Benjamin S. Brooke, MD, George Arnaoutakis, MD, Nazli B

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Presentation transcript:

Contemporary management of vascular complications associated with Ehlers-Danlos syndrome Benjamin S. Brooke, MD, George Arnaoutakis, MD, Nazli B. McDonnell, MD, PhD, James H. Black, MD Journal of Vascular Surgery Volume 51, Issue 1, Pages 131-139 (January 2010) DOI: 10.1016/j.jvs.2009.08.019 Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 1 Kaplan-Meier estimates of cumulative survival free of any vascular complication among 40 patients with Ehlers-Danlos syndrome (EDS) who underwent 45 endovascular (dashed line) and 17 open vascular procedures (solid line). SEM > 10% after 4 years for open procedures and after 3 years for endovascular procedures. Journal of Vascular Surgery 2010 51, 131-139DOI: (10.1016/j.jvs.2009.08.019) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 2 Reconstruction of abdominal CT angiography scan showing a ruptured right anterior hepatic arterial aneurysm and associated hemoperitoneum in a patient with vascular Ehlers-Danlos syndrome (EDS) who presented with 2.4 years following successful elective coil embolization of a splenic artery aneurysm. Journal of Vascular Surgery 2010 51, 131-139DOI: (10.1016/j.jvs.2009.08.019) Copyright © 2010 Society for Vascular Surgery Terms and Conditions

Fig 3 Technique for management of the access vessel in fragile vasculature of Ehlers-Danlos syndrome (EDS) patient. (A) A “U” stitch monofilament suture is placed with a pledget buttress, and needle entry is made within the area. (B) Sheath access is obtained and manipulated or exchanged minimally to avoid femoral tears. (C) The pledgetted “U” stitch suture is tied down as sheath is removed. (D) Circumferential felt reinforcement is approximated to reduce systolic pulse wave stretch on sutures and to prevent late pseudoaneurysm formation. Journal of Vascular Surgery 2010 51, 131-139DOI: (10.1016/j.jvs.2009.08.019) Copyright © 2010 Society for Vascular Surgery Terms and Conditions