Methylprednisolone increases urinary nitrate concentrations and reduces subclinical renal injury during infrarenal aortic ischemia reperfusion.

Objective: This study tests the hypothesis that methylprednisolone may influence eNOS activity in renal arterial and venous vascular beds and impede subclinical renal injury.

Summary Background Data: Acute renal failure is a major complication of cardiovascular surgery. Renal damage arises in part from excessive vasoconstriction mediated by an imbalance of vasoconstrictive ET-1 and vasodilatory NO produced by eNOS.

Ischemic preconditioning before lower limb ischemia--reperfusion protects against acute lung injury.

Objective: Prolonged limb ischemia followed by reperfusion (I/R) is associated with a systemic inflammatory response syndrome and remote acute lung injury. Ischemic preconditioning (IPC), achieved with repeated brief periods of I/R before the prolonged ischemic period, has been shown to protect skeletal muscle against ischemic injury. The aim of this study was to ascertain whether IPC of the limb before I/R injury also attenuates systemic inflammation and acute lung injury in a fully resuscitated porcine model of hind limb I/R.

Successful exclusion of a high internal carotid pseudoaneurysm using the Wallgraft endoprosthesis.

A 43-year-old woman presented with a several-month history of transient ischemic attacks 7 years following surgery for a malignant carotid body tumor. Angiography revealed a pseudoaneurysm at the distal vein graft anastomosis and a stenosis related to the proximal anastomosis. Due to the extensive previous surgery an endovascular approach was advocated and the pseudoaneurysm was successfully excluded using a covered stent (Wallgraft).

Lower limb ischemia-reperfusion injury triggers a systemic inflammatory response and multiple organ dysfunction.

Restoration of blood flow to an acutely ischemic lower limb may, paradoxically, result in systemic complications and unexpected mortality. We investigated the effect of acute ischemia-perfusion of the lower limb on cytokine production and end organ function. Plasma concentrations of tumor necrosis factor-alpha (TNF-a) and interleukin-6 (IL-6) were determined in five groups of male Wistar rats: control, 3 hours of bilateral hind limb ischemia alone, and 3 hours of bilateral hind limb ischemia followed by 1 hour, 2 hours, or 3 hours of reperfusion, respectively.