Objective Abdominal aortic aneurysm (AAA) wall stiffness has been suggested to be an important factor in the overall rupture risk assessment compared to anatomical measure; we hypothesize that AAA diameter will have no correlation to AAA wall stiffness. The aim of this study is to 1) determine MRE-derived aortic wall stiffness in AAA patients and its correlation to AAA diameter; 2) determine correlation between AAA stiffness and amount of thrombus and calcium; and 3) compare the AAA stiffness measurements against age matched healthy subjects. Methods In-vivo abdominal aortic MRE was performed on 36 subjects (24 patients with AAA measuring 3-10 cm and 12 healthy volunteers) aged 36-78 years old after obtaining written informed consent under the approval of the institutional review board. MRE images were processed to obtain spatial stiffness maps of the aorta. AAA diameter, amount of thrombus and calcium score were reported by experienced interventional radiologists. Spearman correlation, Wilcoxon signed rank test and Mann-Whitney test were performed to determine the correlation between AAA stiffness and diameter, and also to determine significant difference in stiffness measurements between AAA patients and healthy subjects. Results No significant correlation (P>.1) was found between AAA stiffness and diameter or amount of thrombus or calcium score. AAA stiffness (mean:13.97±4.2kPa) is significantly (P≤.02) higher than remote normal aorta in AAA (mean:8.87±2.2kPa) patients and in normal subjects (mean:7.1±1.9kPa). Conclusion Our results suggest that AAA wall stiffness may provide additional information independent of AAA diameter, which may contribute to our understanding of AAA pathophysiology, biomechanics, and risk for rupture.

Super cial venous thrombosis (SVT) of the lower extremities is a common ailment seen in outpatient of ces of vascular medicine and surgery practices. This study of 60 consecutive outpatients was carried out to examine the incidence of concomitant deep venous thrombosis (DVT), risk factors associated with SVT, recurrence of SVT and=or new DVT, and the role of anticoagulant therapy in the prevention of recurrence. Concomitant SVT and DVT (13%) were signi cantly less likely to be present in patients with varicose veins as compared to patients without varicose veins (p < 0.04) and more likely to be present in patients with a previous history of DVT (p < 0.02). Fifteen patients (25%) developed either recurrent SVT or new DVT, with two patients developing both SVT and DVT. The absence of varicose veins and the presence of a hypercoagulable condition (nˆ12) appeared to in uence the development of new DVT but not the recurrence of SVT. Recurrent SVT was much more likely in patients with thrombosis of the tributaries (p < 0.0008). New DVT was seen signi cantly less frequently in patients on anticoagulants (p < 0.02).

We conclude that men and women with AAAs have similar cardiac risks and survival rates associated with surgical treatment. Our results also illustrate that the potential benefit of coronary intervention for severe CAD in patients of either gender must be considered in the context of long-term outcome and the early mortality rate of AAA repair.

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Abdominal aortic aneurysms have an incidence that is approximately four to six times higher in men than in women. However, the incidence in women also rises with older age, although starting later in life than in men. There are also sex differences in the risk of rupture and in outcomes after endovascular and open abdominal aortic aneurysm repair. Various explanations have been proposed. Women historically have been under-represented in clinical trials to evaluate the differences between the sexes. We present a review of current recommendations and recent literature to help identify some of these differences.

The EPIC stent system demonstrated safety and effectiveness through 12 months, including improvements for complex lesions. The EPIC stent is a viable alternative to surgery for patients with either complex or non-complex lesions.

Introduction Ultrasound guided thrombin injection (UGTI) is a well-established practice for treatment of femoral artery pseudoaneurysm. This procedure is highly successful but dependent on appropriate pseudoaneurysm anatomy and adequate ultrasound visualization. Morbid obesity can present a significant technical challenge due to increased groin adiposity, resulting in poor visualization of critical structures needed to safely perform the procedure. We aim to evaluate the safety and efficacy of UGTI to treat femoral artery pseudoaneurysm in the morbidly obese. Methods This is a retrospective cohort study in which all patients who underwent UGTI at The Ohio State University Ross Heart Hospital from 2009 to 2014 were analyzed for patient characteristics and stratified by body mass index (BMI). Patients with BMI ≥ 35 were considered morbidly obese and were compared to patients with a BMI < 35. Outcome was failed treatment resulting in residual pseudoaneurysm. Results Our cohort consisted of 54 patients who underwent thrombin injection. There were 41 non-morbidly obese, and 13 morbidly obese patients. Mean age was 64.5 years. The cohort was 44.4% male. There were 6 failures of which 1 underwent successful repeat injection, and 5 underwent open surgical repair. There was no statistically significant difference in failure between non-morbidly obese, and morbidly obese patients (9.8% vs. 15.4%, p=0.45). There were no embolic/thrombotic complications. Conclusion UGTI is a safe and effective therapy in the morbidly obese for the treatment of femoral artery pseudoaneurysm. In the hands of experienced sonographers and surgeons with adequate visualization of the pseudoaneurysm sac, ultrasound guided thrombin injection should remain standard therapy in the morbidly obese.

This report describes a new approach for management of iliac vein injury. These injuries are often difficult to expose, and the associated hemorrhage further hinders visualization and subsequent repair. In this case, the use of an endovascular balloon from groin access controlled venous hemorrhage and permitted a primary repair of a torn left iliac vein. We believe that this approach is unique in that it uses a compliant, low-pressure balloon, thus preventing further iatrogenic injury in otherwise fragile venous structures and allowing direct access to the tear when exposure in the operative field is limited.