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Objectives: Abdominal aortic aneurysms with a wide proximal neck (>32 mm) are a contraindication for the use of conventional abdominal endovascular stent grafts because of their limited maximum proximal diameter (36 mm). In these cases, it is customary to resort to sophisticated techniques such as parallel or fenestrated grafts. In very selected cases, such as symptomatic wide neck aneurysm or patient with limited life expectancy, Funnel Technique may find an indication. Methods: It consists in placing a bifurcated endograft in the abdominal aorta embricated with a thoracic endograft as a proximal cuff in an infrarenal position. Results: In the literature review, we found 32 cases of this technique, whose characteristics are collected in a table. Conclusion: The Funnel Technique, taking advantage of the larger diameters of the thoracic prostheses, may easily treat abdominal aortic aneurysm cases with a wide neck. [ABSTRACT FROM AUTHOR]

Purpose: To compare the incidence of distal emboli occurring during percutaneous transluminal angioplasty (PTA) and primary stent on the superficial femoral artery (SFA) Methods: A total of 50 consecutive patients were entered in a prospective, randomized trial. Inclusion criteria were the presence of symptomatic limb ischemia due to stenosis or occlusion of the SFA. An embolic protection device was placed in the popliteal artery. The patients were then randomly assigned to undergo primary stent implantation or PTA. The filters were retrieved and sent for histologic examination. Results: Stenting in the SFA produced more emboli (1.44 mm3) than PTA (0.772 mm3), P = .031. Reanalyzing the patients according to actual treatment performed, volume of debris in the stent group was 1.271 mm3 and in the PTA group was 0.191 mm3, P = .00087. Conclusion: Volume of embolized material during endovascular interventions in the SFA-above-knee popliteal artery is higher when a stent is used. [ABSTRACT FROM PUBLISHER]

The aim was to present a technical modification to the 'funnel technique' that allows endovascular repair of infrarenal abdominal aortic aneurysms with an ectatic neck. The body of the Excluder endograft is opened inside the aneurysm, using the slow deployment technique, stopping as soon as the contralateral limb is open. The gate is cannulated in the usual fashion. A percutaneous transluminal angioplasty (PTA) balloon is introduced in the contralateral limb and inflated to nominal pressure. By pulling the introducer of the Excluder delivery system on one side and the PTA balloon on the other, the graft is positioned on the bifurcation with the contralateral leg inside the common iliac artery. At this point, the ipsilateral iliac leg is deployed and the thoracic endograft can be positioned through the abdominal component. Finally, the contralateral iliac leg is deployed. The technique described offers a simple method to treat aortic abdominal aneurysms with an ectatic neck by positioning a bifurcated abdominal graft in such a way that subsequent insertion of the thoracic component is facilitated. [ABSTRACT FROM AUTHOR]

Revascularization of an acutely ischemic limb may lead to the development of a reperfusion syndrome, characterized by acidosis, hyperkalemia, myogloe binuria, and disseminated intravascular coagulation. The authors evaluated the components of the lemon) venous efflux after reperfusion of an acutely ischemic limb in both an experimental model and in a small clinical series. [ABSTRACT FROM AUTHOR]

A patient with evidence of both heparin-related thrombocytopenia and coumarin-induced skin necrosis is presented. Etiology, diagnostic evaluation, histopathology, and therapeutic options are discussed. [ABSTRACT FROM AUTHOR]

Upper arm arteriovenous bridge grafts are often required after failure of more distal access grafts. A retrospective review was performed comparing 57 brachioaxillary bridge grafts fistulas (BAGF) with 79 brachiosubclavian bridge graft fistulas (BSGF) performed over a twelve-year period. There was no statistical difference in primary or secondary patency rates. There was a statically higher rate of infection in the BSGF group (p<.05) while thrombosis was more common in the BAGF group (p<.05). [ABSTRACT FROM AUTHOR]

A high-risk patient underwent exclusion of an abdominal aortic aneurysm with aortofemoral bypass. During the procedure a horseshoe kidney was found to be overlying the aorta. Postoperatively retrograde perfusion of the aneurysm via a recanalized right iliac artery occurred and led to doubling of the aneurysm's size, necessitating reoperation. The operative approach and pertinent literature are reviewed. [ABSTRACT FROM AUTHOR]

Anastomotic false aneurysm is a commonly reported complication of bypass surgery, but blunt trauma has been a rare etiologic mechanism. An unusual case of a traumatic false aneurysm arising in the distal anastomosis of an in-situ femoro-popliteal bypass graft is presented and the pathophysiology of the entity is discussed. [ABSTRACT FROM AUTHOR]

Upper arm arteriovenous bridge grafts are often required after failure of more distal access grafts. A retrospective review was performed comparing 57 brachioaxillary bridge grafts fistulas (BAGF) with 79 brachiosubclavian bridge graft fistulas (BSGF) performed over a twelve-year period. There was no statistical difference in primary or secondary patency rates. There was a statically higher rate of infection in the BSGF group (p<05). while thrombosis was more com mon in the BAGF group (p<.05) [ABSTRACT FROM PUBLISHER]

A high-risk patient underwent exclusion of an abdominal aortic aneurysm with aortofemoral bypass. During the procedure a horseshoe kidney was found to be overlying the aorta. Postoperatively retrograde perfusion of the aneurysm via a recanalized right iliac artery occurred and led to doubling of the aneu rysm's size, necessitating reoperation. The operative approach and pertinent literature are reviewed. [ABSTRACT FROM PUBLISHER]

Anastomotic false aneurysm is a commonly reported complication of bypass surgery, but blunt trauma has been a rare etiologic mechanism. An unusual case of a traumatic false aneurysm arising in the distal anastomosis of an in-situ femoro-popliteal bypass graft is presented and the pathophysiology of the entity is discussed. [ABSTRACT FROM PUBLISHER]

The routine or selective use of an intraarterial shunt during carotid endarterectomy (CEA) remains a controversial issue. Numerous investigators have proposed various shunting devices in an effort to minimize possible associated complications. The presented case illustrates an unusual complication that developed during a CEA, felt to he related to a malfunction of a Pruitt-Inahara (P-I) shunt. [ABSTRACT FROM AUTHOR]

The routine or selective use of an intraarterial shunt during carotid endar terectomy (CEA) remains a controversial issue. Numerous investigators have proposed various shunting devices in an effort to minimize possible associated complications. The presented case illustrates an unusual complication that de veloped during a CEA, felt to be related to a malfunction of a Pruitt-Inahara (P I) shunt. [ABSTRACT FROM PUBLISHER]

Describes a radiological procedure for intraoperative assessment of mesh position during giant prosthetic reinforcement of the visceral sac for the treatment of groin hernias. Steps in the procedure; Advantages of prosthetic reinforcement of the visceral sac.