Ann Vasc Surg 2012; 26(6) Originals

1. Ann Vasc Surg. 2012 Aug;26(6):885. doi: 10.1016/j.avsg.2012.03.004.

Femorofemoral bypass in addition to femoropopliteal bypass.

Gokalp O, Yurekli I, Gur S, Bademci M, Ozcem B, Gurbuz A. Comment on

Femorofemoral bypass as an alternative to a direct aortic approach in daily practice: appraisal of its current indications and midterm results. [Ann Vasc Surg. 2012]

PMID: 22794338 [PubMed - indexed for MEDLINE] Related citations

2. Ann Vasc Surg. 2012 Aug;26(6):884-5. doi: 10.1016/j.avsg.2012.02.003.

Modified "stent-graft sandwich" technique for treatment of isolated common iliac artery aneurysm in patient with Marfan syndrome.
Bozzani A, Arici V, Odero A. Comment on

Modified "stent-graft sandwich" technique for treatment of isolated common iliac artery aneurysm in patient with Marfan syndrome. [Ann Vasc Surg. 2012]

PMID: 22794337 [PubMed - indexed for MEDLINE] Related citations

3. Ann Vasc Surg. 2012 Aug;26(6):883-4. doi: 10.1016/j.avsg.2012.02.002.

How to perform aortic arch debranching in the hybrid procedure applied to the thoracic aorta: total or partial?
Gokalp O, Yilik L, Yetkin U, Yurekli I, Gunes T, Gurbuz A. Comment on

Thoracic endovascular repair (TEVAR) in the management of aortic arch pathology. [Ann Vasc Surg. 2012]

PMID: 22794336 [PubMed - indexed for MEDLINE] Related citations

4. Ann Vasc Surg. 2012 Aug;26(6):862-70. doi: 10.1016/j.avsg.2012.02.005.

Opportunities in abdominal aortic aneurysm epidemiology, genetics, and pathophysiology.

Kuivaniemi H, Elmore JR. Source

research:

Department of Vascular and Endovascular Surgery, The Sigfried and Janet Weis Center for Research, Geisinger Clinic, Danville, PA 17822-2610, USA. shkuivaniemi@geisinger.edu Abstract Aortic aneurysms are a complex genetic disorder with known environmental risk factors such as smoking. Along the length of the aorta, significant heterogeneity occurs in the distribution of aneurysmal disease. The prevalence of aneurysm in the abdominal aorta is at least nine times higher than that in the thoracic section of the aorta. A number of studies have shown that aortic aneurysms are frequently familial, even when they are not associated with rare heritable disorders such as Marfan syndrome or Ehlers-Danlos syndrome type IV. The pathobiology of aortic aneurysms is complex and largely unsolved. Unbiased whole-genome approaches are now being used to elucidate the genetic basis of aortic aneurysms to uncover the germline genetic variants that influence the disease risk. The findings will provide critical information about underlying biology of the disease and will help identify potential targets for pharmacological therapies. These studies may lead to therapies that may increase survival rates for individuals with aortic aneurysms and reduce the need for surgical interventions. Abdominal aortic aneurysms were the topic of an international conference "Abdominal Aortic Aneurysm: Epidemiology, Genetics, and Pathophysiology" held recently at the Geisinger Clinic, Danville, Pennsylvania.

Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794334 [PubMed - indexed for MEDLINE] Related citations

5. Ann Vasc Surg. 2012 Aug;26(6):852-7. doi: 10.1016/j.avsg.2011.12.013.

Comparison of outcomes of one-stage basilic transpositions and two-stage basilic vein transpositions.

vein

Syed FA, Smolock CJ, Duran C, Anaya-Ayala JE, Naoum JJ, Hyunh TT, Peden EK, Davies MG. Source Dialysis Access Program, Methodist DeBakey Heart & Vascular Center, The Methodist Hospital, Houston, TX 77030, USA. Abstract BACKGROUND: Basilic vein transpositions (BVTs) provide autologous hemodialysis access in the upper extremity. We report and compare our experience using the two techniques that are commonly performed to create BVTs: the one-stage and the two-stage technique. METHODS: A retrospective review was performed on patients who underwent BVT from June 2006 to June 2010 from a database of all patients undergoing dialysis access procedures. One hundred six patients, mean age of 54 years (41% male), who received upper-arm basilic vein-only transposition were identified and were stratified based on one-stage and two-stage BVTs. Anatomic outcomes and functionality were determined and compared between stages. RESULTS: Seventy-seven patients underwent two-stage BVT, and 29 underwent one-stage BVT. Fifty-one percent and 79% of the two-stage group and the one-stage group, respectively, had had a previous failed ipsilateral permanent access. Catheter dialysis at time of surgery was 14% in one-stage BVT and 43% in two-stage BVT. Immediate technical success was obtained in all cases. The rate of primary failure was 21% in the one-stage group and 18% in the two-stage group. Reintervention rates for the onestage group and the two-stage group were 62% and 66%, respectively. Primary patency for the one-stage group and the two-stage group at 1 year was 82% and 67%, at 2 years was 81% and 27%, and at 3 years was 51% and 18%, respectively.

Secondary patency for the one-stage group and the two-stage group at 1 year was 91% and 81%, at 2 years was 80% and 61%, and at 3 years was 58% and 45%, respectively. Thirty-day mortality was 0% in both groups, and all-cause morbidity was 12% in both groups (counting all stages). CONCLUSION: One-stage BVTs have a similar number of initial failures and secondary interventions as two-stage BVTs. One-stage BVTs achieved better primary and cumulative patencies. There appears to be no advantage to a two-stage BVT in equally matched patients. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794333 [PubMed - indexed for MEDLINE] Related citations

6. Ann Vasc Surg. 2012 Aug;26(6):845-51. doi: 10.1016/j.avsg.2012.01.022.

Long-term experience of endovascular aneurysm repair with Zenith prosthesis: diminishing graft-related complications over time.
Vrmki S, Suominen V, Pimenoff G, Saarinen J, Salenius J. Source Division of Vascular Surgery, Department of Surgery, Tampere University Hospital, Tampere, Finland. suvi.vaaramaki@uta.fi Abstract BACKGROUND: Only limited data on the long-term results after endovascular aneurysm repair exist to date. MATERIALS: Data on 282 patients with an abdominal aortic aneurysm treated with a Zenith endoprosthesis between March 2000 and March 2010 were retrospectively analyzed from a prospective database. Operative, total, and aneurysm-related mortality was assessed, as were graft-related complications and reinterventions. RESULTS:

