Ruptured traumatic ovarian artery pseudoaneurysm in a pregnant patient.

A woman at 36 weeks' gestation was involved in a motor vehicle crash. She required emergency delivery of a healthy infant by cesarean section. She received anticoagulation, despite a splenic injury, for a possible inferior vena cava clot.

Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease.

Objective: To compare outcomes of mesenteric angioplasty and stenting using iCAST covered stents (CS; Atrium, Hudson, NH) or bare metal stents (BMS) in patients with chronic mesenteric ischemia (CMI).

Methods: We reviewed the clinical data of 225 patients (65 male and 160 female; mean age, 72 ± 12 years) treated for CMI at two academic centers (2000-2010). Outcomes were analyzed in patients who had primary intervention or reintervention using BMS (n = 164 patients/197 vessels) or CS (n = 61 patients/67 vessels).

Pharmacomechanical thrombolysis for phlegmasia cerulea dolens.

Phlegmasia cerulea dolens (PCD) is limb-threatening. Traditional treatments are very morbid. We examine the efficacy of percutaneous treatment of PCD.

Management of chronic mesenteric vascular insufficiency: an endovascular approach.

Background: In patients with chronic mesenteric insufficiency (CMI), traditional bypass surgery carries a high operative mortality. Endovascular therapy for reconstruction of the mesenteric vascular system has high technical success but poor long-term patency. Secondary procedures are often mandatory for recurrent disease.

Balloon-expandable covered stent therapy of complex endovascular pathology.

The current study was designed to investigate our hypotheses that balloon-expandable covered stents display acceptable function over longitudinal follow-up in patients with complex vascular pathology and provide a suitable alternative for the treatment of recurrent in-stent restenosis. All stents were Atrium iCast, which is a balloon-mounted, polytetrafluoroethylene-covered stent with a 6F/7F delivery system. A retrospective review was performed of 49 patients with 66 stented lesions.

Spontaneous vein graft rupture after infrainguinal vascular reconstruction: report of three cases.

We report three cases of spontaneous vein graft rupture within 2 weeks of infrainguinal vein bypass for limb salvage. Two of the three ruptures were in the distal vein graft and the last just beyond the proximal anastomosis. All were longitudinal slits in the vein with no proximity to branches or valves.

Encouraging results with endoscopic vein harvest for infrainguinal bypass.

Background: Wound complications after infrainguinal vein bypass remain a significant source of morbidity. Endoscopic saphenous vein harvest has emerged as a viable alternative to minimize vein harvest incisions.

Methods: Infrainguinal bypass using endoscopic vein harvest was performed in 214 limbs in 197 consecutive patients between May 1998 and July 2004.

The relative contributions of carotid duplex scanning, magnetic resonance angiography, and cerebral arteriography to clinical decisionmaking: a prospective study in patients with carotid occlusive disease.

Purpose: Recent reports suggest that 80% to 90% of patients can safely undergo carotid endarterectomy on the basis of duplex scanning alone without cerebral angiography. Other investigators have recommended that a complementary imaging study such as magnetic resonance angiography (MRA) also be obtained.

Methods: We prospectively evaluated 103 consecutive patients with carotid occlusive disease.

Comparative analysis of percutaneous transluminal angioplasty and operation for renal revascularization.

Contemporary patients requiring renal revascularization often have diffuse atherosclerosis, and increasingly undergo intervention for salvage of renal function rather than control of hypertension alone. Risk-benefit analyses and outcome data are difficult to obtain, since few reports have analyzed a modern, unselected series of consecutive patients subjected to renal revascularization by surgical as well as interventional techniques. We reviewed our 5-year experience with 76 consecutive renal revascularizations in 63 patients.

Prospective evaluation of peripheral vascular disease in heart transplant recipients.

Purpose: Retrospective reviews suggest that the progression of peripheral vascular disease (PVD) may be accelerated in heart transplant recipients. This study was undertaken to determine the incidence and to identify those risk factors that may be associated with the development or progression of PVD in these patients.

Methods: Between January 1990 and December 1993 a prospective vascular screening protocol including abdominal ultrasonography, Doppler-derived ankel-brachial pressure indexes (ABI), and carotid artery duplex imaging was added to the routine preoperative and annual postoperative evaluation of 239 heart transplant recipients.

Clinical and CT evaluation of a new stretch polytetrafluoroethylene aortic graft.

A new stretch polytetrafluoroethylene (PTFE) aortic graft became available for clinical use in early 1991. We prospectively evaluated our first 107 stretch aortic PTFE grafts by means of serial CT imaging and compared them with a cohort of concurrently placed Dacron grafts. Stretch PTFE requires no preclotting and is claimed to resist long-term dilation and conform well to anastomoses.

Dissection of the external iliac artery in highly trained athletes.

We report a series of four acute external iliac artery dissections occurring in three patients within days of completion of ultraendurance athletic events. Acute dissection of the external iliac artery in highly trained athletes after competition has not been previously documented. A retrospective review of three cases was performed with subsequent follow-up, including imaging and hemodynamic measurements.

Ruptured ulnar artery pseudoaneurysm.

Ulnar artery aneurysms and pseudoaneurysms are rare lesions that usually occur distal to the wrist and cause symptoms as a result of embolization and not rupture. An elderly woman presented with acute rupture of an ulnar artery pseudoaneurysm proximal to the wrist, which caused severe neurologic compromise as a result of bleeding into Guyon's canal and the carpal tunnel. The patient had a remote wrist fracture resulting in a deformity that allowed the ulnar head to be in proximity to the ulnar artery.

Application of computed tomography for surveillance of aortic grafts.

Background: This study was undertaken to assess the application of computed tomography (CT) for surveillance of aortic grafts.

Methods: Demographics, operative technique, and graft type and size at the time of implantation of aortic grafts in 178 patients were recorded. CT measurements of graft diameters were made with calipers.

Aortofemoral graft occlusion: strategy and timing of reoperation.

The authors' experience with 46 patients treated over 8.5 years was reviewed to determine the optimal secondary revascularization procedure after occlusion of a unilateral aortobifemoral graft limb. A total of 64 procedures was performed on these patients to restore and maintain graft patency.

Distinguishing carotid artery pseudo-occlusion with color-flow Doppler.

Background And Purpose: This study was undertaken to determine the impact of color-flow Doppler on the accuracy of noninvasive carotid imaging for distinguishing an internal carotid artery pseudo-occlusion (string sign) from a complete occlusion.

Methods: From January 1985 to January 1994, review of noninvasive vascular studies, arteriograms, and operative reports of 26 consecutive patients undergoing 27 carotid endarterectomies for carotid pseudo-occlusion was performed. Further review was conducted of all patients identified with carotid occlusion by noninvasive testing who underwent confirmatory arteriography during the same interval.

Popliteal vascular compression in a normal population.

Purpose: Positional popliteal artery obstruction is believed to be an important factor contributing to popliteal artery entrapment syndromes. This study was undertaken to define the positional anatomy and physiologic condition of the vessels in the popliteal fossa in groups of highly trained and normally active young men and women. We postulate that at least some symptom-free individuals can occlude the popliteal artery with leg positioning.

Critical carotid artery stenosis: diagnosis, timing of surgery, and outcome.

Purpose: Patients with critical carotid artery stenoses have been considered to be at high risk for carotid artery occlusion necessitating urgent or emergency endarterectomy once the stenosis is identified. Included in this group of patients are those with carotid string sign or atheromatous pseudoocclusion (APO). This review was conducted to determine the impact of the severity of stenosis including APO on the treatment and outcome of patients undergoing carotid endarterectomy.