matrix. This results in a thickened vessel wall which may cause stenosis and/or thrombosis of the distal graft-artery junction. It has been shown that IH is a more significant problem in stiff synthetic grafts than in more compliant vein grafts (Bassiouny et al., 1992), and that synthetic grafts have a higher failure rate (Waiden et al., 1980). Consequently, autogenous vein (or artery) grafts are used clinically whenever possible. In cases where autogenous grafts are not long enough or not available (for e.g. if they have already been harvested or have been obliterated by disease), a vein cuff interposed between the distal end of a synthetic graft and the host artery can improve long term patency by reducing distal anastomotic IH (Miller et al., 1984; Suggs et al., 1988).
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Qiao, Aike, and Teruo Matsuzawa. "Hemodynamics of End-to-End Femoral Bypass Graft." In ASME/JSME 2004 Pressure Vessels and Piping Conference. ASMEDC, 2004. http://dx.doi.org/10.1115/pvp2004-3125.

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In the conventional femoral bypassing operation, side-to-end (STE) configuration at the proximal anastomosis and end-to-side (ETS) configuration at the distal anastomosis are usually employed. With these configurations, blood flow from the bypass graft at the distal anastomosis strongly strikes on the floor of the host artery opposite the anastomosis. This will result in the violent variations of hemodynamics in the vicinity of distal anastomosis, and further bring about anastomotic intimal hyperplasia (IH) and restenosis. Consequently, the effectiveness of bypassing surgery is compromised in the medium and long term by the development of these pathological changes. It is widely accepted that hemodynamics is close correlated to the geometry configuration of femoral bypass graft. It is verified that flow field at the distal junction has more influences on the pathogenesis and its aftereffects are more critical because the development of IH and restenosis is prone to occur in that region and endangers the patency of subsequent arteries. Nonuniform hemodynamics, characterized by nonuniform Wall Shear Stress (WSS) and large sustained Wall Shear Stress Gradients (WSSG), is also commonly considered as one of the most important causes among the numerous complex physiological and biomechanical factors. Purpose of the present study is to investigate an alternative geometry configuration to improve the hemodynamics at the vicinity of distal anastomosis and increase the medium and long term patency rate of bypass graft surgery. According to the clinical observation, the stenosed host artery may become fully stenosed after bypassing surgery and the bypass graft is the only way to restore normal blood flow to ischemic limbs. The authors presented a modified bypassing configuration with an end-to-end (ETE) conjunction at the distal anastomosis. In this new model, the proximal graft is arc-shaped with STE junction and the distal graft is sinusoid-shaped with ETE junction. The bypass graft is of the same diameter of d = 8mm as the host femoral artery, so the graft can be connected with the femoral artery smoothly at the distal junction. The polytetrafluoroethylene (PTFE) is employed as the graft material. The blood is assumed to be an isotropic, homogeneous, incompressible, Newtonian continuum having a constant density and viscosity. The vessel walls are assumed to be rigid and impermeable. The blood flow is assumed to be physiologically pulsatile laminar flow. The mean Reynolds number is Rem = 204.7, Womersley number is α = 6.14. The boundary conditions include: the physiologically pulsatile entrance velocities at the inlet section, the no-slip boundary condition on the wall, the symmetric condition in the centerline plane of femoral and graft, and the outlet pressure condition with a reference pressure P = 0 at the exit section. Three-dimensional idealized femoral bypass graft model is developed and discretized. The blood flow in the proposed model is simulated with computational fluid dynamics (CFD) method using the finite element analysis. The temporal and spatial distributions of hemodynamics such as flow patterns and WSS in the vicinity of distal anastomosis during the cardiac cycle were analyzed. Especially, the emphasis here was on the analysis of WSS, the temporal and spatial WSSG and the Oscillating Shear Index (OSI). The simulation results indicated that: (1) the ETE model is featured with small secondary flow; (2) WSS at the distal anastomosis is uniform, WSSG is small, and OSI of the ETE model has not much changes compared with ETS graft. The present study showed that the femoral bypassing configuration with ETE bypass graft was of more favorable hemodynamics, and it could consequently improve the flow conditions and decrease the probability of IH and restenosis. With the consideration of that numerical simulation was proved to be of great help and guidance meaning for the biofluidmechanics research and the biomedical engineering, the results of the present study can be applied to medical device design and clinical treatment planning in addition to the application of computational methods to cardiovascular disease research.
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Kratzberg, Jarin A., William Barnhart, Jafar Golzarian, and Madhavan L. Raghavan. "The Effect of Aortic Endovascular Graft Oversizing on Barb Penetration and Fixation Strength." In ASME 2008 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2008. http://dx.doi.org/10.1115/sbc2008-192928.

