Rupture after endovascular abdominal aortic aneurysm repair: a multicenter study.

A total of 22 patients with ruptured abdominal aortic aneurysms (rAAAs) after previous endovascular aortic repair (EVAR; rAAAevar) were presented to 7 referral hospitals in Greece, between January 2006 and April 2012. Type Ia endoleak and endograft migration were identified in 72.7% and 50%, respectively.

Predictors affecting in-hospital mortality of ruptured abdominal aortic aneurysms: a Greek multicenter study.

Background: Endovascular aortic repair (EVAR) is being used with increasing frequency for the treatment of ruptured abdominal aortic aneurysms (rAAAs), although conflicting results have been reported concerning perioperative mortality. The aim of our study was to evaluate potential difference in mortality rates between EVAR and open surgical repair (OSR) and identify independent risk factors for in-hospital mortality in rAAAs. This study also aimed to evaluate the Glasgow Aneurysm Score (GAS) in predicting in-hospital mortality.

Suprarenal graft fixation in endovascular abdominal aortic aneurysm repair is associated with a decrease in renal function.

Introduction: Suprarenal endograft fixation is routinely used in the endovascular repair of abdominal aortic aneurysms (EVAR) to enhance proximal endograft attachment but can be associated with an adverse outcome in renal function. This prospective study assessed the effect of suprarenal fixation on serum creatinine concentration and estimated glomerular filtration rate (eGFR), calculated by the Modified Diet in Renal Disease equation, 12 months after elective EVAR.

Methods: Patients undergoing elective EVAR were divided into suprarenal vs infrarenal fixation groups matched for age, sex, smoking, and aneurysm diameter.

Surgical treatment for large hepatocellular carcinoma: does size matter?

Despite significant progress in the management of hepatocellular carcinoma (HCC), patients with large HCC (defined as >10 cm) continue to present a significant challenge. The goal of this paper is to review the existing literature regarding large HCC, with emphasis on identifying the issues and challenges involved in approaching these tumours surgically. A computerized search was made of the Medline database from January 1992 to December 2010.

Anemia is associated with mortality following endovascular repair of abdominal aortic aneurysm.

Aim: The aim of this study was to compare midterm mortality between anemic and nonanemic patients undergoing endovascular repair of abdominal aortic aneurysm and to assess a correlation with markers of inflammation.

Methods: Anemia was defined as hemoglobin <13 (men) and <12 g/dL (women). The impact of anemia and inflammatory markers on mortality was assessed using Kaplan-Meier curves and Cox regression.

Helical EndoStaples enhance endograft fixation in an experimental model using human cadaveric aortas.

Objective: This study evaluated the contribution of Aptus EndoStaples (Aptus Endosystems, Sunnyvale, Calif) in the proximal fixation of eight endografts used in the endovascular repair of abdominal aortic aneurysms (EVAR).

Methods: Nine human cadaveric aortas were exposed, left in situ, and transected to serve as fixation zones. The Zenith (Cook, Bloomington, Ind), Anaconda (Vascutek, Inchinnan, Scotland, UK), Endurant (Medtronic, Minneapolis, Minn), Excluder (W.

Management of traumatic aortic isthmus rupture in case of aberrant right subclavian artery (arteria lusoria).

Background: To present an unusual case of blunt aortic injury in a 30-year-old male patient with an aberrant right subclavian artery.

Methods And Results: Driven by the complicated and challenging nature of the case, we decided to treat the patient by a combined approach-right subclavian artery transposition and endograft implantation at the isthmus level. During the 24-month follow-up (clinical examination, angiogram, computed tomographic scan), we registered no complaints; normal perfusion of the right arm; and adequate sealing of the aortic tear.

Isolated common iliac artery aneurysms: a revised classification to assist endovascular repair.

Isolated common iliac artery aneurysms (CIAAs) are relatively rare; they typically progress asymptomatically and are revealed incidentally, usually after they have acquired significant dimensions. Traditional open reconstruction is associated with high morbidity and mortality rates. Rupture is a common initial manifestation.

