Multimodality Imaging Approach towards Primary Aortic Sarcomas Arising after Endovascular Abdominal Aortic Aneurysm Repair: Case Series Report.

Primary aortic neoplasms are rare. Aortic sarcoma arising after endovascular aneurysm repair (EVAR) is a scarce subset of primary aortic malignancies, reports of which are infrequent in the published literature. The diagnosis of aortic sarcoma is challenging due to its non-specific clinical presentation, and the prognosis is poor due to delayed diagnosis, rapid proliferation, and propensity for metastasis.

Surgical management of abdominal aortic aneurysms: a lost art?

Endovascular repair of abdominal aneurysms has become the dominant treatment modality for infrarenal aneurysms. Initial reports showed a constant number of open repairs although there was a shift toward complicated juxtra-renal aneurysms. In the past several years, more aggressive endoluminal approaches and the introduction of fenestrated grafts have appeared to dilute the open aneurysm operating experience.

Society for Vascular Surgery (SVS) Vascular Registry evaluation of comparative effectiveness of carotid revascularization procedures stratified by Medicare age.

Objective: Recent randomized controlled trials have shown that age significantly affects the outcome of carotid revascularization procedures. This study used data from the Society for Vascular Surgery Vascular Registry (VR) to report the influence of age on the comparative effectiveness of carotid endarterectomy (CEA) and carotid artery stenting (CAS).

Methods: VR collects provider-reported data on patients using a Web-based database.

Early protection and compression of residual limbs may improve and accelerate prosthetic fit: a preliminary study.

Background: The goal of rehabilitation following lower extremity amputation is to restore the highest level of independent function. As much as possible, this includes the functional use of a prosthetic device fitted to the residual limb. Early prosthetic fit depends, in turn, on rapid healing of the amputation site.

Society for Vascular Surgery Vascular Registry evaluation of stent cell design on carotid artery stenting outcomes.

Objective: The Society for Vascular Surgery (SVS) Vascular Registry (VR) collects data on outcomes of carotid endarterectomy and carotid artery stenting (CAS). The purpose of this study was to evaluate the impact of open vs closed cell stent design on the in-hospital and 30-day outcome of CAS.

Methods: The VR collects provider-reported data on patients using a Web-based database.

Hybrid repair of distal arch aortic aneurysms: endovascular elephant trunk completion.

Background: Traditional open repair of distal arch aortic aneurysms requires a two-stage procedure associated with significant morbidity and mortality. The introduction of thoracic endovascular aneurysm repair has created a less invasive option to complete the second stage of the repair after proximal elephant trunk creation. The present study reports a series of patients treated with a combined open proximal and endovascular distal repair of distal arch aortic aneurysms.

Long-term outcome of endovascular popliteal artery aneurysm repair.

Background: Popliteal artery aneurysms have traditionally been repaired with an open surgical approach. However, endovascular popliteal artery repair (EVPAR) has been used in selected patients because of its less invasive nature. In this report, we present our long-term outcomes for EVPAR.

A 5-year evaluation using the talent endovascular graft for endovascular aneurysm repair in short aortic necks.

Background: Although endovascular aneurysm repair has been shown to be an effective way to treat abdominal aortic aneurysm (AAA), certain anatomic characteristics such as a short aortic neck, limit its applicability. Initially, commercially available devices were approved only for the treatment of AAA with an aortic neck length ≥ 15 mm. The purpose of this study was to evaluate the outcomes of the recently approved Talent endograft for AAAs with a short aortic neck length (10-15 mm).

Who is unfit for carotid endarterectomy?

Carotid endarterectomy (CEA) has long been considered the "gold standard" in the treatment of patients with symptomatic or asymptomatic carotid stenosis. However, the utility of this treatment modality in medical or surgical "high-risk" patients remains in question. Numerous clinical trials have demonstrated that carotid angioplasty and stenting (CAS) is not inferior to CEA.

Arterial access for thoracic endograft placement.

Background: Endovascular repair of thoracic aortic disease continues to evolve since FDA approval of the first thoracic endograft in the United States in March 2005. Certain anatomic characteristics, including adequacy of arterial access, remain a significant limiting factor in thoracic endovascular repair. In clinical trials evaluating thoracic endografts, vascular access complications occurred in >20% of cases.

A comparative analysis of the outcomes of aortic cuffs and converters for endovascular graft migration.

Objective: Proximal attachment failure, often leading to graft migration, is a severe complication of endovascular aneurysm repair (EVAR). Aortic cuffs have been used to treat proximal attachment failure with mixed results. The Zenith Renu AAA Ancillary Graft (Cook Inc, Bloomington, Ind) is available in two configurations: converter and main body extension.

