Clinical outcomes after crossed-limb vs. conventional endograft configuration in endovascular AAA repair.

Purpose: To report a case controlled analysis of endovascular aneurysm repair (EVAR) outcomes using the crossed-limb (CxL) endovascular configuration vs. the straight-limb configuration (SLC).

Methods: From January 2007 to July 2012, 27 patients (25 men; mean age 73.

Surgical or endovascular therapy of abdominal penetrating aortic ulcers and their natural history: a systematic review.

Little is known regarding the outcomes of endovascular and surgical treatment of penetrating ulcers in the abdominal aorta. The potential benefit of conservative management of asymptomatic disease is also debatable. A systematic review of the literature was undertaken to investigate these issues.

Endovascular therapy for penetrating ulcers of the infrarenal aorta.

Background: We sought to investigate the short- and mid-term results of the endovascular repair of infrarenal abdominal penetrating aortic ulcers (aPAUs).

Methods: Patients with infrarenal aPAUs treated by endovascular means between March 2004 and June 2012 were recruited. Pre-interventional imaging included computed tomography (CT) or CT angiography.

Hybrid endografts combinations for the treatment of endoleak in endovascular abdominal aortic aneurysm repair.

Hybrid endografting in endovascular abdominal aortic aneurysm repair (EVAR) is defined as the process of placing a series of two or more different types of covered stents, usually to treat a complex abdominal aortic aneurysm (AAA) or a primary or secondary endoleak. We describe the treatment of a type III, a type Ib, and a type Ia endoleak in three patients respectively, using hybrid solutions, assembling components from different manufacturers. An update of the current clinical and experimental evidence on the application of anatomically compatible, hybrid endograft systems in conventional EVAR is also provided.

Successful endovascular treatment of a ruptured gigantic pseudoaneurysm of the common iliac artery secondarily complicated by infection.

We report our experience with a case of emergent endovascular treatment of a large ruptured pseudoaneurysm of the common iliac artery. A 65-year-old male was admitted to the surgical department in hypovolemic shock, due to active retroperitoneal bleeding. A computerized tomography scan with intravenous contrast revealed a ruptured gigantic pseudoaneurysm of the right common iliac artery, with a maximal diameter of 7 cm and retroperitoneal hematoma.

Thromboprophylaxis practices following varicose veins surgery.

Objective: It is not clear whether patients undergoing varicose veins operations should receive thromboprophylaxis. A nationwide survey was conducted to assess thromboprophylaxis practice patterns in patients undergoing conventional vein surgery or endovenous procedures.

Methods: A questionnaire was e-mailed to all members of the Greek Society of Vascular and Endovascular Surgery (n = 163).

Technical advances with newer aortic endografts provide additional support to withhold the early endovascular repair of small abdominal aortic aneurysms until it is really needed.

The idea of early endovascular aortic repair (EVAR) of "small" abdominal aortic aneurysms (AAAs) has gained attention over "watchful waiting," mostly due to the concern for losing the anatomic suitability for endovascular repair over time. Generally, small AAAs have longer, smaller, less angulated necks, and less tortuous iliac arteries than larger ones. Though the borderline anatomic characteristics were assumed to be contraindications for older generation endografts, the modifications of modern devices seem promising to overcome those limitations, in order to treat the small AAAs when reaching the 5.

An overview of the hemodynamic aspects of the blood flow in the venous outflow tract of the arteriovenous fistula.

Upper limb vein aneurysms complicate all types of autogenous arteriovenous fistulae (AVF) and comprise false aneurysms secondary to venipuncture trauma as well as true aneurysms, characterized by dilatation of native veins. The dilatation of a normal vein and the development of a true aneurysm are strongly influenced by local hemodynamic factors affecting the flow in the drainage venous system and are also the target of operative interventions. This review article focuses on the description of these hemodynamic aspects which all physicians involved in the management of dialysis patients should be aware of.

Early results of the Endurant endograft system in patients with friendly and hostile infrarenal abdominal aortic aneurysm anatomy.

Objective: To evaluate and compare the outcome after endovascular abdominal aortic aneurysm repair (EVAR) with the newly released Endurant endograft system in patients with different aortoiliac anatomic characteristics.

Methods: We conducted a prospective observational study assigning patients with infrarenal abdominal aortic aneurysm (AAA) treated with the Endurant endoprosthesis from February 2009 to March 2010. Two groups were studied, according to the presence of a friendly (group I [GI] = 43) or hostile (group II [GII] = 34) infrarenal aortoiliac anatomy.

A hybrid approach to salvage a failing long-standing autogenous aneurysmal fistula in a hemodialysis patient.

Very few studies have addressed the repair of autogenous and prosthetic-related false arteriovenous access (AVA) aneurysms in hemodialysis patients. Surgical management of complicated AVA-related aneurysms remains the gold standard method although covered stents have recently been introduced for the exclusion of such aneurysms, offering a minimally invasive therapy. In this paper, we describe a combination of open and endovascular repair for treating an anastomotic and a puncture-site aneurysm to salvage a failing long-standing autogenous radial-cephalic fistula in the wrist.

Current tips for ensuring successful transfemoral short limb cannulation in modular aortic endografts: a new method for incorporation in practice.

One of the most crucial steps in endovascular infrarenal abdominal aortic aneurysm repair is the short limb catheterization of the modular device and the confirmation of the intrastent position of the guidewire. Failed connection of the contralateral iliac limb to the main body because of malposition of the catheterizing guidewire may lead to serious complications. A new method confirming successful passage of the guidewire in the short leg of the main body of the modular stent graft, thus ensuring that the extension will be accurately docked within the short limb, is described in detail.