All procedures were performed successfully without primary conversions. Median follow-up was 40 months (range: 1-119 months). Thirty-day mortality was 1.4%, and aneurysm-related mortality was 0.7%. Cumulative survival was 62% at 5 years and 52% at 8 years. Graft-related complications occurred in 107 (38%) patients. The most common finding was a type II endoleak (n = 73) that sealed mainly spontaneously (n = 46, 63%). Most endoleaks, and complications in general (87%), appeared during the first 3 years of follow-up, and no events occurred after 6 years. Altogether, 59 additional procedures, mainly embolizations (n = 35), in 38 patients (24%) were required owing to graft-related complications. Of all the reinterventions, 82% were performed during the first 4 years, and no new complications were treated after 6 years. CONCLUSION: Complications and reinterventions related to endovascular aneurysm repair become practically nonexistent after 5 to 6 years. This finding suggests that a lifelong follow-up may not always be needed after treatment with a Zenith endoprosthesis. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794332 [PubMed - indexed for MEDLINE] Related citations

7. Ann Vasc Surg. 2012 Aug;26(6):775-82. doi: 10.1016/j.avsg.2012.01.020.

Perioperative approach in the surgical management of carotid body tumors.

Zhang TH, Jiang WL, Li YL, Li B, Yamakawa T. Source Department of Vascular Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, People's Republic of China. Abstract BACKGROUND: Now, surgical resection still remains the gold standard for the treatment of carotid body tumors (CBTs). Although advances in surgical techniques and the introduction of sensitive imaging modalities have significantly reduced mortality, the incidence of perioperative neurovascular complications, especially cranial nerve deficit and intraoperative hemorrhage, remains considerable. To solve these problems, preoperative embolization has been suggested; the reported benefits of preoperative embolization performed <48 hours before surgery include a reduction in tumor size,

decreased blood loss, and improved visualization, theoretically reducing neurologic morbidity by lessening the risk of stroke and damage to cranial nerves. The purpose of this study was to review our experience in the surgical management of CBTs with preoperative embolization and evaluate the outcomes and complications according to the Shamblin classification. METHODS: Thirty-two patients who had been diagnosed with and surgically treated for CBTs were enrolled from January 2005 till July 2010. All perioperative scans were evaluated by computed tomography angiography. We reviewed patient demographics, radiographic findings, and surgical outcomes collected from medical records. RESULTS: Thirty-two patients underwent surgical excision without mortality. Angiography with selective preoperative tumor embolization was performed on 21 patients. The median blood loss, operation time, and hospital stay for these patients were significantly reduced compared with those without embolization. There were no recurrences or delayed complications at the median follow-up of 20 months. CONCLUSION: Embolization as an adjunctive tool was beneficial for CBT surgery outcomes. Embolization should only be undertaken in those vessels that can be subselectively catheterized and determined not to allow free reflux of contrast medium into the internal carotid artery. Tumor embolization was performed on patients with Cook detachable coils, which are highly effective for supply artery closure if properly selected, and complications can be minimized by proper selection and positioning of the coil. Operation within 48 hours after embolization is recommended to minimize revascularization edema or a local inflammatory response. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794331 [PubMed - indexed for MEDLINE] Related citations

8. Ann Vasc Surg. 2012 Aug;26(6):783-9. doi: 10.1016/j.avsg.2012.01.021. Epub 2012 Jun 22.

Surgical treatment of carotid restenosis after eversion endarterectomy--Serbian bicentric prospective study.
Radak D, Davidovic L, Tanaskovic S, Koncar I, Babic S, Kostic D, Ilijevski N. Source

Vascular Surgery Clinic, School of Medicine, Belgrade Cardiovascular Institute, Belgrade, Republic of Serbia. Abstract BACKGROUND:

University,

Dedinje

The increased number of carotid endarterectomies performed worldwide in recent years is associated with a greater need for carotid restenosis evaluation. Carotid restenosis rate ranges from 0.6% to 3.6% in symptomatic patients and from 8.8% to 19% in asymptomatic patients. Carotid angioplasty and stenting is a preferable therapeutic choice for carotid restenosis treatment, but whenever it is not technically feasible (tortuosities of supra-aortic branches, calcifications, pathological elongation, or very extensive lesions), redo surgical treatment is indicated. The aim of our study was to examine outcome of redo surgical treatment in patients with symptomatic and asymptomatic carotid restenosis, in whom carotid angioplasty could not be done, and its impact on early and late morbidity and mortality. METHODS: The study included 52 patients who were surgically treated for significant carotid restenosis from January 2000 to December 2008 in two high-volume vascular surgery university clinics. Surgical techniques included redo eversion endarterectomy, standard endarterectomy with Dacron patch closure, and Dacron tubular graft interposition. The patients were followed for significant events (transient ischemic attack, stroke, cranial nerve injuries, surgical site hematoma, the occurrence of carotid re-restenosis, or occlusion), and mortality after 1 month, 6 months, 1 year, and annually afterward. RESULTS: In the early postoperative period (within 30 days), there were no lethal outcomes. Transient ischemic attack was diagnosed in four patients (7.6%), minor stroke in two patients (3.8%), and cranial nerve injury in four patients (7.6%). After 4 years, three patients died (5.7%), two due to a fatal myocardial infarction (3.8%) and one after a major stroke (1.9%); four patients (7.6%) had ipsilateral stroke; and graft occlusion was verified in one patient (1.9%). CONCLUSION: Carotid angioplasty might be a primary option for carotid restenosis treatment, but whenever it cannot be performed, redo surgical treatment is indicated, owing to its acceptable rate of early and late postoperative complications. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22728108 [PubMed - indexed for MEDLINE] Related citations

9. Ann Vasc Surg. 2012 Aug;26(6):825-32. doi: 10.1016/j.avsg.2012.01.010. Epub 2012 Jun 22.

Major vascular injury during nonvascular surgeries.

