The impact of radiation dose exposure during endovascular aneurysm repair on patient safety.

Objective: Endovascular aneurysm repair (EVAR) exposes patients to radiation during the procedure and in subsequent follow-up. The study goal was to calculate the radiation dose in our unit and compare it against other published data and national guidelines.

Methods: All EVAR procedures were identified from a prospectively maintained database.

Setting the standards for reporting ruptured abdominal aortic aneurysm.

Introduction: Reported mortality rates for endovascular repair (EVR) of ruptured abdominal aortic aneurysm (rAAA) vary from 0% to 50%. Selection bias, inaccurate reporting, and lack of uniform reporting standards are responsible for this significant discrepancy.

Material And Methods: Existing literature about the classification/reporting systems of rAAA is reviewed.

Common polymorphisms of Fibulin-5 and the risk of abdominal aortic aneurysm development.

Fibulin-5 is a crucial protein in the connective tissue structure of the aortic wall. The purpose of this study was to determine if genetic variation within the Fibulin-5 gene was associated with abdominal aortic aneurysms (AAA). AAA patients, with disease-free controls, were recruited and a past medical history questionnaire completed.

Evaluation of angiography as the sole imaging study for the proximal aortic neck prior to EVAR.

Background: Angiographic assessment is an alternative to computerised tomography (CT) prior to endovascular aneurysm repair (EVAR). We evaluated angiography in aortic neck morphology assessment as an alternative investigation.

Methods: Patients admitted for elective or emergency EVAR were assessed by pre-operative CT and intra-operative angiography.

Collected world and single center experience with endovascular treatment of ruptured abdominal aortic aneurysms.

Background: Case and single center reports have documented the feasibility and suggested the effectiveness of endovascular aneurysm repair (EVAR) of ruptured abdominal aortic aneurysms (RAAAs), but the role and value of such treatment remain controversial.

Objective: To clarify these we examined a collected experience with use of EVAR for RAAA treatment from 49 centers.

Methods: Data were obtained by questionnaires from these centers, updated from 13 centers committed to EVAR treatment whenever possible and included treatment details from a single center and information on 1037 patients treated by EVAR and 763 patients treated by open repair (OR).

Retroperitoneal approach to abdominal aortic aneurysm repair preserves splanchnic perfusion as measured by gastric tonometry.

Background: We investigated if minimizing bowel manipulation and mesenteric traction using the retroperitoneal approach in open abdominal aortic aneurysm (AAA) repair preserves splanchnic perfusion, as measured by gastric tonometry, and reduces the systemic inflammatory response and dysfunction of the various organs.

Methods: Patients undergoing elective AAA repair were randomized into three groups. Group I had repair via the retroperitoneal approach, while groups II and III were repaired via the transperitoneal approach with the bowel packed within the peritoneal cavity or exteriorized in a bowel bag, respectively.

The influence of COX-2 single nucleotide polymorphisms on abdominal aortic aneurysm development and the associated inflammation.

Introduction: Cyclooxygenase (COX)-2 influences cardiovascular disease and serum concentration of high-sensitivity C-reactive protein (hsCRP). The study purpose was to determine the influence of single nucleotide polymorphisms (SNPs) of the COX-2 gene on abdominal aortic aneurysm (AAA) development and serum hsCRP concentrations.

Patients And Methods: Patients with AAA and disease-free controls were recruited.

Inferior vena cava thrombosis in young adults--a review of two cases.

We present two cases of clinically extensive bilateral DVTs associated with inferior vena caval thrombosis. Young patients presenting with symptoms of DVT should be investigated not only to establish any thrombophilic pre-disposition, but to ascertain the proximal extent of thrombus which may itself influence treatment.

The effects of abdominal compartment hypertension after open and endovascular repair of a ruptured abdominal aortic aneurysm.

Objective: This study assessed if emergency endovascular repair (eEVR) reduces the increase in intra-abdominal compartment pressure and host inflammatory response in patients with ruptured abdominal aortic aneurysm (AAA).

Methods: Thirty patients with ruptured AAA were prospectively recruited. Patients were offered eEVR or emergency conventional open repair (eOR) depending on anatomic suitability.

The vascular and biochemical effects of cilostazol in patients with peripheral arterial disease.

Objectives: Cilostazol improves walking distance and quality of life in patients with peripheral arterial disease (PAD). This study assessed the vascular and biochemical effects of cilostazol therapy in PAD patients.

Methods: PAD patients were prospectively recruited to a randomized, double-blinded, placebo-controlled trial.

Advantages and pitfalls of abdominal aortic aneurysm screening in high-risk patients.

Screening for abdominal aortic aneurysm (AAA) has been suggested for older men. Our aim was to determine the effect of participant selection on prevalence and treatment suitability. Men aged 65 to 75 years attending cardiology clinics composed the high-risk group; the control group was from the community.

C-reactive protein (CRP) elevation in patients with abdominal aortic aneurysm is independent of the most important CRP genetic polymorphism.

Objective: C-reactive protein (CRP) is a marker of cardiovascular disease. The objective was to determine if abdominal aortic aneurysm (AAA) and CRP serum concentration and its CRP gene are associated.

Methods And Results: AAA patients and AAA negative controls were recruited.

