Prognostic value of a low post-exercise ankle brachial index as assessed by primary care physicians.

Objective: We aimed to investigate whether the post-exercise ankle brachial index (ABI) performed by primary care physicians offers useful information for the prediction of death or cardiovascular events, beyond the traditional resting ABI. An additional focus was on patients with intermittent claudication and normal resting ABI.

Methods: Using data from the 5-year follow-up of 6468 elderly patients in the primary care setting in Germany (getABI study) we used multivariate Cox regression models adjusted for age, gender and conventional risk factors to determine the association of resting ABI and/or post-exercise ABI and all-cause mortality/morbidity.

Postoperative neurological deficit after carotid endarterectomy: a mid-term outcome analysis.

Background: To evaluate the neurological outcome of postoperative neurological deficit (PND) in patients undergoing carotid endarterectomy (CEA).

Methods: A total of 3.7% (n = 48) out of 1,290 consecutive patients developed PND and were assessed neurologically after a mid-term follow-up.

Mortality and vascular morbidity in older adults with asymptomatic versus symptomatic peripheral artery disease.

Background: Our aim was to assess the mortality and vascular morbidity risk of elderly individuals with asymptomatic versus symptomatic peripheral artery disease (PAD) in the primary care setting.

Methods And Results: This prospective cohort study included 6880 representative unselected patients >or=65 years of age with monitored follow-up over 5 years. According to physician diagnosis, 5392 patients had no PAD, 836 had asymptomatic PAD (ankle brachial index <0.

Results of the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) study to treat symptomatic stenoses at 2 years: a multinational, prospective, randomised trial.

Background: The SPACE trial is a multinational, prospective, randomised study to test the hypothesis that carotid artery stenting is not inferior to carotid endarterectomy for treating patients with severe symptomatic carotid artery stenosis. We did not prove non-inferiority of carotid artery stenting compared with carotid endarterectomy for the 30-day complication rate, and we now report the results at 2 years.

Methods: Between March, 2001, and February, 2006, patients with symptomatic, severe (>or=70%) carotid artery stenosis were recruited to this non-inferiority trial and randomly assigned with a block randomisation design to have carotid artery angioplasty with stenting or carotid artery endarterectomy.

Open decompression, proximal banding, and aneurysm sac fenestration as an alternative to conversion in the management of endotension after EVAR.

Purpose: To present a technique to treat endotension and avoid surgical conversion after endovascular aneurysm repair (EVAR).

Technique: The surgical procedure is based on decompression, downsizing, and fenestration of the aneurysm sac combined with proximal aortic neck banding and transmural endograft fixation with sutures. Among 193 patients who underwent infrarenal EVAR between October 2001 and October 2007, 3 (1.

Late outcome after surgical management of carotid body tumors from a 20-year single-center experience.

Background And Aims: Surgical resection is the treatment of choice for carotid body tumors. The aim of this study was to assess not only the perioperative, but also the long-term outcome after surgical treatment.

Patients/methods: All patients that were operated on a carotid body tumor at our institution between 1986 and 2006 were reviewed.

Thoracic aortic endografting in patients with connective tissue diseases.

Purpose: To present midterm results after thoracic endovascular aortic repair (TEVAR) in patients with connective tissue diseases focusing on secondary endoleak and reintervention due to disease progression.

Methods: Between January 1997 and January 2007, 167 patients received 241 thoracic aortic stent-grafts. Eight patients (6 men; median age 48 years, range 32-67) with connective tissue diseases (6 Marfan and 2 Ehlers-Danlos syndrome) treated with stent-graft repair were retrospectively analyzed at a median follow-up of 31 months (range 3-79).

Hybrid procedures for thoracoabdominal aortic aneurysms and chronic aortic dissections - a single center experience in 28 patients.

Objective: We report our 6-year experience with the visceral hybrid procedure for high-risk patients with thoracoabdominal aortic aneurysms (TAAA) and chronic expanding aortic dissections (CEAD).

Methods: Hybrid procedure includes debranching of the visceral and renal arteries followed by endovascular exclusion of the aneurysm. A series of 28 patients (20 male, mean age 66 years) were treated between January 2001 and July 2007.

Late aneurysm rupture after repressurization of a thrombosed stent-graft.

Purpose: To report late abdominal aortic aneurysm (AAA) rupture after endovascular stent-graft repair despite complete thrombotic stent-graft occlusion.