Yoo TK, Min SK, Ahn S, Kim SY, Min SI, Park YJ, Ha J, Kim SJ. Source Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. Abstract BACKGROUND: Intraoperative vessel injuries can be serious enough to threaten the patient's survival. This study was performed to analyze the pattern, management, and outcome of intraoperative major vessel injuries and to clarify the risk factors leading to the injury. METHODS: From January 2007 to July 2010, patients with intraoperative vessel injuries during nonvascular surgeries that were treated by vascular surgeons at a tertiary referral center were enrolled, and electronic medical records were reviewed retrospectively. RESULTS: Twenty-seven intraoperative vessel injuries occurred during urologic (29.6%), general (29.6%), orthopedic (22.2%), gynecologic (14.8%), or neurosurgical (3.7%) operations. There were 17 cancer surgeries (63.1%), 3 benign tumor surgeries (11.1%), 2 nephrectomies, 2 spine surgery, and 1 knee arthroplasty. A vascular surgeon was contacted intraoperatively in 23 cases and postoperatively in 4. The presenting symptoms in the intraoperative contact group were bleeding (n = 21), bowel ischemia (n = 1), and decreased intraoperative sensory evoked potential (n = 1). In comparison, the presenting symptoms in the postoperative delayed contact group were leg ischemia in three cases and hematochezia in one case. All cases were arterial injuries in this group. There was one mortality (25%) due to ischemia-reperfusion syndrome and two significant morbidities (50%) that needed secondary operations including amputation and stent-graft insertion. CONCLUSIONS: Intraoperative vessel injury was most common in cancer surgery. The mortality and morbidity rate was higher in the postoperative late contact group. Early diagnosis and prompt contact to a vascular surgeon could reduce serious complications. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22728107

[PubMed - indexed for MEDLINE] Related citations

10. Ann Vasc Surg. 2012 Aug;26(6):755-65. doi: 10.1016/j.avsg.2011.12.015. Epub 2012 Jun 22.

Eversion carotid endarterectomy is associated with impaired postoperative hemodynamic stability compared with the conventional technique.
Demirel S, Attigah N, Bruijnen H, Hakimi M, Macek L, Bckler D. Source Department of Vascular and Endovascular Surgery, University Hospital of RuprechtKarls, Heidelberg, Germany. serdar.demirel@med.uni-heidelberg.de Abstract BACKGROUND: Carotid endarterectomy is associated with a profound effect on blood pressure. The aim of this study was to evaluate 24-hour ambulatory blood pressure measurements (ABPMs) after eversion carotid endarterectomy (E-CEA) and conventional carotid endarterectomy (C-CEA). METHODS: Seventy-one patients were included in this prospective study (E-CEA [37]/C-CEA [34]). Daytime (8 AM-10 PM) and nighttime (10 PM-8 AM) ABPMs were analyzed preoperatively and on postoperative days 1 and 3. RESULTS: Patients' demographics and preoperative antihypertensive regimens were similar in the two groups. Compared with baseline, ABPM decreased on postoperative day 1 in the C-CEA group (P < 0.01) but normalized by day 3. By contrast, ABPM values were unchanged on day 1 in the E-CEA group but increased above baseline on day 3 (P < 0.01). E-CEA was associated with higher ABPM on day 1 (daytime: P < 0.001; nighttime: P < 0.01) and again on day 3 (daytime: P < 0.001; nighttime: P < 0.01). The use of vasodilators was more frequent in the E-CEA group, both in the recovery room (P = 0.007) and on the ward (P = 0.004). CONCLUSION: E-CEA may be associated with higher postoperative blood pressure and the need for more additional antihypertensive therapy in the postoperative period compared with CCEA.

Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22728106 [PubMed - indexed for MEDLINE] Related citations

11. Ann Vasc Surg. 2012 Aug;26(6):833-8. doi: 10.1016/j.avsg.2012.02.009. Epub 2012 Jun 21.

Treatment of lymphocutaneous fistulas after vascular procedures of the lower limb: accurate wound reclosure and 3 weeks of consistent and continuing drainage.
Van den Brande P, von Kemp K, Aerden D, Debing E, Vanhulle A, Staelens I, Haentjens P. Source Department of Vascular Surgery, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium. pierre.vandenbrande@uzbrussel.be Abstract BACKGROUND: Lymphocutaneous fistulas occurring after vascular procedures of the lower limb are a rare, but frustrating, complication. Many treatment options exist, but may lead to inconsistent results, with infection, delayed wound healing, and prolonged hospital stay. We present a simple surgical treatment of wound closure and drainage. METHODS: In this single-center, single-intervention, observational clinical study (case series), prospectively collected data of 23 consecutive lymphocutaneous fistulas in 22 patients (19 male and three female; age, 42 to 91 years) treated between June 2005 and October 2008 were retrospectively analyzed. Twenty-two fistulas were situated in the groin and one at the knee incision. The standardized therapy consisted of the installation of a Redon to drain the lymph, and accurate closure of the wound. Postoperatively, drainage was maintained for 21 days: suction Redon drainage for the first 7 days, passive Redon drainage for the next 7 days, and further drainage in a pouch after removal of the drain for the last 7 days. RESULTS: In 19 of the initial 23 lymphocutaneous fistulas, the whole drainage procedure was completed, with healing of the wound, without infection, recurrence, or lymphocele formation after 1 year of follow-up. In these cases, there had been a steady decrease

of daily lymph drainage: a mean of 163.4 (standard error on the mean, 39.6) mL on the first day of suction, 56.8 (15.5) mL on the first day of passive drainage, 11.6 (4.3) mL on the last day of passive drainage, and 2.1 (0.9) mL on the 21st day when the drainage treatment was stopped. In four fistulas, this treatment was considered a failure because of inadvertent early drain removal (two cases), infection (one case), and lymphorrhea recurrence with wound breakdown (one case). CONCLUSION: This standardized surgical therapy, consisting of accurate wound closure and 3 weeks of drainage, allowed the healing of 19 of 23 postoperative lymphocutaneous fistulas (an 82.6 % success rate), without infection, recurrence, or lymphocele formation after 1 year of follow up. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22727062 [PubMed - indexed for MEDLINE] Related citations

12. Ann Vasc Surg. 2012 Aug;26(6):802-8. doi: 10.1016/j.avsg.2011.12.011. Epub 2012 Jun 19.

Outcomes after heparin-induced thrombocytopenia in patients with Propaten vascular grafts.

