Carotid Artery Endarterectomy Effect on Choroidal Thickness: One-Year Follow-Up.

Purpose: To evaluate the change in choroidal thickness after carotid artery endarterectomy (CEA) in patients without retinal pathology.

Methods: A prospective series of patients who underwent CEA at the Tel Aviv Medical Center. Spectral domain optical coherence tomography (SD-OCT) was performed one day before the CEA and at least 6 months after.

When the chimney is blocked: malignant renovascular hypertension after endovascular repair of abdominal aortic aneurysm.

Background: The Chimney graft (CG) procedure is one of the novel modification techniques of the endovascular aneurysm repair (EVAR) surgery to treat suprarenal and juxtarenal abdominal aortic aneurysms. Other indications for the use of CG placement include thoracic and thoracoabdominal aneurysms with supraortic branches orifice involvement and cases of common iliac artery aneurysms with or without internal iliac artery involvement. The technique is used in patients who due to aortic-neck morphology and lack of adequate fixation and/or sealing zones are not eligible for standard EVAR.

Preferential use of basilic vein for surgical repair of popliteal aneurysms via the posterior approach.

The facedown position used for the posterior surgical approach to repair popliteal aneurysms limits access to the great saphenous vein. Using the basilic vein as the conduit of choice in five patients, we were able to harvest the vein conveniently and simultaneously with aneurysm exposure. On follow-up of 4 to 36 months, all grafts were functioning well.

Size of normal and aneurysmal popliteal arteries: a duplex ultrasound study.

Objective: To define diameter at three levels along the popliteal artery and its relation to the inflow arteries in the normal state and in popliteal aneurysms.

Methods: The external diameter of the arteries was determined by duplex ultrasound scanning at the common femoral (CFA), superficial femoral artery (SFA), proximal popliteal artery (PPOP), mid-popliteal artery (MPOP), and distal popliteal artery (DPOP). Examinations were performed in 104 healthy men and 100 women.

Survival with intact cerebral function after gunshot injury to both internal carotid arteries.

A 24-year-old man was admitted after sustaining a single gunshot wound to the neck with an expanding hematoma on the left. Computed tomography angiography demonstrated bilateral internal carotid artery pseudoaneurysms, with disruption of flow on the left and a carotid-jugular fistula on the right. At operation, transection of the left internal carotid artery necessitated ligation of the artery.

Association of cardiac troponin, CK-MB, and postoperative myocardial ischemia with long-term survival after major vascular surgery.

Objectives: The aim of this study was to determine the long-term prognosis with postoperative markers of myocardial ischemia and infarction.

Background: Cardiac troponins (cTn) are superior to creatine kinase-MB fraction (CK-MB) in detecting perioperative myocardial infarction (PMI). However, their threshold levels signifying PMI and their long-term prognostic value are not yet determined.

Preoperative thallium scanning, selective coronary revascularization, and long-term survival after major vascular surgery.

Background: Ischemia on thallium scanning is a strong predictor of long-term mortality in CAD patients. Whether coronary revascularization (CR) in patients with significant ischemia on preoperative thallium scanning (PTS) improves long-term survival after major vascular surgery has not been determined.

Methods And Results: The perioperative data, including PTS and subsequent CR in patients with moderate to severe reversible ischemia on PTS, and long-term survival of 502 consecutive patients who underwent 578 major vascular procedures were analyzed retrospectively.

Changes in aneurysm volume after endovascular repair of abdominal aortic aneurysm.

Objective: The purpose of this study was to define changes in aneurysm volume after endovascular repair of abdominal aortic aneurysm.

Methods: A total of 154 consecutive patients who underwent endovascular repair of abdominal aortic aneurysm with the Medtronic AneuRx stent graft at Stanford University Hospital were evaluated. During a mean follow-up period of 15.

The first 150 endovascular AAA repairs at a single institution: how steep is the learning curve?

Purpose: To determine whether increasing experience with endovascular abdominal aortic aneurysm (AAA) repair in a single institution will result in improved outcome.

Methods: A retrospective review was undertaken of 150 consecutive cases of endovascular AAA repairs performed using the AneuRx device between October 1996 and April 2000 in a university-based medical center. The population was divided into early and late groups of 75 patients each.

Open versus endovascular AAA repair in patients who are morphological candidates for endovascular treatment.

Purpose: To compare the outcomes of open versus endovascular repair of abdominal aortic aneurysm (AAA) in a cohort of patients who fulfill morphological criteria for endovascular repair.

Methods: A retrospective review of 229 consecutive AAA patients treated over a 3-year period identified 149 patients who were candidates for endovascular repair based on preoperative computed tomography and angiography. Of the 149 patients, 79 (68 men; mean age 74 +/- 8 years) underwent endovascular repair with the AneuRx stent-graft; the remaining 70 (56 men; mean age 72 +/- 8 years) had open repair.

Gender differences in endovascular abdominal aortic aneurysm repair with the AneuRx stent graft.

Objective: The objective of this study was to evaluate gender differences in the selection, procedure, and outcome of endovascular abdominal aortic aneurysm repair (EVAR).

Patients: Between October 1996 and January 2001, 378 patients were evaluated for EVAR and 189 patients underwent EVAR with the Medtronic AneuRx stent graft at a single center.

Results: Women constituted 17% of patients considered for EVAR.

Vascular trauma in high-velocity gunshot wounds and shrapnel-blast injuries in Israel.

High-velocity gunshot and shrapnel-blast vascular injuries pose a great challenge and need to be approached in a systematic, multidisciplinary fashion. Early revascularization with temporary shunts, the use of autologous tissue, major venous reconstruction, a low threshold for fasciotomy, and reliable tissue coverage are the mainstays of management.

Late endoleak after endovascular repair of an abdominal aortic aneurysm with multiple proximal extender cuffs.

Late onset graft or attachment site-related endoleaks may be hazardous, and early identification of patients at risk is important. We describe a patient who underwent implantation of a bifurcated stent graft 5.5 cm below the renal arteries because of a technical error with three extender cuffs implanted proximally to bridge the gap.

Perioperative myocardial ischemia and infarction: identification by continuous 12-lead electrocardiogram with online ST-segment monitoring.

Background: Perioperative myocardial ischemia is conventionally monitored using five electrocardiographic leads, with only one precordial lead placed at V5. This is based on studies from more than a decade ago. The authors reassessed this convention by analyzing data obtained from continuous on-line 12-lead electrocardiographic monitoring.