Hybrid procedures for peripheral obstructive disease.

The incidence and prevalence of high-risk patients suffering from critical limb ischemia due to multilevel arterial obstructive disease is growing rapidly. Invasive surgical procedures to restore inflow to the crural and pedal circulation in case of TransAtlantic InterSociety Consensus C and D (TASC) lesions of the iliacofemoral arteries are related with substantial morbidity and mortality. The mid-term and long-term outcomes of sole percutaneous revascularization procedures are disappointing for TASC C and D lesions.

An animal paired crossover ePTFE arteriovenous graft model.

Purpose: Previously, we developed a porcine model for Arterio Venous Graft (AVG) failure to allow assessment of new access strategies. This model was limited concerning graft length. In the present technical report, we describe a modification of our model allowing the assessment of long AVGs.

Endovascular treatment of ruptured thoracic aortic aneurysm in patients older than 75 years.

Objectives: To investigate the outcomes of thoracic endovascular aortic repair (TEVAR) for ruptured descending thoracic aortic aneurysm (rDTAA) in patients older than 75 years.

Methods: We retrospectively identified all patients treated with TEVAR for rDTAA at seven referral centres between 2002 and 2009. The cohort was stratified according to age ≤75 and >75 years, and the outcomes after TEVAR were compared between both groups.

Age and coumarin-type anticoagulation are associated with the occurrence of intraplaque hemorrhage, while statins are associated less with intraplaque hemorrhage: a large histopathological study in carotid and femoral plaques.

Introduction: Intraplaque hemorrhage (IPH) is an important determinant of progression and destabilization of atherosclerotic plaque. We recently demonstrated that IPH is an independent predictor of future cardiovascular events after carotid endarterectomy. Thus far, it is unknown whether clinical patient characteristics, such as medication use, are associated with the occurrence of IPH.

Adipocyte fatty acid binding protein in atherosclerotic plaques is associated with local vulnerability and is predictive for the occurrence of adverse cardiovascular events.

Aims: There is an increasing need for translational studies identifying molecular targets contributing to atherosclerotic plaque destabilization. Local molecular plaque markers that are related to plaque vulnerability may hold predictive value to identify patients who are at increased risk to suffer from cardiovascular events. Animal studies revealed that adipocyte fatty acid binding protein (FABP4) is associated with the progression of atherosclerosis; however, FABP4 expression studies in human atherosclerotic plaques are lacking.

Long-term results of Talent endografts for endovascular abdominal aortic aneurysm repair.

Background: Since the introduction of endovascular aneurysm repair (EVAR), long-term follow-up studies reporting single-device results are scarce. In this study, we focus on EVAR repair with the Talent stent graft (Medtronic, Santa Rosa, Calif).

Methods: Between July 2000 and December 2007, 365 patients underwent elective EVAR with a Talent device.

Mortality after hospital admission for ruptured abdominal aortic aneurysm.

Background: The purpose of this study is to quantify age- and gender-specific mortality risks for patients hospitalized for ruptured abdominal aortic aneurysm (rAAA).

Methods: The mortality risks for 28-day, 1-year, and 5-year were derived from a retrospective nation-wide cohort study of patients who were first hospitalized for rAAA in 1997 or 2000, formed through linkage of the Hospital Discharge Register with the Dutch population register. The Hospital Discharge Register contains a record for each hospital admission, giving information about patient demographics and diagnosis.

Remote endarterectomy versus supragenicular bypass surgery for long occlusions of the superficial femoral artery: medium-term results of a randomized controlled trial (the REVAS trial).

Background: To investigate the optimal surgical treatment, remote superficial femoral artery endarterectomy (RSFAE) or supragenicular bypass, for Transatlantic Inter-Society Consensus (TASC) C and D lesions of the superficial femoral artery. Medium-term results will be presented.

Methods: The study randomized 116 patients, 61 to RSFAE and 55 to supragenicular bypass surgery.

Molecular MRI of murine atherosclerotic plaque targeting NGAL: a protein associated with unstable human plaque characteristics.

Aims: Neutrophil gelatinase-associated lipocalin (NGAL) is an effector molecule of the innate immune system. One of its actions is the prolongation of matrix metalloproteinase-9 (MMP-9) activity by the formation of a degradation-resistant NGAL/MMP-9 complex. We studied NGAL in human atherosclerotic lesions and we examined whether NGAL could act as a target for molecular imaging of atherosclerotic plaques.

Aortic neck angulations decrease during and after endovascular aneurysm repair.

Purpose: To investigate whether suprarenal and infrarenal aortic neck angles change immediately after endovascular aneurysm repair (EVAR) or during follow-up. A change in aortic angulation influences the proximal stent-graft sealing and fixation zone, thereby possibly influencing the long-term results of EVAR.