Kasirajan K. Source Natural Molecular Testing kasi@naturalmolecular.com Abstract BACKGROUND: Heparin-induced thrombocytopenia (HIT) can result in a life- or limb-threatening condition that can be reversed with early detection and prompt discontinuation of systemic heparin. The advent of heparin-bonded grafts may introduce a new level of complexity in some patients with a suspected diagnosis of HIT. This review evaluates the outcomes of patients who received the Gore Propaten vascular graft with a subsequent suspicion of HIT. METHODS: Corporation, Walnut Creek, CA 94596, USA.

This is a retrospective analysis of cases with suspected type II HIT after implant of the Propaten vascular graft that were reported to W.L. Gore & Associates. Data reviewed included clinical studies, including physician-sponsored studies, both inside and outside the United States; published literature; and Gore's product surveillance records. RESULTS: Overall, as of June 2011, there have been 27 cases (27 patients and 30 vascular grafts) of suspected HIT after graft implant. Of these 27 patients, 18 were tested for HIT antibodies (enzyme-linked immunosorbent assay, heparin-induced platelet activation test, serotonin release assay, drug-induced platelet activation test, platelet aggregation test, an HIT panel, or an unknown HIT test), with a positive test result in 17 of the 18 cases. In 5 of the 18 cases, patients were tested with two distinct HIT assays, resulting in one positive and one negative test. Among patients with available data, the mean preoperative heparin dose was 4850 1634 U, and four patients had a postoperative heparin drip. The mean preoperative platelet count was 227,000 71,616. Mean platelet count at time of diagnosis of HIT was 53,429 36,832. For the majority of those patients known to have had heparin discontinued once HIT was suspected, Argatroban was the anticoagulant of choice. Sixteen patients had grafts that remained implanted and in circulation, eight patients had grafts that were explanted, two patients had grafts that were ligated in situ, and the outcome was unknown for one patient. Among the 16 patients with grafts remaining in circulation, four grafts required thrombectomy for occlusion. Two patients died, one other patient had a remote thrombotic event, and the remaining patients had no reported adverse events. Among the 10 patients with graft removal or ligation, six had a graft occlusion, four required an amputation, and two died. Among the cases in which the recovery of platelet count was reported after systemic heparin was discontinued, the majority were cases in which the grafts were left in circulation. CONCLUSION: Analysis of the cases of suspected HIT in patients with implanted Propaten vascular grafts reveals that the HIT observed appears to be related to the systemic administration of heparin. After discontinuation of systemic heparin, platelet counts normalized in the presence of patent Propaten vascular grafts. Hence, based on current data, our recommendation would be to tailor treatment to individual patients. Functioning grafts in patients with or without thrombotic events and return of platelet count to normal values may not require grafts to be explanted in the presence of HIT. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22717356 [PubMed - indexed for MEDLINE] Related citations

13. Ann Vasc Surg. 2012 Aug;26(6):766-74. doi: 10.1016/j.avsg.2011.12.009. Epub 2012 Jun 19.

Influence of the contralateral carotid artery on carotid surgery outcome.

Kretz B, Abello N, Astruc K, Terriat B, Favier C, Bouchot O, Brenot R, Steinmetz E. Source Service de Chirurgie Cardio-vasculaire, benjamin.kretz@wanadoo.fr Abstract BACKGROUND: Any obstacle in the contralateral artery has long been considered a high risk for carotid surgery. Here, we report the results of a monocentric, continuous, consecutive, prospective series and present a review of the literature. METHODS: All carotid endarterectomies performed under locoregional anesthesia in our department between 2003 and 2010 were recorded in a prospective database (n = 1,212). Different statuses of the contralateral carotid artery--occlusion (group O, n = 81) and stenosis of >60% (group S, n = 173)--were compared with a control group (group C, n = 958). A shunt was used in cases of clinical intolerance to clamping. The assessment criteria concerned the need for a shunt and the combined 30-day nonfatal stroke and death rate. A stepwise logistic regression was performed. RESULTS: Overall, a shunt was necessary in 7.3% of cases. The proportion was greater in group O (25.9%, P < 0.001). Severe renal insufficiency (odds ratio [OR] = 1.94) and contralateral carotid occlusion (OR = 5.53) were the sole factors predicting the need for shunting. The overall 30-day nonfatal stroke and death rate was 2.5%, with no difference between groups (P = 0.738), and severe renal insufficiency was the single predictor of a poor outcome (OR = 3.11; 95% confidence interval: 1.21-7.97; P = 0.18). CONCLUSION: In this series, and in a large review of literature, occlusion of the contralateral internal carotid artery increased the incidence of intolerance to clamping and thus the use of shunts but did not worsen postoperative morbidity and mortality. The presence of a stenosed contralateral carotid was not predictive of postoperative events. In our experience, the status of the contralateral carotid artery cannot be considered a high risk for carotid surgery. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22717355 [PubMed - indexed for MEDLINE] Related citations CHU Le Bocage, Dijon, France.

14. Ann Vasc Surg. 2012 Aug;26(6):797-801. doi: 10.1016/j.avsg.2011.11.034. Epub 2012 May 22.

Safety and efficacy of surgical treatment of carotid stump syndrome: pilot study.
Hrb T, Bene V, irek P, Jonszta T, Herzig R, Prochzka V, Skoloudk D. Source Department of Neurosurgery, University Hospital Ostrava, Ostrava, Czech Republic. Abstract Surgical exclusion of the internal carotid artery (ICA) stump combined with endarterectomy of the external carotid artery is an established treatment approach. The aim of this pilot study was to compare the risk of cerebrovascular events between surgical treatment and best medical treatment in patients with ICA occlusion and carotid stump syndrome. Forty patients (23 males; age: 43-80 years; mean age: 61.1 9.0 years) with carotid occlusion and carotid stump syndrome were enrolled. Ten patients with asymptomatic ICA occlusion and 10 patients with symptomatic ICA occlusion and carotid stump syndrome were enrolled to the best medical therapy group. Patients with chronic ICA occlusion, carotid stump syndrome, and one (15 patients) or recurrent (three patients) episodes of ipsilateral stroke or transient ischemic attack were enrolled to the surgical group. Neurological examination was undertaken on the day of randomization and then every 6 months in all patients for 4 years. All vascular events and death were recorded. Only one vascular event occurred in patients with symptomatic ICA occlusion without recurrent stroke or transient ischemic attack who were treated medically. No other vascular event was noted in the other subgroups. One patient with symptomatic carotid occlusion without recurrent stroke died due to myocardial infarction 6 months after surgery. Surgical treatment of carotid stump syndrome seems to be a safe procedure. Nevertheless, the benefit of a surgical approach in comparison with the best medical treatment is not clear. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22622073 [PubMed - indexed for MEDLINE] Related citations

15. Ann Vasc Surg. 2012 Aug;26(6):790-6. doi: 10.1016/j.avsg.2011.09.012. Epub 2012 Apr 24.

Carotid artery surgery: high-risk patients or high-risk centers?