Inferior vena cava stent-graft placement to treat endoleak associated with an aortocaval fistula.

Purpose: To report a case in which a persistent high-flow type II endoleak after endovascular aneurysm repair (EVAR) of a leaking abdominal aortic aneurysm (AAA) complicated by an aortocaval fistula was repaired with a stent-graft in the inferior vena cava (IVC).

Case Report: A 76-year-old man underwent emergent EVAR with an aortomonoiliac device to exclude a leaking 9-cm AAA. The 30-day computed tomography (CT) scan showed 2-mm sac expansion and a type II endoleak arising from a lumbar artery; the outflow vessel was the inferior vena cava (IVC) via a fistula that was not depicted on the non-contrast preoperative CT or the intraoperative angiogram.

New exposure technique for management of giant internal carotid artery aneurysm.

We are presenting a case of giant internal carotid artery aneurysm (ICAA) managed by a new exposure technique. Following double mandibular osteotomy, the exposure of the entire aneurysm was achieved by mandible mobilization. The aneurysm repair was performed by resection and graft interposition.

Synchronous carotid artery stenting and open heart surgery.

Background: The optimal management of the patients requiring cardiac surgery with concomitant severe carotid disease remains a controversy. The traditional approach involves staged or combined carotid endarterectomy and cardiac surgery. This study evaluated the feasibility and safety of angioplasty and stenting for the treatment of carotid stenoses concomitantly to cardiac operations to reduce the risk of perioperative stroke.

Abdominal aortic aneurysm: a review of the genetic basis.

Background: Abdominal aortic aneurysm (AAA) is a complex disease with a largely unknown pathophysiological background and a strong genetic component. Various studies have tried to link specific genetic variants with AAA.

Methods: Systematic review of the literature (1947-2009).

Preoperative screening and management of carotid artery disease in patients undergoing cardiac surgery.

Background: Carotid artery stenosis (CAS) is a well-known risk factor for perioperative stroke in cardiac surgery. It is unclear whether preoperative carotid screening should be applied to all patients. Carotid intervention concomitantly with cardiac operations is also controversial.

Reporting mid- and long-term results of endovascular grafting for abdominal aortic aneurysms using the aortomonoiliac configuration.

Purpose: This study evaluated the feasibility, efficacy, and durability of a specific aortomonoiliac endograft for the treatment of abdominal aortic aneurysm (AAA) during a midterm follow-up.

Methods: From January 2002 until November 2008, 106 patients (6 women; mean age, 73.37 +/- 7.

Endovascular repair of inadvertent subclavian artery perforation during cannulation for dialysis access: case report and review of the literature.

Central venous catheterization is a routine vascular-access procedure; however, it may be associated with life-threatening complications such as arterial puncture, leading to arterial occlusion, embolism, pseudoaneurysm formation, vessel laceration or dissection, haemopneumothorax or massive haemorrhage. We report a case of an accidental subclavian artery perforation with a wide dialysis catheter. A Jostent endovascular covered stent was deployed to seal the deficit.

Pharmacotherapy before and after endovascular repair of abdominal aortic aneurysms.

Endovascular (EVAR) abdominal aortic aneurysm (AAA) repair has been established as a successful procedure in the short term and may constitute a viable long-term alternative to open repair (OR). The procedure has been associated with lower operative and mid-term morbidity and mortality compared to OR, but long-term results remain largely controversial. EVAR has also been associated with a significant risk of implant and procedure-related complications, such as graft thrombosis and cardiovascular events, necessitating interventional and pharmaceutical management.

Minimally invasive endovascular intervention in emergent and urgent thoracic aortic pathologies: single center experience.

Introduction: We report mid-term results from the endovascular treatment of acute thoracic aortic pathologies in a single center.

Methods: We retrospectively interrogated our clinical database and identified the following patients who were treated for an acute thoracic aortic pathology during a 3-year period (January 2003 to February 2006) with the deployment of a thoracic endograft: 8 male patients diagnosed with a thoracic aortic pseudoaneurysm and/or a thoracic aortic disruption following blunt chest trauma; 1 male patient with a large mobile mural thrombus of the descending thoracic aorta; 1 patient with an aortobronchial fistula; and 8 patients with a symptomatic descending thoracic aortic aneurysm.