Society of vascular surgery vascular registry comparison of carotid artery stenting outcomes for atherosclerotic vs nonatherosclerotic carotid artery disease.

Objective: The Vascular Registry (VR) on carotid procedures collects long-term outcomes on carotid artery stenting (CAS) and carotid endarterectomy (CEA) patients. The purpose of this report is to describe in-hospital and 30-day CAS outcomes in patients with atherosclerotic carotid artery disease (CAD; atherosclerosis [ATH]) compared to recurrent carotid stenosis (RES) and radiation-induced stenosis (RAD).

Methods: The VR collects provider-reported data on CAS using a Web-based data management system.

Acceptable risk but small benefit of endovascular aneurysm repair in nonagenarians.

Background: We report the outcomes of a single-center experience with endovascular aneurysm repair (EVAR) in nonagenarians.

Methods: Via a retrospective medical records review, we identified all patients > or = 90 years old who underwent EVAR at a single university teaching hospital during a 5-year period (January 2004 to December 2008). Patients were evaluated for surgical risk factor profile, preoperative imaging, technical success, postoperative complications, length of hospital stay, and need for secondary intervention.

Patient-specific artery shrinkage and 3D zero-stress state in multi-component 3D FSI models for carotid atherosclerotic plaques based on in vivo MRI data.

Image-based computational models for atherosclerotic plaques have been developed to perform mechanical analysis to quantify critical flow and stress/strain conditions related to plaque rupture which often leads directly to heart attack or stroke. An important modeling issue is how to determine zero stress state from in vivo plaque geometries. This paper presents a method to quantify human carotid artery axial and inner circumferential shrinkages by using patient-specific ex vivo and in vivo MRI images.

Incidence of deep venous thrombosis after subarachnoid hemorrhage.

Object: The aim of this study was to determine the efficacy of venous ultrasonography in screening for deep venous thrombosis (DVT) after subarachnoid hemorrhage (SAH). A large cohort of patients who had suffered SAH was evaluated with the primary end points of ascertaining the incidence of asymptomatic DVT with venous Doppler ultrasonography screening and of identifying risk factors for the development of DVT and subsequent pulmonary embolism.

Methods: Data from patients with aneurysmal SAH who had been admitted to the neurosurgical intensive care unit (ICU) between December 2002 and October 2006 were retrospectively evaluated.

Risk-adjusted 30-day outcomes of carotid stenting and endarterectomy: results from the SVS Vascular Registry.

Objective: As the first operational societal registry of carotid procedures, the Outcomes Committee of the Society for Vascular Surgery (SVS) developed the Vascular Registry (VR) in response to the Centers for Medicare and Medicaid Services' (CMS) National Coverage Decision on carotid artery stenting (CAS). Although CMS requires data submission only on CAS, the VR collects similar data on carotid endarterectomy (CEA) to allow comparison of outcomes, as well as potential for expansion to other procedures.

Methods: SVS-VR on-line provider-reported data include baseline through follow-up visits to better understand long-term risks and benefits associated with CAS and CEA.

Clinical significance of endoleak detected on follow-up CT after endovascular repair of abdominal aortic aneurysm.

Objective: The purpose of this study was to evaluate the clinical significance of endoleaks detected on combined arterial and delayed contrast-enhanced follow-up CT examinations of patients who have undergone endovascular aneurysm repair of abdominal aortic aneurysm.

Materials And Methods: One hundred forty-four patients underwent periodic follow-up CT examinations 12-72 months after abdominal aortic aneurysm repair. The CT protocol consisted of an unenhanced scan and contrast-enhanced scans in the arterial and 90-second delayed phases.

Complications of carotid artery stenting are largely preventable: a retrospective error analysis.

Procedure-related complications with carotid artery stenting must be minimized for it to be a valid treatment for carotid stenosis. Failure analysis was done for 207 carotid stent procedures. All complications were reviewed and technical errors were identified.

Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts.

Between 43,000 and 47,000 people die annually in the United States from diseases of the aorta and its branches and continues to increase. For the thoracic aorta, these diseases are increasingly treated by stent-grafting. No prospective randomized study exists comparing stent-grafting and open surgical treatment, including for disease subgroups.

Mid-term outcomes of endovascular popliteal artery aneurysm repair.

Objective: This study documents mid-term outcomes of a series of endovascular popliteal aneurysm repairs compared with concurrent results of open surgical repair.

Methods: A retrospective chart review was done of all popliteal artery aneurysm repairs since January 1, 2000. Patency was defined as continued presence of palpable pulses or maintenance of postoperative ankle-brachial index +/- 0.