Bouziane Z, Nourissat G, Duprey A, Albertini JN, Favre JP, Barral X. Source Department of vascular surgery, St Etienne University Hospital, St Etienne, France. zakibouzi@yahoo.fr Abstract BACKGROUND: Carotid angioplasty and stenting has been proposed as an alternative to carotid endarterectomy (CEA) in patients deemed as at high risk for this surgical procedure. To date, definitely accepted criteria to identify "high-risk" patients for CEA do not exist. Our objective was to assess the relevance of numerous supposed high-risk factors in our experience, as well as their possible effect on our early postoperative results. METHODS: A retrospective review of 1,033 consecutive CEAs performed during a 5.6-year period at a single institution was conducted (Vascular Surgery Department, St. Etienne University Hospital, France). Early results in terms of mortality and neurologic events were recorded. Univariate and multivariate analyses for early risk of stroke, myocardial infarction, and death were performed, considering the influence of age, sex, comorbidities, clinical symptoms, and anatomic features. RESULTS: The cumulative 30-day stroke and death rate was 1.2%. A total of 10 strokes occurred and resulted in three deaths. The postoperative stroke risk was significantly higher in the subgroup of patients treated for symptomatic carotid artery disease: 2,6% (P = 0,004). Univariate analysis and logistic regression did not show statistical significance for 30-day results in any of the considered variables. CONCLUSION: Patients with significant medical comorbidities, contralateral carotid occlusion, and high carotid lesions can undergo surgery without increased complications. Those parameters should not be used as exclusion criteria for CEA. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22534262 [PubMed - indexed for MEDLINE] Related citations

16. Ann Vasc Surg. 2012 Aug;26(6):839-44. doi: 10.1016/j.avsg.2011.08.026. Epub 2012 Mar 22.

Aortic aneurysm surgery: long-term patency of the reimplanted intercostal arteries.

David N, Roux N, Douvrin F, Clavier E, Bessou JP, Plissonnier D. Source Department of Vascular Surgery, Rouen University Hospital, Rouen, France. Abstract BACKGROUND: During aortic surgery, the long-term patency of reimplanted intercostal arteries is unknown, limiting the relevance to preserve spinal cord vascularization. METHODS: Between January 2001 and January 2007, 40 patients were operated for either thoracic aortic aneurysm (TAA) or thoracoabdominal aortic aneurysm (TAAA). Twenty cases of aneurysms limited to the proximal descending thoracic aorta were treated using endovascular repair, without preoperative spinal cord artery identification. Twenty patients--seven with extensive TAA, seven with type I TAAA, two with type II TAAA, and four with type III TAAA--underwent open surgery. Before open surgery, preoperative angiography was performed to identify spinal cord vascularization; in one case, the angiography failed to identify it. The segmental artery destined to the spinal cord artery was identified as originating from outside the aneurysm in 7 patients and inside the aneurysm in 12 patients: T6 R (1), T8 L (2), T9 L (3), T10 L (3), T11 L (3), L1 L (1). During the surgery, normothermic and femorofemoral bypass was used for visceral protection. All segmental arteries identified as critical before surgery were reattached in the graft. Twenty-four months later, computed tomography scans were performed to assess the patency of the reattached segmental arteries. RESULTS: Three patients died, including one with paraplegia (T9 L). No other cases of paraplegia were reported. Computed tomography scans were performed in 10 patients. Segmental artery reattachment was patent in nine patients. CONCLUSION: Our experience indicates the long-term patency of reimplanted segmental artery, without any convincing evidence of its utility in preventing neurologic events during TAA and TAAA direct repair. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

PMID: 22445246 [PubMed - indexed for MEDLINE] Related citations

17. Ann Vasc Surg. 2012 Aug;26(6):809-18. doi: 10.1016/j.avsg.2011.09.005. Epub 2012 Feb 8.

Comparison of early and midterm results of open and endovascular treatment of popliteal artery aneurysms.
Pulli R, Dorigo W, Fargion A, Pratesi G, Innocenti AA, Angiletta D, Pratesi C. Source Department of Vascular Surgery, University of Florence, Florence, Italy. rpulli@unifi.it Abstract BACKGROUND: Aim of this study was to retrospectively compare perioperative (<30 days) and 2-year results of open and endovascular management of popliteal artery aneurysms (PAAs) in a single-center experience. METHODS: From January 2005 to December 2010, 64 PAAs in 59 consecutive patients were operated on at our institution; in 43 cases, open repair was performed (group 1), whereas the remaining 21 cases had an endovascular procedure (group 2). Data from all the interventions were prospectively collected in a dedicated database, which included main preoperative, intraoperative, and postoperative parameters. Early results in terms of mortality, graft thrombosis, and amputation rates were analyzed and compared by (2) text or Fisher exact text. The surveillance program consisted of clinical and ultrasonographic examinations at 1, 6, and 12 months and yearly thereafter. Follow-up results (survival, primary and secondary patency, limb salvage) were analyzed by Kaplan-Meier curves, and differences in the two groups were assessed by log-rank test. RESULTS: There were no differences between the two groups in terms of sex, age, risk factors for atherosclerosis, and comorbidities; PAAs were symptomatic in 48% of cases in group 1 and in 29% in group 2 (P = 0.1). Fifteen patients with mild-to-moderate acute ischemia due to PAA thrombosis underwent preoperative intra-arterial thrombolysis, 13 in group 1 and 2 in group 2. In open surgery group, nine cases were treated with aneurysmectomy and prosthetic graft interposition, and in seven cases, the aneurysm was opened and a prosthetic graft was placed inside the aneurysm. In 27 cases, ligation of the aneurysm with bypass grafting (21 prosthetic grafts and 6 autologous

