Gender differences in blood flow velocities after carotid angioplasty and stenting.

Gender differences have been demonstrated in blood flow velocities by duplex ultrasonography (DU) in patients with carotid stenosis. Currently, DU is the most widely used method of follow-up monitoring after carotid angioplasty and stenting (CAS). To identify possible gender differences in carotid flow velocities, we analyzed our experience with DU obtained before and immediately after CAS.

Histologic and duplex comparison of the perclose and angio-seal percutaneous closure devices.

The intravascular and extravascular effects of percutaneous closure devices have not been well studied. We assessed the performance and healing characteristics in dogs of two devices approved by the US Food and Drug Administration. Nine adult male dogs were anesthesized prior to percutaneous access of both femoral arteries with a 6F sheath.

Experience with inferior vena cava filter placement in patients undergoing open gastric bypass procedures.

Objective: Patients undergoing open gastric bypass (OGB) for morbid obesity are at significant risk for pulmonary embolism (PE) despite the use of subcutaneous heparin injections and sequential compression devices. Prophylactic preoperative inferior vena cava (IVC) filter placement may reduce this risk. We report our experience with simultaneous IVC filter placement and OGB in an operating room setting.

Type II endoleak after endoaortic graft implantation: diagnosis with helical CT arteriography.

Purpose: To retrospectively assess endoleak shapes and locations within aneurysms to differentiate type II from type I and type III endoleaks.

Materials And Methods: The institutional review board granted an exemption for this HIPAA-compliant study; patient informed consent was not required. A retrospective review of arterial phase helical computed tomographic (CT) studies and medical records was performed for 39 patients (29 men, 10 women; age range, 60-89 years; mean, 78.

Femoral artery to prosthetic graft anastomotic dehiscence owing to infection: successful treatment with arterial reconstruction and limb salvage.

A 66-year-old man had foot gangrene and a fixed contracture of the knee following two failed femoropopliteal bypasses, one with vein and one with polytetrafluoroethylene (PTFE). An external iliac to anterior tibial artery bypass and skeletal traction via the os calcis resulted in limb salvage and successful normal ambulation. After 3 months, he ruptured the infected femoral anastomosis of the failed PTFE femoropopliteal bypass with external bleeding.

Absence of proximal neck dilatation and graft migration after endovascular aneurysm repair with balloon-expandable stent-based endografts.

Objective: Proximal neck dilatation (PND) and/or endograft migration with the subsequent development of type I endoleak is a significant cause of late endograft failure after endovascular abdominal aortic aneurysm repair (EVAR). Although there are numerous reports examining PND in patients receiving endografts that use self-expanding stents (SES) for proximal fixation, there are no such reports for patients treated with endografts that use balloon-expanding stents (BES). The purpose of this study was to investigate PND and endograft migration after EVAR with BES endografts.

Balloon occlusion of the aorta during endovascular repair of ruptured abdominal aortic aneurysm.

Purpose: To describe a technique of aortic clamping during endovascular aneurysm repair (EVAR) in patients with ruptured abdominal aortic aneurysms (AAA) and circulatory collapse.

Technique: A balloon catheter is inserted percutaneously from the femoral artery and inflated in the suprarenal aorta. An introducer sheath must support the balloon.

1992: Parodi, Montefiore, and the first abdominal aortic aneurysm stent graft in the United States.

In 1990 Juan C. Parodi performed the first endovascular abdominal aortic aneurysm (AAA) repair in Buenos Aires. Two years later, in 1992, Parodi and Claudio Schonholz visited Montefiore Medical Center in New York to perform with us the first endovascular AAA repair to be done in the United States.

Subintimal angioplasty in the management of critical lower-extremity ischemia: value in limb salvage.

The interest in and overall usage of endovascular procedures for the treatment of lower extremity ischemia continues to grow at a rapid pace. An increasing number of centers throughout the world are gaining experience with subintimal angioplasty. Promising results have been reported and the application of the technique has been expanded to include the iliac and crural arteries.

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.

Endovascular aortic aneurysm repair with the Zenith endograft in patients with ectatic iliac arteries.

Endovascular aortic aneurysm repair (EVAR) in patients with ectatic iliac arteries is feasible; however, most studies have reported experience from single institutions where distal flare techniques with endograft components were used on an "off-label basis." The Zenith endovascular graft allows adequate seal in ectatic common iliac arteries (CIAs) with diameters up to 20 mm. To determine whether large or ectatic CIAs are a risk factor for early and late endograft failure, we analyzed data from the Zenith U.

Giant femoropopliteal artery aneurysm and vein rupture.

Atherosclerotic popliteal aneurysms are the most common peripheral artery aneurysms. Thrombosis, embolization, rupture, and compression of adjacent structures are well-known complications. We report a patient with a giant thigh hematoma and a pulsatile mass thought to be a ruptured popliteal artery aneurysm.

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.

Effects of bilateral hypogastric artery interruption during endovascular and open aortoiliac aneurysm repair.

Purpose: Hypogastric artery interruption is sometimes required during aortoiliac aneurysm repair. We have not experienced some of the life-threatening complications of pelvic ischemia reported by others. Therefore we analyzed our experience to identify factors that help minimize pelvic ischemia with unilateral and bilateral hypogastric artery interruption.

Relationship of proximal fixation to renal dysfunction in patients undergoing endovascular aneurysm repair.

Technological advancements have lead to dramatic improvements in stentgraft device design resulting in more trackable delivery systems and transrenal uncovered stents and barbs for better fixation. Transrenal bare-stents may limit stentgraft migration, particularly in patients with short or flared proximal aortic necks. However, potential disadvantages might be in worsening renal function, particularly in patients with preexisting renal insufficiency.

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).

The value of subintimal angioplasty in the management of critical lower extremity ischemia: failure is not always associated with a rethreatened limb.

The technique of subintimal angioplasty was developed in Leicester, UK in 1987. Recently a growing number of centers in Europe and the United States have been gaining experience with this technique. Promising results have been reported and the application of the technique expanded to include the iliac and crural arteries.

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

American board of vascular surgery: the first 7 years.

The American Board of Vascular Surgery (ABVS) was incorporated in 1996 with a vision of improved training standards and certification of vascular surgeons. At that time, 91% of those holding American Board of Surgery Certificates of Added Qualifications in Vascular Surgery supported the formation of the ABVS. Subsequent events have led to a clear definition of specific educational issues important to the vascular surgery community.

A new approach to carotid angioplasty and stenting with transcervical occlusion and protective shunting: Why it may be a better carotid artery intervention.

Objective: The purpose of this study was to evaluate the effectiveness and demonstrate the advantages of a new technique for carotid angioplasty and stenting (CAS) with proximal cerebral protection through a direct transcervical approach, as compared with a percutaneous transfemoral approach.

Methods: CAS procedures were carried out in 25 consecutive patients, 4 with the femoral approach and 21 through a 2-cm incision at the base of the neck, with the patient under local anesthesia. For transcervical occlusion and protective shunting (TOPS), a short 9F sheath was inserted directly into the common carotid artery and connected to a 6F sheath placed percutaneously in the ipsilateral internal jugular vein.