Results of Carotid Endarterectomy Using Bovine Pericardium Patch Closure, with a Review of Pertinent Literature.

Patch closure after carotid endarterectomy lowers risk of recurrent stenosis and perioperative neurologic events. Although vein patches have theoretic benefits, few differences between vein and nonautologous patches have been noted. Bovine pericardium has been increasingly used in carotid surgery over the last 15 years, with favorable reports.

Rebuilding after the tsunami: getting it right.

The practice of integrated coastal management (ICM) has matured sufficiently since its beginnings in the early 1980s to suggest a set of principles that could be used to guide the massive investments that will be made over the next several years to rehabilitate and reconstruct the thousands of kilometers of coastlines devastated by the 26 December 2004 tsunami. We offer six principles to guide what can be done to make coastal communities less vulnerable, to improve the conditions of the poor, and to avoid repeating the mistaken judgements that have been made in the past about how shorelines are allocated and developed. We then offer a set of five principles to guide how action plans are formulated and implemented.

Intraoperative use of isosulfan blue in the treatment of persistent lymphatic leaks.

Background: Lymphatic leaks are a major source of morbidity after lower extremity vascular surgery. We determined the ability of isosulfan blue (Lymphazurin) use to identify and help ligate offending lymphatics, and compared postoperative complication rates and length of stay versus nonoperative therapy alone.

Methods: From January 1993 through March 2002, we identified 15 patients with lymphatic leaks.

Intraoperative duplex ultrasonography as an adjunct to technical excellence in 100 consecutive carotid endarterectomies.

Purpose: To evaluate the relationship of intraoperative duplex ultrasonography (duplex) results to neurologic outcomes and restenosis among patients undergoing carotid endarterectomy (CEA).

Methods: One hundred consecutive CEAs were performed at a military medical center over 28 months. Prospectively acquired demographics, duplex results, revisions, and surgical outcomes were reviewed.

Carotid endarterectomy remains the gold standard.

Background: To compare the safety and efficacy of carotid endarterectomy (CEA) as performed in a community medical center with the Asymptomatic Carotid Atherosclerosis Study (ACAS) and North American Symptomatic Carotid Endarterectomy Trial (NASCET) standards and with representative published results regarding carotid angioplasty and stenting (CAS).

Methods: Between 1 January 1994 and 31 July 2000, 267 CEA procedures were performed on 236 patients at Madigan Army Medical Center (MAMC). Prospectively acquired patient demographics, operative indications, and surgical outcomes were reviewed using clinical records, carotid duplex evaluations, and follow-up examinations.