veins) was carried out. In group 2, 20 patients had endoprosthesis placement, whereas in the remaining patient, a multilayer nitinol stent was used. There was one perioperative death in a patient of group 2 who underwent concomitant endovascular aneurysm repair and PAA endografting. Cumulative 30-day death and amputation rate was 4.5% in group 1 and 4.7% in group 2 (P = 0.9). Follow-up was available in 61 interventions (96%) with a mean follow-up period of 22.5 months (range: 1-60). Estimated primary patency rates at 24 months were 78.1% in group 1 and 59.4% in group 2 (P = 0.1). Freedom from reintervention rates at 24 months were 79% in group 1 and 61.5% in group 2 (P = 0.2); estimated 24-month secondary patency rates were 81.6% in group 1 and 78.4% in group 2 (P = 0.9), and freedom from amputation rates were 92.7% and 95%, respectively (P = 0.7). CONCLUSIONS: Endovascular treatment of PAAs provided, in our initial experience, satisfactory perioperative and 1-year results, not significantly different from those obtained with prosthetic open repair in patients with similar clinical and anatomical status. There is, however, a trend toward poorer primary patency rates among patients endovascularly treated, who also seem to require more frequently a reintervention. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22321483 [PubMed - indexed for MEDLINE] Related citations

18. Ann Vasc Surg. 2012 Aug;26(6):871-80. doi: 10.1016/j.avsg.2011.11.005. Epub 2012 Jan 27.

Buerger's disease.
Dargon PT, Landry GJ. Source Department of Surgery, Oregon Health and Science University, Portland, OR 97239, USA. Abstract Buerger's disease (thromboangiitis obliterans) is a nonatherosclerotic segmental inflammatory disease of small- and medium-sized arteries of the distal extremities of predominantly young male tobacco users. Early symptoms may include episodic pain and coldness in fingers, and late findings may present as intermittent claudication, skin ulcers, or gangrene requiring eventual amputation. Tobacco cessation is the cornerstone of treatment. Other modalities of reducing pain or avoiding amputation

have not been as successful. This review summarizes in tabular form the types of treatment that have been used, including therapeutic angiogenesis. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22284771 [PubMed - indexed for MEDLINE] Related citations

Ann Vasc Surg 2012; 26(6) Case Reports

1. Ann Vasc Surg. 2012 Aug;26(6):861.e7-9. doi: 10.1016/j.avsg.2012.01.013.

Transesophageal echocardiography guidance for stent-graft repair of a thoracic aneurysm is facilitated by the ability of partial stent deployment.
Crimi E, Lee JT, Dake MD, van der Starre PJ. Source Department of Anesthesia, Stanford University School of Medicine, Stanford, CA 94305, USA. Abstract Transesophageal echocardiography (TEE) is routinely used in our Institution for monitoring correct positioning of thoracic aortic stent grafts. We present a case of successful endovascular repair of three discrete thoracic aortic aneurysms with Zenith TX2 endovascular stent grafts in an 82-year-old female patient. Our focus is on the increased value of TEE guidance because of the ability of partial stent deployment and manipulation during insertion. Copyright 2012. Published by Elsevier Inc. PMID: 22794345 [PubMed - indexed for MEDLINE] Related citations

2. Ann Vasc Surg. 2012 Aug;26(6):861.e11-5. doi: 10.1016/j.avsg.2012.01.016.

Endovascular repair of an iliac arteriovenous fistula secondary to perforation from a common iliac aneurysm in a patient with Ehler-Danlos syndrome.
Sala Almonacil VA, Zaragoz Garca JM, Gmez Palons FJ, Plaza Martnez , Ortz Monzn E. Source

Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitario Doctor Peset, Valencia, Spain. sala_and@gva.es Abstract BACKGROUND: Type IV Ehler-Danlos syndrome (EDS) patients are prone to life-threatening vascular complications. Surgical management of those complications is challenging owing to vessel wall fragility, which may result in hemorrhagic events and high mortality rates. Here we report a case of left common iliac aneurysm perforation of the ipsilateral iliac vein repaired using endovascular technique in a patient with EDS. METHOD AND RESULTS: A 54-year-old patient presented with heart failure symptoms that evolved over 1 week in association with left leg edema and steal syndrome due to a perforation of the left iliac vein caused by a left common iliac aneurysm. A thrombosed right common iliac aneurysm and several other visceral and peripheral aneurysms were discovered on computed tomographic scan at admission. An aortouniiliac stent graft was used to seal the fistula. After 18 months of follow-up, the patient remained asymptomatic. CONCLUSIONS: We suggest that endovascular therapy is useful to manage vascular complications in patients with EDS. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794344 [PubMed - indexed for MEDLINE] Related citations

3. Ann Vasc Surg. 2012 Aug;26(6):861.e1-6. doi: 10.1016/j.avsg.2012.01.012.

Aberrant right subclavian artery in blunt aortic injury: implication for treatment and review of the literature.
Coppi G, Tshomba Y, Psacharopulo D, Marone EM, Chiesa R. Source Vascular Surgery-Scientific Institute H. San Raffaele, Vita-Salute University School of Medicine, Milano, Italy. giovanni.coppi@gmail.com Abstract

Blunt aortic injury (BAI) involving an aberrant right subclavian artery (ARSA) is uncommon. The presence of an ARSA entails several treatment issues, in particular regarding the risk of perioperative posterior cerebral stroke. We report the case of a man with an ARSA who suffered from BAI. An initial conservative treatment with delayed open repair was chosen. A review of the published literature with discussion of the case is presented. The presence of an ARSA in patients with BAI can be considered a poor anatomy for endovascular repair, and suitable patients may benefit from delayed open repair. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794343 [PubMed - indexed for MEDLINE] Related citations

4. Ann Vasc Surg. 2012 Aug;26(6):860.e9-11. doi: 10.1016/j.avsg.2011.12.017.

Pseudoaneurysm of the inferior phrenic artery presenting as an upper gastrointestinal bleed by directly rupturing into the stomach in a patient with chronic pancreatitis.
Arora A, Tyagi P, Gupta A, Arora V, Sharma P, Kumar M, Goyal M, Kumar A. Source Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India. dranilarora50@gmail.com Abstract Pseudoaneurysms occurring in patients with chronic pancreatitis are associated with significant morbidity and mortality. These pseudoaneurysms occur more commonly in the splenic, pancreaticoduodenal, and gastroduodenal arteries. Upper gastrointestinal bleeding (UGIB) due to pseudoaneurysms in patients with pancreatitis with pseudocyst usually presents as hemosuccus pancreaticus. However, pseudoaneurysm directly perforating the gastrointestinal tract and presenting as UGIB is a rare complication. We report here the first case of UGIB from the inferior left phrenic artery pseudoaneurysm rupturing directly into the stomach of a patient with chronic pancreatitis. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794342 [PubMed - indexed for MEDLINE] Related citations

5. Ann Vasc Surg. 2012 Aug;26(6):860.e13-8. doi: 10.1016/j.avsg.2012.01.011.

Aortic dissection in the presence of an aberrant right subclavian artery.

