Contemporary outcomes for arterial reconstruction with non-saphenous vein cryo-preserved conduits.

Objective: Cryopreserved (CP) products are utilized during challenging cases when autogenous or prosthetic conduit use is not feasible. Despite decades of experience with cadaveric greater saphenous vein (GSV), there is limited available data regarding the outcomes and patency of other CP products, specifically arterial and deep venous grafts. This study was designed to evaluate outcomes of non-GSV CP conduits in patients undergoing urgent, emergent, and elective arterial reconstruction at our institution.

Outcomes of upper extremity interventions for chronic critical ischemia.

Background: Critical hand ischemia owing to below-the-elbow atherosclerotic occlusive disease is relatively uncommon. The aim of this study was to examine the outcomes in patients presenting with critical ischemia owing to below-the-elbow arterial atherosclerotic disease who underwent nonoperative and operative management.

Methods: A database of patients undergoing operative and nonoperative management for symptomatic below-the-elbow atherosclerotic disease between 2006 and 2016 was retrospectively queried.

Target lesion characteristics in failing vein grafts predict the success of endovascular and open revision.

Objectives: This study examined the association of anatomic and temporal characteristics of graft-threatening lesions with the efficacy of percutaneous and open graft revision for failing infrainguinal vein grafts.

Methods: Consecutive open and endovascular revisions for graft threatening lesions were reviewed. We evaluated graft durability and individual target lesion response to open and endovascular treatment to determine characteristics that may influence outcomes.

Type 2 endoleaks after abdominal aortic aneurysm stent grafting with systematic mesenteric and lumbar coil embolization.

We evaluated the results of our policy of systematic coil embolization of the inferior mesenteric artery (IMA) and/or lumbar arteries (LAs) prior to endovascular abdominal aortic aneurysm (AAA) repair (EVAR). We retrospectively reviewed all patients undergoing EVAR over a 4-year period at one hospital. Results were analyzed using uni- and multivariate analyses.

Are type II endoleaks after endovascular aneurysm repair endograft dependent?

Purpose: Most clinical end points after endovascular aneurysm repair (EVAR) are endograft-specific, but type II endoleaks have been assumed to be an unavoidable consequence of the repair method and independent of the type of endograft used. Some recent data have suggested that the rate of type II endoleaks may also be graft-dependent. We reviewed a large clinical experience with six endografts to determine the behavior of type II endoleaks and whether they are graft-specific.

Can computed tomography scan findings predict "impending'' aneurysm rupture?

Several findings on computed tomography (CT) scans of intact aneurysms have been taken to suggest "imminent'' or "impending'' aneurysm rupture. Often these are identified incidentally in asymptomatic patients when an urgent operation was not planned and may even be ill advised. The authors evaluated whether these signs can truly predict short-term aneurysm rupture.

Use of endoluminal aortic stent-grafts for the repair of abdominal aortic aneurysms.

Abdominal aortic aneurysms affect approximately 1.5% of the United States population. Randomized trials recommend repair when the maximal aneurysm diameter is 5.

Is abdominal aortic aneurysm repair appropriate in oxygen-dependent chronic obstructive pulmonary disease patients?

Background: The life expectancy of patients with oxygen-dependent chronic obstructive pulmonary disease (COPD) is significantly reduced, but the risk of any intervention is considered prohibitive. However, severe COPD may increase the risk of abdominal aortic aneurysm (AAA) rupture. We reviewed our experience with AAA repair in oxygen-dependent patients to determine whether operative risk and expected long-term survival justify surgical intervention.

Effectiveness of coiling in the treatment of endoleaks after endovascular repair.

Background: Persistent endoleaks are a common problem following endovascular repair of abdominal aortic aneurysms, and the best method of treatment has been an issue of debate. Some experimental evidence has suggested that coiling may not be an effective method because it allows transmission of pressure across the coils with continued expansion of the sac. We reviewed our experience with endoleak coiling to assess the degree of clinical success of this treatment.

Same-evening discharge after carotid endarterectomy: our initial experience.

Purpose: The purpose of this study was to review the initial implementation of a same-evening discharge algorithm for patients undergoing carotid endarterectomy (CEA).

Method: We conducted a retrospective review of a prospective database of patients undergoing CEA over 3 years.

Results: From January 2000 to December 2002, 207 patients underwent CEA, of which 186 qualified for same-evening discharge.

Spectrum of cystic neoplasms of the pancreas and their surgical management.

Background: Owing to increased awareness and the widespread use of abdominal ultrasonography and computed tomography, an increasing number of cystic neoplasms are being identified. Cystic neoplasms of the pancreas are divided into the following 4 main groups: serous cystic neoplasms, mucinous cystic neoplasms, solid pseudopapillary neoplasms, and intraductal pancreatic mucinous neoplasms.

Objective: To review our experience with cystic neoplasms of the pancreas at our institution from January 1992 through September 2002.

The effect of intraoperative duplex on the management of postoperative stroke.

Background: Stroke after carotid endarterectomy (CEA) may be a result of intraoperative ischemia, embolism, or thrombosis at the operative site. Intraoperative duplex should eliminate the occurrence of a severe internal carotid artery (ICA) thrombosis and, thus, negate the benefit of reoperation. This article will detail the results of our evolving treatment algorithm for immediate versus delayed post-CEA neurologic deficit (ND).

Distal pancreatectomy: does the method of closure influence fistula formation?

The appropriate closure of the pancreatic remnant after distal pancreatectomy is still debated. Suture techniques, stapled closure, and pancreaticoenteric anastomosis all have their supporters. In this study we have reviewed our data from distal pancreatectomy to determine whether the type of remnant closure or underlying pathologic process had any relation to postoperative fistula formation.