Tremor Induced by Cyclosporine, Tacrolimus, Sirolimus, or Everolimus: A Review of the Literature.

Calcineurin inhibitors such as cyclosporine and tacrolimus are immunosuppressant drugs that are known to induce tremors. Non-calcineurin inhibitors such as sirolimus and everolimus have also reportedly been accompanied by tremors, albeit less likely. However, the prevalence rates reported in the literature are notably wide, and the risk profiles for these drug-induced tremors are less understood.

Heparin-bonded expanded polytetrafluoroethylene femoropopliteal bypass grafts outperform expanded polytetrafluoroethylene grafts without heparin in a long-term comparison.

Objective: Expanded polytetrafluoroethylene (ePTFE) grafts have become an acceptable prosthetic alternative to autologous vein for infrainguinal arterial reconstructions. Recently, heparin bonding to the graft's luminal surface has been used as an adjunctive method of improving graft patency. We retrospectively evaluated a prospective experience with heparin-bonded ePTFE (HePTFE) vs the results of a prior experience with standard ePTFE (SePTFE) to compare patency rates in above-knee (AK) and below-knee (BK) femoropopliteal bypass through the 5-year follow-up.

Endovascular brachytherapy for renal artery in-stent restenosis.

Objective: Renal artery in-stent restenosis (RAISR) is not an infrequent occurrence and may be in part responsible for the failure of renal stents to improve clinical outcome. A variety of treatments have been used to restore patency, with mixed results. These include repeated percutaneous transluminal renal angioplasty (PTRA), repeated PTRA with bare-metal stents, and repeated PTRA with drug-eluting stents or covered stents.

Contralateral carotid artery occlusion is not a contraindication to carotid endarterectomy even if shunts are not routinely used.

Objective: Although controversial, carotid artery stenting (CAS) has been proposed as being safer than carotid endarterectomy (CEA) for patients with a contralateral internal carotid occlusion (CCO). Arguably, with a CCO, CAS should be even safer than CEA if a shunt is not used. Accordingly, we reviewed our experience with 2183 CEAs performed routinely without a shunt to evaluate the risk of CEA performed in a subset of 147 patients with a CCO.

Can pharmacologic agents slow abdominal aortic aneurysm growth?

Multiple medical therapies have been proposed to prevent abdominal aortic aneurysm expansion. Use of these medications, hormones, vitamins, and dietary products is based on their ability to alter the pathophysiology of continued aortic wall growth. In this review, the explanation of how these medications can achieve suppression of abdominal aortic aneurysm is explained in relation to their effect on the various aspects of aortic wall inflammation.

Influence and critique of the JUPITER Trial (Statins v no statins for primary prevention of cardiovascular events in patients with normal lipids and elevated C-reactive protein).

Perhaps no recent trial in primary prevention of cardiovascular disease has resulted in more controversy than the JUPITER (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin) trial, which was first published in 2008. The study evaluated a patient cohort previously considered to be "healthy," ie, men 50 years of age or older and women 60 years of age or older, who did not have a history of cardiovascular disease and, at the initial screening visit, had a low-density lipoprotein cholesterol level of <130 mg/dL (3.4 mmol/L) and a high-sensitivity C-reactive protein level ≥2.

Setting up an imaging center, adding CT, MR, [corrected] and an angiography suite to vascular labs.

Computed tomographic angiography (CTA), magnetic resonance angiography (MRA), and diagnostic arteriography are all vascular diagnostic tools that may be included in modern vascular diagnostic laboratories. Before undertaking the establishment of such an all-purpose diagnostic, and possibly interventional, facility the vascular specialist or group needs to ensure safe patient care and the ability to provide these diagnostic tests and procedures without incurring a financial loss. This article will detail one method of setting up such a facility and suggest some other approaches.

Setting up an outpatient imaging center: adding computed tomographic angiography, magnetic resonance angiography and an outpatient angiography suite to surgeon-run vascular laboratories.

Computed tomographic angiography, magnetic resonance angiography and diagnostic arteriography are all vascular diagnostic tools that should be included in modern vascular diagnostic laboratories. Before undertaking the establishment of such a facility, the vascular specialist or group needs to ensure safe patient care and the ability to provide such diagnostic tests and procedures without incurring a financial loss. This article will detail one method of setting up such a facility and suggest some other approaches.

Have statins changed the natural history of atheromatous disease and its treatment?

Statins are among the most widely prescribed medications in the world and there are now numerous clinical trials demonstrating the beneficial effects of these medications on the natural history of atheromatous disease and its treatment. There is now voluminous data to show that patients treated by vascular surgeons benefit from statins and that these medications do effect the natural history of atheroma, its consequences, and treatment. This article will attempt to summarize the more relevant data that highlights the beneficial effects of statins in patients with peripheral arterial disease and how use of these drugs affects cardio-, peripheral, and cerebrovascular risk.

The role of statin drugs in the management of the peripheral vascular patient.

The impact of statin therapy on established vascular conditions and recurrent disease is most relevant for long-term care. Patients receiving statin therapy have been shown to experience less recurrent stenosis following carotid endarterectomy and stent angioplasty, reduced cardiac events following cardiac and noncardiac vascular surgery, and reduction in aneurysm development. In patients with peripheral arterial disease, claudication distance is increased, as well as patency rates following infrainguinal arterial bypass grafting.