Diagnosis and treatment of vascular graft and endograft infections: a structured clinical approach.

A vascular graft or endograft infection (VGEI) is a severe complication that can occur after vascular graft or endograft surgery and is associated with high morbidity and mortality rates. A multidisciplinary approach, consisting of a team of vascular surgeons, infectious diseases specialists, medical microbiologists, radiologists, nuclear medicine specialists, and hospital pharmacists, is needed to adequately diagnose and treat VGEI. A structured diagnostic, antibiotic, and surgical treatment algorithm helps clinical decision making and ultimately aims to improve the clinical outcome of patients with a VGEI.

Predictors of early aortic neck dilatation after endovascular aneurysm repair with EndoAnchors.

Objective: Dilatation of the aorta within the proximal neck after endovascular aneurysm repair (EVAR) can be associated with late endoleaks and migration. This study was designed to identify predictors of early neck dilation in patients undergoing EVAR with Heli-FX EndoAnchors (Medtronic, Santa Rosa, Calif) measured perioperatively to 1 year at different longitudinal levels of neck length.

Methods: The study group of Aneurysm Treatment Using the Heli-FX Aortic Securement System (ANCHOR) comprises 257 consecutive patients prospectively enrolled between April 2012 and September 2014 undergoing EVAR with Heli-FX EndoAnchor implantation at 38 investigational sites.

Endovascular Treatment of Common Iliac Artery Aneurysms With an Iliac Branch Device: Multicenter Experience of 140 Patients.

Purpose: To evaluate the efficacy, feasibility, and long-term outcomes of the Zenith ZBIS iliac branch device (IBD) to preserve internal iliac artery (IIA) perfusion in a large Dutch multicenter cohort.

Methods: Between September 2004 and August 2015, 140 patients (mean age 70.9±7.

Chimney technique in combination with a sac-anchoring endograft for juxtarenal aortic aneurysms: technical aspects and early results.

Background: Juxtarenal aortic aneurysms (JAAs) pose clinical challenges for vascular specialists. Chimney endovascular sealing (Ch-EVAS) might be an ideal endovascular solution in the treatment of JAAs. We present technical aspects and early clinical results of a multicenter experience with Ch-EVAS.

Is a history of radiation therapy a contraindication for carotid surgery?

Advances in surgical and medical oncology have seen a significant increase in survival of patients suffering from head and neck malignancies. Many of these patients are treated with radiotherapy to the neck, including the cervical carotid artery. Cervical irradiation (CI) may induce carotid stenosis.

Mechanochemical endovenous ablation versus radiofrequency ablation in the treatment of primary small saphenous vein insufficiency (MESSI trial): study protocol for a randomized controlled trial.

Background: Minimally invasive endothermal techniques, for example, radiofrequency ablation (RFA), have revolutionized the treatment of insufficient truncal veins and are associated with an excellent outcome. The use of thermal energy requires the instillation of tumescent anesthesia around the vein. Mechanochemical endovenous ablation (MOCA™) combines mechanical endothelial damage, using a rotating wire, with simultaneous infusion of a liquid sclerosans.

Mechanochemical endovenous ablation for the treatment of great saphenous vein insufficiency.

Objective: This study evaluated the feasibility, safety, and 1-year results of mechanochemical endovenous ablation (MOCA) of great saphenous vein (GSV) insufficiency.

Methods: A consecutive 106 patients were treated for primary GSV insufficiency with MOCA by the ClariVein device and polidocanol. The primary outcome measures were technical success, clinical success, and anatomic success after 1 year of follow-up.

Mechanochemical endovenous Ablation versus RADiOfrequeNcy Ablation in the treatment of primary great saphenous vein incompetence (MARADONA): study protocol for a randomized controlled trial.

Background: Radiofrequency ablation (RFA) is associated with an excellent outcome in the treatment of great saphenous vein (GSV) incompetence. The use of thermal energy as a treatment source requires the instillation of tumescence anesthesia. Mechanochemical endovenous ablation (MOCA) combines mechanical endothelial damage, using a rotating wire, with the infusion of a liquid sclerosant.

Postoperative pain and early quality of life after radiofrequency ablation and mechanochemical endovenous ablation of incompetent great saphenous veins.

Objective: Thermal ablative techniques of varicose veins carry a risk of heat-related complications, including postoperative pain. Mechanochemical endovenous ablation (MOCA) might avoid these complications and reduce postoperative pain because of the absence of thermal energy. This study evaluated postoperative pain and quality of life after radiofrequency ablation (RFA) and MOCA for great saphenous vein (GSV) incompetence.

[Endovenous mechanochemical ablation for varicose veins--a new endovenous technique without tumescent anaesthesia].

In the past decades, endovenous techniques have played an increasingly important role in the treatment of varicose veins. The method of action of these techniques is based on heat, making tumescent anesthesia necessary. Despite this anesthesia, heat-induced complications such as skin burns, nerve damage and prolonged pain may occur.

Long-term results of Talent endografts for endovascular abdominal aortic aneurysm repair.