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Endovascular repair of abdominal aortic aneurysm (AAA), where an endovascular graft (EVG) — a stented vascular graft — is implanted intraluminally into the AAA has shown excellent short term outcome. However, long term outcome of implanted EVGs is fraught with new complications, the most severe of which is endoleak from graft migration, which can lead to re-pressurization of the AAA and potentially rupture. Graft migration is defined as the distal drift of an implanted EVG of 5mm or more from its initial anchor site (Figure 1). There have been many design changes to help decrease the rate of EVG migration including the addition of proximal attachment barbs to grafts to help secure them to the aortic wall. However, studies show that freedom from migration rates have not significantly increased for those grafts containing barbs compared to grafts without barbs [1]. We believe that controlled studies of endovascular graft parameters can lead to improvements in its design that increase graft attachment strength and hence decrease the risk of migration. The aim of the current study was to assess a key design variable in barbed grafts namely, graft oversizing (GO), defined as the ratio of expanded graft dia to aorta dia. We sought to assess the relationship between GO and attachment strength in barbed EVGs. Specifically, we hypothesized that a high GO will impede the ability of the EVG barbs to effectively penetrate the aortic wall.
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Ballyk, Peter D., Matadial Ojha, and Colin Walsh. "Comparing the Influence of Graft Angle on Peri-Anastomotic Wall and Fluid Mechanics." In ASME 1997 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1997. http://dx.doi.org/10.1115/imece1997-0248.

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Abstract Distal anastomotic intimal hyperplasia (DAIH) can lead to outflow stenosis of vascular bypass grafts. In end-to-side graft-artery anastomoses, two separate regions of DAIH have been identified: (i) the suture line and (ii) the floor of the anastomosis across from the suture line (Bassiouny et al., 1992). Suture-line intimal thickening seems to be associated with post-surgical healing and influenced by graft-artery compliance mismatch (Trubel et al., 1994), while floor hyperplasia appears to be linked to fluid mechanical phenomena, such as temporal variations in wall shear stress (Ojha, 1994).
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Suzuki, T., M. Hata, K. Yamaya, T. Saitou, H. Haba, and M. Matsuno. "Elephant Trunk Technique versus J Graft Open Stent Graft at Distal Anastomosis of Total Arch Replacement." In 48th Annual Meeting German Society for Thoracic, Cardiac, and Vascular Surgery. Georg Thieme Verlag KG, 2019. http://dx.doi.org/10.1055/s-0039-1678976.

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Keynton, Robert S., Mary M. Evancho, Rick L. Sims, Nancy V. Rodway, and Stanley E. Rittgers. "Do Temporal Wall Shear Stress Gradients Promote the Development of Intimal Hyperplasia Within Vascular Bypass Grafts?" In ASME 1997 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1997. http://dx.doi.org/10.1115/imece1997-0247.

