Huntingtin-deficient zebrafish exhibit defects in iron utilization and development.

Huntington's disease (HD) is one of nine neurodegenerative disorders caused by expansion of CAG repeats encoding polyglutamine in their respective, otherwise apparently unrelated proteins. Despite these proteins having widespread and overlapping expression patterns in the brain, a specific and unique subset of neurons exhibits particular vulnerability in each disease. It has been hypothesized that perturbation of normal protein function contributes to the specificity of neuronal vulnerability; however, the normal biological functions of many of these proteins including the HD gene product, Huntingtin (Htt), are unclear.

Radiofrequency ablation of incompetent perforator veins.

Chronic venous insufficiency continues to be a major source of disability and cost, with accompanying socio-economic burdens. Incompetent perforator veins play a significant role in chronic venous insufficiency. This article describes the technique of radiofrequency ablation of incompetent perforating veins for patients with chronic venous insufficiency.

Iliac vein stenting for chronic venous insufficiency.

Chronic venous insufficiency has devastating sequelae in terms of patients' lifestyles and negative economic impact on society. Traditional surgical procedures have yielded variable patency results, and follow-up has not always been reported. This review summarizes the current applications, patency rates, stent selection, and complications of balloon angioplasty and stenting in the treatment of chronic venous outflow obstruction in the lower extremity.

Percutaneous transhepatic thrombectomy and pharmacologic thrombolysis of mesenteric venous thrombosis.

Mesenteric venous occlusion is a rare yet highly morbid condition that is traditionally treated with anticoagulation while surgery serves as the last resort. Percutaneous intervention provides an effective option with relatively low mortality and morbidity. We herein describe use of transhepatic percutaneous thrombectomy and pharmacologic thrombolysis in treating two cases of symptomatic mesenteric venous thrombosis.

Cyclic strain induces vascular smooth muscle cell differentiation from murine embryonic mesenchymal progenitor cells.

Background: Hemodynamic forces play a crucial role in regulating vascular cell phenotype. However, the underlying molecular mechanisms are largely unknown. The objective of this study was to test our hypothesis that cyclic strain could affect smooth muscle cell (SMC) differentiation.

Peripheral arterial occlusive disease: magnetic resonance imaging and the role of aggressive medical management.

Atherosclerosis accounts for most peripheral arterial occlusive disease (PAD). Although many of the risk factors for atherosclerotic coronary artery disease (CAD) such as hyperlipidemia have been identified as risk factors for peripheral arterial disease, strong evidence is lacking that risk factor modification is effective in halting progression or improving outcomes. A better understanding is needed regarding the clinical and pathophysiologic responses to risk factor modification.

RALDH-independent generation of retinoic acid during vertebrate embryogenesis by CYP1B1.

Several independent lines of evidence have revealed an instructive role for retinoic acid (RA) signalling in the establishment of normal pattern and cellular specification of the vertebrate embryo. Molecular analyses have previously identified the major RA-synthesising (RALDH1-3) and RA-degrading (CYP26A-C1) enzymes as well as other components involved in RA processing (e.g.

Performance of endovascular aortic aneurysm repair in high-risk patients: results from the Veterans Affairs National Surgical Quality Improvement Program.

Objective: Recent results after endovascular abdominal aortic aneurysm repair (EVAR) have brought into question its value in patients deemed at high-risk for surgical intervention. The Department of Veteran Affairs (VA) National Surgical Quality Improvement Program (NSQIP) is the largest prospectively collected and validated United States surgical database representing current clinical practice. The purpose of our study was to evaluate outcomes after elective EVAR performed in high-risk veterans.

Prospective randomized study evaluating an absorbable cyanoacrylate for use in vascular reconstructions.

Background: An easy-to-use vascular sealant with good safety and efficacy is needed to prevent anastomotic bleeding in vascular surgery. This study evaluated the safety and efficacy of cyanoacrylate surgical sealant in establishing hemostasis of expanded polytetrafluoroethylene to arterial vascular anastomoses in arteriovenous (AV) grafts and femoral bypass grafts.

