Follow-up and surveillance of vein grafts: when and how to intervene to prevent complications.

Despite advances in endovascular strategies, surgical infrainguinal lower limb revascularization remains the gold standard treatment for critical lower limb ischemia and disabling claudication. Maintaining patency of infrainguinal vein bypass grafts has been a challenging task for vascular surgeons as they are prone to developing stenoses which may precipitate failure of the bypass. Duplex ultrasound scanning has evolved as the investigation of choice to identify vein graft lesions but graft surveillance programs using this technique remain controversial.

MRI using ultrasmall superparamagnetic particles of iron oxide in patients under surveillance for abdominal aortic aneurysms to predict rupture or surgical repair: MRI for abdominal aortic aneurysms to predict rupture or surgery-the MA(3)RS study.

Introduction: Population screening for abdominal aortic aneurysms (AAA) halves the associated mortality and has led to the establishment of national screening programmes. Prediction of aneurysm growth and rupture is challenging and currently relies on serial diameter measurements with ultrasound. Recently, a novel MRI-based technique using ultrasmall superparamagnetic particles of iron oxide (USPIO) has demonstrated considerable promise as a method of identifying aneurysm inflammation and expansion.

Contemporary outcomes of open repair of thoracoabdominal aortic aneurysm in young patients.

Background: Endovascular technology now permits total endovascular thoracoabdominal aortic aneurysm (TAAA) repair with high volume centres reporting encouraging results. The long-term durability of such stent grafts is unknown, leading to concerns regarding their use in younger patients. This study reports contemporary outcomes of open repair in young patients.

Institutional differences in endovascular aneurysm repair and aneurysm morphology.

Background: Variability exists between institutions in the application of endovascular aneurysm repair (EVAR). This study compares patient-specific variables from a high-volume North American institution with one from the UK.

Methods: One hundred consecutive patients from each institution were studied.

Abdominal aortic aneurysm growth predicted by uptake of ultrasmall superparamagnetic particles of iron oxide: a pilot study.

Background: Abdominal aortic aneurysms are a major cause of death. Prediction of aneurysm expansion and rupture is challenging and currently relies on the simple measure of aneurysm diameter. Using MRI, we aimed to assess whether areas of cellular inflammation correlated with the rate of abdominal aortic aneurysm expansion.

Prognostic scoring in ruptured abdominal aortic aneurysm: a prospective evaluation.

Background: Prospective validation of prognostic scoring systems for ruptured abdominal aortic aneurysm (AAA) is lacking. This study assesses the validity of three established risk scores and a new prognostic index.

Method: Patients admitted with ruptured AAA during a 26-month period (August 2002-December 2004) were recruited prospectively.

Prediction of outcome after abdominal aortic aneurysm rupture.

Background: Most vascular surgeons practice a selective policy of operative intervention for patients with ruptured abdominal aortic aneurysm (AAA). The evidence on which to justify operative selection remains uncertain. This review examines the prediction of outcome after attempted open repair of ruptured AAA.

Systemic inflammation and repair of abdominal aortic aneurysm.

Background: Inflammation is integral to the pathogenesis of abdominal aortic aneurysm (AAA). This study examines preoperative biomarkers of systemic inflammation in patients undergoing open repair of intact and ruptured AAA.

Methods: One-hundred twelve patients were entered into a prospective observational study.

Plasma creatine kinase indicates major amputation or limb preservation in acute lower limb ischemia.

Objective: Acutely ischemic limbs are often of uncertain viability. To assist operative management, this study determined prospectively which indicators on admission were the best predictors of major amputation and, conversely, limb preservation.

Methods: Data were collected on admission.

Outcome and survival of patients aged 65 years and younger after abdominal aortic aneurysm rupture.

Advanced age (> 80 years) confers a survival disadvantage after operative repair of a ruptured abdominal aortic aneurysm (AAA). This study aimed to determine if young age (< or =65 years) confers a survival benefit. Consecutive patients undergoing attempted repair of a ruptured AAA between 1995 and 2001 were included in the study.

Functional outcome after open repair of ruptured abdominal aortic aneurysm.

Background: Outcome after operative repair of ruptured abdominal aortic aneurysm (AAA) has traditionally been assessed in terms of survival. This study examines the functional outcome of patients who survive operation.

Methods: Consecutive patients who survived open repair over an 18-month period were entered into a prospective case-control study.

Ruptured inflammatory abdominal aortic aneurysm: insights in clinical management and outcome.

Background: Ruptured inflammatory abdominal aortic aneurysm (AAA) is relatively rare, and little has been written on the outcome of operative treatment.

Methods: Patients undergoing attempted repair of ruptured inflammatory AAA between 1995 and 2001 were included in a retrospective case-cohort study. Demographic, clinical, and operative factors were analyzed, together with in-hospital morbidity, in-hospital mortality, and duration of postoperative hospital stay.

Autologous deep vein reconstruction of infected thoracoabdominal aortic patch graft.

Graft infection remains a serious complication of prosthetic aortic repair. Infection of thoracoabdominal aortic prosthetic grafts, in particular, is a significant clinical challenge and is associated with high mortality. We report successful in situ reconstruction of an infected thoracoabdominal aortic prosthetic patch graft with autogenous superficial femoral vein.

Duplex saphenous vein mapping: venous occlusion and dependent position facilitate imaging.

The purpose of this study was to develop an optimal technique for greater saphenous vein distention during preoperative duplex assessment. An Acuson 128 scanner with a 7.5-MHz sector probe was used to assess the effects of venous occlusion and dependent position on the diameter of the greater saphenous vein in 20 male volunteers.