Background: Since the introduction of endovascular aneurysm repair (EVAR), long-term follow-up studies reporting single-device results are scarce. In this study, we focus on EVAR repair with the Talent stent graft (Medtronic, Santa Rosa, Calif).

Methods: Between July 2000 and December 2007, 365 patients underwent elective EVAR with a Talent device.

Molecular MRI of murine atherosclerotic plaque targeting NGAL: a protein associated with unstable human plaque characteristics.

Aims: Neutrophil gelatinase-associated lipocalin (NGAL) is an effector molecule of the innate immune system. One of its actions is the prolongation of matrix metalloproteinase-9 (MMP-9) activity by the formation of a degradation-resistant NGAL/MMP-9 complex. We studied NGAL in human atherosclerotic lesions and we examined whether NGAL could act as a target for molecular imaging of atherosclerotic plaques.

Endovascular therapy for recurrent type III endoleak.

We report a case in which an aortouniiliac revision for a type IIIb endoleak of a primarily implanted AneuRx bifurcation endograft for infrarenal aortic aneurysm repair caused a renewed type IIIa endoleak 2 months after revision. The type IIIa endoleak was successfully repaired with a bridging endoprosthesis. In this report, we discuss the pitfalls that should be considered when aortouniiliac revision procedures are performed for type III endoleaks in bifurcated endografts.

Carotid angioplasty and stenting: treatment of postcarotid endarterectomy restenosis is at least as safe as primary stenosis treatment.

Objectives: This study compared transcranial Doppler (TCD) imaging and outcomes of carotid angioplasty and stenting (CAS) in stenosis after carotid endarterectomy (CEA) vs primary atherosclerotic stenoses.

Methods: A prospectively accumulated database of 812 CAS procedures was analyzed retrospectively. Two groups were created.

Renal artery pseudoaneurysm caused by a complete stent fracture: a case report.

We report the case of a 71-year-old man with acute back and left flank pain caused by a large pseudoaneurysm of the left renal artery. The pseudoaneurysm resulted from a complete fracture of a stent that had been placed at the origin of this vessel 10 months earlier. Because the left kidney had no residual function, the patient was treated by percutaneous occlusion of the left renal artery with a vascular plug.

Superselective coil embolization of arterial esophageal hemorrhage.

The authors report a case of arterial esophageal bleeding resistant to endoscopic hemostasis in a patient in critical condition after complicated gastrointestinal and pulmonary surgery. Unfit for surgery, the patient's massive hemorrhage was successfully treated with superselective coil embolization of the afferent esophageal branch of the thoracic aorta. In patients with severe arterial bleeding of the esophagus, percutaneous superselective arterial coil embolization may be feasible for control of hemorrhage.

Levels of extra domain A containing fibronectin in human atherosclerotic plaques are associated with a stable plaque phenotype.

Background: Extra domain A (EDA), splice-variant of fibronectin, is a Toll-like receptor 4 (Tlr4) ligand. Recently, EDA has been demonstrated to enhance atherogenesis in mice but human data on the role of EDA in atherosclerotic disease are lacking. We hypothesized that EDA is associated with unstable plaque phenotypes and that plasma EDA could serve as biomarker for atherosclerosis.

Statin treatment is not associated with consistent alterations in inflammatory status of carotid atherosclerotic plaques: a retrospective study in 378 patients undergoing carotid endarterectomy.

Background And Purpose: Anti-inflammatory qualities are held partially responsible for the reduction of cardiovascular events after statin treatment. We examined the phenotype of carotid atherosclerotic plaques harvested during carotid endarterectomy in relation to the previous use of different statins prescribed in clinical practice.

Methods: Three hundred and seventy-eight patients were included.

Carotid atherosclerotic plaques in patients with transient ischemic attacks and stroke have unstable characteristics compared with plaques in asymptomatic and amaurosis fugax patients.

Introduction: Atherosclerotic carotid artery disease is responsible for a variety of clinical presentations, ranging from asymptomatic to cerebral ischemic events. Considering the upcoming use of noninvasive imaging modalities, plaque characteristics could serve as a marker in the selection of patients eligible for carotid endarterectomy (CEA). This would be more likely if characteristics corresponded with clinical manifestations and were predictive of future events.

Age-related changes in plaque composition: a study in patients suffering from carotid artery stenosis.

Objective: The extent of atherosclerotic plaque burden and the incidence of atherosclerosis-related cardiovascular events accelerate with increasing age. The composition of the plaque is associated with plaque thrombosis and acute coronary occlusion. Surprisingly, however, the relation between advancing age and atherosclerotic plaque composition is still unclear.

Athero-express: differential atherosclerotic plaque expression of mRNA and protein in relation to cardiovascular events and patient characteristics. Rationale and design.

In clinical practice, biological markers are not available to routinely assess the progression of atherosclerotic disease or the development of restenosis following endarterectomy or catheter based interventions. Endarterectomy procedures provide an opportunity to study mechanisms of restenosis and progression of atherosclerotic disease since atherosclerotic tissue is obtained. Athero-Express is an ongoing prospective study, initiated in 2002, with the objective to investigate the etiological value of plaque characteristics for long term outcome.