Repetitive bypass and revisions with extensions for limb salvage after multiple previous failures.

The optimal treatment of patients facing imminent amputation after multiple (≥ 2) failed prior ipsilateral bypasses is unclear. We analyzed a group of patients undergoing multiple lower extremity bypasses for limb salvage to assess the utility of attempting multiple revascularizations. From 1990 to 2005, 105 revascularization procedures were performed in 55 limbs of 54 patients with imminent limb-threatening lower extremity ischemia after failure of ≥ 2 prior infrainguinal bypasses in the same leg.

Factors influencing the incidence of endovenous heat-induced thrombosis (EHIT).

Introduction: Extension of thrombus from the great saphenous vein into the common femoral vein can be an early postprocedural complication of endothermal ablation (ETA).

Methods: A retrospective review was performed over a 3-year period. Intraprocedural ultrasound images demonstrating the distance of the catheter tip to the saphenofemoral junction (SFJ) were available for 519 procedures, and this distance was measured.

Percutaneous intervention for infrainguinal occlusive disease in women: equivalent outcomes despite increased severity of disease compared with men.

Objectives: Experience with open surgical bypass suggests similar overall outcomes in women compared with men, but significantly increased risk of wound complications. Percutaneous treatment of lower extremity occlusive disease is therefore an attractive alternative in women, although it is not clear whether there is a difference in outcomes between women and men treated with this technique. We sought to determine the results and predictors of failure in women treated by percutaneous intervention.

Minimally invasive retrieval of a dislodged Wallstent endoprosthesis after an endovascular abdominal aortic aneurysm repair.

Endovascular abdominal aortic aneurysm repair (EVAR) is being performed more frequently in patients with concomitant iliac artery occlusive disease. We report a case of a 70-year-old male status post angioplasty and stenting of bilateral iliac arteries for occlusive disease who subsequently underwent EVAR for a rapidly expanding abdominal aortic aneurysm (AAA). One month after the placement of the endograft, it was discovered that the previously placed Wallstent had been dislodged during the endovascular abdominal aortic aneurysm repair.

Lesion severity and treatment complexity are associated with outcome after percutaneous infra-inguinal intervention.

Objectives: Percutaneous revascularization has become increasingly utilized for the treatment of lower extremity ischemia. Patients with limb-threat have been shown to be at increased risk of failure, although the reasons for this remain unclear. This study analyzed factors associated with percutaneous treatment failure, focusing specifically on lesion characteristics and treatment complexity.

Influence of type II endoleak volume on aneurysm wall pressure and distribution in an experimental model.

Objective(s): We have previously shown that type II endoleak size is a predictor of aneurysm growth after aortic endografting. To better understand this observation, we investigated the influence of endoleak size on pressure transmitted to the aneurysm wall and its distribution within the aneurysm sac.

Methods: In an ex vivo model, an artificial aneurysm sac was incorporated within a mock circulation comprised of rubber tubing and a pulsatile pump.

Discontinuous, staccato growth of abdominal aortic aneurysms.

Background: To evaluate whether abdominal aortic aneurysm (AAA) growth in individual patients can be characterized as continuous or discontinuous (staccato).

Study Design: From 1996 to 2002, 609 patients presented with unruptured AAAs. Of these, 278 underwent prompt repair and 331 were observed.

Predicting aneurysm enlargement in patients with persistent type II endoleaks.

Objective: The clinical significance of type II endoleaks is not well understood. Some evidence, however, indicates that some type II endoleaks might result in aneurysm enlargement and rupture. To identify factors that might contribute to aneurysm expansion, we analyzed the influence of several variables on aneurysm growth in patients with persistent type II endoleaks after endovascular aortic aneurysm repair (EVAR).

Fate of collateral vessels following subintimal angioplasty.

Purpose: To evaluate the fate of collateral vessels adjacent to and within the target lesion following subintimal angioplasty (SIA).

Methods: Pre and postprocedural angiograms were reviewed for 29 patients undergoing SIA of the lower extremity arteries over a 3-year period. The number of patent collateral vessels View Article and Find Full Text PDF

Patency rates of femorofemoral bypasses associated with endovascular aneurysm repair surpass those performed for occlusive disease.

Purpose: To evaluate the patency rates of femorofemoral grafts performed in conjunction with aortomonoiliac or aortomonofemoral (AMI/F) endografts.

Methods: Over the past 8 years, 110 patients (98 men; mean age 77+/-7 years, range 57-90) underwent aortoiliac aneurysm repair with an AMI/F endograft. Follow-up data in these patients were prospectively collected for a mean 2.

Delayed open conversion following endovascular aortoiliac aneurysm repair: partial (or complete) endograft preservation as a useful adjunct.

Objectives: The purpose of this study was to review our experience with delayed open conversion (>30 days) following endovascular aortoiliac aneurysm repair (EVAR) and to introduce the concept and advantages of endograft retention in this setting.

Methods: From January 1992 to January 2003, a total of 386 EVARs using a variety of endografts were successfully deployed. Eleven (2.

Does transrenal fixation of aortic endografts impair renal function?

Objectives: Transrenal fixation (TFX) of aortic endografts is thought to increase the risk for renal infarction and impaired renal function. We studied the late effects of TFX on renal function and perfusion.

Methods: Of 189 patients with commercial aortic endografts, which we inserted between 1995 and 2002, we reviewed data for 130 patients (112 men, 18 women) with available creatinine (Cr) concentration and contrast enhanced computed tomography (CT) scans preoperatively and 1 to 97 months after the procedure.