Early Carotid Occlusion After Endarterectomy in a Patient With a Mutation for MTHFR A1298C Polymorphism.

Introduction: Significant carotid stenosis is a well-documented risk factor for ischemic stroke. Carotid endarterectomy (CEA) and carotid artery stenting are effective procedures for the prevention of stroke in patients with this disease. However, the occurrence of restenosis could contribute to an increase in the risk of ischemic stroke.

Endovascular therapy for chronic mesenteric ischemia.

Purpose: The purpose of this article is to report on the effectiveness and durability of endovascular therapy for obstructive disease of the superior mesenteric artery and celiac trunk.

Patients And Methods: Our retrospective study population included nine patients (five women, four men; mean age 64 years, range 34-83 years) with 15 lesions. The indication for endovascular therapy was chronic mesenteric ischemia.

Endovascular treatment for mobile thrombus of the thoracic aorta.

Detection levels of mobile thrombus of the thoracic aorta have greatly increased after any embolic event. Although the indication for treatment remains controversial, there is a growing interest about the etiopathogenesis of this rare entity and to define proper diagnostic and therapeutic approaches. We present a case of mobile thrombus of the thoracic aorta causing recurrent peripheral emboli managed with endovascular stent graft.

Endovascular treatment for traumatic injuries of the peripheral arteries following blunt trauma.

Objectives: The continued advances in imaging and stent/stent-graft technology have considerably expanded the indications for endovascular approach also in vascular trauma. We report our institutional experience with endovascular treatment of peripheral arterial injuries after blunt trauma.

Methods: Between January 2000 and June 2006 out of a series of 81 patients, 10 male patients (mean age of 50+/-14 years) with peripheral arterial injuries were managed endovascularly.

Endovascular repair of abdominal infrarenal penetrating aortic ulcers: a prospective observational study.

Objective: Penetrating atherosclerotic ulcer generally occurs in elderly patients with systemic atherosclerosis, predominantly in the descending thoracic aorta, and it is uncommon in the infrarenal aorta. We reviewed our experience of endovascular treatment of penetrating aortic ulcer in the infrarenal aorta.

Methods: In the last 4 years, out of 348 patients who underwent abdominal aortic procedures, a total of 13 patients (12 men and 1 woman) were found to have an abdominal penetrating aortic ulcer, corresponding to an incidence of 3.

Endovascular treatment of anastomotic pseudoaneurysms after aorto-iliac surgical reconstruction.

Purpose: To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction.

Materials: We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21).

Penetrating ulcers of the thoracic aorta: results from a single-centre experience.

Objectives: To report our mid-term results of stent-graft (SG) placement for the treatment of penetrating thoracic aortic ulcers.

Methods: In the last 30 months, 11 patients (9 men; mean age 73 years; range 55 to 81) were treated for 12 penetrating thoracic aortic ulcers using SGs. Five patients were symptomatic: 2 had ruptured ulcers and 2 cases were complicated with dissection.

Splenic artery aneurysms: postembolization syndrome and surgical complications.

Background: This study assessed the endovascular embolization of splenic artery aneurysms and false aneurysms with special consideration given to postoperative complications.

Methods: Fifteen patients (11 women; mean age, 56 y; range, 39-80 y) with splenic artery aneurysm (n = 13) or false aneurysm (n = 2) were treated with coil embolization. The lesion was asymptomatic in 9 patients, symptomatic in 5 patients, and ruptured in 1 patient.

Endovascular versus open repair of ruptured abdominal aortic aneurysms.

Although major improvement has occurred to make elective repair of abdominal aortic aneurysms a safe procedure, the incidence of ruptured abdominal aortic aneurysms and mortality rates are still disappointing. Endovascular abdominal aortic aneurysm repair has produced quantum changes in aneurysm treatment. The successful application of the endovascular approach for the treatment of abdominal aortic aneurysms in the elective setting has prompted a strong interest regarding its possible use in dealing with the long-standing challenge of a ruptured abdominal aortic aneurysm.

Stent-graft repair of peroneal arteriovenous fistula.

Arteriovenous fistulas (AVFs) are infrequently seen in the civilian health-care system; traditionally, these lesions have been treated with ligation, or direct surgical repair with concomitant revascularization. We describe a rare case of a peroneal AVF treated with a stent-graft.

Complications after endovascular stent-grafting of thoracic aortic diseases.

Background: To update our experience with thoracic aortic stent-graft treatment over a 5-year period, with special consideration for the occurrence and management of complications.

Methods: From December 2000 to June 2006, 52 patients with thoracic aortic pathologies underwent endovascular repair; there were 43 males (83%) and 9 females, mean age 63 +/- 19 years (range 17-87). Fourteen patients (27%) were treated for degenerative thoracic aortic aneurysm, 12 patients (24%) for penetrating aortic ulcer, 8 patients (15%) for blunt traumatic injury, 7 patients (13%) for acute type B dissection, 6 patients (11%) for a type B dissecting aneurysm; 5 patients (10%) with thoraco-abdominal aortic aneurysms were excluded from the analyses.

Surgical treatment of malignant involvement of the inferior vena cava.

Background: Resection and replacement of the inferior vena cava to remove malignant disease is a formidable procedure. The purpose of this review is to describe our experience with regard to patient selection, operative technique, and early and late outcome.

Methods: The authors retrospectively reviewed a 12-year series of 11 patients; there were 10 males, with a mean age 57 +/- 13 years (range 27-72) who underwent caval thrombectomy and/or resection for primary (n = 9) or recurrent (n = 2) vena cava tumours.

