Early duplex predicts restenosis after renal artery angioplasty and stenting.

Objective: To examine the relationship between early renal duplex sonography (RDS) and restenosis after primary renal artery percutaneous angioplasty and stenting (RA-PTAS).

Methods: Consecutive patients undergoing RA-PTAS for hemodynamically significant atherosclerotic renal artery stenosis with hypertension and/or ischemic nephropathy between September 2003 and July 2010 were identified from a prospective registry. Patients had renal RDS pre-RA-PTAS, within 1 week of RA-PTAS and follow-up RDS examinations after the first postoperative week for surveillance of restenosis.

Results of endovascular aortic aneurysm repair with general, regional, and local/monitored anesthesia care in the American College of Surgeons National Surgical Quality Improvement Program database.

Background: This study examined outcomes of endovascular repair of infrarenal abdominal aortic aneurysms (EVAR) using general, spinal, epidural, and local/monitored anesthesia care (MAC) in a multicenter North American hospital database reflecting contemporary anesthesia and surgical practices.

Methods: Elective EVAR cases performed between 2005 and 2008 were identified from the American College of Surgeons National Surgical Quality Improvement Program database using Current Procedural Terminology codes. Excluded were emergency cases and patients with concomitant procedures requiring general anesthesia.

A vascular disease educational program in the preclinical years of medical school increases student interest in vascular disease.

Background: New training paradigms in vascular surgery necessitate medical student interest in vascular disease. We examined the effects of incorporation of a vascular disease educational program during the second year of the medical school curriculum on student acquisition of knowledge and interest in the treatment of vascular disease.

Methods: We developed and administered a new educational program on vascular disease and delivered the program to all second-year medical students.

Late erosion of a prophylactic Celect IVC filter into the aorta, right renal artery, and duodenal wall.

We present the case of a patient with retrievable inferior vena cava (IVC) filter-related pseudoaneurysms of the infrarenal aorta and right renal artery, with associated erosion into the duodenal wall. The patient was seen 10 months following multiorgan trauma and placement of a prophylactic retrievable IVC filter (R-IVCF). Management required autogenous aortic reconstruction, caval repair, and subsequent right nephrectomy.

Accuracy of duplex sonography scans after renal artery stenting.

Purpose: Reports of duplex sonography scan criteria for recurrent renal arterial (RA) stenosis after endoluminal stenting have suggested that criteria for native arteries may overestimate recurrent disease. This retrospective report examines the utility of renal duplex sonography (RDS) scans to define the presence of significant (ie, ≥ 60%) renovascular disease (RVD) after percutaneous angioplasty and endoluminal stenting (PTAS).

Methods: Demographic, duplex, and angiographic data were reviewed and compared.

Trends in vena caval interruption.

Objective: This study examined the national use of vena cava filters (VCFs) from 1998 to 2005.

Methods: Methods for complex surveys were used to examine hospital discharge data from the Nationwide Inpatient Sample (NIS) to determine the use of VCFs for the years 1998 to 2005. VCF placement in the absence of deep venous thrombosis (DVT) or pulmonary embolus (PE) was categorized as prophylactic.

Atherosclerotic renovascular disease among hypertensive adults.

Purpose: This report describes the change in atherosclerotic renovascular disease (AS-RVD) among hypertensive adults referred for renal duplex sonography (RDS) scan.

Methods: From Oct 1993 through July 2008, 20,994 patients had RDS at our center. A total of 434 hypertensive patients with two or more RDS exams without intervention comprised the study cohort.

Effect of challenging neck anatomy on mid-term migration rates in AneuRx endografts.

Objective: To establish the effect of challenging neck anatomy on the mid- and long-term incidence of migration with the AneuRx bifurcated device in patients treated after Food and Drug Administration approval and to identify the predictive factors for device migration.

Methods: Prospectively maintained databases at the University of North Carolina (UNC) and Washington University (WU) were used to identify 595 patients (UNC, n = 230; WU, n = 365) who underwent endovascular repair of an infrarenal abdominal aortic aneurysm with the AneuRx bifurcated stent graft. Those patients with at least 30 months of follow-up were identified and underwent further assessment of migration (UNC, n = 25; WU, n = 59) by use of multiplanar reconstructed computed tomographic scans.

Computed tomographic angiography allows accurate planning of the setting and technique of open and percutaneous vascular interventions.

Background: Vascular surgeons can offer patients with arterial and venous disorders a multitude of endovascular and surgical options. Computed tomographic angiography (CTA) has the potential to allow the development of an effective interventional strategy without subjecting patients to invasive diagnostic testing.

Methods: A prospectively maintained database was reviewed comprising 6 consecutive months of arterial and venous procedures performed using an algorithm emphasizing CTA supplemented with other noninvasive imaging.

Aortic neck attachment failure and the AneuRx graft: incidence, treatment options, and early results.

Some investigators have reported that proximal attachment failure is a long-term complication of endovascular abdominal aortic aneurysm repair (EVAR) with the AneuRx (Medtronic, Santa Rosa, CA) device. We evaluated the need for an intervention in patients with suboptimal proximal fixation as well as the feasibility and early success of a variety of treatment strategies. From October 1999 to October 2003, we performed 365 EVARs using the AneuRx graft.

Natural killer cells participate in bacterial clearance during septic peritonitis through interactions with macrophages.

Natural killer (NK) cells have a well-established role in host defense against viral infections and malignancies. However, their function in bacterial infection and sepsis is poorly defined. We hypothesized that NK cells, as a major producer of interferon-gamma during sepsis, would be important in host defense against bacterial infections.

Treatment of Helicobacter pylori infection in patients with peptic ulcer disease.

Helicobacter pylori is an organism that is thought to be important in the pathophysiology of peptic ulcer disease and gastritis. Eradication of the organism is useful in clinical cure of infected patients. Efficacious regimens generally include an antisecretory agent combined with two to three antimicrobials.

Genetic background determines susceptibility during murine septic peritonitis.

Background: The tolerance of mouse strains to cecal ligation and puncture (CLP), a clinically relevant model of sepsis, can vary greatly. We compared the immune response and bacterial eradication during CLP in two mouse strains with different susceptibilities to the lethal effects in an effort to understand alterations in tolerance.

Materials And Methods: CLP of increasing severity was performed on Swiss Webster mice.