Postoperative Infections are Associated with Increased Risk of Cardiac Events in Vascular Patients.

Background: Despite advances in perioperative care, the rate of cardiac events in vascular patients remains high. We have previously shown that infections in trauma patients are associated with higher rates of subsequent cardiac complications, likely due to the additive effect of a second hit of an infection following the trauma. The aim of this study was to investigate whether there is an association between postoperative infections and subsequent cardiac events in vascular patients.

Open revascularization procedures are more likely to influence smoking reduction than percutaneous procedures.

Background: Among patients with peripheral arterial disease (PAD), smokers have a higher incidence of life- and limb-threatening complications, including lower extremity ischemic rest pain, myocardial infarction, and cardiac death, highlighting the need for smoking reduction. Several studies have previously investigated the perioperative period as a teachable moment for smoking cessation. The purpose of this study is to determine whether the type of revascularization for PAD (percutaneous versus open) is associated with smoking reduction.

A 14-year experience with blunt thoracic aortic injury.

Objective: This study reviewed the natural history of blunt thoracic aortic trauma (BTAT) over a 14-year period at our level 1 trauma center and compared open vs endovascular treatment.

Methods: All patients with BTAT presenting to a level 1 trauma center from 1998 to 2011 were included in a retrospective analysis. Multiple data points and short-term and midterm outcomes were ascertained through a retrospective record review.

Endovascular repair of mycotic aneurysm of the descending thoracic aorta.

Background: Mycotic thoracic aortic aneurysms (MTAAs) are a rare yet life-threatening disease. The current standard of care consists of surgical resection, in situ or extra-anatomic revascularization, and antibiotic therapy. Despite this treatment, mortality remains high (range, 5-40%).

Escherichia coli primary aortitis presenting as sequelae of incompletely treated urinary tract infection.

We report a rare case of nonaneurysmal infectious aortitis (IA) with the causative microorganism being Escherichia coli. The patient was a 78-year-old man who presented with a 3-week history of abdominal pain, fevers, and anorexia after treatment for a urinary tract infection. The patient had positive blood cultures and a computed tomography scan that had signs of IA.

Predictors of shunt during carotid endarterectomy with routine electroencephalography monitoring.

Background: The routine use of intraoperative electroencephalography (EEG) monitoring with selective shunt placement during carotid endarterectomy (CEA) has been shown to be safe and effective. We attempt to identify the anatomic and clinical factors associated with significant EEG changes requiring shunt placement during CEA.

Methods: Between January 2005 and June 2007, 242 CEAs were performed with selective shunt placement for significant EEG changes.

The effects of vasoactive agents on flow through saphenous vein grafts during lower-extremity peripheral vascular surgery.

Purpose: The purpose of this study was to assess the effects of hemodynamic alterations on vein graft flow during peripheral vascular surgery. It was hypothesized that vasopressors can be administered without compromising flow through the vein grafts.

Setting: Tertiary care center, university medical center.

Aortoiliac insufficiency: long-term experience with stent placement for treatment.

Purpose: To establish and report the authors' experience with the long-term outcomes of aortoiliac stent placement for treatment of chronic lower-extremity ischemia.

Materials And Methods: Stents were placed in 505 arterial segment lesions in 365 patients who presented with symptoms of chronic leg ischemia between February 1992 and March 2001. The 505 treated lesions were 88 occlusions and 417 stenoses.

Hemodynamic and biochemical characteristics of the aorta in the WKY, SHR, WKHT, and WKHA rat strains.

This study was designed to characterize the hemodynamic and biochemical properties of the abdominal aorta in four genetically related inbred rat strains that express genetic hypertension and hyperactive behavior in varying combinations. These include (1) the spontaneously hypertensive rat (SHR), which is hypertensive, hyperactive, and hyperreactive to stress; (2) Wistar-Kyoto (WKY) rats, which express none of these traits; (3) WKHT rats, which are hypertensive but not hyperactive; and (4) WKHA rats, which are hyperactive and hyperreactive to stress, but normotensive. Together, these four strains allowed us to examine the structural and functional changes in the aorta in the hypertensive SHR, the most widely used animal model of genetic hypertension, while controlling for the variables of hyperactivity and hyperreactivity that are also expressed in the SHR.

Effects of hypertension and propranolol upon aneurysm expansion in the Anidjar/Dobrin aneurysm model.

Propranolol has been suggested to slow aortic aneurysm (AAA) expansion by a mechanism independent of simple blood pressure (BP) reduction. To investigate this hypothesis, we designed a series of experiments to examine the effects of hypertension and propranolol upon AAA expansion. Using an established animal model, we induced AAA in normotensive and genetically hypertensive rats by perfusion of the isolated infrarenal aorta with elastase for two hours.

Late recurrence of Hodgkin's disease after partial splenectomy.

The use of laparotomy and splenectomy for staging purposes in patients with Hodgkin's disease (HD) gained popularity in the early 1970s. Accurate staging and more effective treatment regimens, including combined chemotherapy and irradiation, have resulted in improved patient survival rates. Similarly, an increased number of late complications have been reported, including the development of thyroid disease, second malignancies, and septic complications related to splenectomy.

Anti-CD 18 monoclonal antibody slows experimental aortic aneurysm expansion.

Purpose: Inflammation has been implicated as a contributing factor in the expansion of abdominal aortic aneurysms (AAA). To test this hypothesis, we examined the effects of a monoclonal antibody (MAB) to the leukocyte CD18 adhesion molecule on the expansion of experimental AAA.

Methods: Aneurysms were induced by perfusion of an isolated segment of the infrarenal aorta with elastase in 22 normotensive (WKY) and 17 genetically hypertensive (WKHT) rats.

Expansion of aortic aneurysms is reduced by propranolol in a hypertensive rat model.

Purpose: It has been suggested that propranolol has unique effects that slow aneurysm expansion by remodeling the structural proteins of the aorta. These effects are believed to be independent of blood pressure reduction, a hypothesis we tested in this investigation with a rat model of abdominal aortic aneurysm (AAA).

Methods: With an established model, AAA were induced in normotensive Wistar-Kyoto (WKY) rats and genetically hypertensive Wistar-Kyoto (WKHT) rats by perfusing an isolated segment of the infrarenal aorta with elastase.

Insulin sensitivity and responsiveness of epitrochlearis and soleus muscles from fed and starved rats. Recognition of differential changes in insulin sensitivities of protein synthesis and glucose incorporation into glycogen.

The insulin sensitivity of protein synthesis and glucose incorporation into glycogen by the soleus and epitrochlearis muscles from fed rats and 24 h-starved rats was determined in vitro during the first and second hours of incubation after isolation of the muscles. Rates of protein synthesis by both muscles from fed rats in the first hour of incubation were 2-fold higher than in the second hour and were not increased by insulin. Rates of protein synthesis during the first hour in the presence of 6000 microunits of insulin/ml were increased in soleus, but not in epitrochlearis, muscles from starved rats.