Guzman ED, Eagleton MJ. Source Cleveland Clinic Foundation, edgar_guzman@sbcglobal.net Abstract The presence of an aberrant right subclavian artery arising from the proximal descending aorta is a relatively common anomaly of the aortic arch. These vessels may be involved in aortic dissections, either as the site of the primary intimal tear or as a dissected aortic branch, subject to flow limitation and future aneurysmal degeneration. In this report, we review our experience in treating these lesions in the endovascular era. In two cases, the dissected aorta was treated with an endovascular approach, whereas in two others, proximal open surgical repair was followed by distal stent grafting. The ostium of the aberrant vessel was covered in all cases. Preservation of antegrade flow into the right subclavian was obtained via extra-anatomic bypass. Creation of end-to-side bypasses as opposed to transpositions allowed transbrachial endovascular access to the aberrant right subclavian artery with the purpose of embolization while preserving the right vertebral artery. The hybrid approaches described here effectively address the aortic dissection and degenerative changes associated with an aberrant right subclavian artery while minimizing the need for extensive open repair. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794341 [PubMed - indexed for MEDLINE] Related citations

Cleveland,

OH

44195,

USA.

6. Ann Vasc Surg. 2012 Aug;26(6):860.e1-7. doi: 10.1016/j.avsg.2011.12.018.

Spinal cord ischemia after endovascular embolization of a type II endoleak following endovascular aneurysm repair.

Ioannou CV, Tsetis DK, Kardoulas DG, Katonis PG, Katsamouris AN. Source Vascular Surgery Unit, University of Crete Medical School, Heraklion, Crete, Greece. ioannou@med.uoc.gr Abstract BACKGROUND: We report a rare case of severe spinal cord ischemia with neurological consequences in a patient who presented after endovascular treatment of a type II endoleak following endovascular aneurysm repair. METHODS AND RESULTS: An enlarging abdominal aortic aneurysm post-endovascular aneurysm repair was detected owing to a persistent type II endoleak caused by a communication between the iliolumbar and L4 lumbar artery for which the patient underwent supraselective embolization with particles and coils. Immediately after the procedure, the patient experienced an acute onset of neurological symptoms in the right lower limb while limb arterial perfusion remained unaffected. Magnetic resonance imaging-magnetic resonance angiography revealed an acute ischemic process at the L2-L4 level. Further follow-up revealed persistence of the endoleak, and the patient was referred to our institution for open surgical treatment. CONCLUSIONS: To the best of our knowledge, this is the first report of severe spinal cord ischemia after transcatheter embolization of the feeding iliolumbar branches of a type II endoleak. Care must be taken during embolization of the feeding artery of type II endoleaks, which may also supply the spinal cord, to minimize the risk of possible spinal cord ischemia. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794340 [PubMed - indexed for MEDLINE] Related citations

7. Ann Vasc Surg. 2012 Aug;26(6):858.e11-4. doi: 10.1016/j.avsg.2011.11.039.

Thoracic aorta to popliteal artery bypass for bilateral lowerextremity critical limb ischemia.
Jayaraj A, Starnes BW, Tran NT, Hatsukami T.

Source Division of Vascular Surgery, Department of Surgery, University of Washington, Seattle, WA 98195, USA. arjun@u.washington.edu Abstract Thoracic aortic to infrainguinal arterial bypasses are rare in the literature, even more so when the outflow is the popliteal artery bilaterally. The case of a patient presenting with critical limb ischemia, chronic infrarenal aortic occlusion, and recurrent thrombosis of a unilateral axillobifemoral graft managed with thoracoretroperitoneal bitransobturator bipopliteal bypass is presented. The patient's vascular history was significant for multiple previous groin procedures for thrombectomy of her axillobifemoral graft, aortomesenteric bypass, redo aortomesenteric bypass for graft thrombosis, and multiple bowel resection procedures for acute mesenteric ischemia. The thoracic aorta and popliteal arteries were selected as sites for proximal and distal anastomoses, respectively, given anticipated difficulty in exposing the supraceliac aorta and femoral arteries. The technique of this operative approach is discussed. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22794339 [PubMed - indexed for MEDLINE] Related citations

8. Ann Vasc Surg. 2012 Aug;26(6):859.e9-12. doi: 10.1016/j.avsg.2011.11.044. Epub 2012 Jun 19.

Endovascular treatment of late aortic perforation due to vena cava filter.

Yoshida Rde A, Yoshida WB, Kolvenbach R, Vieira PR. Source Vascular and Endovascular Surgery Department, Botucatu School of Medicine, So Paulo State University UNESP, Botucatu, So Paulo, Brazil. ricardoyoshida@gmail.com Abstract Perforation of inferior vena cava (IVC) by filter struts ranges from 9% to 24%, and clinical sequelae and complications are unpredictable. The aim of this article was to report an unusual case of late complication of IVC filter that caused an IVC wall perforation and penetration of the filter's hooks in the aorta, which was treated by endovascular procedure. Molding strut tip by balloon angioplasty, its accommodation

with a bare stent, and its coverage and protection with an endoprosthesis is probably the first technique reported so far in this situation. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22717360 [PubMed - indexed for MEDLINE] Related citations

