Cerebral perfusion and vascular reserve in fibromuscular dysplasia of the internal carotid artery.

We report of a case of abnormal cerebral perfusion but normal vascular reserve by single-photon emission computed tomographic imaging in a 65-year-old woman with fibromuscular dysplasia of the internal carotid artery (ICA). The patient had an aneurysm in her left ICA at the level of second cervical vertebra without evidence of stenosis and was excised with primary anastomosis 3 years ago when she presented with months of dizziness. But follow-up angiography showed high-grade long segmental stenosis in her left ICA, characteristic of fibromuscular dysplasia.

Open infrarenal abdominal aortic aneurysm repair: the Cleveland Clinic experience from 1989 to 1998.

Purpose: The purpose of this study was to determine the safety and durability of traditional surgical treatment for asymptomatic infrarenal abdominal aortic aneurysms (AAAs) in a large series of patients who underwent open operations during the decade preceding the commercial availability of stent graft devices for endovascular AAA repair.

Methods: From 1989 to 1998, 1135 consecutive patients (985 men [87%], 150 women; mean age, 70 +/- 7 years) underwent elective graft replacement of infrarenal AAA. Computerized perioperative data have been supplemented with a retrospective review of hospital charts/outpatient records and a telephone canvass to calculate survival rates and the incidence rate of subsequent graft-related complications.

Simultaneous aortic replacement and renal artery revascularization: the influence of preoperative renal function on early risk and late outcome.

Purpose: We documented the postoperative complication rate and the late results of simultaneous infrarenal aortic replacement and renal artery (RA) revascularization at the Cleveland Clinic and correlated these findings with the preoperative serum creatinine level (S(Cr)) and other baseline risk factors.

Methods: A retrospective review of hospital charts and outpatient records was supplemented with a telephone canvass and the invitation to return for a complimentary RA duplex scan, when a scan had not been done within the previous year. Data were collected for 73 consecutive patients (mean age, 69 years) who underwent aortic procedures that were combined with the repair of RA stenosis from 1989 to 1997 (mean follow-up, 44 months).

Initial experience of platelet glycoprotein IIb/IIIa inhibition with abciximab during carotid stenting: a safe and effective adjunctive therapy.

Background And Purpose: Abciximab has been shown to decrease periprocedural ischemic complications after coronary intervention. However, the adjunctive use of abciximab in carotid stenting has not been adequately studied. We sought to determine the efficacy and safety of abciximab in carotid stenting.

Reoperation for recurrent carotid stenosis: early results and late outcome in 199 patients.

Purpose: This study was undertaken to determine the safety and efficacy of reoperations for recurrent carotid stenosis (REDOCEA) at the Cleveland Clinic.

Materials And Methods: From 1989 to 1999, 206 consecutive REDOCEAs were performed in 199 patients (131 men, 68 women) with a mean age of 68 years (median, 69 years; range, 47-86 years). A total of 119 procedures (57%) were performed for severe asymptomatic stenosis, 55 (27%) for hemispheric transient ischemic attacks or amaurosis fugax, 26 (13%) for prior stroke, and 6 (3%) for vertebrobasilar symptoms.