Successful endovascular treatment of chronic mesenteric ischemia in a patient with variant celiacomesenteric trunk anatomy.

The celiacomesenteric trunk (CMT) is a rare anatomical variant where the celiac axis and superior mesenteric artery share a common origin. Despite its rarity, CMT has significant implications across various medical fields, particularly in surgical planning and interventional procedures. We report a case of chronic mesenteric ischemia owing to atherosclerotic stenosis at the CMT bifurcation, necessitating a complex interventional approach.

Hepatic artery aneurysms: evolution from open to endovascular repair techniques.

With the development of endovascular therapy, treatment for hepatic artery aneurysm (HAA) has evolved from open excision and repair to include endovascular approaches. We reviewed our recent experience with HAA to help define the treatment of HAA. From 2002 to 2010, five patients underwent treatment of HAA, all men with a median age of 63.

Stenting and angioplasty with protection in patients at high-risk for endarterectomy: SAPPHIRE Worldwide Registry first 2,001 patients.

Background: Previously, the Stenting and Angioplasty with Protection of Patients with High Risk for Endarterectomy (SAPPHIRE) randomized trial showed that carotid artery stenting (CAS) was not inferior to carotid endarterectomy (CEA) in the treatment of high-surgical risk patients.

Objective: The primary objective of the SAPPHIRE Worldwide Registry is to evaluate 30-day major adverse events (MAE) after CAS performed by physicians with varied experience and utilizing a formal training program. Data will be analyzed on the overall patient population and by high-risk inclusion criteria.

Midterm outcomes from the TALON Registry: treating peripherals with SilverHawk: outcomes collection.

Purpose: To determine midterm clinical outcomes among patients with lower extremity peripheral arterial disease who underwent revascularization with catheter-based plaque excision (PE).

Methods: Between August 2003 and February 2005, 19 institutions participating in the observational, nonrandomized, multicenter TALON registry enrolled 601 consecutive patients (353 men; mean age 70+/-11, range 36-98) with 1258 symptomatic lower extremity atherosclerotic lesions (748 limbs) treated by plaque excision with the SilverHawk catheter. Approximately 50% of the patients had diabetes, and nearly one third of the procedures were indicated for Rutherford ischemia category > or =4.

Initial experience with routine selective carotid arteriography by vascular surgeons.

We report the results of our first 2 years of experience with routine carotid angiography with an emphasis on technique and complications. We reviewed the hospital records, office charts, and prospective quality-assurance database records of 336 patients undergoing cerebrovascular arteriograms and collected data on the indications, complications, and technical aspects of the procedures. Indications for angiography included carotid stenosis in 331 (95%) patients, subclavian steal syndrome in 9 patients, vertebrobasilar insufficiency in 6 patients, and carotid body tumor in 2 patients.

Accelerated migration and proliferation of smooth muscle cells cultured from neointima induced by a vena cava filter.

Formation of a neointima is associated with grafted artery or vein, angioplasty, and stent and inferior vena cava filter (IVCF) implantation. Contributing to the neointima is a population of vascular smooth muscle cells (SMC) that migrates from media and subsequently proliferates within intima. The purpose of this present study was to culture SMC from normal vessel wall and from neointima and to compare migration and growth of these cells.

Removal of the OptEase retrievable vena cava filter is not feasible after extended time periods because of filter protrusion through the vena cava.

Background: Therapeutic and prophylactic vena cava filters (VCFs) are used to prevent pulmonary embolism. Concerns exist over placing a permanent filter in a young trauma patient. Recently, retrievable VCFs have become available.

The results of superficial femoral, popliteal, and tibial artery stenting for peripheral vascular occlusive disease.

The purpose of this study was to evaluate the patentcy rates and physiological effectiveness of angioplasty and stenting as a primary therapy for superficial femoral (SFA), popliteal (POP), and tibial (TIB) arterial occlusive disease. Seventy-eight patients had stents placed in the infra-inguinal vessels between January 1, 2001, and July 31, 2004. We collected data on patient demographics, symptoms, as well as pre- and postprocedure ankle-brachial index (ABI) and angiographic findings.

Laparoscopic orchiectomy for unilateral intra-abdominal testis.

Purpose: A brief description of laparoscopic orchiectomy for undescended testis and a representative case report.

Methods: A 22-year-old Chinese man was admitted for removal of an intra-abdominal testis. Laparoscopic orchiectomy was used to remove the testis at the time of laparoscopic orchiectomy.

Stent-graft repair of traumatic thoracic aortic disruptions.

Objective: Blunt traumatic thoracic aortic disruption results in pre-hospital death in 80% to 90% of patients. Because of the significant surgical morbidity and mortality associated with open operative repair, endovascular stent-graft repair has been investigated. The objective of this study was to evaluate the efficacy of thoracic aortic disruptions treated with commercially available proximal aortic extension cuffs.

