Left or right carotid endarterectomy in patients with atherosclerotic disease: ipsilateral effects on cognition?

We evaluated hemispheric functions ipsilateral to the side of carotid endarterectomy (CEA) in patients with a severe stenosis in the left or right carotid artery. Assessments took place 1 day before and 3 months after CEA. Only right-handed males were included.

AneuRx stent-graft failure four years after TAA exclusion.

Purpose: To present a case of graft material disruption 4 years after thoracic aortic aneurysm (TAA) exclusion with the AneuRx stent-graft.

Case Report: In 1999, a 62-year-old man underwent successful exclusion of a descending 98-mm TAA with 2 AneuRx stent-grafts. A type I distal endoleak was diagnosed 1 month later, and a distal extension cuff was placed just proximal to the celiac trunk.

Freedom from secondary interventions to treat stenotic disease after percutaneous transluminal angioplasty of infrarenal aorta: long-term results.

Purpose: The purpose of this study was to determine the long-term results (1-15 years) of percutaneous transluminal angioplasty (PTA) of localized atherosclerotic lesions of the infrarenal aorta.

Methods: This was a retrospective study. From January 1987 to January 2002, 69 patients underwent PTA of an isolated stenosis of the lower abdominal aorta under local anesthesia in the department of interventional radiology.

The da Vinci telerobotic surgical system: the virtual operative field and telepresence surgery.

The United States Department of Defense developed the telepresence surgery concept to meet battlefield demands. The da Vinci telerobotic surgery system evolved from these efforts. In this article, the authors describe the components of the da Vinci system and explain how the surgeon sits at a computer console, views a three-dimensional virtual operative field, and performs the operation by controlling robotic arms that hold the stereoscopic video telescope and surgical instruments that simulate hand motions with seven degrees of freedom.

[Diaphragmatic traumatic chronic hernia. Report of 3 cases].

Diaphragmatic traumatic chronic hernias are infrequent. Diagnostic can be difficult if don't exist suspicion and treatment is always by surgery. The aim of this paper is to present three cases and makes an actualisation in basis to our experience and the literature.

Remote iliac artery endarterectomy: seven-year results of a less invasive technique for iliac artery occlusive disease.

Objective: Remote endarterectomy of external and common iliac artery occlusions through a single, groin incision under fluoroscopic guidance is a relative unknown surgical procedure. This prospective single center cohort study describes this less invasive endovascular technique with the ring strip cutter and its early complications. The results at midterm follow-up are presented.

Three-dimensional rotational angiography in peripheral endovascular interventions.

Purpose: To demonstrate the feasibility and applicability of 3-dimensional rotational angiography (3D-RA) in the assessment of candidates for endovascular treatment of occlusive or aneurysmal arterial disease.

Technique: In 3D-RA, a continuous rotation of the fluoroscopic tube around the region of interest is made while intra-arterial contrast is continuously infused. The area of interest is placed in the isocenter in both frontal and lateral planes.

Operative management of carotid artery in-stent restenosis: first experiences and duplex follow-up.

Objectives: Carotid Artery Stenting (CAS) may be comparable to Carotid Endarterectomy (CEA) as a durable and effective procedure in stroke prevention. Concern remains about the incidence of restenosis after stenting and its management. We evaluated the surgical management of restenosis after CAS.

A percutaneous approach to deep venous valve insufficiency with a new self-expanding venous frame valve.

Purpose: To ascertain if a percutaneously delivered venous valve bioprosthesis (PVVB) can be implanted in the porcine venous system and function without complications.

Methods: The PVVB is a glutaraldehyde-preserved, valve-bearing venous xenograft sutured inside a memory-coded nitinol frame (diameter 10, 12, or 14 mm). In 10 50-kg pigs, the external jugular vein was exposed, and a 16-F introducer sheath was positioned in the common iliac vein.

Surgical robotic applications in otolaryngology.

Objectives: To explore the feasibility of performing endo-robotic neck surgery in a porcine model and to compare the results of robotically enhanced endoscopic surgery with those from a conventional endoscopic technique.

Study Design: Prospective, nonrandomized experimental investigation in a porcine model.

Methods: We performed a consecutive series of endoscopic neck surgeries using the daVinci surgical system (Intuitive Surgical Inc.

Remote endarterectomy: first choice in surgical treatment of long segmental SFA occlusive disease?

Objectives: to report the long term results of remote superficial femoral artery endarterectomy (RSFAE) with the MollRing Cutter for the treatment of long segmental SFA occlusive disease.

Design: retrospective open study.

Patients And Methods: from March 1994 to August 2000 183 RSFAEs were performed in 164 selected patients (105 males, 120 procedures) with a median age of 63 years (43-84 years).

The cerebral correlates of set-shifting: an fMRI study of the trail making test.

