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L-Tyrosine is converted to 3-bromo-L-tyrosine in good yield by reaction with 1.2 equiv. of DMSO in HBr/AcOH, while reaction with 2.2 equiv. of DMSO under comparable conditions results in formation of 3,5-dibromo-L-tyrosine in good yield. This is the simplest, safest and most efficient method for the preparation of gram quantities of either 3-bromo-L-tyrosine or 3,5-dibromo-L-tyrosine.

Objective: Although the effect of body mass index on the treatment of infrainguinal peripheral arterial disease (PAD) has been analyzed, outcomes of patients on the high end of the spectrum of morbid obesity (MO; body mass index >40) and superobesity (SO) are unclear. Our goal was to analyze perioperative outcomes of infrainguinal PAD after lower extremity bypass (LEB) and peripheral vascular interventions (PVIs) in this population of patients.Methods: The Vascular Quality Initiative was reviewed for all infrainguinal PAD interventions from 2010 to 2017. Patient and case details were recorded. Multivariable analysis was used to analyze outcomes.Results: We identified 30,389 LEB cases (69.8% nonobese, 27.1% obese, 2.8% MO, 0.33% SO) and 84,649 PVI cases (67.9% nonobese, 28.1% obese, 3.5% MO, 0.52% SO). For LEB and PVI, MO and SO patients were younger, more often female, less often with smoking history, more often on Medicaid, and more often ambulatory, with diabetes, end-stage renal disease, congestive heart failure, and fewer previous inflow procedures (P < . 05 for all). LEB and PVIs in MO and SO were less often elective and more often for tissue loss. For LEB, MO and SO patients more often had great saphenous vein used as conduit and had popliteal artery origin grafts (P < .05). In PVI, MO and SO patients more often had tibial interventions (P < .05). Multivariable analysis showed that after LEB, MO and SO were not associated with increased perioperative cardiac complications, return to operating room, primary patency, and mortality. MO was associated with increased surgical site infection. Multivariable analysis showed that after PVI, MO and SO were not associated with periprocedural access site hematoma, access site stenosis or occlusion, and mortality.Conclusions: MO and SO were not independently associated with increased major adverse outcomes after LEB and PVI, aside from surgical site infections after LEB. Overall, MO and SO patients have more comorbidities and have more advanced presentation. MO and SO alone should not deter appropriate revascularization.

compared between the two groups. Long-term follow-up was collected by telephone survey inquiring about intensity of symptoms on a numeric rating scale of 0 to 10 before and after treatment. A multivariable analysis was performed to identify predictors of recurrence.Results: There were 362 patients with 529 veins treated. The mean age was 59.2 6 14.4 years (63% women). There were significant differences in history of hypertension (P ¼ .02) and deep venous thrombosis (P ¼ .02) between the two groups (Table I). The clinical success, technical success, and complication rates were 80%, 95.6%, and 11.5%. There were no significant differences between the two groups in outcomes (Table II). After a mean follow-up of 27.5 months, recurrence rate was 22.2%. There was a trend toward higher recurrence in group B that did not reach statistical significance (P ¼ .1). On multivariable analysis, there was no clinical or technical factor that could predict recurrence.Conclusions: The experience with radiofrequency VA does not support difference in outcomes when treatment starts at $3 cm from the deep junction. However, there is a trend toward increased longterm recurrence that warrants further investigation with the newer technology.