Long-term comparison of endovascular and open repair of abdominal aortic aneurysm.

Background: Whether elective endovascular repair of abdominal aortic aneurysm reduces long-term morbidity and mortality, as compared with traditional open repair, remains uncertain.

Methods: We randomly assigned 881 patients with asymptomatic abdominal aortic aneurysms who were candidates for both procedures to either endovascular repair (444) or open repair (437) and followed them for up to 9 years (mean, 5.2).

Outcomes following endovascular vs open repair of abdominal aortic aneurysm: a randomized trial.

Context: Limited data are available to assess whether endovascular repair of abdominal aortic aneurysm (AAA) improves short-term outcomes compared with traditional open repair.

Objective: To compare postoperative outcomes up to 2 years after endovascular or open repair of AAA in a planned interim report of a 9-year trial.

Design, Setting, And Patients: A randomized, multicenter clinical trial of 881 veterans (aged > or = 49 years) from 42 Veterans Affairs Medical Centers with eligible AAA who were candidates for both elective endovascular repair and open repair of AAA.

Recanalization of infrainguinal vessels: silverhawk, laser, and the remote superficial femoral artery endarterectomy.

There are multiple endovascular options to achieve percutaneous revascularization of chronic superficial femoral artery (SFA) stenoses and occlusions. Most rely on forceful displacement of plaque via balloon angioplasty, either as a stand-alone therapy or supplemented by cold thermal injury (cryoplasty), microtome assistance (cutting balloon angioplasty), nitinol stent deployment, or expanded polytetrafluoroethylene-lined nitinol stent deployment. Excellent technical success rates are routinely described in the literature.

Discretionary carotid patch angioplasty leads to good results.

Background: This study evaluated the type and need for angioplasty in 253 consecutive carotid endarterectomies.

Methods: Polyester knitted gelatin sealed patch (DP) and polytetrafluoroethylene (PTFE) patches were used in, respectively, 159 and 29 patients, with 65 vessels closed primarily (no patch [NP]).

Results: Surgical results, estimated blood loss, and surgical time were similar in each group.

Endovascular vs open AAA repair: does size matter?

Since the natural tendency of the aorta is to increase in diameter and tortuosity with age and since abdominal aortic aneurysms (AAAs) increase in diameter and length over time, encroaching on the renal and hypogastric orifices, early repair of AAAs (when > or =4.0 cm) may allow greater applicability of the endovascular option because of more favorable aortoiliac morphology. Patients who present at an older age with larger AAAs should be more likely to be anatomically excluded from endovascular AAA repair.

Open surgical repair of children less than 13 years old with lower extremity vascular injury.

Purpose: We sought to review the diagnosis and treatment of children with lower extremity vascular injury.

Methods: We performed a query of our vascular surgery database from 1996 through 2002 to determine those with lower extremity vascular injuries requiring surgery who were also less than 13 years of age. Patient demographics, presentation, cause, surgical specifics, and outcome were sought.

Short-stay carotid endarterectomy in a tertiary-care Veterans Administration hospital.

Background: This study focused on 200 carotid endarterectomies (CEA) performed at our Veterans Administration Hospital (VAH) to determine whether 1-day hospitalization after CEA is safe and the degree to which it can be achieved.

Methods: Over 36 months, 200 CEAs were performed for asymptomatic stenosis (n = 104), transient ischemic attacks (n = 68), and stroke (n = 28). General anesthesia was used in 189 procedures.

The Ehlers-Danlos specter revisited.

Ehlers-Danlos type IV is a major concern to vascular surgeons because it is often associated with spontaneous hemorrhage from arteries containing decreased type III collagen. Five members of a family with Ehlers-Danlos type IV and a review of another family of five with Ehlers-Danlos type IV are reported. Evaluation of the recent family included clinical evaluation as well as assay of collagen production.