The trail making test (TMT) pertains to a family of tests that tap the ability to alternate between cognitive categories. However, the value of the TMT as a localizing instrument remains elusive. Here we report the results of a functional magnetic resonance imaging (fMRI) study of a verbal adaptation of the TMT (vTMT).

Carotid endarterectomy in octogenarians with symptomatic high-grade internal carotid artery stenosis: long-term clinical and duplex follow-up.

The objective of this study was to evaluate the clinical and duplex outcome after carotid endarterectomy (CEA) in recently symptomatic patients aged 80 years or older. Information was assembled from a prospective data collection of all CEAs performed from January 1986 to December 1999. Included were all patients with recently symptomatic carotid artery stenosis who were aged 80 years or older at time of operation.

Spontaneous external carotid-jugular fistula in repetitive hyperextension of the neck.

Arteriovenous malformations between the external carotid artery and the jugular vein are very uncommon. We describe our findings in a patient with symptoms of such a spontaneous fistula.

Midterm follow-up of balloon-expandable ePTFE endografts in the femoropopliteal segment.

Purpose: To evaluate the midterm clinical outcome of patients treated with a balloon-expandable polytetrafluoroethylene (ePTFE) endograft for long-segment occlusive disease of the femoropopliteal segment.

Methods: Eighty-nine patients (68 men; median age 69 years, range 43-81) with disabling claudication (n=73) or critical ischemia (n=16) were treated with an ePTFE endograft (mean length 29 cm) for 7 stenosis (mean length 9 cm) and 82 occlusions (mean length 19 cm) in the femoropopliteal segment. The follow-up protocol included Doppler ankle-brachial pressure measurement and duplex scanning or angiography of the endograft at 6-month intervals.

New brain lesions at MR imaging after carotid angioplasty and stent placement.

Purpose: To assess, with magnetic resonance (MR) imaging, the number and size of new brain lesions after carotid angioplasty and stent placement (CAS) and to evaluate the association of these new lesions with neurologic deficits and transcranial Doppler ultrasonographic (US) data.

Materials And Methods: Seventy-two consecutive CAS procedures were performed in 72 patients. Patients underwent neurologic examination before, during, immediately after, and 1 day, 3 months, and 1 year after CAS.

Significance of peptidoglycan, a proinflammatory bacterial antigen in atherosclerotic arteries and its association with vulnerable plaques.

Peptidoglycan (PG) is a major component of the cell wall of gram-positive bacteria that is abundantly present in all human mucosa. PG is a functional lipopolysaccharide analog that binds to CD14 on macrophages and induces proinflammatory cytokine production and metalloproteinases. We investigated the hypothesis that bacterial PG is present in atherosclerotic tissue.

Estrogen induction and overexpression of fibulin-1C mRNA in ovarian cancer cells.

Fibulin-1 is an extracellular matrix protein induced by estradiol in estrogen receptor (ER) positive ovarian cancer cell lines. Alternative splicing of fibulin-1 mRNA results in four different variants named A, B, C and D that may have distinct biological functions. We studied the relative expression of fibulin-1 mRNA variants and their estrogen regulation in human ovarian cancer cells.

Endovascular stent-grafting for descending thoracic aortic aneurysms.

Objective: Endoluminal placement of covered stent-grafts emerges as a less-invasive alternative to open surgical repair of thoracic aortic aneurysms (TAA). The present report describes our experience with endovascular stent-grafting in the treatment of descending TAA.

Methods: From 1997 to 2001, 28 descending TAA's were treated in 27 patients (17 male, mean age 70 years) by endovascular stent-grafting.

Using three-dimensional rotational angiography for sizing of covered stents.

Objective: The purpose of our study was to determine the value of three-dimensional (3D) rotational angiography in the assessment of patients to be treated with covered stents for peripheral arterial aneurysms.

Conclusion: Our preliminary experience suggests that 3D rotational angiography appears to be a valid tool in the pre- and perprocedural assessment of patients treated endovascularly for arterial aneurysms.

Executive amnesia in a patient with pre-frontal damage due to a gunshot wound.

This paper reports the case of a young patient with extensive pre-frontal damage in whom we tested the hypothesis that intensive training improves executive performance as assessed by the Wisconsin Card Sorting Test (WCST). As long as her declarative memory, complex perceptual abilities and global cognitive status were spared, we surmised that any deficit in executive learning would have occurred in relative isolation. We showed that her abnormal performance on the WCST, both on the standard as well as on the post-instruction condition, was due to an impairment of shifting attention across perceptual dimensions (extra-dimensional).

A minimally invasive technique in occlusive disease of the superficial femoral artery: remote endarterectomy using the MollRing Cutter.

Remote endarterectomy is a minimally invasive technique for revascularization that shortens hospital length of stay and reduces patient morbidity and mortality. With the use of the MollRing Cutter (Vascular Architects, Inc., San Jose, CA), a modification of the single ring stripper, the surgeon is able to cut the endoluminal atheroma core remotely from the site of entrance to the vessel.