CAS, Carotid artery stenting; CAS ϩ EPD, carotid artery stenting plus distal embolic filter protection; CAS ϩ FRS, carotid artery stenting plus flow reversal system protection; CEA, carotid endarterectomy; CEA/EPD, comparison of CEA versus CAS ϩ EPD; CEA/FRS, comparison of CEA versus CAS ϩ FRS.

PTFE and SVG for above knee bypasses have comparable patency and limb salvage rates in claudicant patients with bilateral superficial femoral artery occlusion and 2- to 3-vessel runoff This may justify the use of PTFE for above knee locations in these selected patients.

Results:A 54-year-old man with abdominal and back pain abdomen was found to have a ruptured10 cm infrarenal AAA on computed tomography (CT). He was hemodynamically stable and a candidate for endovascular repair. Arteriogram revealed an AAA with extension to the right iliac artery, and an associated aortocaval fistula. Repair was undertaken with a bimodular stent graft with selective embolization of the right internal iliac artery. Initial attempt at exclusion of the ACF were unsuccessful, however. Eight days postop follow up CT revealed an ongoing ACF. He was returned to the operating room, where a venogram through the femoral vein revealed ongoing ACF and aortogram through the femoral artery revealed a type 2 endoleak involving the inferior mesenteric artery (IMA). The IMA was cannulated by catheterizing the SMA and traversing a patent meandering artery and embolized with coils. Through a percutaneous approach through the IVC the aortic aneurysm sac was cannulated through the fistulous tract and embolized with multiple coils. Follow up angiogram revealed obliteration of the ACF and type IIa endoleak. At 14 months follow up the aneurysm sac remained stable with no evidence of ACF recurrence.Conclusions: Endovascular treatment of ACF complicating ruptured AAA has been reported in case reports and small series. Long term follow-up and large series are lacking. Our case represents a unique endovascular approach to a rare complication of AAA.

This prospective, randomized study was performed at a single institution. Low-risk patients undergoing elective vascular procedures were enrolled (August 2007 to June 2009). Participants were randomized into 3 separate arms. They received cefazolin, cefazolin + vancomycin, or cefazolin + daptomycin prior to surgery. In total, 169 patients were included in the analysis. Mean age was 64 (range, 26-85), and the patients' comorbidities were similar across all groups. Only Szilagyi II and III infections were analyzed. Any infection/methicillin-resistant Staphylococcus aureus (MRSA) infections was seen in 8 (12.9%)/2 (3.23%) in the cefazolin group, 7 (12.5%)/4 (7.14%) in the cefazolin + vancomycin group, and 2 (3.92%)/(0%) in the cefazolin + daptomycin group. In this study, population of low-risk patients undergoing elective vascular procedures, there was a trend toward fewer infectious complications in the cefazolin + daptomycin group. Adding anti-MRSA agents to the current standard prophylaxis regimen does not appear to reduce the incidence of MRSA infection in low-risk patients.