Comparison of contrast-enhanced ultrasound and computed tomography in classifying endoleaks after endovascular treatment of abdominal aorta aneurysms: preliminary experience.

The purpose of the study was to assess the effectiveness of contrast-enhanced ultrasonography (CEUS) in endoleak classification after endovascular treatment of an abdominal aortic aneurysm compared to computed tomography angiography (CTA). From May 2001 to April 2003, 10 patients with endoleaks already detected by CTA underwent CEUS with Sonovue to confirm the CTA classification or to reclassify the endoleak. In three conflicting cases, the patients were also studied with conventional angiography.

New trends in prosthesis infection in cardiovascular surgery.

Background: Adult cardiovascular surgery entails, in many cases, the use of some kind of prosthesis. Among the potential complications, prosthetic device infection is one of the most devastating in incidence, as well as in prognosis and damage to surrounding tissues.

Results: The most common bacterial agents in vascular and cardiac prosthetic device infections are Staphylococcus aureus and S.

Emergency endovascular stent-graft treatment for acute thoracic aortic syndromes.

Objective: We report the results of our ongoing experience of urgent and emergency stent-graft implantation in acute thoracic aortic syndromes.

Methods And Results: In the last 5-years, 19 patients were treated for acute thoracic aortic syndromes. Traumatic rupture was diagnosed in 7 patients, complicated acute type B dissection was present in 5 patients, penetrating ulcer in 4, and symptomatic thoracic aortic aneurysm in 3 patients.

Endovascular treatment of femoropopliteal aneurysms: a five-year experience.

Purpose: To assess the effectiveness of endovascular treatment of femoropopliteal aneurysms (FPAs).

Methods: In the last 5 years, we have treated 17 FPAs (diameter 21-75 cm, mean 38.4 cm; length 27-100 cm, mean 72.

Endovascular treatment of isolated iliac artery aneurysms.

We report our experience of endovascular repair of isolated iliac artery aneurysms using commercially available stent grafts (SGs). Twenty-five patients (mean age 71 +/- 7 years) presented with 33 isolated iliac artery aneurysms (common iliac artery n = 29, external iliac artery n = 4). Five patients were symptomatic.

Stent-graft treatment for isolated infrarenal aortic dissecting aneurysms.

Objectives: We report three cases of isolated infrarenal aortic dissecting aneurysms managed with stent-graft.

Materials And Methods: Three patients, two men and one woman, with a mean age at diagnosis of 69 years were identified. In all cases, chest CT-A did not reveal evidence of thoracic aortic dissection.

Multimodal approach to endovascular treatment of visceral artery aneurysms and pseudoaneurysms.

Purpose: To assess the feasibility and the effectiveness of endovascular treatment of visceral arteries aneurysms (VAAs) using a "multimodal approach".

Material And Methods: Twenty-five patients (mean age 60.1 years) with 29 VAAs (13 splenic, 4 hepatic, 3 gastroduodenal, 6 renal, 2 pancreatic-duodenal, 1 superior mesenteric) were considered suitable for endovascular treatment; 8/29 were ruptured.

Intravenous uterine leiomyomatosis with right heart extension: successful two-stage surgical removal.

Intravenous leiomyomatosis is an uncommon nonmalignant tumor which originates from the smooth muscle cells and is usually confined to the pelvic venous system. Rarely, intracaval and intracardiac extension has been described: the literature includes only 100 cases with cardiac involvement. We report a case of a young woman with intravenous leiomyomatosis originating from the uterus and extending into the right atrium, successfully treated through a two-stage surgical approach.

Incidence of vascular injuries after use of the Angio-Seal closure device following endovascular procedures in a single center.

Introduction: Percutaneous closure devices have been used to obtain rapid hemostasis and early mobilization of the patient after arterial catheterization. However, we observed challenging problems with the sealing procedure that require further surgical intervention. The present report is a retrospective analysis of the patterns of injury and the final outcome of four cases of femoral artery injury following the use of Angio-Seal.

Emergency endovascular treatment of abdominal aortic aneurysms: feasibility and results.

Purpose: To assess the feasibility and effectiveness of emergency endovascular treatment of abdominal aortic aneurysms (AAAs).

Methods: During 36 months we treated, on an emergency basis, 30 AAAs with endovascular exclusion. In 21 hemodynamically stable patients preoperative CT angiography (CTA) was performed to confirm the diagnosis and to plan the treatment; 9 patients with hemorrhagic shock were evaluated with angiography performed in the operating room.

Emergency endovascular repair for traumatic injury of the inferior vena cava.

Conventional open repair of the traumatic injuries of the inferior vena cava still represents a surgical challenge, since it carries high morbidity and mortality rates close to 100% in emergency setting. Surgical techniques required the total mobilization of the liver in the former case and the anatomic exposure of the aorto-iliac bifurcation in the latter. We report a case of uncontrolled hemorrhage from the inferior vena cava, managed by endovascular technique.

Hybrid treatment for juxtarenal aortic occlusion: successful revascularization using iliofemoral semiclosed endarterectomy and kissing-stents technique.

A 53-year-old man with a significant respiratory history waiting for lung transplantation presented with severe bilateral buttock and thigh claudication. Angiography revealed severe stenosis of the left renal artery and total occlusion of the infrarenal abdominal aorta and iliac vessels. Via a bilateral surgical femoral exposure, we performed semiclosed endarterectomy of the iliofemoral vessels and percutaneous transluminal angioplasty stenting of the infrarenal aorta with two Palmaz stents and percutaneous transluminal angioplasty "kissing stents" of the iliac arteries with three Luminexx stents bilaterally.