Results: Complete exclusion of the lesion was achieved in all patients.

Midterm results of a modified technique for implanting tube grafts during endovascular abdominal aortic aneurysm repair.

Purpose: To retrospectively analyze the efficacy and midterm results of endovascular aneurysm repair (EVAR) with a tubular stent-graft using 2 different implantation techniques.

Methods: Between November 2004 and September 2007, 53 patients (49 men; mean age 68.5+/-8.

Aortoduodenal fistulas after endovascular stent-graft repair of abdominal aortic aneurysms: single-center experience and review of the literature.

Purpose: To report a single-center experience with aortoduodenal fistula (ADF) after successful endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA).

Methods: Five patients (all men; mean age 68.4 years, range 60-75) developed an ADF between 18 days to 1 year after successful EVAR using 3 types of commercially available endografts: 1 bifurcated Anaconda, 1 unibody Powerlink, and 3 EndoFit stent-grafts in a tubular (n=1) or aortomonoiliac configuration (n=2).

Surgical intervention for gastrointestinal foreign bodies in adults: a case series.

Objective: The aim of our study was to demonstrate our experience regarding the surgical treatment of complications after foreign body ingestion.

Subject And Methods: From 1997 to 2005, we treated 16 adult patients (mean age 44.8 years, range 21-77), who presented with complications after foreign body ingestion.

Failure and success of percutaneous angioplasty in a hypertensive child with bilateral renal artery stenosis.

We describe the clinical course of a 5-year-old girl with severe arterial hypertension that was uncontrollable with antihypertensive medication. Renal angiography revealed bilateral renal artery stenoses. Because percutaneous transluminal renal angioplasty (PTRA) failed to dilate the stenotic lesions, a renal artery bypass grafting in both renal arteries was performed.

Non-activated autologous platelet-rich plasma for the prevention of inguinal wound-related complications after endovascular repair of abdominal aortic aneurysms.

The endovascular repair (EVAR) of abdominal aortic aneurysms (AAAs) usually involves the surgical exposure and catheterization of the femoral arteries. Several inguinal surgical wound-related complications have been reported postoperatively. The aim of this report was to evaluate the safety and efficacy of intraoperative application of autologous platelet-rich plasma (PRP) for the prevention of wound-related complications in AAA EVAR.

Anaconda aortic stent-graft: single-center experience of a new commercially available device for abdominal aortic aneurysms.

Purpose: To report a retrospective evaluation of the efficacy and midterm clinical results of the Anaconda stent-graft in the endovascular repair of infrarenal abdominal aortic aneurysms.

Methods: Fifty-one patients (48 men; mean age 71+/-8 years, range 62-89) were treated with the Anaconda stent-graft from January 2006 to September 2007. Six patients were considered at high risk for open repair (defined as ASA grade 3) and 10 had undergone previous laparotomy.

Mid-term comparison of bifurcated modular endograft versus aorto-uni-iliac endograft in patients with abdominal aortic aneurysm.

The aim of this prospective study was to compare the outcome of the Talent bifurcated endograft versus the Endofit aorto-uni-iliac endograft in the short-term and mid-term. Between March 2000 and December 2003, 86 patients were treated with the Talent bifurcated endograft (group A) and 21 with the Endofit aorto-uni-iliac endograft (group B) in the same institute by the same surgical team. All patients followed a prospective protocol of preoperative evaluation and postoperative follow-up.

Carotid artery stent placement with embolic protection: single-center experience.

Purpose: To evaluate the efficacy of carotid artery stent placement with embolic protection.

Materials And Methods: During a 2-year period (May 2003 to April 2005), 232 patients underwent carotid artery stent placement with the Acculink RX stent-graft and an embolic protection device. There were 150 men (mean age,70 years; age range, 58-85 years) and 82 women (mean age, 76 years; age range, 56-82 years).