Completion Arteriogram Following Carotid Endarterectomy Yields Lower Perioperative Stroke Rate.

Completion imaging following carotid endarterectomy (CEA) remains controversial. We present our experience performing routine completion arteriography (CA). A retrospective review of our prospectively maintained institutional database was performed for patients undergoing isolated CEA.

Site of service influence on stent use for hemodialysis access interventions.

Objective: With rising health care spending in the United States, the Centers for Medicare and Medicaid Services (CMS) in recent years attempted to use reimbursement rates to influence use of less expensive care sites for covered patients, such as ambulatory surgery centers (ASCs) and office-based laboratories (OBLs), in lieu of hospital service sites. It has been suggested that cost savings have not been realized because of more procedures being performed by physicians with ownership interests in nonhospital facilities. CMS adopted massive reimbursement changes for 2019 OBL and ASC-based procedures, which reduced dialysis access angioplasty reimbursement in the ASC setting by 50%, whereas facility reimbursement for stenting increased by 33% above prior levels.

Giant renal vein aneurysm.

A 37-year-old asymptomatic man presented with incidentally identified intra-abdominal venous aneurysms. Workup, which included venography, demonstrated an absent segment of the inferior vena cava between the inferior right and superior left renal vein, resulting in a 4.4-cm right renal vein aneurysm, dilated common iliac veins, and left external iliac vein aneurysm.

Persistent Hypoglossal Artery: Challenges Associated With Carotid Revascularization.

Anomalous connections between the anterior and posterior cranial circulation are rare embryologic entities. A persistent hypoglossal artery has a reported incidence of 0.03% to 0.

Outcomes of Brachial Artery Access for Endovascular Interventions.

Background: A percutaneous brachial artery (BA) approach is a suitable or even favorable alternative to femoral artery access when performing certain endovascular interventions. However, this approach may have a higher complication rate compared to femoral artery access. We analyzed our results using percutaneous BA approach for noncardiac endovascular interventions.

Lateral femoral bypass for prosthetic arterial graft infections in the groin.

Objective: Prosthetic arterial graft infections (PAGIs) in the groin pose significant challenges in terms of revascularization options and risk of limb loss as well as associated morbidities. Although obturator canal bypass (OCB) has been suggested for revascularization of the extremity in these cases, moderate success rates and technical challenges have limited widespread use. Our study analyzed lateral femoral bypass (LFB) as an alternative approach for the treatment of groin PAGIs.

Celiac artery stent placement for coronary ischemia.

Introduction: The use of endovascular technology for mesenteric interventions has become an increasingly accepted treatment modality. We present an unusual case of celiac artery stent placement for coronary ischemia.

Case Description: A 66-year-old male with a history most notable for coronary artery disease and coronary artery bypass grafting (CABG) x 3 utilizing left internal mammary artery to left anterior descending, radial artery to first diagonal and his right gastroepiploic artery (GEA) to posterior descending artery presented with chest pain.

Duplex ultrasound diagnosis of failing stent grafts placed for occlusive disease.

Objective: We previously showed that duplex ultrasound (DU) imaging is beneficial in the diagnosis of failing vein and prosthetic grafts performed for arterial occlusive disease. The purpose of this study was to evaluate whether DU imaging can reliably diagnose failing stent grafts (ie, covered stents) placed for arterial occlusive disease.

Methods: Between July 1, 2005, and June 30, 2013, we placed 142 stent grafts in 92 arterial segments (1.

Use of a small intestine submucosa extracellular matrix patch in repeated carotid endarterectomy.

Various patches have been described in the literature for patients undergoing carotid endarterectomy. In the present report, the authors present the case of a 71-year-old woman who had bilateral carotid endarterectomies 17 years earlier and greater than 80% restenosis of the right internal carotid artery. The patient underwent a repeated right carotid endarterectomy using a small intestine submucosa extracellular matrix patch for closure of the arteriotomy.

Comparison of inflammatory response during on-pump and off-pump coronary artery bypass surgery.

Purpose: On-pump coronary artery bypass graft (CABG) surgery has been traditionally associated with a higher magnitude of inflammatory response than off-pump CABG. However with the development of polymer-coated biocompatible extracorporeal circuits, we wanted to see if cardiopulmonary bypass still played an important role in triggering this inflammatory response.

Methods: In this prospective observational study, 33 patients undergoing CABG surgeries (25 on-pump and 8 off-pump patients) were studied.

Preload responsiveness is associated with increased interleukin-6 and lower organ yield from brain-dead donors.

Objective: Brain death induces dramatic changes in hemodynamics. Ischemic injury and inflammation resulting from inadequate resuscitation might influence organ yield for transplantation. Using functional hemodynamic monitoring in brain-dead organ donors, we test the hypothesis that donor preload (fluid) responsiveness is associated with increased inflammatory response and lower organ yield for transplantation.

Increased plasma interleukin-6 in donors is associated with lower recipient hospital-free survival after cadaveric organ transplantation.

Objectives: Brain death induces a massive inflammatory response. However, the influence of this inflammatory response on organ procurement, transplantation, and recipient outcome is unknown. We describe the inflammatory response characteristics in brain-dead organ donors and examine associations with organ transplantation and recipient survival.