Pulmonary complications occur commonly following major vascular surgery. The spectrum of such complications has been best studied following abdominal aortic aneurysm (AAA) repair. This high incidence of pulmonary morbidity is perhaps not surprising when one considers that tobacco exposure, a…
Diseases of the abdominal aorta and aortoiliac system share many important pathophysiologic factors with coronary artery disease (CAD). Many of the risk factors that contribute to abdominal aortic aneurysms (AAA) and aortoiliac occlusive disease (AIOD), including diabetes, tobacco use, hyperlipidemia,…
Chyloperitoneum and chylothorax are unusual but morbid conditions that were first recognized in the 17th century as complications of trauma. Each is caused by the formation of a fistula between the lymphatics and the peritoneal cavity or thoracic cavity, and…
Groin lymphoceles and lymphocutaneous fistulas (LCFs) are rare but known complications of lower extremity vascular procedures that involve operative dissection within the femoral triangle. By definition, a lymphocele is a cystic collection of lymphatic fluid from a disrupted lymphatic channel.…
The erectile mechanism is, in part, controlled by neural and endothelial nitric oxide (NO), which initiates the production of intracellular cyclic guanosine monophosphate (cGMP) in the smooth muscle tissue of the corpora cavernosa. The cGMP initiates a signaling cascade that…
Erectile dysfunction (ED) is defined as the “recurrent or persistent inability of the male to attain and maintain erection of the penis to permit satisfactory sexual intercourse,” according to the 1993 National Institutes of Health Consensus Development Panel on Impotence.…
Secondary aortoenteric fistulas (SAEFs) involve a communication between the gastrointestinal (GI) tract and a prosthetic vascular graft. Their successful management requires control of any bleeding, maintenance of adequate perfusion to the lower extremities, restoration of gastrointestinal tract continuity, and eradication…
Aortic graft infection is one of the most devastating complications in vascular surgery. Because of routine antibiotic prophylaxis before surgical procedures and adherence to aseptic surgical technique, the overall incidence of infection involving synthetic vascular grafts is relatively low. When…
There are no simple solutions to aortic graft infection, but a thoughtful approach to the surgical treatment of this condition minimizes the risk of major morbidity and mortality. No single operation is appropriate for all patients, so a working knowledge…
The incidence of infection affecting a prosthetic aortic graft varies from less than 1% to about 4%, depending on whether the vascular prosthesis is entirely intrathoracic (1%–2%), is retroperitoneal (<1%), extends to the femoral level (2%–4%), or is an endovascular…