Risk factors for abdominal aortic aneurysm and the influence of social deprivation.

Introduction: the objective of this abdominal aortic aneurysm (AAA) screening study was to determine attendance and disease prevalence patterns in Northern Ireland and the role of deprivation and other risk factors.

Patients And Methods: patients from primary care practices from Belfast, Lisburn, and Saintfield were screened. Past medical history and deprivation details were determined.

Effects of antioxidants on endothelial function in human saphenous vein in an ex vivo model.

This ex vivo study is aimed at determining the beneficial effects of antioxidant agents on human saphenous vein endothelial function. Vein rings harvested during infrainguinal bypass surgery were assessed in an organ bath for endothelium-dependent relaxation, initially without and then with the addition of 10 microM manganese tetrakis benzoic acid porphyrin (MnTBAP), 0.01% N-acetylcysteine (NAC), 0.

The effects of cilostazol on peripheral neuropathy in diabetic patients with peripheral arterial disease.

Background: Evidence from diabetic animal models suggests that cilostazol, a cyclic AMP phosphodiesterase inhibitor used in the treatment of claudication, is efficacious in the treatment of peripheral neuropathy, although this is unproven in humans. The main aim of this study was to assess the effects of cilostazol on neuropathic symptomatology in diabetic patients with peripheral arterial disease (PAD).

Methods: Diabetic patients with PAD were prospectively recruited to a randomized double-blinded placebo-controlled trial.

Effect of preoperative renal dysfunction on mortality and postoperative renal failure following endovascular abdominal aortic aneurysm repair.

This study was aimed to assess the effect of preoperative renal dysfunction on mortality and postoperative renal failure in patients undergoing elective endovascular repair of abdominal aortic aneurysm. A total of 155 patients with a mean age of 74.9 years (+/-6.

The role of smoking in abdominal aortic aneurysm development.

Abdominal aortic aneurysm is common. The aim of this study was to assess the effect of smoking on prevalence and management. Patients attending the vascular unit and appropriate controls were prospectively recruited.

Bilateral popliteal artery occlusion in a competitive bike rider: case report and clinical review.

Since its first description in 1879, popliteal artery entrapment syndrome remains a debilitating condition, which frequently affects young active people. Increased awareness of popliteal artery entrapment syndrome combined with improvements in investigative modalities has resulted in a more frequent diagnosis of this eminently treatable condition. In this article, a rare case of bilateral popliteal artery entrapment syndrome in a physically active 33-year-old man precipitated by competitive Bicycle Moto-Cross riding is presented.

Prescribing practice of general practitioners in Northern Ireland for peripheral arterial disease.

Peripheral arterial disease is prevalent and reflects overall cardiovascular disease state. Best medical treatment is the cornerstone of management to reduce peripheral arterial disease symptoms and to minimize vascular morbidity and mortality. The aim of this study was to assess the prescription practice of general practitioners in Northern Ireland for patients with peripheral arterial disease.

No difference in medium-term outcome between Zenith and Talent stent-grafts in endovascular aneurysm repair.

Background: Many devices are available for endovascular aneurysm repair (EVAR). Our aim was to analyze morphological effects of the Zenith and Talent systems.

Methods: Patients included underwent EVAR from June 1999 to June 2005 using a Zenith or Talent stent-graft, with computed tomography follow-up.

Inflammatory infrarenal abdominal aortic aneurysm in a young woman.

Inflammatory abdominal aortic aneurysm is a rare cause of abdominal pain in young adults that may be difficult to diagnose in the Emergency Department. This case highlights the significance of this condition as a possible diagnosis in young patients presenting with abdominal symptoms. A 32-year old woman presented with lower abdominal and back pain.

Prosthetic stent graft infection after endovascular abdominal aortic aneurysm repair.

Objective: The purpose of this report is to discuss the incidence, diagnosis, and management of stent graft infections after endovascular aneurysm repair (EVAR).

Methods: Data were collected from the hospital database and medical case notes for all patients with infected endografts after elective or emergency EVAR for abdominal aortic aneurysm (AAA) during the last 8 years in two university teaching hospitals in Northern Ireland. The data included the patient's age, gender, presentation of sepsis, treatment offered, and the ultimate outcome.

Decreased antioxidant vitamin concentration may be a risk factor for recurrent carotid stenosis.

Carotid endarterectomy has been found to be associated with a transient increase in systemic oxidative stress, and this has been shown to be a predictor of restenosis. The aim of this study was to determine the incidence of early recurrent stenosis and investigate a possible role of oxidative stress in its development by measuring the concentration of antioxidant vitamins. Patients undergoing carotid endarterectomy between August 2001 and February 2003 were included in the study.

Role of the Hardman index in predicting mortality for open and endovascular repair of ruptured abdominal aortic aneurysm.

Purpose: To correlate the Hardman prognostic index with perioperative mortality in patients undergoing open and endovascular repair of ruptured abdominal aortic aneurysm (rAAA).

Methods: Over a 5-year period, 126 patients (109 men; mean age 74 years, range 51-91) underwent open (n=74) or endovascular (n=52) repair of rAAA in a single unit. Five Hardman factors (age>76 years, history of loss of consciousness, ECG evidence of ischemia, hemoglobin<9.