Endovascular repair of an actively hemorrhaging aortoduodenal fistula.

Aortoenteric fistulae require urgent definitive intervention and traditionally carry a high mortality. We describe a patient who suffered a traumatic aortic dissection following an auto versus pedestrian collision. He underwent open fenestration of his infrarenal aorta and visceral resection, complicated by abdominal sepsis and enterocutaneous fistulae.

Combined peripheral and coronary artery percutaneous intervention in patients with significant coronary and peripheral vascular disease. Case reports and review.

Combined percutaneous coronary and peripheral intervention in patients with coronary and peripheral vascular disease can be time and cost saving. Despite the potential benefit, such hybrid procedures have been rarely reported. We report two cases of hybrid peripheral and coronary intervention that were performed at our institution with excellent outcomes.

Aortic graft infection: update on management and treatment options.

Replacement of the abdominal aorta, whether by autogenous or prosthetic conduit, has been an a priori requisite in the vascular surgeon's armamentarium since its technical feasibility was described in the early 1950s. The Achilles' heel of this operation, in spite of the progress made over the last half century, is still, however, aortic graft infection. Though survival and limb salvage rates have improved over time-commensurate with advances in surgical technique, critical care, and antimicrobial agents-the prevention and treatment of aortic graft infection remains a formidable challenge to the vascular surgeon.

Superiority of autogenous arteriovenous hemodialysis access: maintenance of function with fewer secondary interventions.

The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF K/DOQI) guidelines have advocated autogenous arteriovenous fistulae as a primary procedure for hemodialysis access. This study compared the clinical outcomes between autogenous and prosthetic arteriovenous hemodialysis accesses, determining factors contributing to primary and secondary patency and function. Associated risk factors and number of interventions required to maintain secondary patency in each cohort were also assessed.

Internal carotid artery pseudoaneurysms: treatment with the Wallgraft endoprosthesis.

Purpose: To report several cases illustrating the feasibility and mid-term efficacy of deploying a self-expanding stent-graft to treat traumatic ruptures, pseudoaneurysms, and a spontaneous dissection of the internal carotid artery (ICA).

Case Reports: One patient suffered a stab wound and another developed a large pseudoaneurysm years after a gunshot to the neck. The third patient presented with a spontaneous rupture in the setting of fibromuscular dysplasia, and the final patient developed a pseudoaneurysm following carotid endarterectomy in an irradiated neck.

Techniques for the percutaneous treatment of acute arterial occlusion.

There are many modalities utilized in the treatment of acute arterial occlusions. The purpose of this report will be to review the various studies defining percutaneous chemical thrombolysis, mechanical thrombectomy, and combination therapies. A clinical paradigm for acute limb ischemia will be defined, and a detailed description of techniques utilized in the above percutaneous interventions will be outlined.

Dual contrast enhanced magnetic resonance imaging of the liver with superparamagnetic iron oxide followed by gadolinium for lesion detection and characterization.

Aim: Iron oxide contrast agents are useful for lesion detection, and extracellular gadolinium chelates are advocated for lesion characterization. We undertook a study to determine if dual contrast enhanced liver imaging with sequential use of ferumoxides particles and gadolinium (Gd)-DTPA can be performed in the same imaging protocol.

Materials And Methods: Sixteen patients underwent dual contrast magnetic resonance imaging (MRI) of the liver for evaluation of known/suspected focal lesions which included, metastases (n = 5), hepatocellular carcinoma (HCC;n = 3), cholangiocharcinoma(n = 1) and focal nodular hyperplasia (FNH;n = 3).

The effect of growth factors, cytokines, and extracellular matrix proteins on fibronectin production in human vascular smooth muscle cells.

Purpose: Although 60% to 80% of the mature intimal hyperplastic plaque is composed of extracellular matrix (ECM) proteins, little is known about the factors that stimulate smooth muscle cells (SMCs) to produce these proteins. A major component of the ECM protein is fibronectin. Thus we studied fibronectin production and its response to various growth factors, cytokines, and other ECM proteins that are released at the time of vascular injury.

Bilateral carotid endarterectomy during the same hospital admission.

The efficacy of carotid endarterectomy for the prevention of strokes has been well demonstrated in recent multicenter randomized trials. However, patients presenting with bilateral significant disease pose a difficult problem to the vascular surgeon. Currently, bilateral carotid endarterectomies are staged at varying intervals between operations, with surgeon and patient weighing the risks of waiting for surgery versus the risks of having both procedures done within a shortened interval.