Case Report: A 65-year-old man underwent successful endovascular aneurysm repair (EVAR) with a Stentor device in 1995. In the interim course, the patient developed complete thrombotic stent-graft occlusion, which was treated with an axillobifemoral bypass.

Feeding arteries of the spinal cord at CT angiography before and after thoracic aortic endografting.

Purpose: To study the visualization of spinal cord feeding arteries in patients with complex thoracic aortic pathology undergoing endovascular aortic repair (EVAR) using an optimized protocol for multislice computed tomographic angiography (MSCTA).

Methods: Eighteen consecutive patients (13 men; mean age 63 years, range 45-79) with aortic type B dissections (n=5), chronic expanding aortic dissections (n=5), thoracic aortic aneurysms (n=6), or penetrating aortic ulcers (n=2) underwent 16-slice CTA before and after (mean interval 9 days) EVAR. Pulse rate and neurological status were documented.

Early and midterm results after open and endovascular repair of ruptured abdominal aortic aneurysms in a comparative analysis.

Purpose: To compare early and midterm results of open versus endovascular aortic repair of ruptured abdominal aneurysms (rAAA).

Methods: A retrospective analysis was performed of 58 consecutive patients with rAAA who were treated with open or endovascular aneurysm repair (EVAR) at a single center between January 2000 and December 2005. Patients without definitive signs of rupture (symptomatic patients) were excluded from the study.

Hybrid procedures as a combined endovascular and open approach for pararenal and thoracoabdominal aortic pathologies.

Objectives: to report our experience with hybrid vascular procedures in patients with pararenal and thoracoabdominal aortic pathologies.

Methods: 68 patients were treated for thoracoabdominal aortic pathologies between October 1999 and February 2004; 19 patients (16 men; mean age 68, range 40-79) with high risk for open thoracoabdominal repair were considered to be candidates for combined endovascular and open repair. Aortic pathologies included five thoracoabdominal Crawford I aneurysms, one postdissection expanding aneurysm, three symptomatic plaque ruptures (Crawford IV), five combined thoracic descending and infrarenal aneurysms with a healthy visceral segment, three juxtarenal or para-anastomotic aneurysms, and two patients with simultaneous open aortic arch replacement and a rendezvous maneuver for thoracic endografting.

Complications after endovascular repair of acute symptomatic and chronic expanding Stanford type B aortic dissections.

Objective: To outline the complications after endovascular repair in patients with acute symptomatic and chronic expanding Stanford type B aortic dissections.

Methods: Between 1997 and 2004, of 125 patients with acute and chronic aortic type B dissections, 88 were treated conservatively. Thirty-seven patients (29 male, mean age 58 years, range 30-82 years) underwent endovascular repair (30%) using 44 stent grafts of 3 different designs: Excluder (W.

Association of low ankle brachial index with high mortality in primary care.

Aims: We aimed to assess the increased risk of death and severe vascular events in elderly individuals with subclinical or manifest peripheral arterial disease (PAD), evidenced by low ankle brachial index (ABI < 0.9) in primary care.

Methods And Results: In this monitored prospective observational study, 6880 representative unselected patients aged >or=65 years were followed up over 3 years by 344 primary care physicians.

Malignant vascular tumors: clinical presentation, surgical therapy, and long-term prognosis.

Background: The aim of this study was to analyze the presentation of, surgery for, and prognosis of malignant vascular tumors (MVTs).

Methods: This was an observational single-center study. Patients who underwent operation for MVTs between 1988 and 2004 were included.

Relationship between lipid parameters and the presence of peripheral arterial disease in elderly patients.

Objective: To investigate the relationship between various lipid parameters and the presence of peripheral arterial disease (PAD).

Methods: Cross-sectional analysis of the observational epidemiological getABI study (German epidemiological trial on Ankle Brachial Index) with 6,880 unselected elderly patients in 344 primary care centers.

Results: In the multivariate analysis, the strength of the association between the various lipid parameters and PAD was found to be generally limited, when accounting for other risk factors.

Early surgical outcome after failed primary stenting for lower limb occlusive disease.

Purpose: To evaluate the early results of revascularization after failed primary stent placement for lower limb occlusive disease.

Methods: A retrospective review was conducted of 25 consecutive patients (16 men; mean age 65 years, range 32-89) treated between January 2001 to October 2003 for infrainguinal stent failure at a median 6.6 months (range 3-60) after primary stent implantation (27 femoropopliteal and 20 popliteal-crural) at referring hospitals.