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Abstract The purpose of this paper is to determine the relationship between the temporal wall shear stress gradient and the development of intimal hyperplasia (IH) within an in vivo animal model of the distal anastomoses of vascular bypass grafts. Tapered Teflon® grafts were placed in the common carotid arteries of adult, mongrel dogs with 30° end-to-side proximal and distal anastomoses and a graft-to-artery diameter ratio of either 1:1 or 1:1.5. Simultaneous axial velocity measurements were obtained using a specially designed 20-MHz ultrasonic wall shear rate transducer. Peak and oscillatory temporal WSSGs were found, at best, to only weakly correlate with IH (r = 0.20 and r = 0.27, respectively). The results from this study suggest that the temporal WSSG parameter, by itself, does not promote the development of IH.
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Ben-Hamo, Nati, Simcha Milo, Oded Gottlieb, and Gad Hetsroni. "Characterization of Venous Graft Wall Motion as an Indicator of Distal Anastomosis Quality in Coronary Artery By-Pass Surgery." In ASME 2008 9th Biennial Conference on Engineering Systems Design and Analysis. ASMEDC, 2008. http://dx.doi.org/10.1115/esda2008-59177.

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An essential parameter in assessing anastomosis quality and graft patency is associated with the graft flow rate measured at the end of a by-pass surgery. To date, no objective method to determine the quality of the anastomosis graft and to obtain graft flow rate has been endorsed by the medical community. This paper describes a non-invasive technique for measuring the integrity of a venal graft in a coronary artery bypass upon conclusion of surgery. An in vitro laboratory setup was designed to illustrate the dynamic conditions in a coronary by-pass graft. Experiments were conducted for a graft with constant flow and for a graft with pulsatile flow. The behavior of the vein wall was examined when both ends of the graft were open to flow, and also when one end of the graft was occluded. The dynamic behavior of the graft was found to change as a function of graft patency and venal pressure. A correlation was confirmed between the oscillation frequency at the graft mid span and the change in pressure at vein exit.
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Gu, Xuelian, Kai Yu, Licheng Lu, and Wenjing Tang. "A Study on the Effects of Struts of Z-Shaped Stent-Grafts on Radial Forces." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3412.

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Endovascular aneurysm repair (EVAR) techniques have been widely used for the treatment of abdominal aortic aneurysm (AAA). EVAR is associated with lower postoperative morbidity and mortality than traditional surgical procedure to treat AAA [1]. However, during the patient’s follow-up, postoperative complications may occur and secondary interventions are required [2]. Stent-grafts fixation in the vessel affects the success of endovascular aneurysm repair. Researches indicate that insufficient stent-graft radial force is attributed to post-surgery complications, such as prosthesis migration and endoleak type I [3, 4]. Endoleak type I happens when there is not a complete contact between stent graft rings and vessel wall. A great radial force can prevent full obturation in the landing zone. The distal endograft fixation also has a great influence on proximal endograft migration after EVAR [5]. Therefore the radial force of the stent plays a significant role. Single stent-graft ring comprise a series of expandable Z-shaped structural elements (known as “struts”). Currently, there are series of Z-shaped stent-grafts on the market and the struts number ranges from 5 to 12. This work intends to analyze the influence of stent-graft struts number on the radial force. Finite-element analysis (FEA) and experimental method are used.
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DiCicco, John R., and Ayodeji O. Demuren. "Distal Placement of an End-to-Side Bypass Graft Anastomosis: A 3-D Computational Study." In ASME 2005 Fluids Engineering Division Summer Meeting. ASMEDC, 2005. http://dx.doi.org/10.1115/fedsm2005-77332.

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A three-dimensional (3-D) computational fluid dynamics study of shear rates around distal end-to-side anastomoses has been conducted. Three 51% and three 75% cross-sectional area reduced 6 mm cylinders were modeled each with a bypass cylinder attached at a 30 degree angle at different placements distal to the constriction. Steady, incompressible, Newtonian blood flow was assumed, and the full Reynolds-averaged Navier-Stokes equations and turbulent kinetic energy and specific dissipation rate equations were solved on a locally structured multi-block mesh with hexahedral elements. Consequently, distal placement of an end-to-side bypass graft anastomosis was found to have an influence on the shear rate magnitudes. For the 75% constriction, closer placements produced lower shear rates near the anastomosis. Hence, there is potential for new plaque formation and graft failure.
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