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Endovascular interventions with antegrade brachial arterial access are highly effective in restoring function in failing Brescia-Cimino fistulas.

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Results of decompressive surgery for lumbar spinal stenosis vary. We evaluated the density of lumbar muscles by computed tomography (CT) at the L2-L4 levels in patients 4 years after they had undergone surgery for lumbar spinal stenosis. Twenty of these patients had an excellent outcome clinically, and 16 patients had very poor outcome. The residual stenosis and density of lumbar muscles in Hounsfield units were measured on CT images. The clinical evaluation of outcome also included the Oswestry questionnaire and a walking test. The density of lumbar flexors was higher in the group with excellent results than in the group with poor results. The density of lumbar extensors showed a marked decrease in the operated area. These results suggest that the decrease of muscular density can be partially explained by disuse or inactivity. The decrease in the operated area probably reflects muscular atrophy caused by muscle denervation.

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In the detection of Hill-Sachs lesion US showed a sensitivity of 91% (21 of 23), a specificity of 95% (60 of 63) and an accuracy of 94% (81 of 86) when compared with CTA, and a sensitivity of 94% (18 of 19), specificity of 91% (61 of 67) and accuracy of 91% (79 of 86) when compared with arthroscopy. In only 2% (2 of 86) of patients was there reduced visualization because of restriction of movement. Hill-Sachs lesion and its relationship to the humeral head can be reliably diagnosed with US.

Patients' perception of improvement had a much stronger correlation with long-term surgical outcome than structural findings seen on postoperation magnetic resonance imaging. Moreover, degenerative findings had a greater effect on patients' walking capacity than stenotic findings.

The aim of this 8-year follow-up study was to investigate the role of conventional cardiovascular risk factors as predictors for asymptomatic femoral atherosclerosis. The authors also evaluated the association of insulin resistance with atherosclerosis in a cross-sectional setting. Cardiovascular risk factors of 118 subjects were studied at the baseline study in 1983-1985 in Kuopio, Finland. Femoral atherosclerosis, defined as a presence of plaques, was investigated by ultrasonography in the follow-up study in 1992-1993. In the univariate logistic regression analyses, age (p = 0.002), systolic and diastolic blood pressure (p = 0.002 and p = 0.013, respectively), total cholesterol (p = 0.005), low density lipoprotein (LDL) cholesterol (p = 0.005), total triglycerides (p = 0.033), LDL triglycerides (p = 0.033), apolipoprotein B (p = 0.045), and fasting plasma glucose (p = 0.011) had a significant association with the presence of femoral plaques. Plasma insulin levels and insulin sensitivity index, determined in 87 subjects by an intravenous glucose tolerance test and minimal model at the follow-up study, were not associated with femoral plaques. The results demonstrate that atherogenic lipid and lipoprotein pattern and blood pressure are strongly associated with femoral atherosclerosis, whereas insulin sensitivity and hyperinsulinemia seem not to play such a significant role.