[Iliac endofibrosis in high-performance sports: an interdisciplinary diagnostic challenge].

Objectives: Iliac endofibrosis (IE) is a rare arterial disease in endurance athletes, especially cyclists and triathletes. The diagnosis is considered challenging and the latency from the onset of initial symptoms to diagnosis is often several years. Diagnostic options include determination of the ankle brachial index (ABI) after maximal exercise as a non-invasive procedure, as well as duplex sonography, CT or MRI angiography, and invasive angiography.

Wound closure by means of free flap and arteriovenous loop: Development of flap autonomy in the long-term follow-up.

Free flaps in combination with arterial reconstruction by means of arteriovenous loops or bypass have, meanwhile, been established as a therapeutic option in defect reconstruction for areas without recipient vessels. Our aim was to analyse the long-term performance, flap autonomy, and the flap perfusion. Patients receiving this combined reconstruction at a single-centre institution were included.

Filarial extract of induces a type 2 immune response and attenuates plaque development in hyperlipidemic ApoE-knockout mice.

A type 1 immune response is involved in atherosclerosis progression, whereas the role of a type 2 polarization, especially with regard to an enhanced T helper (T)2 cell differentiation, is still unclear. Helminths trigger type 2 immune responses, protecting the host from inflammatory disorders. We investigated whether an increased type 2 polarization by administration of adult worm extract (LsAg) affects atherosclerosis in apolipoprotein E-deficient (ApoE) mice.

Quantitative assessment of microperfusion by indocyanine green angiography in kidney transplantation resembles chronic morphological changes in kidney specimens.

Objective: ICG fluorescence angiography enables a quantitative real-time perfusion assessment in kidney transplantation. The results of intraoperative microperfusion of the kidney allograft were compared to the renal chronicity score in pre-transplantation kidney biopsy specimens. The intrarenal resistance index was calculated by duplex sonography as a method of reference.

Pilot study using intraoperative fluorescence angiography during arteriovenous hemodialysis access surgery.

Introduction:: In this pilot study, we used indocyanine green fluorescence angiography during hemodialysis access surgery. The aim was to evaluate its relevance as a diagnostic tool to visualize changes in hand microperfusion.

Patients And Methods:: In this prospective single-center study, 47 adult patients (33 male, 14 female) with renal disease (24 preemptive, 23 endstage) were enrolled.

Open Versus Endovascular Revascularization of Below-Knee Arteries in Patients With End-Stage Renal Disease and Critical Limb Ischemia.

Background:: Evaluation of below-the-knee open revascularization (OR) versus endovascular revascularization (EVT) in patients with end-stage renal disease and critical limb ischemia (CLI) was performed.

Patients And Methods:: Seventy-seven dialysis patients with CLI and infrapopliteal involvement from 2007 to 2017 were included. Thirty-five patients received OR and 42 patients were treated with EVT.

Comparison between open and pharmacomechanical repair of acutely thrombosed arteriovenous hemodialysis fistulae within a decade.

Introduction: Different declotting techniques are available for acutely thrombosed arteriovenous hemodialysis fistulae (AVF). The aim of this single-center study was to compare immediate and follow-up results between surgical repair and a modified interventional lyse-and-wait technique characterized by prolonged local reaction times of recombinant tissue-plasminogen activator (rtPA).

Materials And Methods: We retrospectively analyzed medical records of 110 consecutively treated patients between the years 2003 and 2013.

MRI to investigate iliac artery wall thickness in triathletes.

Objectives: Endofibrosis was first described in endurance athletes. This rare disease is characterized by intimal hyperplasia of iliac arteries. Due to non-specific symptoms diagnosing could be very challenging and delayed.

Pilot Assessment of the Angiosome Concept by Intra-operative Fluorescence Angiography After Tibial Bypass Surgery.

Objectives: The "angiosome" concept as a model for decision making in revascularisation of patients with critical limb ischaemia (CLI) has been subject to lively discussion in recent years. The aim of this prospective pilot study was to use intra-operative fluorescence angiography to provide further data on the angiosome concept on the level of microcirculation after tibial bypass surgery.

Design, Materials, And Methods: This was a prospective analysis of 40 patients presenting with CLI Rutherford stage IV to VI before and after tibial bypass surgery.

Retrospective cohort study of combined approach for trunk reconstruction using arteriovenous loops and free flaps.

Defect reconstruction of the trunk can be performed using microsurgical free flap transplantation. In cases of missing or inappropriate recipient vessels, microsurgical defect reconstruction of the trunk can be achieved by combining free flaps with arteriovenous loops. Here we present our 5-year experience of trunk reconstruction using AV loops and free flaps in a retrospective evaluation.

Dosing of indocyanine green for intraoperative laser fluorescence angiography in kidney transplantation.

Objective: Sufficient blood supply is a crucial factor determining postoperative allograft function in kidney transplantation. Therefore, besides the surgeon's individual impression, a method for evaluating the quality of the organ's microperfusion is required. Laser fluorescence angiography with indocyanine green (ICG) is an emerging tool for this purpose.

Benefits of Long Versus Short Thrombolysis Times for Acutely Thrombosed Hemodialysis Native Fistulas.

Introduction: Local thrombolysis with a time of exposure to recombinant tissue plasminogen activator of 15 to 150 minutes is commonly used to declot acutely thrombosed hemodialysis fistulas. The duration of thrombolysis for the restoration of arteriovenous blood flow remains controversial. The aim of this study was to investigate the outcomes of long thrombolysis treatment (LTT, 3 hours or more) and short thrombolysis treatment (STT, less than 3 hours) in our institution.

