Migration of vascular embolisation material from the intravascular space to surrounding interstitial tissues in arteriovenous malformations.

We present the case of a young man active duty in the military who initially presented with pelvic pain and fullness during sexual activity. Extensive workup showed a large pelvic arteriovenous malformation (AVM). He underwent over 10 interventional radiology procedures to embolise his AVM and suffered multiple postoperative complications resulting in exploratory laparotomies, bowel resections and ultimately a colostomy.

Congenital agenesis of inferior vena cava: a rare cause of unprovoked deep venous thrombosis.

Congenital anomalies of the inferior vena cava (IVC), although rare, are a risk factor for lower limb deep venous thrombosis (DVT). A 19-year-old male presented with a left flank and groin pain caused by iliofemoral venous thrombosis. Vascular imaging by computed tomography (CT) scanning and venography demonstrated agenesis of the IVC.

Incorporating robot-assisted prostatectomy at a Veterans Affairs hospital: outcomes.

Purpose: To evaluate a unique method of extended mentorship in robot-assisted laparoscopic prostatectomy (RALP) at VA San Diego Healthcare System (VASDHS). As novel robotic technologies diffuse into surgical practice, developing safe apprenticeships remains a challenge.

Patients And Methods: Between October 2008 and November 2010, 90 RALPs were prospectively divided into three phases: Proctored, Independent, and Instructor.

Assessment and remedial clinical education of surgeons in California.

Hypothesis: Assessment and remedial clinical education of practicing surgeons is feasible and possibly beneficial.

Design: Retrospective series.

Setting: Urban academic medical center.

Spinal cord ischemia occurring in association with induced hypotension for colonic surgery.

A 19-year-old woman underwent an ileoanal pull-through. Intraoperatively, deepening of anesthesia was associated with reduced bleeding. Therefore, induced hypotension, mean arterial blood pressure 50 to 55 mm Hg, was maintained for 2.

Endovascular repair of an aortopulmonary fistula via the axillary artery.

A 62-year-old man presented with several months of progressive hemoptysis. He has a history of aortobifemoral bypass and thoracofemoral bypass grafts, which were both removed due to infection. Evaluation with multiple imaging modalities revealed a descending thoracic aortic pseudoaneurysm around the retained Dacrontrade mark graft with bronchiectatic changes and consolidation of the adjacent left lower lobe.

Surgical and endovascular treatment of lower extremity venous insufficiency.

Lower extremity venous insufficiency is a highly prevalent condition. Now it is understood that telangiectasias, reticular varicosities, and true varicose veins are physiologically similar and etiologically identical. The four main influences causing these abnormalities are heredity, female sex, gravitational hydrostatic forces, and hemodynamic muscular compartment pressure.

Early experience using the Wallgraft in the management of distal microembolism from common iliac artery patholology.

Blue toe syndrome commonly occurs as a result of aneurysmal or atherosclerotic disease in the iliac arteries. Surgery, angioplasty, or intraarterial stent placement are the most common treatment options but the optimal management has not been defined. Here we report managing distal microembolization from iliac artery atherosclerosis associated with aneurysmal dilation with the Wallgraft Endoprosthesis, a self-expanding metallic stent covered with Dacron.

Surgical management of acute complications and critical restenosis following carotid artery stenting.

Carotid artery angioplasty with stenting (CAS) is being increasingly used in the treatment of extracranial carotid artery stenosis. As in other catheter-based approaches to the treatment of arterial disease, surgical intervention may be required because of either acute complications or correct critical restenosis. We have reviewed our experience managing early complications and critical in-stent restenoses after CAS in a tertiary care university hospital and a Veterans Affairs Medical Center.

Small-caliber mesothelial cell-layered polytetraflouroethylene vascular grafts in New Zealand white rabbits.

Reduction in the thrombogenicity of small-caliber synthetic vascular grafts by lining them with mesothelial cell has been suggested as a method to reduce thrombosis. The purpose of this research is to determine whether creation of a mesothelial lining on the inner surface of a synthetic vascular graft would improve the patency rate of a small-caliber vascular grafts. Carotid interposition grafting was performed using mesothelial-lined grafts (MLG) in 30 New Zealand rabbits and compared with similar carotid interposition grafts using non-mesothelial-lined grafts (NLG) on the contralateral side.