Outcomes and complications of the midline anterior approach 3 years after lumbar spine surgery.

Objective. The purpose of this study was to evaluate a new questionnaire to assess outcomes related to the midline anterior lumbar approach and to identify risk factors for negative patient responses. Methods.

Variations in the iliolumbar vein during the anterior approach for spinal procedures.

Study Design: Retrospective study from data from a single access surgeon at 2 hospitals.

Objective: To increase the surgeon's awareness of iliolumbar vein (ILV) variants during the anterior approach to the lumbar spine.

Summary Of Background Data: Although there are many advantages to using the anterior approach, serious risks are involved, namely, vascular injury.

Perioperative outcomes of anterior lumbar surgery in obese versus non-obese patients.

Background Context: Anterior lumbar surgery is a common procedure for anterior lumbar interbody fusion and disc replacement but the impact of obesity on this procedure has not been determined.

Purpose: To assess the perioperative outcomes of anterior retroperitoneal lumbar surgery in obese versus non-obese patients.

Study Design/setting: Prospective review of patients with anterior retroperitoneal lumbar disc procedures

Patient Sample: Seventy-four patients with anterior retroperitoneal lumbar disc procedures performed were evaluated.

Is endovascular therapy the preferred treatment for all visceral artery aneurysms?

Endovascular intervention can provide an alternative method of treatment for visceral artery aneurysms. We conducted a retrospective review of all patients with visceral artery aneurysms at a single university medical center from 1990 to 2003, focusing on the outcome of endovascular therapy. Sixty-five patients with visceral artery aneurysms were identified: 39 splenic (SAA), 13 renal, seven celiac, three superior mesenteric (SMA), and three hepatic.

Successful management of carotid stenosis in a high-risk population at an inner-city hospital.

This is a retrospective review of all carotid endarterectomies (CEA) (n=91) done from 1993 to 2002 at an inner-city hospital (Group I). This group was compared to a randomly selected group of patients (n=445) treated at a private hospital (Group II). The same high-volume surgeons performed CEAs at both hospitals.

Ischemic complications after endovascular abdominal aortic aneurysm repair.

Objectives: Limb and pelvic ischemia are known complications after endovascular abdominal aortic aneurysm repair (EVAR). The objective of this paper is to present our experience with the incidence, presentation, and management of such complications.

Methods: Over 9 years 311 patients with aortic aneurysms underwent EVAR.

Impact of carotid artery angioplasty and stenting on management of recurrent carotid artery stenosis.

Citing the higher perioperative risk of redo carotid surgery, balloon angioplasty and stenting of the carotid artery (CAS) has been advocated for recurrent carotid stenosis (RCS). To examine the impact of CAS on the management and outcome of recurrent stenosis, a retrospective review of a prospectively compiled database was performed. From a registry of patients treated for carotid disease, 105 procedures were performed from 1992 to 2002 for RCS.

Attitudes of applicants for surgical residency toward work hour limitations.

Background: There is an ongoing debate regarding the merits of resident work-hour limitations. We postulated that this issue would be a factor in the decision-making process of applicants to surgical residency.

Methods: Candidates for surgical residency at a university-based program completed an anonymous survey during their visit.

Improved patency of prosthetic arteriovenous grafts with an acute anastomotic angle and flow diffuser.

Objective: Conventional end-to-side anastomosis to establish venous outflow for prosthetic arteriovenous grafts often requires operative patch angioplasty within 1 year because of venous stenosis. Rather than conventional venous anastomosis, a modified end-to-side anastomosis at a 15-degree angle with a flow diffuser was constructed. Such diffusers allow decreased flow velocity and increased pressure, inhibiting boundary layer separation.

Aneurysm morphology as a predictor of endoleak following endovascular aortic aneurysm repair: do smaller aneurysm have better outcomes?

Since the Food and Drug Administrations' approval of endovascular devices for abdominal aortic aneurysm (AAA) repair, clinicians have been relaxing the strict inclusion criteria present during the clinical trials. Although the long-term natural history of endoleaks remains unclear, attachment site leaks (type I) are believed to represent an ongoing risk for future rupture. We reviewed our experience with endovascular AAA repair to elucidate factors that predispose toward the development of endoleaks and found that larger AAAs are significantly more likely to have a short proximal neck and severe proximal angulation.

Are type II (branch vessel) endoleaks really benign?

The natural history and clinical significance of type II or branch vessel endoleaks following endovascular aortic aneurysm (AAA) repair remain unclear. Some investigators have suggested that these endoleaks have a benign course and outcome and that they can be safely observed. The purpose of this study was to document the natural history and outcome of all type II endoleaks that have occurred following endovascular AAA repair at our institution.