Patients referred for arteriovenous fistula construction: a retrospective outcome analysis.

Objectives: With lower rates of sepsis and re-interventions, arteriovenous fistula (AVF) is the preferred vascular access modality. The aim of this study is to evaluate the outcomes of patients referred for AVF construction at a single center in Cork, Ireland.

Methods: The current study is a single-center retrospective review of all patients who underwent AVF creation between 2015 and 2017.

A Systematic Review and Meta-analysis of Thrombotic Events Following Endovenous Thermal Ablation of the Great Saphenous Vein.

Objectives: A systematic review and meta-analysis was performed to determine the incidence of thrombotic events following great saphenous vein (GSV) endovenous thermal ablation (EVTA).

Methods: MEDLINE, Embase and conference abstracts were searched. Eligible studies were randomised controlled trials and case series that included at least 100 patients who underwent GSV EVTA (laser ablation or radiofrequency ablation [RFA]) with duplex ultrasound (DUS) within 30 days.

Preconditioning Shields Against Vascular Events in Surgery (SAVES), a multicentre feasibility trial of preconditioning against adverse events in major vascular surgery: study protocol for a randomised control trial.

Background: Patients undergoing vascular surgery procedures constitute a 'high-risk' group. Fatal and disabling perioperative complications are common. Complications arise via multiple aetiological pathways.

Early outcome following endovascular repair of pararenal aortic aneurysms: triple- versus double- or single-fenestrated stent-grafts.

Purpose: To review the early outcome following endovascular repair of pararenal aortic aneurysm using fenestrated stent-grafts and to determine if the number of fenestrations required is predicative of outcome.

Methods: A retrospective analysis was conducted of 20 consecutive patients (18 men; mean age of 75 ± 7 years) treated with stent-grafts containing either ≤ 2 fenestrations (n = 10, group 1) or 3 fenestrations (n = 10, group 2). Target vessels also included those accommodated by a scallop (renal artery or superior mesenteric artery in group 1 and the celiac artery in group 2).

Temporary axillobifemoral bypass as an adjunct to endovascular aneurysm repair using fenestrated stent grafts.

Prolonged endovascular procedures requiring a large diameter sheath in each groin can be associated with significant intraoperative lower limb ischemia, particularly in those with pre-existing peripheral vascular disease. We report the case of a patient who suffered severe ischemia-reperfusion injury following endovascular repair of a pararenal aortic aneurysm using a fenestrated stent graft and describe the use of temporary axillobifemoral bypass in a patient with similar comorbidities undergoing the same procedure. We propose this adjunctive technique as a means of maintaining antegrade limb perfusion and avoiding the peripheral and central metabolic consequences of ischemia-reperfusion injury.

Preloaded fenestrated stent-grafts for the treatment of juxtarenal aortic aneurysms.

Purpose: To describe a novel technique for target vessel catheterization in patients with juxtarenal abdominal aortic aneurysms requiring treatment with fenestrated stent-grafts (FSG).

Methods: The standard FSG design was modified, substituting a thin-wall tube for the solid central obturator that serves as both an attachment point for the distal end of the graft as well as a top cap retriever. Through this tube, two 0.

In situ fenestration in the aortic arch.

In situ fenestration of aortic stent grafts has the potential to allow for continued perfusion of supra-aortic trunks, without the need for extra-anatomic bypass, and without the need for custom-made devices. Angulation of the target vessel relative to the arch is an obstacle to success with this technique. In this report, we describe a case of successful in situ fenestration of the left subclavian artery (LSA) in a patient with an aortic arch aneurysm, treated with an endovascular stent graft.

Endovascular treatment for chronic type B dissection: limitations of short stent-grafts revealed at midterm follow-up.

Purpose: To examine the incidence of and the indications for re-intervention, as well as the changes in aortic morphology, in patients with chronic type B aortic dissection who underwent endovascular intervention for false lumen aneurysms.

Methods: A retrospective analysis was conducted of 10 patients (8 men; mean age 63 years, range 45-79) who underwent stent-graft repair of aneurysmal false lumen expansion related to chronic type B aortic dissection at a median 16 months (range 2-71) from the initial diagnosis. All grafts had been oversized by 10% relative to the normal non-dissected aorta and were implanted to cover the primary entry tear.

Endovascular treatment of acute complicated type B dissection: morphological changes at midterm follow-up.