Methods: This multicenter, randomized, controlled, open-label study was conducted in a hospital setting at 12 sites: 10 in the United States and 2 in Europe.

Endovascular occlusion of right to left arteriovenous shunt associated with persistent left superior vena cava.

Left-sided superior vena cava (SVC) as the result of persistence of the left superior cardinal vein in postnatal life is a rare congenital anomaly, is usually associated with other cardiac defects, and can cause symptoms of right to left shunt. We report the case of a 58-year-old Asian man with a history of end-stage renal disease and Ebstein anomaly that was corrected surgically who presented with progressively worsening disabling dyspnea. An echocardiogram with concomitant intravenous saline injection raised the suspicion of right to left shunt, a finding that was confirmed with contrast injection of the left SVC that rapidly filled the left heart chambers and subsequently the aortic arch.

Ginkgolide A attenuates homocysteine-induced endothelial dysfunction in porcine coronary arteries.

Background: Homocysteine is an independent risk factor for atherosclerosis. The objective of this study was to investigate whether ginkgolide A (GA), a major constituent of Ginkgo biloba, could block homocysteine-induced endothelial dysfunction in porcine coronary arteries.

Methods: Porcine coronary artery rings were assigned to six treatment groups: control; homocysteine (50 micromol/L); low-dose (50 micromol/L) or high-dose (100 micromol/L) GA; and homocysteine plus low-dose or high-dose GA.

Use of parietal peritoneum for aortic stump coverage following removal of an infected aortic prosthesis: A case report.

Aortic graft infections, albeit rare, pose a significant treatment challenge. Aortic stump disruption, in particular, is a potentially devastating complication. We describe a novel technique of using the parietal peritoneum to bolster a friable aortic stump in a 56-year-old man after an infected aortobifemoral graft was removed.

Optimal medical management of peripheral arterial disease.

Patients with peripheral vascular disease are less likely to receive optimal medical management than patients with coronary artery disease. However, early medical treatment is critical because it is profoundly beneficial and the benefits are maximized. Even in patients with advanced disease requiring invasive intervention, medical management has been proven to improve outcome, prolong the success of the intervention, improve functional capacity, and prolong life.

Laser atherectomy for lower extremity revascularization: An adjunctive endovascular treatment option.

Excimer laser atherectomy (LA) employs precision laser energy control (shallow tissue penetration) and safer wavelengths (ultraviolet as opposed to the infrared spectra in older laser technology), which decreases perforation and thermal injury to the treated vessels. Though extensively used by cardiologists for severe obstructive coronary artery disease, peripheral interventionalists have not accepted LA as a routine adjunctive technique for stenotic or occluded vessels. We report herein the technical and clinical outcomes with LA for complex peripheral vascular disease in patients deemed high-risk for conventional surgical revascularization.

Mouse models of neointimal hyperplasia: techniques and applications.

Neointimal hyperplasia is a major cause of the failure in vascular reconstructive procedures such as angioplasty, vascular stenting, small caliber vascular graft, and vein graft. However, the underlying molecular mechanisms are not yet fully understood. The study of neointimal hyperplasia has relied heavily on the use of experimental animal models.

Hybrid approach to complex thoracic aortic aneurysms in high-risk patients: surgical challenges and clinical outcomes.

Background: Endovascular therapy is a less invasive alternative treatment for high-risk patients with thoracic aortic aneurysms. However, this technology alone is often not applicable to complex aneurysmal morphology. The purpose of this study was to evaluate the utility of hybrid strategies in high-risk patients who are otherwise unsuitable for endovascular therapy alone.

IMA clipping for a type ii endoleak: combined laparoscopic and endovascular approach.

We describe herein a combined laparoscopic and endovascular approach to treat a type II endoleak due to retrograde flow in the patent inferior mesenteric artery (IMA). A 61-year-old gentleman presented with enlarging aneurysm sac confirmed on computed tomography scan evaluation after elective endovascular repair of an infrarenal abdominal aortic aneurysm. A combined laparoscopic and endovascular approach was used.

