The Impact of Operating Surgeon Experience, Supervised Trainee vs. Trained Surgeon, in Vascular Surgery Procedures: A Systematic Review and Meta-Analysis.

Objective: The operative caseload of a surgeon has a positive influence on post-operative outcomes. For surgical trainees to progress effectively, maximising operating room exposure is essential, vascular surgery being no exception. Our aim was to ascertain the impact of supervised trainee led vs.

Association Between Abdominal Visceral Artery Calcification and All-Cause Mortality-A Computerized Tomography Imaging-Based Longitudinal Follow-Up Study.

Arterial calcification in different arterial beds has been observed to be an independent predictor of mortality. The association of abdominal visceral artery calcium with all-cause mortality remains unexplored. Patients who had undergone contrast-enhanced computerized tomography (CT) imaging for routine assessment of peripheral arterial disease (PAD) were considered for this study.

Neovascularization in Vertebral Artery Atheroma-A Dynamic Contrast-Enhanced Magnetic Resonance Imaging-Based Comparative Study in Patients with Symptomatic and Asymptomatic Carotid Artery Disease.

Background: Atherosclerosis is a systemic inflammatory disease intertwined with neovascularization. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables the assessment of plaque neovascularization. This study aimed to explore the systemic nature of atherosclerosis by assessing difference in severity of neovascularization as quantified by DCE-MRI of vertebral arteries (VAs) between patients with symptomatic and asymptomatic carotid artery disease.

Magnetic Resonance Imaging-Based Assessment of Carotid Atheroma: a Comparative Study of Patients with and without Coronary Artery Disease.

Background: Functional magnetic resonance (MR) imaging of atheroma using contrast media enables assessment of the systemic severity of atherosclerosis in different arterial beds. Whether black-blood imaging has similar ability remains widely unexplored. In this study, we evaluate whether black-blood imaging can differentiate carotid plaques of patients with and without coronary artery disease (CAD) in terms of morphological and biomechanical features of plaque vulnerability, thereby allowing assessment of the systemic severity nature of atherosclerosis in different arterial beds.

Arterial thoracic outlet syndrome: rare and triggering.

Arterial thoracic outlet syndrome (TOS) is the least common type of TOS. Patient's symptoms, clinical examination and duplex ultrasonography usually suffice in deciding patient's management. Our proposed treatment strategies are based on the Scher classification.

Arterial thoracic outlet syndrome: rare and triggering.

Arterial thoracic outlet syndrome (TOS) is the least common type of TOS. Patient's symptoms, clinical examination and duplex ultrasonography usually suffice in deciding patient's management. Our proposed treatment strategies are based on the Scher classification.

Use of ultrasmall superparamagnetic iron oxide particles for imaging carotid atherosclerosis.

Based on the results of histopathological studies, inflammation within atherosclerotic tissue is now widely accepted as a key determinant of the disease process. Conventional imaging methods can highlight the location and degree of luminal stenosis but not the inflammatory activity of the plaque. Iron oxide-based MRI contrast media particularly ultrasmall supermagnetic particles of iron oxide have shown potential in assessing atheromatous plaque inflammation and in determining efficacy of antiatherosclerosis pharmacological treatments.

Acute Limb Ischemia in Pediatric Population Secondary to Peripheral Vascular Cannulation: Literature Review and Recommendations.

Introduction: In this article, we discuss published literature on the management of pediatric patients with acute limb ischemia and also present our center's experience.

Results: Literature review suggests that in the absence of imminent risk of limb loss, noninterventional management with anticoagulants and systemic thrombolysis is preferable and associated with better clinical outcomes than surgery such as reduced per operative morbidity and mortality. In selected more severe cases, surgery may be required.

Independence and mobility after infrainguinal lower limb bypass surgery for critical limb ischemia.

Background: Critical limb ischemia (CLI) is a common condition associated with high levels of morbidity and mortality. Most work to date has focused on surgeon-oriented outcomes such as patency, but there is increasing interest in patient-oriented outcomes such as mobility and independence.

Objective: This study was conducted to determine the effect of infrainguinal lower limb bypass surgery (LLBS) on postoperative mobility in a United Kingdom tertiary vascular surgery unit and to investigate causes and consequences of poor postoperative mobility.

Profound acute limb ischemia affecting all four limbs following cocaine inhalation.

Recreational drug use is a recognized cause of a number of acute vascular events. Cocaine is associated with a number of cardiovascular diseases, including myocardial ischemia, arrhythmias, and aortic dissection. Cutting agents are commonly used to dilute the amount of cocaine required to enhance the profits of the seller.

Perioperative fluid restriction in major abdominal surgery: systematic review and meta-analysis of randomized, clinical trials.

Background: Fluid management is a fundamental component of surgical care. Recently, there has been considerable interest in perioperative fluid restriction as a method of facilitating recovery following elective major surgery. A number of randomized trials have addressed the issue in various surgical specialities, and a recent meta-analysis proposed uniform definitions regarding fluid amount as well as examining fluid restriction in patients undergoing colonic resection.

Microelectromechanical systems and nanotechnology: a platform for the next stent technological era.

