Modifications in Near Infrared Spectroscopy for Cerebral Monitoring During Carotid Endarterectomy in Asymptomatic and Symptomatic Patients.

Background: To evaluate trends and differences in Near Infrared Spectroscopy (NIRS) monitoring during carotid endarterectomy (CEA) in patients affected by asymptomatic and symptomatic carotid artery stenosis, to predict postoperative neurological complications (PNCs).

Methods: NIRS data of CEAs performed in a University Hospital were retrospectively reviewed. All the interventions were performed under general anesthesia and patients with intraoperative complications were excluded.

Risk Scoring Systems to Predict Long-Term Mortality After Carotid Endarterectomy in Asymptomatic Patients: A Systematic Review.

The present review was conducted to describe current published risk scoring systems to predict late mortality after carotid endarterectomy (CEA). The aim of the study is to identify simple, clinical, and reproducible tools to predict life expectancy in patients with asymptomatic carotid artery stenosis candidates to CEA and therefore which patients may benefit from surgery, reaching the goal of life expectancy >3 to 5 years, recommended by guidelines. Advantages, disadvantages, feasibility, simplicity, and reproducibility of each selected score were analyzed.

Development and validation of a score to predict life expectancy after carotid endarterectomy in asymptomatic patients.

Objective: Recent improvement of best medical treatment for carotid stenosis has sparked a debate on the role of surgery-identification of patients who may benefit from carotid endarterectomy (CEA) is crucial to avoid overtreatment. An expected 5-year postoperative survival is one of the main selection criteria. The aim of this study was the development of a score for predicting survival of asymptomatic patients after CEA.

Medical Therapy Before Carotid Endarterectomy: Changes Over a 13-Year Period and Comparison Between Asymptomatic and Symptomatic Patients.

We evaluated the evolution of chronic medical therapy in patients admitted for carotid endarterectomy (CEA) over a 13-year period and to analyze the difference in medical treatment between symptomatic and asymptomatic patients. A retrospective study was conducted on patients treated between 2002 and 2015. The use of antiplatelets (acetylsalicylic acid [ASA], ticlopidine, and clopidogrel), oral anticoagulant therapy (OAT), statins and antihypertensives (angiotensin-converting enzyme inhibitors [ACE-I]/angiotensin receptor blockers [ARBs], β-blockers [BB]) administration was evaluated.

Open and endovascular elective treatment of abdominal aortic aneurysms: a real-world experience.

Purpose: To present a real-world experience of the elective treatment of abdominal aortic aneurysms (AAAs) using both open repair (OR) and endovascular repair (EVAR).

Methods: Data from patients treated consecutively between January 1, 2000 and December 31, 2014 were collected retrospectively and reviewed. The primary outcomes were 30-day mortality and complication rates, freedom from reintervention, and survival in the long-term.

Feeding and reproductive patterns of Astyanax intermedius in a headwater stream of Atlantic Rainforest.

In this paper, we determined diet composition, reproductive periodicity and fecundity of Astyanax intermedius in a headwater stream of a State Park of an Atlantic rainforest. We also evaluated the influence of rainfall, water temperature and fish size on niche width and niche overlap. Sampling was conducted monthly throughout one year in the Ribeirão Grande stream, southeastern Brazil.

Comparison of posterior and medial approaches for popliteal artery aneurysms.

Background: Long-term results of the posterior approach (PA) for the treatment of popliteal artery aneurysms are lacking in the literature. We reviewed our experience during a 13-year period in patients with popliteal artery aneurysms, comparing those treated through a PA with those operated on through a standard medial approach (MA).

Methods: Clinical data of all patients treated between February 1998 and October 2011 were retrospectively reviewed and outcomes analyzed.

Role of preoperative serum creatinine and estimated glomerular filtration rate values in asymptomatic patients undergoing carotid endarterectomy.

Background: The aim of this study was to evaluate the effect of chronic kidney disease (CKD), assessed by preoperative estimated glomerular filtration rate (eGFR) and serum creatinine (Cr), on postoperative outcomes and long-term survival in asymptomatic patients undergoing carotid endarterectomy (CEA).

Methods: We examined data about patients that underwent CEA between January 2002 and September 2014 in our Institution. Retrospective analysis to assess preoperative comorbidities and postoperative complications was performed.

Use of ultrasound debridement as an adjunctive tool for treating infected prosthetic vascular grafts in the lower extremities.

Background: To evaluate the role of an ultrasound (US) debridement system to treat conservatively patients with poor medical conditions who presented with infection of a prosthetic vascular graft in the lower extremities.

Methods: Data of all patients who underwent debridement of the grafts and/or surrounding tissue using an ultrasonic generator (Genera, Italia Medica, Milan, Italy) were recorded and retrospectively reviewed. Based on cultures, patients received specific antibiotic therapy.

Outcomes of urgent carotid endarterectomy for stable and unstable acute neurologic deficits.

Objective: The aim of the study was to assess the outcomes of carotid endarterectomy (CEA) performed in an urgent setting on acutely symptomatic patients selected through a very simple protocol.

