Sequential Graft Limb Occlusion Following Endovascular Aneurysm Repair: A Case Report and Literature Review.

Limb graft occlusion (LGO) is a common complication that can occur after endovascular aneurysm repair (EVAR). There are many factors that can contribute to LGO, including patient-related variables, device-related considerations, and factors associated with the procedural technique. Patients with LGO may exhibit no symptoms, have intermittent claudication, or suffer from acute limb ischemia.

Identification of vulnerable carotid plaque with histologically validated CT-derived plaque maps.

Objectives: Ruptured carotid plaque causes stroke, but differentiating rupture-prone necrotic core from fibrous tissue with CT is limited by overlap of X-ray attenuation. We investigated the ability of CT-derived plaque maps created from ratios of plaque/contrast attenuation to identify histologically proven vulnerable plaques.

Methods: Seventy patients underwent carotid CT angiography and carotid endarterectomy.

Assessment of Atherosclerosis in Ischemic Stroke by means of Ultrasound of Extracranial/Intracranial Circulation and Serum, Urine, and Tissue Biomarkers.

It is a common practice to take into consideration age, diabetes, smoking, treated and untreated systolic blood pressure, total cholesterol, and high-density lipoprotein cholesterol for the prediction of atherosclerosis and stroke. There are, however, ultrasound markers in use for the assessment of atherosclerosis and the evaluation of stroke risk. Two areas of investigation are of interest: the carotid artery and the intracranial arterial circulation.

Predictors and clinical significance of progression or regression of asymptomatic carotid stenosis.

Objective: To determine baseline clinical and ultrasonographic plaque factors predictive of progression or regression of asymptomatic carotid stenosis and the predictive value of changes in stenosis severity on risk of first ipsilateral cerebral or retinal ischemic events (including stroke).

Methods: A total of 1121 patients with asymptomatic carotid stenosis of 50% to 99% in relation to the bulb diameter (European Carotid Surgery Trial [ECST] method) underwent six monthly clinical assessments and carotid duplexes for up to 8 years (mean follow-up, 4 years). Progression or regression was considered present if there was a change of at least one grade higher or lower, respectively, persisting for at least two consecutive examinations.

A new technique of branched stent graft treatment for ruptured thoracoabdominal aortic aneurysms.

Endovascular repair of thoracoabdominal aortic aneurysms (TAAAs) using a branched stent graft is a technically challenging procedure. A 64-year-old man with multiple medical problems, including severe renal impairment, is presented with a ruptured type IV TAAA. He underwent emergency repair using an off-the-shelf branched stent graft and carbon dioxide as the exclusive contrast agent.

Temporary axillobifemoral bypass during fenestrated aortic aneurysm repair.

Objective: Fenestrated endovascular aortic aneurysm repair (f-EVAR) of juxtarenal aneurysms requiring cannulation of the superior mesenteric artery and renal arteries is technically challenging, has a long operating time, and requires bilateral large-caliber sheath insertion into the femoral arteries. Consequently, the risk of lower limb ischemia and subsequent reperfusion injury is increased. We describe the use of an adjunct temporary axillobifemoral bypass graft (TABFBG) for f-EVAR and propose that it be used as a strategy to avoid ischemia-reperfusion injury in patients anticipated as being at increased risk.