Our experience with staple aneurysmorrhaphy shows that it is an effective, safe, and durable procedure to preserve a functioning autogenous AVF with complicated aneurysmal degeneration. Key principles are to reduce the vein to normal adjacent diameter and to provide healthy skin coverage. The remodeled AVF has a low aneurysm recurrence rate and maintains the beneficial properties of superior patency and low infection. It is important to aggressively monitor for and treat proximal outflow venous stenoses to prevent aneurysm recurrence. The surgery can be done safely under local anesthesia in selected patients.

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Retrograde superior mesenteric artery stenting (ROMS) represents a significant development in the treatment of acute mesenteric ischemia. Compared to traditional surgical mesenteric bypass, ROMS is a less invasive technique that avoids many complications associated with emergent mesenteric bypass. This case report illustrates that retrograde superior mesenteric artery (SMA) stenting is an option for the treatment of acute mesenteric ischemia for patients in extremis.

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prandial sugar (pϽ0.001); serum cholestrol (pϽ0.001) and HbA1c (pϽ0.005).Conclusions: The clustering of risk factors called metabolic syndrome (or probably better dysmetabolic syndrome) confers an increased risk for accelerated atherosclerosis in diabetic individuals predisposing them to macrovascular disease and hence considerably contributing to both morbidity and mortality associated with it. Increase carotid IMT can be a useful predictor of macrovascular disease in newly detected type-2 diabetes.

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CEA alone was performed in 581 symptomatic patients (32%) and in 1233 asymptomatic patients (68%). Stroke/ death/MI was 4.5% (2.8%/0.5%/1.2%) for symptomatic patients and 4.0% (2.4%/0.4%/1.1%) for asymptomatic patients. CEA and coronary artery bypass grafting (CABG) was performed in 155 patients (98.7% asymptomatic), S/D/MI of 11.1% (3.9%/5.8/%1.3%). Of 332 patients, CAS was performed in 119 symptomatic patients (36%) and in 213 asymptomatic patients (64%), with 255 (77%) treated as part of a Food and Drug Administrationapproved trial. S/D/MI was 9.2% (4.2%/4.2%/0.8%) for symptomatic patients and 5.2% (3.3%/1.4%/0.4%) for asymptomatic patients. Symptomatic CAS patients treated in a clinical trial (n ¼ 64) had two eventsdS/D/MI of 3.1% (3.1%/0%/0%). Symptomatic patients treated outside a clinical trial (n ¼ 55) had nine eventsdS/D/MI of 16.4% (5.5%/9%/1/1.8%). Conclusions: (1). The prospectively collected, independently verified S/D/MI rates for all CEA and CAS performed within a clinical trial were equivalent to the CREST results. (2) S/D/MI for CAS in symptomatic patients was significantly higher than CEA (9.2% vs 4.5%; P ¼ .034). (3). S/D/MI for CAS in symptomatic patients within a clinical trial was equivalent to CEA (3.1% vs 4.5%; P ¼ .759). Symptomatic CAS patients who did not qualify for a clinical trial had a five times increased risk of S/D/MI of 16.4%. (4) S/D/MI for CAS in asymptomatic patients was equivalent to CEA (5.2% vs 4.0%; P ¼ .42). (5). CEA/CABG in asymptomatic patients is associated with a three-times increased risk of S/D/MI compared with patients undergoing CEA for asymptomatic disease.

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