9. Ann Vasc Surg. 2012 Aug;26(6):859.e1-5. doi: 10.1016/j.avsg.2011.11.043. Epub 2012 Jun 19.

Leiomyosarcoma of the inferior vena cava in a patient with double inferior vena cava.
Padilla-Fernandez B, Lorenzo-Gomez MF, Herrero-Polo M, Silva-Abuin JM, MartinIzquierdo M, Antunez-Plaza P. Source Department of Urology, University Hospital of Salamanca, Salamanca, Spain. padillaf83@hotmail.com Abstract BACKGROUND: Leiomyosarcoma of the inferior vena cava (IVC) is a rare tumor arising from its smooth muscle cells. METHODS AND RESULTS: We report the case of a 38-year-old woman presenting with back pain and weight loss who was diagnosed with a 22-cm leiomyosarcoma of the right IVC and thrombosis of the left IVC. The patient is alive and free of recurrence a year after radical tumor resection with removal of the affected IVC, reconstruction with polytetrafluoroethylene prosthetic graft, and anastomosis of both right and left IVC. CONCLUSIONS: Leiomyosarcoma is a rare and aggressive tumor with a deceitful course. Radical surgical en bloc resection is the mainstay of treatment for IVC leiomyosarcomas. For an adequate restoration of venous return, complex vascular repair may be necessary. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

PMID: 22717359 [PubMed - indexed for MEDLINE] Related citations

10. Ann Vasc Surg. 2012 Aug;26(6):859.e17-21. doi: 10.1016/j.avsg.2011.12.008. Epub 2012 Jun 19.

Cystic adventitial degeneration of the popliteal artery.

Keese M, Diehl SJ, Huck K, Strbel P, Schoenberg SO, Niedergethmann M. Source Clinic for Vascular and Endovascular Surgery, Department of Surgery, Klinikum der Johann Wolfgang Goethe Universitt Frankfurt am Main, Frankfurt, Germany. Michael.keese@kgu.de Abstract Cystic adventitial degeneration (CAD) of the popliteal artery is a rare, but wellrecognized, disorder leading to claudication. Usually, surgical treatment is indicated. So far, <400 patients have been described. We report on a series of three patients with CAD. Because we observed local recurrence of CAD after local resection, we conclude that 360 resection and venous interposition is preferable for a favorable outcome. Furthermore, we review etiology, pathology, and different surgical treatment approaches. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22717358 [PubMed - indexed for MEDLINE] Related citations

11. Ann Vasc Surg. 2012 Aug;26(6):859.e13-5. doi: 10.1016/j.avsg.2011.12.007. Epub 2012 Jun 15.

Novel repair of an external iliac vein aneurysm.

Jayaraj A, Meissner M. Source

University of Washington, Seattle, WA 98195, USA. arjun@u.washington.edu Abstract Aneurysms involving the venous system are a rare entity. We report the case of a 37year-old woman who presented to us with activity-limiting left gluteal pain and who on consequent workup was found to have a left external iliac vein aneurysm in a setting of iliocavomegaly. She underwent successful treatment of her aneurysm with a novel approach that involved staple plication and resection of the aneurysm over a balloon mandrel. We discuss the presentation, diagnosis, and surgical technique adopted for the treatment of this uncommon condition. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22704912 [PubMed - indexed for MEDLINE] Related citations

12. Ann Vasc Surg. 2012 Aug;26(6):859.e7-8. doi: 10.1016/j.avsg.2011.12.006. Epub 2012 Jun 15.

SIADH after carotid endarterectomy.

Siani A, Gabrielli R, Accrocca F, Marcucci G. Source Department of Vascular Surgery, ASL RMF S Paolo Hospital, Civitavecchia, Rome, Italy. Abstract The syndrome of inappropriate secretion of antidiuretic hormone after carotid endarterectomy is very rare; only two cases have been reported in medical literature. We describe the case of an 82-year-old woman presenting with lethargy and drowsiness due to severe hyponatremia with urine hyperosmolarity and plasma hypoosmolarity after carotid endarterectomy. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22704192 [PubMed - indexed for MEDLINE] Related citations

13. Ann Vasc Surg. 2012 Aug;26(6):858.e1-2. doi: 10.1016/j.avsg.2011.11.040. Epub 2012 Jun 13.

Ruptured inferior mesenteric artery aneurysm in a patient with a type 1 neurofibromatosis.

Kerger L, Tomescot A, Chafai N. Source General and Visceral Surgery Department, Saint Antoine Hospital, St. Antoine, Paris, France. Abstract We describe the case of a 61-year-old woman having a type 1 neurofibromatosis (von Recklinghausen disease), whose acute abdominal pain revealed a voluminous retroperitoneal hemorrhage caused by a 25-mm ruptured inferior mesenteric artery aneurysm. She underwent emergent aneurysm and left colonic resection. This report of a rare digestive artery aneurysm rupture, which added to increasing reports of vascular abnormalities in type 1 neurofibromatosis patients, underlines the need to maintain a high suspicion index of a vascular etiology in case of any abdominal complaint in these patients. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22698409 [PubMed - indexed for MEDLINE] Related citations

14. Ann Vasc Surg. 2012 Aug;26(6):858.e7-10. doi: 10.1016/j.avsg.2011.11.041. Epub 2012 May 23.

Takayasu arteritis complicating pregnancy in adolescence.

Li LT, Gilani R, Tsai PI, Wall MJ Jr. Source Division of Vascular Surgery, Baylor College of Medicine, Houston, TX 77030, USA. Abstract Pregnant adolescent patients afflicted with Takayasu arteritis represent a clinical entity not seen by many. The care of such patients is often managed by multidisciplinary

teams, where vascular surgeons are asked to provide input on cardiovascular implications during and after a pregnant state. Knowledge and understanding of the interaction between the two conditions allows for well-informed decision making and favorable outcomes with pregnancy, as well as proper long-term follow-up and care with appropriate clinicians. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22633271 [PubMed - indexed for MEDLINE] Related citations

15. Ann Vasc Surg. 2012 Aug;26(6):858.e3-6. doi: 10.1016/j.avsg.2011.11.038. Epub 2012 May 23.

Persistent abdominal pain caused by an inferior vena cava filter protruding into the duodenum and the aortic wall.
Malgor RD, Hines GL, Terrana L, Labropoulos N. Source Division of Vascular Surgery, Stony Brook University Medical Center, Stony Brook, NY 11794-8191, USA. rmalgor@notes.cc.sunysb.edu Abstract Inferior vena cava (IVC) filter placement has increased dramatically over the past 2 decades. Symptomatic duodenal perforation by IVC filters with involvement of the aorta is a very rare, but challenging, complication. We report a case of persistent atypical right upper quadrant pain secondary to duodenal and aortic perforation by an IVC filter treated with cavotomy for filter removal, primary repair of the duodenum, and extraction of prongs from the aorta. Copyright 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved. PMID: 22627053 [PubMed - indexed for MEDLINE] Related citations