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9. Safety, Feasibility, and Early Efficacy of Subfascial Endoscopic Perforator Surgery: A Preliminary Report from the North American Registry

Author

Gloviczki, Peter, Bergan, John J., Menawat, Sunil S., Hobson, Robert W., II, Kistner, Robert L., Lawrence, Peter F., Lumsden, Alan, O'Donnell, Thomas F., DePalma, Ralph G., Murray, Jay, Pigott, John P., Schanzer, Harry, Ascer, Enrico, Kalman, Peter, Calligaro, Keith D., Ballard, Jeffrey L., Cambria, Robert A., Rhee, Robert Y., Rubin, Brian G., Ilstrup, Duane M., Harmsen, W. Scott, and Canton, Linda G.

Published
1997

10. Use of lower extremity deep veins as arterial substitutes: functional status of the donor leg

Author

Schanzer, Harry, Chiang, Konan, Mabrouk, Mounir, and Peirce, E. Converse, II

Subjects
Veins -- Transplantation, Vascular grafts -- Physiological aspects, Vascular grafts -- Methods, Leg -- Blood-vessels, Health
Abstract

It is well known that patients who require vascular grafting of arteries below the inguinal, or groin, region have a better outcome when the saphenous vein of the leg is used as the graft conduit, rather than synthetic graft material. When the saphenous vein can not be used, good results have been obtained using other veins, such as the short saphenous vein, an arm vein or even a deep leg vein. The advantages of using the patient's own vein as a conduit are even greater when a vein, rather than an artery, is being replaced. If a vein is to replace another vein, the caliber (size of the lumen, or internal diameter) of the vessels must match. Large veins, such as the vena cava, may be replaced by using deep leg veins, such as the superficial femoral-popliteal vein in the thigh-knee area. This procedure has not gained widespread acceptance because of fear of restricting the venous outflow from the donor leg. A study was undertaken to evaluate the effects of excision of a deep leg vein in two groups of patients: 21 patients (25 legs) underwent femoropopliteal arterial bypass using the femoral-popliteal vein; 19 patients (22 legs) had the same bypass operation performed, except that synthetic graft was used and the femoral-popliteal vein was left intact (control group). Patients were evaluated after surgery both clinically and functionally. The legs that had been vein donors showed a small, but significant increase in average calf diameter compared with the control group. This was the only sign or symptom of chronic venous stasis. Venous outflow obstruction was shown on X-ray study of the veins in 21 of 25 vein donor legs (84 percent), compared with only 50 percent of the control legs. However, symptomatically the vein donor patients were not statistically different from the control group; three months after surgery 40 percent of the donor group and 40.9 percent of the control group complained of swelling. These results suggest that the deep veins of the leg may be considered for use as arterial grafts if superficial veins are not available. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1991

11. End-stage renal disease - is infrainguinal limb revascularization justified?

Author

Harrington, Elizabeth B., Harrington, Martin E., Schanzer, Harry, and Haimov, Moshe

Subjects
Peripheral vascular diseases -- Care and treatment, Chronic kidney failure -- Complications, Vascular grafts -- Health aspects, Health
Abstract

There are few reports of vascular (blood vessels) reconstructive surgery performed to relieve arterial insufficiency in patients who have end-stage (terminal) kidney disease. These patients are believed to be poor risks for vascular surgery; many are diabetic and often have diffuse, severe arterial disease with calcification of the arteries. A study was undertaken of 39 patients with end-stage renal disease who underwent limb revascularization surgery to determine if the standard criteria for revascularization could be applied to this group of patients. Fifty-six legs underwent infrainguinal revascularization (bypass graft) surgery; nine legs had additional surgery for the removal of blood clots. Thirty-seven of the 39 patients were on dialysis, and 3 patients had functioning transplanted kidneys. Vascular surgery was performed because of ischemia (inadequate blood supply) resulting in gangrene (tissue death), leg pain at rest, leg ulcers, or severe claudication (leg cramping when walking). The rate of patency of the grafts at one year was 77 percent, and 68 percent at two years. During the follow-up period, which averaged 23 months (range 0 to 115 months), there were 24 deaths. Five deaths occurred in the perioperative period (shortly before to shortly after surgery), three of which were due to heart attack. At three years, 39 percent of the patients were alive with 84 percent of legs saved. These findings suggest that limb revascularization can be successfully performed on patients with end-stage renal disease, and that the standard criteria for revascularization surgery can be applied. (Consumer Summary produced by Reliance Medical Information, Inc.)

Published
1990

15. Outcomes of dialysis catheters placed by the Y-TEC peritoneoscopic technique: a single-center surgical experience.

Author

Azzi, Yorg Al, Zeldis, Etti, Nadkarni, Girish N., Schanzer, Harry, and Uribarri, Jaime

