Annals of vascular surgery
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In a number of relatively small-size studies, investigators have measured and compared circulating interleukin-6 (IL-6) levels in cases with abdominal aortic aneurysm (AAA) and controls without AAA to assess its possible role in the pathogenesis or progression of AAA. To summarize the present evidence for an association between circulating IL-6 levels and AAA presence, we performed a meta-analysis of case-control studies that compared circulating IL-6 levels between patients with AAA and subjects without AAA. ⋯ Circulating IL-6 levels are greater in patients with AAA than those in subjects without AAA, which suggest that greater circulating IL-6 levels are associated with AAA presence. As the mean AAA diameter and the proportion of men increase, circulating IL-6 levels in patients with AAA are respectively more and less greater than those in controls without AAA.
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Review Case Reports
Bier spots are an under-recognized cutaneous manifestation of lower extremity lymphedema: a case series and brief review of the literature.
Bier spots represent a benign vascular mottling characterized by multiple irregular white macules along the extensor surfaces of the arms and legs. They have been reported in a variety of diverse conditions with no consistent disease association. ⋯ The thighs were affected as well in 2 morbidly obese subjects. We suspect that these lesions are not uncommon in lymphedema but are simply under-recognized.
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The etiology of postoperative delirium (POD) following vascular surgery is generally unknown. The incidence, however, can be as high as 35%. A possible neuroinflammatory basis for delirium is likely and C-reactive protein (CRP) as a marker for inflammation can possibly play a predictive role. ⋯ In this study, CRP can be used as a marker for an increased risk of POD after vascular surgery. In addition, it was found that POD was associated with a 10-fold increase in the need of long-stay care after discharge.
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Case Reports
A case of type-2 endoleak from a bronchial artery after endovascular aortic repair for Kommerell diverticulum.
We describe a case of type-2 bronchial artery endoleak after endovascular aortic repair of Kommerell diverticulum (KD) involving right-sided aortic arch and aberrant left subclavian artery (LSA). A 68-year-old woman underwent an endovascular repair of KD with an aberrant LSA in our hospital. ⋯ We performed coil embolization of the KD and the left subclavian artery. The endoleak disappeared in the postoperative CT.
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A ruptured abdominal aortic aneurysm (RAAA), complicated by an aortocaval fistula (ACF), is usually associated with high morbidity and mortality during open operative repair. We report a case of endovascular treatment of an RAAA with ACF. ⋯ We proceeded by covering the fistula with an Excluder aortic stent-graft cuff to prevent pressurization of the aneurysm sac and secondary endoleaks. This procedure is feasible and may reduce the chances of posterior endoleaks.