Delayed deformation of self-expanding stents after carotid artery stenting for postendarterectomy restenoses.

Carotid artery stenting has become an acceptable alternative for treating patients with severe atherosclerotic lesions, particularly those with significant surgical risks, such as recurrent stenosis after endarterectomy. Stent deformation, a phenomenon primarily associated with balloon-expandable stents, is largely avoided by exclusively using self-expanding stents in treating carotid artery stenosis. Nonetheless, we herein report two patients who presented with delayed Wallstent deformation after carotid artery stenting for postendarterectomy restenosis.

Lymphotoxin-alpha and cardiovascular disease: clinical association and pathogenic mechanisms.

Inflammation plays an important role in atherosclerotic plaque formation, rupture and thrombogenicity. Many cytokines are the most important biomediates of inflammation and its associated vascular lesions. Lymphotoxin-alpha (LTalpha) is part of the tumor necrosis factor (TNF) family of cytokines that mediates an inflammatory or immunologic response that can affect cell death or differentiation, and provide an important link of communication between lymphocytes and stromal cells.

Endovascular training of vascular surgeons: have we made progress?

The rapid evolution of catheter-based technologies during the last 5 years has created a critical need for development of effective resident level and postgraduate education programs in both open and endovascular techniques and associated cognitive and clinical skills. Currently, significant variability exists in endovascular training formats and in the number of endovascular procedures performed during the course of a graduate or postgraduate program. Little information on the quality of these programs exists and in the subsequent practice patterns of the trainees.

Chlamydia pneumoniae and vascular disease: an update.

Exposure to Chlamydia pneumoniae is extremely common, and its incidence increases with age. C pneumoniae infection is strongly associated with coronary artery disease, as well as with atherosclerosis of the carotid artery, aorta, and peripheral arteries. This association has been shown in seroepidemiologic studies and by direct detection of the organism in atherosclerotic lesions by immunohistochemistry, polymerase chain reaction, electron microscopy, and tissue culture.

Endovascular repair of a proximal aortic arch aneurysm: a novel approach of supra-aortic debranching with antegrade endograft deployment via an anterior thoracotomy approach.

Although open surgical repair continues to be the standard therapy for thoracic aortic aneurysms, endovascular intervention has evolved into an acceptable strategy for patients who have prohibitive risks for conventional surgical treatments. Aortic arch aneurysm, in particular, is associated with substantial surgery-related morbidities, yet is typically not suitable for endovascular intervention. We describe a combined technique of supra-aortic trunk debranching through an anterior thoracotomy followed by endovascular repair of a large proximal arch aneurysm in an 82 year-old man 8 years after an ascending aortic aneurysm repair.

In situ reconstruction with cryopreserved arterial allografts for management of mycotic aneurysms or aortic prosthetic graft infections: a multi-institutional experience.

We designed this study to evaluate a multi-institutional experience regarding the efficacy of cryopreserved aortic allografts in the treatment of infected aortic prosthetic grafts or mycotic aneurysms. We reviewed clinical data of all patients from 4 institutions who underwent in situ aortic reconstruction with cryopreserved allografts for either infected aortic prosthetic graft or mycotic aneurysms from during a 6-year period. Relevant clinical variables and treatment outcomes were analyzed.

Open versus endovascular abdominal aortic aneurysm repair in VA hospitals.

Background: Endovascular abdominal aortic aneurysm repair (EVAR), when compared with conventional open surgical repair, has been shown to reduce perioperative morbidity and mortality. We performed a retrospective cohort study with prospectively collected data from the Department of Veterans Affairs to examine outcomes after elective aneurysm repair.

Study Design: We studied 30-day mortality, 1-year survival, and postoperative complications in 1,904 patients who underwent elective abdominal aortic aneurysm repair (EVAR n=717 [37.