Nanotechnology is the design and development of materials, structures, and devices with at least 1 dimension between the 1- and 100-nm-size scale. Manipulating matter at the atomic scale offers unique opportunities in material design particularly in biological interfaces. In this short review, we explore the disruptive technological opportunities that nanotechnology and microelectromechanical systems may offer in possible future stent designs along with safety issues that may surface with the use of nanoparticles in medical devices.

Midterm results from internal iliac artery branched endovascular stent grafts.

Purpose: To evaluate the midterm feasibility, efficacy and safety of internal iliac artery branch grafts for endovascular repair of aortoiliac, common iliac, and internal iliac artery aneurysms.

Methods: Between December 2006 and September 2008, 8 patients underwent elective endovascular repair of aortoiliac, common iliac, and internal iliac artery aneurysms. Computed tomography aortography (CTA) was used to detect postoperative endoleak, stent migration, branch patency, and aneurysm sac expansion.

Remote ischemic preconditioning for renal and cardiac protection during endovascular aneurysm repair: a randomized controlled trial.

Purpose: To report a randomized clinical trial designed to determine if remote ischemic preconditioning (IP) has the ability to reduce renal and cardiac damage following endovascular aneurysm repair (EVAR).

Methods: Forty patients (all men; mean age 76+/-7 years) with abdominal aortic aneurysms averaging 6.3+/-0.

Finite element analysis of vulnerable atherosclerotic plaques: a comparison of mechanical stresses within carotid plaques of acute and recently symptomatic patients with carotid artery disease.

Objectives: There is considerable evidence that patients with carotid artery stenosis treated immediately after the ischaemic cerebrovascular event have a better clinical outcome than those who have delayed treatment. Biomechanical assessment of carotid plaques using high-resolution MRI can help examine the relationship between the timing of carotid plaque symptomology and maximum simulated plaque stress concentration.

Methods: Fifty patients underwent high-resolution multisequence in vivo MRI of their carotid arteries.

Comparison of aortomonoiliac endovascular aneurysm repair versus a bifurcated stent-graft: analysis of perioperative morbidity and mortality.

Purpose: To compare the perioperative morbidity and mortality following endovascular aneurysm repair (EVAR) with a bifurcated stent-graft versus an aortomonoiliac stent-graft combined with a femorofemoral crossover graft.

Methods: A prospectively maintained database of patients undergoing EVAR over a 7-year period (January 2001 to June 2008) was interrogated retrospectively to identify all patients receiving either a bifurcated or an aortomonoiliac stent-graft. Patients undergoing emergency treatment or renal/mesenteric fenestrated or iliac branched EVAR were excluded.

CD36 modulation in the subintimal trapping and LDL-mediated migration of macrophages.

EVALUATION OF: Park YM, Febbraio M, Silverstein RL. CD36 modulates migration of mouse and human macrophages in response to oxidized LDL and may contribute to macrophage trapping in the arterial intima. J.

The ATHEROMA (Atorvastatin Therapy: Effects on Reduction of Macrophage Activity) Study. Evaluation using ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging in carotid disease.

Objectives: The aim of this study was to evaluate the effects of low-dose (10 mg) and high-dose (80 mg) atorvastatin on carotid plaque inflammation as determined by ultrasmall superparamagnetic iron oxide (USPIO)-enhanced carotid magnetic resonance imaging (MRI). The hypothesis was that treatment with 80 mg atorvastatin would demonstrate quantifiable changes in USPIO-enhanced MRI-defined inflammation within the first 3 months of therapy.

Background: Preliminary studies indicate that USPIO-enhanced MRI can identify macrophage infiltration in human carotid atheroma in vivo and hence may be a surrogate marker of plaque inflammation.

Preferences for endovascular (EVAR) or open surgical repair among patients with abdominal aortic aneurysms under surveillance.

Objectives: There is no evidence about patient preferences for treatment of abdominal aortic aneurysms (AAA) by endovascular aneurysm repair (EVAR) or open surgical repair (OSR). This study examined patient preferences for elective future aneurysm repair and factors that may influence such preferences.

Methods: Patients with small AAAs under ultrasound scan surveillance at two United Kingdom (UK) hospitals participated in a semi-structured telephone interview.

Atrial fibrillation following elective open abdominal aortic aneurysm repair.

Background: Atrial fibrillation is a common complication following major vascular surgery. It is often considered to be relatively benign but may represent the first sign of cardiac and non-cardiac complications. We conducted a retrospective study to determine the incidence and clinical associations of atrial fibrillation following open elective abdominal aortic aneurysm repair as well as its effect on prognosis.

Cardioprotection by ischemic postconditioning during surgical procedures.

Acute myocardial ischemic insult remains the most prevalent cause of postoperative mortality and morbidity despite major advances in cardiovascular medicine. Preoperative cardiac assessment and optimization, intraoperative anesthetic techniques and perioperative medical prophylaxis are all used to minimize cardiac morbidity. Ischemic postconditioning is one of the latest techniques to be added to this regime of cardioprotection.

Thoracic outlet syndrome: an overview.

Thoracic outlet syndrome is a non-specific label that encompasses the various presentations resulting from compression of neurovascular structures at the thoracic outlet. This overview focuses on its underlying aetiology and management.