Bedside insertion of vena cava filters in the intensive care unit using intravascular ultrasound to locate renal veins.

Background: Historically, contrast venography has been used to determine renal vein location and assist with vena cava filter placement. This technique, however, exposes the patient to nephrotoxic contrast and radiation. For trauma patients in the intensive care unit (ICU), inferior vena cava filters should ideally be placed without contrast at the bedside to avoid nephrotoxic agents, radiation, and transport of a critically injured patient to the operating room or x-ray department.

A prospective evaluation of a bedside technique for placement of inferior vena cava filters: accuracy and limitations of intravascular ultrasound.

Our objective was to evaluate the safety and accuracy of a bedside technique for placing vena cava filters with intravascular ultrasonography. We conducted a prospective case series of 36 patients requiring prophylactic vena cava filter placement. Intravascular ultrasound (IVUS) was used to assess the best location for inferior vena cava filter placement.

Retrograde endovascular hypogastric artery preservation (REHAP) and aortouniiliac (AUI) endografting in the management of complex aortoiliac aneurysms.

The preservation of internal iliac artery (IIA) flow during endovascular repair of abdominal aortic aneurysms (er-AAA) remains a controversial area. Ectasia and aneurysmal disease of the iliac arteries represent a formidable challenge to the endovascular surgeon, particularly when aortic neck length and diameter are suitable for er-AAA. We describe a procedure to maintain arterial perfusion to the pelvis during er-AAA called retrograde endovascular hypogastric artery preservation (REHAP).

Indications and outcomes of AneuRx Phase III trial versus use of commercial AneuRx stent graft.

Objective: Approval by the United States Food and Drug Administration of endoluminal repair of abdominal aortic aneurysm (AAA) with the AneuRx stent graft was based on the outcome of a multicenter trial in which patients met strict inclusion and exclusion criteria. Since widespread use of the commercially available graft, little information is available as to whether indications and outcomes have evolved. We examined this important issue at our institution.

Treatment of type III endoleak with an aortouniiliac stent graft.

The purpose of this study was to present a novel treatment method for repair of a type III endoleak due to separation of modular components of an AneuRx (Medtronic AVE, Sunnyvalle, CA) stent graft as a result of graft kinking. A 73-year-old male had undergone endovascular repair of a 8.2-cm abdominal aortic aneurysm (AAA) 2 years previously.

Conformational changes associated with proximal seal zone failure in abdominal aortic endografts.

Objective: Endovascular aneurysm repair (EVAR) has become a popular treatment for abdominal aortic aneurysm (AAA). This study examines conformational changes in the infrarenal aortas of patients in whom proximal seal zone failures (PSF) developed after EVAR.

Methods: All 189 patients with aortic endograft underwent routine post-EVAR computed tomographic scan surveillance.

Mechanism of failure in the treatment of type II endoleak with percutaneous coil embolization.

Purpose: Type II endoleak after endovascular abdominal aortic aneurysm repair is a failure of aneurysm sac exclusion with unknown long-term consequences. Elevated aneurysm sac pressures documented in these patients have led us to aggressively treat type II endoleaks with percutaneous transluminal coil embolization (PTCE). The purpose of this study was to evaluate the results and the mechanisms of failure of PTCE for type II endoleak.

Pitfalls in achieving the Dialysis Outcome Quality Initiative (DOQI) guidelines for hemodialysis access?

The Dialysis Outcome Quality Initiative (DOQI) mandates that 50% of permanent hemodialysis (HD) access be native arteriovenous fistulae (AVFs). Recent reports have shown that when these guidelines are followed, the percentage of new AVFs can exceed DOQI guidelines. From July 1998 to July 2001, 330 HD access procedures were performed in an academic tertiary care center.

The use of color-flow duplex scan for the detection of endoleaks.

Objective: Computed tomographic (CT) scan represents the criterion standard for surveillance of endoleaks after endoluminal repair of abdominal aortic aneurysms (erAAAs). Given need for surveillance, risks, and expense of CT scan, the accuracy of color-flow duplex (CFD) scan after erAAA was determined.

Methods: During a 43-month period, patients enrolled in phase II and III of the AneuRx Multicenter Clinical Trial at our institution underwent CFD scan 1 month after erAAA.

Endovascular management of iliac limb occlusion of bifurcated aortic endografts.

Although aortic endograft iliac limb occlusion is an uncommon event, its treatment is problematic because standard surgical thrombectomy risks graft dislodgment or component separation. Although femorofemoral bypass grafting can restore perfusion to the affected limb, its longevity may be inferior to reestablishing patency of the endograft itself and represents a failure of the endograft procedure. With aortic endografts now commercially available, implanting surgeons must be aware of this important complication and well versed in all of the endovascular treatment options.