Acute ischemia secondary to popliteal artery stent fracture and embolization.

Femoropopliteal disease comprises more than one half of lesions in peripheral vascular disease. The treatment modalities for stenosis or occlusion of this anatomic region include femoropopliteal bypass and percutaneous transluminal angioplasty with or without stenting. Our patient developed acute leg ischemia 3 years after stenting, secondary to stent fracture, with distal embolization of stent fragments.

Project PROMIS: Peoria Regional Outpatient Medical Imaging Study.

Background: Abdominal aortic aneurysm (AAA) accounts for > 15,000 reported deaths annually. Early screening in high-risk populations is important to decrease morbidity and mortality from rupture.

Methods: A prospective, population-based study of free ultrasound-based AAA screening was conducted from July 2004 to December 2006.

Intravascular ultrasound-guided bedside placement of inferior vena cava filters.

Pulmonary emboli in a critically ill patient population is an occurrence that may be reduced with appropriate utilization of inferior vena cava (IVC) filters. Complications both during transfer or transport of critically ill patients who are dependent upon multiple intravenous drips, ventilators and intensive monitoring may be reduced with bedside placement of inferior vena cava filters. Over the last decade, investigators have been developing techniques for bedside IVC filter placement based on intravascular ultrasound techniques.

Carotid revascularization in the presence of contralateral carotid artery occlusion is safe and durable.

Objective: Complete occlusion of the contralateral carotid artery has been thought to increase the risk of carotid endarterectomy (CEA). This study was conducted to determine whether contralateral occlusion (CO) leads to a higher rate of complications among patients undergoing CEA or alters long-term outcomes.

Methods: All CEAs (N = 221) performed at our institution between September 1997 and June 2002 were reviewed.

Vena cava filters: why, when, what, how?

Pulmonary emboli, a potentially lethal venous thromboembolic complication, is a potentially preventable morbidity or mortality that surgeons should consider in the perioperative period or in high-risk patients. Prophylactic inferior vena cava (IVC) filter placement offers a high protection rate against fatal pulmonary emboli. This manuscript discusses the indications for filter placement, different types of currently available IVC filters, and problems and complications of filter placement and vena cava filters.

Delayed paraplegia following infrarenal abdominal aortic endograft placement: case report and literature review.

The treatment of abdominal aortic aneurysms (AAAs) has changed over the past 12 years, with increased numbers of endovascular procedures being performed. Early morbidity is decreased following endovascular abdominal aortic aneurysm repair (EVAR) compared with open repair, and long-term studies of EVAR have focused on freedom from death, rupture, and conversion to open repair. Other less commonly encountered complications of EVAR are rarely reported.

Endovascular repair of a spontaneous carotid artery dissection with carotid stent and coils.

Dissection of the internal carotid artery is an under-recognized cause of transient ischemic attack and cerebral vascular accident. Spontaneous dissections, in which no precipitating cause can be identified, occur infrequently. Endovascular intervention is an evolving treatment option in patients in whom anticoagulation therapy alone is not adequate, who are not suitable candidates for major surgery, or who have extremely distal dissections that are difficult to access.

Treatment of a late-appearing proximal type-1 endoleak after Ancure graft with an AneuRx cuff--a case report.

The authors describe the case of a patient who developed a type-1 proximal endoleak 10 months after Ancure stent graft placement, despite the lack of stent migration or measurable neck dilatation. The patient had been under observation for a persistent type-2 endoleak and was noted to have an increase in his aneurysm size. The use of an uncovered stent was unsuccessful, and he required a covered proximal extension cuff.

Graft patency is not the only clinical predictor of success after exclusion and bypass of popliteal artery aneurysms.

Purpose: The traditional measure of success after exclusion and bypass of popliteal artery aneurysm (PAA) is graft patency. In addition to fate of the bypass, we hypothesize that late outcome after surgical treatment of PAA is influenced by completeness of exclusion.

Methods: Thirty patients who underwent 41 reconstructions for PAA over a 10-year period were reviewed.

Successful endovascular therapy of a penetrating zone III internal carotid injury.

Penetrating injuries to the internal carotid artery in zone III of the neck can be a significant challenge to the operating surgeon. Direct surgical exposure and repair of the internal carotid artery at the skull base can be extremely difficult, and surgical options for treatment of a pseudoaneurysm at this location are limited. We present a case of an 18-year-old man who sustained a single gunshot wound to the distal cervical internal carotid artery that led to a pseudoaneurysm managed with endovascular exclusion.

Cross-sectional magnetic resonance angiography is accurate in predicting degree of carotid stenosis.

Carotid stenosis is currently estimated using methods based on flow velocity or two-dimensional projection images. Manipulation of magnetic resonance (MR) images in three dimensions (3-D MR) allows for direct measurement of carotid artery cross-sectional luminal area. The objectives of this study were (1) to assess the accuracy of 3-DMR as a technique for estimating carotid artery stenosis, and (2) to compare 3-D MR results with estimates from duplex ultrasound sonography (DUS) and conventional angiography.