Predictors of early discharge following open abdominal aortic aneurysm repair.

Patients undergoing endovascular abdominal aortic aneurysm (AAA) repair have lower perioperative morbidity and leave the hospital earlier than patients undergoing open repair. However, potential complications require continuous surveillance of endografts and there are few data regarding their long-term fate. If an open operation were well tolerated, this might be a preferable alternative.

Same-evening discharge after carotid endarterectomy: our initial experience.

Purpose: The purpose of this study was to review the initial implementation of a same-evening discharge algorithm for patients undergoing carotid endarterectomy (CEA).

Method: We conducted a retrospective review of a prospective database of patients undergoing CEA over 3 years.

Results: From January 2000 to December 2002, 207 patients underwent CEA, of which 186 qualified for same-evening discharge.

Definition of venous reflux in lower-extremity veins.

Purpose: This prospective study was designed to determine the upper limits of normal for duration and maximum velocity of retrograde flow (RF) in lower extremity veins.

Methods: Eighty limbs in 40 healthy subjects and 60 limbs in 45 patients with chronic venous disease were examined with duplex scanning in the standing and supine positions. Each limb was assessed for reflux at 16 venous sites, including the common femoral, deep femoral, and proximal and distal femoral veins; proximal and distal popliteal veins; gastrocnemial vein; anterior and posterior tibial veins; peroneal vein; greater saphenous vein, at the saphenofemoral junction, thigh, upper calf, and lower calf; and lesser saphenous vein, at the saphenopopliteal junction and mid-calf.

Hemodynamic stability, myocardial ischemia, and perioperative outcome after carotid surgery with remifentanil/propofol or isoflurane/fentanyl anesthesia.

This study compares remifentanil/propofol (remi/prop) with isoflurane/fentanyl (iso/fen) anesthesia to determine which provides the greater hemodynamic stability, lesser myocardial ischemia, and morbidity with better postoperative outcomes after carotid endarterectomy. Sixty patients undergoing unilateral carotid endarterectomy were randomized to receive either a remi/prop or iso/fen anesthetic. Hemodynamic variables were recorded during the surgical procedure.

Periorbital Mass in a Squirrel Monkey (Saimiri sciureus).

During a routine annual physical examination, a small, hard, palpable mass was discovered on the left cheek below the lateral canthus of the eye of an adult male squirrel monkey (Saimiri sciureus). Radiographs of the lesion were obtained, and the lesion was surgically removed. Histologic examination of the mass was performed.

The effect of intraoperative duplex on the management of postoperative stroke.

Background: Stroke after carotid endarterectomy (CEA) may be a result of intraoperative ischemia, embolism, or thrombosis at the operative site. Intraoperative duplex should eliminate the occurrence of a severe internal carotid artery (ICA) thrombosis and, thus, negate the benefit of reoperation. This article will detail the results of our evolving treatment algorithm for immediate versus delayed post-CEA neurologic deficit (ND).

Pelvic lymphocele following motor vehicle collision.

The development of lymphocele has been described in the mediastinum following thoracic duct injury from blunt trauma or surgery, in lower extremity surgery or trauma, and in the pelvis following renal transplant or staging lymphadenectomy. We describe a case of pelvic lymphocele following blunt trauma from a motor vehicle collision in which the patient did not sustain any fractures. The patient subsequently experienced right lower extremity pain and swelling thought to result from a deep venous thrombosis.