A novel approach to autogenous hemodialysis access: paired brachial vein transposition in series.

Autogenous arteriovenous fistula (AVF) creation is the preferred method for long-term hemodialysis access. This report describes the novel use of paired brachial veins for the creation of an autogenous AVF in a patient without a traditional superficial venous conduit available. Application of this general concept might serve to expand the options for autogenous AVF creation.

The kissing-stent technique for treatment of distal aortic stenosis and protection of the inferior mesenteric artery orifice.

Focal infrarenal aortic stenosis is relatively rare. Traditionally, aortic endarterectomy and aortic bypass surgery have been used to treat these lesions. However, percutaneous transluminal angioplasty and stenting have become well-defined alternatives.

Challenging neck anatomy is associated with need for intraoperative endovascular adjuncts during endovascular aortic aneurysm repair (EVAR).

Background: The purpose of this study was to determine which proximal seal zone characteristics were predictive of early and late type Ia endoleak development after endovascular aortic aneurysm repair (EVAR) for infrarenal abdominal aortic aneurysmal disease.

Methods: We evaluated 146 patients who underwent EVAR between January 2006 and March 2007. In the cohort, high-resolution computed tomography images of 100 (68.

Quantitative assessment of abdominal aortic aneurysm geometry.

Recent studies have shown that the maximum transverse diameter of an abdominal aortic aneurysm (AAA) and expansion rate are not entirely reliable indicators of rupture potential. We hypothesize that aneurysm morphology and wall thickness are more predictive of rupture risk and can be the deciding factors in the clinical management of the disease. A non-invasive, image-based evaluation of AAA shape was implemented on a retrospective study of 10 ruptured and 66 unruptured aneurysms.

The effect of immunosuppression on lower extremity arterial bypass outcomes.

Background: Myointimal hyperplasia is a pathologic result of the body's natural inflammatory response to injury of the blood vessels and a leading cause of peripheral arterial bypass failure. Because immunosuppressive agents are known to abate inflammation, we hypothesized the superior outcome of lower extremity bypass in renal transplant recipients compared with the hemodialysis population.

Methods: The vascular surgery registry at a single tertiary care center was retrospectively reviewed to identify patients who underwent lower extremity bypass procedures.

Endoluminal treatment of type IA endoleak with Onyx.

Type IA endoleaks associated with endovascular aortic aneurysm repair are typically treated with endovascular adjuncts. Technical failure results when such maneuvers are unsuccessful, and endograft removal may, unfortunately, become necessary. The novel management of a recalcitrant type IA endoleak using the artificial embolization device, Onyx (Micro Therapeutics Inc, Irvine, Calif) is presented for the case of a nonagenarian with prohibitive surgical risk after conventional techniques had failed.