Post-endovascular aneurysm repair patient outcomes and follow-up are not adversely impacted by long travel distance to tertiary vascular surgery centers.

Background: To determine whether patient adherence to follow-up and patient outcomes after endovascular aneurysm repair (EVAR) are affected by the distance between a patient's residence and a tertiary care treatment center.

Methods: A retrospective review of 136 consecutive patients undergoing EVAR at the New Mexico Veterans Affairs Medical Center over a 7-year period was conducted. Patients were stratified as living within a 100-mi radius of the treatment center (group 1) and those living outside this radius (group 2).

Current trends in managing carotid artery disease.

The management of carotid bifurcation disease continues to evolve. Carotid endarterectomy remains the gold standard for symptomatic patients, and for selected asymptomatic patients who have hemodynamically significant carotid stenosis. Medical management of the high-risk plaque has continued to improve and is complementary to carotid endarterectomy.

Vena cava filters: why, when, what, how?

Pulmonary emboli, a potentially lethal venous thromboembolic complication, is a potentially preventable morbidity or mortality that surgeons should consider in the perioperative period or in high-risk patients. Prophylactic inferior vena cava (IVC) filter placement offers a high protection rate against fatal pulmonary emboli. This manuscript discusses the indications for filter placement, different types of currently available IVC filters, and problems and complications of filter placement and vena cava filters.

Prolonged low-volume resuscitation with HBOC-201 in a large-animal survival model of controlled hemorrhage.

Background: Military guidelines call for two 500-mL boluses of Hextend for resuscitation in far-forward environments. This study compared a hemoglobin-based oxygen carrier (HBOC-201; Hemopure) to Hextend when used to treat hemorrhagic shock in situations of delayed definitive care military operations.

Methods: Yorkshire swine (55-65 kg) were hemorrhaged to a mean arterial blood pressure (MAP) of 30 mmHg.

Endovascular repair of a spontaneous carotid artery dissection with carotid stent and coils.

Dissection of the internal carotid artery is an under-recognized cause of transient ischemic attack and cerebral vascular accident. Spontaneous dissections, in which no precipitating cause can be identified, occur infrequently. Endovascular intervention is an evolving treatment option in patients in whom anticoagulation therapy alone is not adequate, who are not suitable candidates for major surgery, or who have extremely distal dissections that are difficult to access.