Early results of a highly selective algorithm for surgery on patients with neurogenic thoracic outlet syndrome.

Objective: Neurogenic thoracic outlet syndrome (nTOS) encompasses a wide spectrum of disabling symptoms that are often vague and difficult to diagnose and treat. We developed and prospectively analyzed a treatment algorithm for nTOS utilizing objective disability criteria, thoracic outlet syndrome (TOS)-specific physical therapy, radiographic evaluation of the thoracic outlet, and selective surgical decompression.

Methods: Patients treated for nTOS from 2000-2009 were reviewed (n = 93).

Intraoperative colon mucosal oxygen saturation during aortic surgery.

Background: Colonic ischemia after aortic reconstruction is a devastating complication with high mortality rates. This study evaluates whether Colon Mucosal Oxygen Saturation (CMOS) correlates with colon ischemia during aortic surgery.

Materials And Methods: Aortic reconstruction was performed in 25 patients, using a spectrophotometer probe that was inserted in each patient's rectum before the surgical procedure.

Long-term thrombotic recurrence after nonoperative management of Paget-Schroetter syndrome.

Background: The purpose of this study was to determine the clinical predictors associated with long-term thrombotic recurrences necessitating surgical intervention after initial success with nonoperative management of patients with primary subclavian vein thrombosis.

Methods: Sixty-four patients treated for Paget-Schroetter syndrome from 1996 to 2005 at our institution were reviewed. The standardized protocol for treatment includes catheter-directed thrombolysis, a short period of anticoagulation, and selective surgical decompression for patients with persistent symptoms.

Plasma cefazolin levels during cardiovascular surgery: effects of cardiopulmonary bypass and profound hypothermic circulatory arrest.

Objectives: We sought to assess the effects of cardiopulmonary bypass and profound hypothermic circulatory arrest on plasma cefazolin levels administered for antimicrobial prophylaxis in cardiovascular surgery.

Methods: Four groups (10 patients per group) were prospectively studied: vascular surgery without cardiopulmonary bypass (group A), cardiac surgery with a cardiopulmonary bypass time of less than 120 minutes (group B), cardiac surgery with a cardiopulmonary bypass time of greater than 120 minutes (group C), and cardiac surgery with cardiopulmonary bypass and profound hypothermic circulatory arrest (group D). Subjects received cefazolin at induction and a second dose before wound closure.

Early and late functional outcome assessments following endovascular and open aneurysm repair.

Purpose: To compare early and late functional outcomes, as well as survival and recovery, following endovascular or open repair of abdominal aortic aneurysm (AAA).

Methods: Between 1996 and 2000, 294 patients underwent AAA repair (141 open and 153 endovascular); 57 patients from each group had 12-month follow-up for functional outcome assessment. Recovery was measured as hospital length of stay, skilled nursing requirement, and hospital readmission within 1 year to determine cumulative hospital utilization.

Arterial and venous injuries in athletes: findings and their effect on diagnosis and treatment.

Unlabelled: Athletes are susceptible to a variety of vascular injuries, yet clinical presentation may be subtle and the extent of injury underestimated.

Objective: To evaluate Stanford University's experience with the diagnosis and management of vascular injuries incurred during athletic competition.

Methods: Between June 1994 and June 2001, 29 patients with athletic competition-related vascular injuries were treated by our service.

Endovascular repair reduces early and late morbidity compared to open surgery for abdominal aortic aneurysm.

Purpose: To compare systemic complications between standard surgery and endovascular repair of abdominal aortic aneurysms (AAA) for both primary and late secondary procedures.

Methods: At a single center between July 1993 and May 2000, 297 patients (255 men; mean age 73.4 +/- 8.

Subclavian vein thrombosis caused by an unusual congenital clavicular anomaly in an atypical anatomic position.

The optimal surgical management of subclavian vein effort thrombosis remains a dilemma because outcomes after different treatment strategies are only on the basis of small retrospective series. SVT treatment should be on the basis of the cause of thrombosis. Primary effort thrombosis or Paget-Schroetter syndrome frequently necessitates a surgical approach.

Aneurysm-related death: primary endpoint analysis for comparison of open and endovascular repair.

Purpose: The purpose of this study was to utilize an objective endpoint analysis of aneurysm treatment, which is based on the primary objective of aneurysm repair, and to apply it to a consecutive series of patients undergoing open and endovascular repair.

Method: Aneurysm-related death was defined as any death that occurred within 30 days of primary aneurysm treatment (open or endovascular), within 30 days of a secondary aneurysm or graft-related treatment, or any death related to the aneurysm or graft at any time following treatment. We reviewed 417 consecutive patients undergoing elective infrarenal aortic aneurysm repair: 243 patients with open repair and 174 patients with endovascular repair.

Duplex ultrasound criteria for defining the severity of carotid stenosis.

Duplex ultrasound scan (DUS) criteria for grading >50% carotid artery stenosis is typically divided into broad categories such as 50-79% stenosis, 80-99% stenosis, and occlusion. The purpose of this study is to validate DUS criteria for stratifying 50 to 100% carotid stenosis into 10% intervals using digital substraction cerebral angiography (DSCA) as the standard of comparison. Between 1996 and 2001, 163 patients were evaluated with duplex ultrasound and angiography.

Open versus endovascular AAA repair in patients who are morphological candidates for endovascular treatment.

Purpose: To compare the outcomes of open versus endovascular repair of abdominal aortic aneurysm (AAA) in a cohort of patients who fulfill morphological criteria for endovascular repair.

Methods: A retrospective review of 229 consecutive AAA patients treated over a 3-year period identified 149 patients who were candidates for endovascular repair based on preoperative computed tomography and angiography. Of the 149 patients, 79 (68 men; mean age 74 +/- 8 years) underwent endovascular repair with the AneuRx stent-graft; the remaining 70 (56 men; mean age 72 +/- 8 years) had open repair.

Gender differences in endovascular abdominal aortic aneurysm repair with the AneuRx stent graft.

Objective: The objective of this study was to evaluate gender differences in the selection, procedure, and outcome of endovascular abdominal aortic aneurysm repair (EVAR).

Patients: Between October 1996 and January 2001, 378 patients were evaluated for EVAR and 189 patients underwent EVAR with the Medtronic AneuRx stent graft at a single center.

Results: Women constituted 17% of patients considered for EVAR.

Will Angiosocopy Replace Operative Arteriography in the 1990s?

Vascular surgeons have always been concerned with the intra-operative assessment of their reconstructions. Failure of vascular reconstructions in the early post-operative period is most commonly a result of a technical error at the time of surgery. Hence, any technique which aids the vascular surgeon in evaluating his reconstruction and in preventing technical errors will be beneficial to both the surgeon and their patient.