Methods: Forty-three EVAR patients (39 men; mean age 73 years, range 62-85) with preoperative, postoperative, and 1, 2, and 3-year follow-up computed tomographic angiography (CTA) data were selected from our center's vascular database.

Symptomatic vertebral artery stent fracture: a case report.

Percutaneous transluminal angioplasty (PTA) with stent placement is the preferred treatment modality at present for atherosclerotic stenotic lesions of vertebral artery origin. A complication of stent placement in the vertebral artery origin that has received little attention is the risk of stent fracture. A case with four-vessel pathology treated with PTA and stent placement in the left vertebral artery origin is presented.

Therapeutic options for carotid in-stent restenosis: review of the literature.

To critically evaluate published evidence on therapeutic options for in-stent restenosis (ISR) after carotid artery stent (CAS) placement, a systematic analysis of studies reporting interventions for ISR after CAS placement was conducted. In total 20 studies were found, describing 100 interventions after carotid ISR in 96 patients. The interventions most performed were repeat percutaneous transluminal angioplasty (PTA; n = 54), repeat CAS placement (n = 31), and carotid endarterectomy with stent removal (n = 9).

The impact of hypovolaemic shock on the aortic diameter in a porcine model.

Objectives: To investigate the impact of hypovolaemic shock on the aortic diameter in a porcine model, and to determine the implications for the endovascular management of hypovolaemic patients with traumatic thoracic aortic injury (TTAI).

Materials And Methods: The circulating blood volume of seven Yorkshire pigs was gradually lowered in 10% increments. At 40% volume loss, an endograft was deployed in the descending thoracic aorta, followed by gradual fluid resuscitation.

Aneurysm-express: human abdominal aortic aneurysm wall expression in relation to heterogeneity and vascular events - rationale and design.

Objective: Elective repair of abdominal aortic aneurysms (AAA) is associated with significant morbidity and mortality. Large amounts of AAA tissue are necessary to assess heterogeneity among AAA and to correct for potential confounders such as known risk factors. The Aneurysm-express study aims to identify different types of AAA using inflammatory markers in the aneurysm wall that predict postoperative cardiovascular adverse events and mortality, therefore allowing individual risk assessment.

High myeloid-related protein: 8/14 levels are related to an increased risk of cardiovascular events after carotid endarterectomy.

Background And Purpose: Myeloid-related protein (Mrp) 8/14 complex is the functional relevant form of Mrp-8 and Mrp-14. Mrp-8/14 complex is actively formed in the cytoplasm of circulating neutrophils and monocytes and then secreted. Plasma Mrp-8/14 complex is emerging as a new biomarker that may discriminate between patients with an acute coronary syndrome and those with stable coronary heart disease.

[Urology and National Socialism: the fate of Alexander von Lichtenberg 1880-1949].

Alexander von Lichtenberg (1880-1949) was one of the famous members of the German Urological Society (DGU) in pre-war Germany. He introduced excretion urography and a special TURP Instrument. In 1928 he was president of the 8th meeting held in the German capital Berlin.

[Research perspectives on the history of urology in Germany, 1933-1945].

Between 1933 and 1945, German medical practitioners were easily persuaded to align themselves with Nazi ideology. Jewish urologists were forced out of academia, editorial boards of medical journals and medical practice. Like most German physicians, urologists quickly accepted their new role as caretakers of public health instead of individual patients' wellbeing.

Detection of occult endoleaks after endovascular treatment of abdominal aortic aneurysm using magnetic resonance imaging with a blood pool contrast agent: preliminary observations.

Objective: To determine whether blood pool contrast agent-enhanced magnetic resonance imaging (MRI) can visualize endoleaks that are occult on computed tomography (CT) in patients with nonshrinking aneurysms after endovascular aneurysm repair.

Materials And Methods: Written informed consent was obtained for this prospective institutional review board approved study. Twelve patients with nonshrinking aneurysms but no evidence of endoleak on CT angiography and delayed CT underwent MRI with a blood pool contrast agent (Gadofosveset trisodium, Bayer Schering Pharma, Berlin, Germany).

[Urology in a museum: 10 years in Düsseldorf : Living history of medicine in the Museum and Archive for Urology of the German Society of Urology].

The Urology History Center of the German Society of Urology is dedicated to the study of the medical past through a distinguished collection of rare books, museum artifacts, archives, and images. The Museum and Archive represent the history of urology and the development of the specialty through the ages with emphasis on the development in the German-speaking countries in Europe. Furthermore 3000 years of urologic science are reflected.

A ruptured aneurysm after stent graft puncture during computed tomography-guided thrombin injection.

Type II endoleaks occur in 5% to 10% of patients who are treated by endovascular aneurysm repair. A persistent type II endoleak combined with documented aneurysm expansion is generally considered an indication for intervention. Thrombin injection directly into the aneurysm sac is described as a safe and efficient treatment option.