Purpose: To review midterm results and morphological changes following endovascular treatment of acute complicated type B dissection and to study the relation between extent of dissection and treatment outcome.

Methods: Between February 2001 and March 2008, 52 patients (38 men; median age 67 years, range 40-82) received thoracic stent-grafts for acute complicated type B dissections. Outcome for those patients treated for intramural hematoma (IMH; group 1, n = 7) or type IIIa dissection (group 2, n = 17) were compared to those with type IIIb dissection (group 3, n = 28).

Abdominal aortic aneurysm diameter: a comparison of ultrasound measurements with those from standard and three-dimensional computed tomography reconstruction.

Objective: Aortic aneurysm size is a critical determinant of the need for intervention, yet the maximal diameter will often vary depending on the modality and method of measurement. We aimed to define the relationship between commonly used computed tomography (CT) measurement techniques and those based on current reporting standards and to compare the values obtained with diameter measured using ultrasound (US).

Methods: CT scans from patients with US-detected aneurysms were analyzed using three-dimensional reconstruction software.

Duplex ultrasound in aneurysm surveillance following endovascular aneurysm repair: a comparison with computed tomography aortography.

Objectives: Cumulative radiation dose, cost, and increased demand for computed tomography aortography (CTA) suggest that duplex ultrasonography (DU) may be an alternative to CTA-based surveillance. We compared CTA with DU during endovascular aneurysm repair (EVAR) follow-up.

Methods: Patients undergoing EVAR had clinical and radiological follow-up data entered in a prospectively maintained database.

Duration of increased bleeding tendency after cessation of aspirin therapy.

Background: Aspirin has a significant effect on hemostasis, so it is often recommended that patients taking aspirin discontinue treatment before elective surgery. While off aspirin, these patients may be at risk of thrombosis. The optimum period of time that aspirin should be withheld is controversial.

The effect of aspirin on blood loss and transfusion requirements in patients with femoral neck fractures.

Although it is widely accepted that aspirin will increase the risk of intra- and post-operative bleeding, clinical studies have not consistently supported this assumption. We aimed to assess the effect of pre-operative aspirin on blood loss and transfusion requirements in patients undergoing emergency fixation of femoral neck fractures. A prospective case-control study was undertaken in patients presenting with femoral neck fractures.

Endotoxin/lipopolysaccharide activates NF-kappa B and enhances tumor cell adhesion and invasion through a beta 1 integrin-dependent mechanism.

Beta(1) integrins play a crucial role in supporting tumor cell attachment to and invasion into the extracellular matrix. Endotoxin/LPS introduced by surgery has been shown to enhance tumor metastasis in a murine model. Here we show the direct effect of LPS on tumor cell adhesion and invasion in extracellular matrix proteins through a beta(1) integrin-dependent pathway.

Hypertonic saline infusion for pulmonary injury due to ischemia-reperfusion.

Hypothesis: Inhibition of neutrophil-endothelial cell interactions by hypertonic saline (HTS) may confer protection against organ injury in states of immunologic disarray. This study tested the hypothesis that infusion of HTS modulates the development of end-organ injury in a model of lower-torso ischemia-reperfusion injury.

Design: Ischemia-reperfusion injury was induced in 30 male Sprague-Dawley rats by infrarenal aortic cross-clamp for 30 minutes, followed by reperfusion for 2 hours.

Cutting edge: bacterial lipoprotein induces endotoxin-independent tolerance to septic shock.

Tolerance to bacterial cell wall components is an adaptive host response. Endotoxin/LPS tolerance is characterized by a survival advantage against subsequent lethal LPS challenge. However, it is uncertain whether LPS tolerance can afford protection against other septic challenges.

Induction of bacterial lipoprotein tolerance is associated with suppression of toll-like receptor 2 expression.

Tolerance to bacterial cell wall components including lipopolysaccharide (LPS) may represent an essential regulatory mechanism during bacterial infection. Two members of the Toll-like receptor (TLR) family, TLR2 and TLR4, recognize the specific pattern of bacterial cell wall components. TLR4 has been found to be responsible for LPS tolerance.

Expression of herpes simplex virus ICP0 inhibits the induction of interferon-stimulated genes by viral infection.

The herpes simplex virus type 1 (HSV-1) mutant d109 does not express any of the immediate-early (IE) proteins and persists in cells for a prolonged length of time. As has been shown by Nicholl et al. (J.