Endovascular treatment of a penetrating injury of the suprarenal inferior vena cava.

In this case, a 22-year-old man sustained multiple gunshot wounds to the abdomen, which required in extremis surgical exploration with damage control laparotomy and hemostatic resuscitation in the surgical intensive care unit. Diagnostic angiography was negative and an inferior vena cava (IVC) injury was suspected. He was returned to the operating room, where the infrarenal IVC was accessed by direct puncture and venography demonstrated active extravasation of the suprarenal vena cava.

Chronic common femoral vein occlusion secondary to endometriosis.

Venous occlusion is sometimes caused by external compression due to adjacent masses. Endometriosis, the presence of functioning endometrial tissue outside the uterine cavity, is a rare cause of venous occlusion. We report a case of chronic common femoral vein occlusion due to endometrioma causing severe leg edema and groin pain that was treated with resection and venous bypass.

Early versus delayed carotid endarterectomy in symptomatic patients.

Background: Delayed carotid endarterectomy (CEA) after a stroke or transient ischemic attack (TIA) is associated with risks of recurrent neurologic symptoms. In an effort to preserve cerebral function, urgent early CEA has been recommended in many circumstances. We analyzed outcomes of different time intervals in early CEA in comparison with delayed treatment.

Stepwise age-related outcomes of elective endovascular abdominal aortic aneurysm repair: 11-year institutional review.

Objective: Endovascular repair of abdominal aortic aneurysms (EVAR) has largely supplanted open surgery over the past 2 decades. Faced with an aging population, the outcomes of EVAR among various age groups were examined.

Method: Retrospective review of elective EVAR cases was performed at a single institution from 1998 to 2009.

Late abdominal aortic endograft explants: indications and outcomes.

Background: Despite advances in endoluminal salvage for failed endografts, certain circumstances necessitate open endovascular abdominal aneurysm repair (EVAR) conversion. We review the indications for and outcomes after late EVAR explants.

Methods: Retrospective review of EVAR patients requiring delayed (>30 days) conversion from 1999 to 2009.

Does a contralateral carotid occlusion adversely impact carotid artery stenting outcomes?

Background: Carotid artery stenting (CAS) has grown as a possible alternative for the treatment of extracranial cerebrovascular disease in the past decade. A preexisting contralateral carotid artery occlusion has been described as a risk factor for inferior outcomes after carotid endarterectomy, but its impact on CAS outcomes is less understood.

Methods: A retrospective review of 417 CAS procedures performed between May 2001 and July 2010 at a single center using self-expanding nitinol stents and mechanical embolic protection devices was conducted.

Carotid artery stenting using proximal balloon occlusion embolic protection.

Carotid artery stenting has rapidly grown as an alternative to carotid endarterectomy for stroke prevention among selected patients with extracranial carotid artery stenosis. Development of mechanical embolic protection devices (EPDs) has been associated with improved clinical outcomes and is now a strongly advocated adjunct to the procedure. Characteristically, EPDs have been broadly defined into 3 primary categories, of which the distal filter elements have largely been the most developed and used.

Timing of carotid surgery after acute stroke.

Carotid endarterectomy (CEA) has been proven to reduce the risk of stroke and death in both asymptomatic and symptomatic patients with carotid occlusive disease. Stroke is the third leading cause of death in the USA. Since up to one-third of stroke patients have a stroke secondary to carotid occlusive disease, it is important to offer CEA to this subgroup of patients that meet indications for surgery.

Bilateral synchronous pleomorphic adenoma diagnosed by fine-needle aspiration.

Pleomorphic adenoma is the most common benign neoplasm of the parotid gland. However, bilateral synchronous pleomorphic adenomas occur infrequently. We report a case of bilateral synchronous pleomorphic adenoma involving the parotid gland in a 50-yr-old man diagnosed by fine-needle aspiration biopsy.