Surgeon experience affects outcome of forearm arteriovenous fistulae more than outcomes of upper-arm fistulae.

Introduction: There is still an ongoing discussion about the influence of vascular surgeon experience on the immediate and long-term outcome of newly created arteriovenous fistula (AVF) for patients on hemodialysis (HD). The aim of this study was to compare failure and patency rates of AVF between experienced consultants and resident trainees with special focus on location of the anastomosis on the forearm or upper arm.

Methods: Between November 2012 and September 2016, 159 patients (83 on HD and 76 preemptive) received an AVF (90 radiocephalic [RCAVF] on the forearm; 69 brachiocephalic [BCAVF] in the elbow) by two experienced vascular surgeons (group A; n = 74) or five residents in training with one-to-four years of experience (group B; n = 85).

Time-extended local rtPA infiltration for acutely thrombosed hemodialysis fistulas.

Introduction: This study describes results of a modified local thrombolysis technique for acutely thrombosed hemodialysis (HD) arteriovenous fistulas (AVF), which is characterized by prolonged recombinant tissue plasminogen activator (rtPA) local exposure times. Contrary to the standard lyse- and- wait (L&W) technique with local reaction times of 20-40 minutes, the modified protocol allows timing of challenging angioplasty maneuvers to the next regular working day.

Methods: From February 2009 to April 2014, 84 patients on HD presented with 152 acutely thrombosed AVF.

Microcirculation Evaluated by Intraoperative Fluorescence Angiography after Tibial Bypass Surgery.

Background: Intact microperfusion of the foot in the critical ischemic limb remains a crucial condition for ulcer healing. Aim of this clinical study was to evaluate the immediate effect of tibial bypass surgery on the microcirculation by usage of fluorescence angiography.

Methods: Prospective analysis of 33 patients presenting with critical limb ischemia (Rutherford IV-VI) undergoing tibial bypass surgery was performed.

Immediate changes of angiosome perfusion during tibial angioplasty.

Objective: In recent years, a controversial discussion about the clinical relevance of the angiosome concept during tibial angioplasty has developed. Therefore, we conducted a prospective study to evaluate the angiosome concept on the level of microcirculation during tibial vascular interventions.

Methods: Thirty patients with isolated tibial angioplasty were examined prospectively.

Pediatric patients undergoing arteriovenous fistula surgery without intraoperative heparin.

Introduction: Arteriovenous fistula (AVF) creation in children could be extremely challenging for vascular surgeons due to small vessels with a high tendency of vasospasm. This could be one reason for primary failures (PF) and early access thrombosis. There exists no guideline for the need of intraoperative heparin administration during hemodialysis fistula creation.

[Acute and chronic limb ischemia in endurance athletes - a serious diagnosis of exercise-induced lower limb pain].

Lower extremity pain due to acute or chronic ischemia in high performance endurance athletes is an often forgotten differential diagnosis. A variety of symptoms constitues a multi-disciplinary challenge. Intermittent claudication or acute ischemia are clinical symptoms indicative of this vascular disease.

Outcomes and Influence of the Pedal Arch in Below-the-Knee Angioplasty in Patients with End-Stage Renal Disease and Critical Limb Ischemia.

Background: Management of dialysis patients with critical limb ischemia (CLI) still represents a challenge to vascular medicine, whereas the effects of the pedal arch quality in these patients with predominant affection of the infrapopliteal vessels have rarely been evaluated. Therefore, our aim was to analyze the outcomes of infrapopliteal angioplasty in the setting of chronic renal failure (end-stage renal disease) and evaluate the influence of the pedal arch involvement on clinical success.

Methods: Prospective follow-up of 32 ERSD patients on hemodialysis (mean age, 72 years) with CLI and consecutive infrapopliteal angioplasty over a 5-year period 2010-2014 was performed.

Timing of first arteriovenous fistula cannulation in children on hemodialysis.

Background: Due to lower complication rates in comparison to central venous catheter (CVC) arteriovenous fistulas (AVFs) are now the preferred hemodialysis access. Recommendations for the first access cannulation range from 6 to 12 weeks, which could lead to temporary or even permanent preference for CVC while awaiting the maturation of the newly created AVF. The aim of this study was to evaluate the influence of first cannulation of AVFs on primary (PP) and secondary (SP) patency rates in children on hemodialysis (HD).

Rupture Risk and Etiology of Visceral Artery Aneurysms and Pseudoaneurysms: A Single-Center Experience.

Background: The aim of this study was to analyze differences in rupture risk and etiology of visceral artery aneurysms (VAAs) and visceral artery pseudoaneurysms (VAPAs) in a single-center experience.

Materials And Methods: We retrospectively reviewed all patients with a VAA or VAPA after treatment by open surgical or endovascular repair (ER) in our institution. Patient history, treatment details, and outcome were recorded and analyzed.

Dissecting aneurysm of common iliac artery in a long-distance runner.

We present an unusual case of a long-distance runner suffering from acute dissection of a common iliac artery (CIA) aneurysm with endofibrotic lesions. He suffered from acute pelvic and abdominal pain after exercise. Computed tomography angiography confirmed the dissecting aneurysm of the left CIA without signs of rupture.