Methods: From January 2002 to January 2012, 193 symptomatic patients underwent CEA. Of these, 90 presented with acute symptoms, and after a congruous carotid stenosis was identified, underwent urgent operations (group 1): 27 patients had transient ischemic attack (group 1A), 52 patients had mild to moderate stroke (group 1B), and 11 patients had stroke in evolution (group 1C).

Tympanometry in infants: a study of the sensitivity and specificity of 226-Hz and 1,000-Hz probe tones.

Introduction For infants under 6 months, the literature recommends 1,000-Hz tympanometry, which has a greater sensitivity for the correct identification of middle ear disorders in this population. Objective To systematically analyze national and international publications found in electronic databases that used tympanometry with 226-Hz and 1,000-Hz probe tones. Data Synthesis Initially, we identified 36 articles in the SciELO database, 11 in the Latin American and Caribbean Literature on the Health Sciences (LILACS) database, 199 in MEDLINE, 0 in the Cochrane database, 16 in ISI Web of Knowledge, and 185 in the Scopus database.

Double osteotomy of mandibula in the treatment of carotid body tumors with skull base extension.

We report two patients with a carotid body paraganglioma that extended to the skull base, a position that is surgically inaccessible by means of a traditional lateral cervical approach. In both patients we were able to remove the lesion by performing a double mandibular osteotomy. Both patients underwent preoperative embolization to reduce the mass.

Vibrometry: a novel noninvasive application of ultrasonographic physics to estimate wall stress in native aneurysms.

Our objective was to test vibrometry as a means to measure changes in aneurysm sac pressure in an in vitro aneurysm model. Explanted porcine abdominal aortas and nitrile rubber tubes were used to model an aneurysm sac. An ultrasound beam was used to vibrate the surface of the aneurysm model.

Evolution from axillofemoral to in situ prosthetic reconstruction for the treatment of aortic graft infections at a single center.

Objective: The primary purpose of this study was to analyze the clinical outcome in patients treated for aortic graft infections with in situ reconstruction (ISR). As a secondary aim, the outcomes were compared between patients who had similar clinical characteristics and extent of infection, needed total graft excision, and had either ISR or axillofemoral reconstruction (AXFR).

Methods: 117 consecutive patients treated for aortic graft infection over a 20 year period from January 1981 to December 2001 were identified.

Noninvasive measurement of aortic aneurysm sac tension with vibrometry.

Objective: Currently, the risk of aneurysm sac rupture after endovascular abdominal aortic aneurysm repair (EVAR) is estimated by using a group of anatomic variables. Available techniques for pressure monitoring include either direct measurement using catheter-based techniques or indirect measurement requiring implantation of a pressure sensor during aneurysm repair. None of these methods is without limitations.

Endovenous laser therapy and radiofrequency ablation of the great saphenous vein: analysis of early efficacy and complications.

Background: Endovenous laser therapy (EVLT) and radiofrequency ablation (RFA) are new, minimally invasive percutaneous endovenous techniques for ablation of the incompetent great saphenous vein (GSV). We have performed both procedures at the Mayo Clinic during two different consecutive periods. At the time of this report, no single-institution report has compared RFA with EVLT in the management of saphenous reflux.

Surgical management of renal fibromuscular dysplasia: challenges in the endovascular era.

Percutaneous transluminal renal angioplasty (PTRA) is the primary treatment for renal fibromuscular dysplasia (RFMD). Surgical revascularization is limited to patients who fail or are unsuitable for PTRA. All patients who were operated on with RFMD since the indications for renal PTRA were expanded in our institution were retrospectively reviewed.

Extension of saphenous thrombus into the femoral vein: a potential complication of new endovenous ablation techniques.

Endovenous techniques such as radiofrequency ablation (RFA) and endovenous laser therapy (ELT) have emerged as percutaneous minimally invasive procedures for ablation of incompetent great saphenous veins in patients with varicosity and venous insufficiency. Early reports showed safety and efficacy of both techniques, with excellent technical success rates and few major complications, such as deep vein thrombosis or pulmonary embolism. During our initial experience with ELT in 56 limbs of 41 patients, 39 underwent postoperative duplex scanning.

A new approach for proximal anastomosis in type "A" acute aortic dissection: prosthesis eversion.

One of the crucial aspects of surgical repair of type A aortic dissection is to achieve hemostasis of the anastomosis. Furthermore, the possibility of improving the suture with additional stitches is often technically demanding. We, therefore, describe a new surgical technique for the proximal anastomosis, positioning the prosthesis within the left ventricle.

An in vitro methodology for evaluating the mechanical properties of aortic vascular prostheses.

The main problem in the replacement of pathological segments of the aorta with vascular prostheses consists of matching the fluid admittance of the host artery and the graft. This mismatch results from the different compliance between natural and prosthetic vessels and from the plastic dilatation of the prosthesis diameter that occurs after implantation. An experimental procedure was set up for evaluating the mechanical properties of aortic vascular prostheses.