Subjects
PERITONEAL dialysis, LAPAROSCOPY, CATHETERIZATION
Abstract

Background: In the last few years, peritoneal dialysis (PD) catheter placement techniques and outcomes have become important because of the growing population of PD patients. Although there are a growing number of catheters placed by the minimally invasive Y-TEC peritoneoscopic technique, there are still limited data on outcomes for these catheters, especially those placed by a surgeon.We aimed to conduct a retrospective study of our experience with PD catheters placed by the Y-TEC peritoneoscopic technique in our institution. Methods: We reviewed patients with peritoneoscopic PD catheter insertion over the last decade and described their complications and outcomes. In a secondary analysis, we compared the outcomes and complications of these catheters with those with open placement placed by the same surgeon. Results: We had complete data on 62 patients with peritoneoscopic catheter placement during the study period. The mean age was 55 years, 48.4% were females and the most common cause of end-stage renal diseasewas diabetes mellitus (33%). Surgical complicationswere seen in only 6/62 (9.6%) and peritonitis in 16/62 (26%) of peritoneoscopic catheters. Most catheterswere used after 2 months of placement, while 12.3%were used within 2 months. When compared with 93 patients with open placement of catheters as a secondary analysis, peritoneoscopic catheters were found to have a higher 2-year survival. Conclusion: Our large series of peritoneoscopically placed catheters by a surgeon demonstrate low surgical complications and peritonitis rates as well as superior 2-year survival compared with open placement of catheters. [ABSTRACT FROM AUTHOR]

Published
2016
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21. Reply

Author

Bazan, Hernan A., primary and Schanzer, Harry S., additional

Published
2005
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22. Classification and grading of chronic venous disease in the lower limbs : A consensus statement

Author

Beebe, Hugh G., Bergan, John J., Bergqvist, David, Eklöf, Bo, Eriksson, Ingvar, Goldman, Mitchel P., Greenfield, Lazar J., Hobson, Robert W., Juhan, Claude, Kistner, Robert L., Labropoulos, Nicos, Malouf, G. Mark, Menzoian, James O., Moneta, Gregory L., Myers, Kenneth A., Neglen, Peter, Nicolaides, Andrew N., O'Donell, Thomas F., Partsch, Hugo, Perrin, Michel, Porter, John M., Raju, Seshadri, Rich, Norman M., Richardson, Graeme, Schanzer, Harry, Coleridge Smith, Philip, Strandness, D. Eugene, Summer, David S., Beebe, Hugh G., Bergan, John J., Bergqvist, David, Eklöf, Bo, Eriksson, Ingvar, Goldman, Mitchel P., Greenfield, Lazar J., Hobson, Robert W., Juhan, Claude, Kistner, Robert L., Labropoulos, Nicos, Malouf, G. Mark, Menzoian, James O., Moneta, Gregory L., Myers, Kenneth A., Neglen, Peter, Nicolaides, Andrew N., O'Donell, Thomas F., Partsch, Hugo, Perrin, Michel, Porter, John M., Raju, Seshadri, Rich, Norman M., Richardson, Graeme, Schanzer, Harry, Coleridge Smith, Philip, Strandness, D. Eugene, and Summer, David S.

Published
1996
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23. Classification and grading of chronic venous disease in the lower limbs. A consensus statement

Author

Beebe, Hugh G., primary, Bergan, John J., additional, Bergqvist, David, additional, Eklof, Bo, additional, Eriksson, Ingvar, additional, Goldman, Mitchel P., additional, Greenfield, Lazar J., additional, Hobson, Robert W., additional, Juhan, Claude, additional, Kistner, Robert L., additional, Labropoulos, Nicos, additional, Malouf, G. Mark, additional, Menzoian, James O., additional, Moneta, Gregory L., additional, Myers, Kenneth A., additional, Neglen, Peter, additional, Nicolaides, Andrew N., additional, O'Donnell, Thomas F., additional, Partsch, Hugo, additional, Perrin, Michel, additional, Porter, John M., additional, Raju, Seshadri, additional, Rich, Norman M., additional, Richardson, Graeme, additional, Schanzer, Harry, additional, Smith, Philip Coleridge, additional, Strandness, D. Eugene, additional, and Sumner, David S., additional

Published
1996
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41. Outcomes of dialysis catheters placed by the Y-TEC peritoneoscopic technique: a single-center surgical experience.

Author

Al Azzi Y, Zeldis E, Nadkarni GN, Schanzer H, and Uribarri J

Abstract

Background: In the last few years, peritoneal dialysis (PD) catheter placement techniques and outcomes have become important because of the growing population of PD patients. Although there are a growing number of catheters placed by the minimally invasive Y-TEC peritoneoscopic technique, there are still limited data on outcomes for these catheters, especially those placed by a surgeon. We aimed to conduct a retrospective study of our experience with PD catheters placed by the Y-TEC peritoneoscopic technique in our institution., Methods: We reviewed patients with peritoneoscopic PD catheter insertion over the last decade and described their complications and outcomes. In a secondary analysis, we compared the outcomes and complications of these catheters with those with open placement placed by the same surgeon., Results: We had complete data on 62 patients with peritoneoscopic catheter placement during the study period. The mean age was 55 years, 48.4% were females and the most common cause of end-stage renal disease was diabetes mellitus (33%). Surgical complications were seen in only 6/62 (9.6%) and peritonitis in 16/62 (26%) of peritoneoscopic catheters. Most catheters were used after 2 months of placement, while 12.3% were used within 2 months. When compared with 93 patients with open placement of catheters as a secondary analysis, peritoneoscopic catheters were found to have a higher 2-year survival., Conclusion: Our large series of peritoneoscopically placed catheters by a surgeon demonstrate low surgical complications and peritonitis rates as well as superior 2-year survival compared with open placement of catheters.

Published
2016
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