Access for endovascular treatment of the superficial femoral artery (SFA) is usually gained through an antegrade approach from the ipsilateral common femoral artery (CFA), or by crossing over from the contralateral CFA. In this technical note, an alternative method, based on retrograde access of the ipsilateral iliac artery (IA), and conversion into an antegrade approach to the SFA, is described. Successful reverse ipsilateral catheterisation was obtained in 15/16 patients. Calcification of the CFA and IA required a crossover approach in one case. There were no complications related to the technique, except for moderate bleeding in relation to the deployment of a closure device.

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El presente artículo describe y analiza la participación de un grupo político, la Acción Patriótica, en la polarizada coyuntura de mediados de los años treinta del siglo XX. Fundado por el reconocido intelectual José de la Riva-Agüero, este movimiento tuvo como principal característica el presentarse como una agrupación de derecha, elaborando un discurso orientado en esa tendencia y materializando su posición a través de su participación en la campaña electoral de 1936. Por ello, en este trabajo se detalla el origen, la constitución y las principales características que desarrolló esta agrupación, para comprender el porqué de su posicionamiento político y el accionar que llevaron a cabo durante la campaña, aliándose con otros movimientos y apoyando una candidatura presidencial.

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Purpose: The aim of this study was to assess the agreement of multiplanar reconstruction (MPR) and semiautomated central lumen line (CLL) analysis of abdominal aortic aneurysms (AAA), with 3 different software workstations (WS1, WS2, WS3) and 2 experienced practitioners as well as to analyze its eventual impact in graft selection. Materials and methods: Twenty computed tomography (CT) angiography data sets were randomly chosen from a series of 100 consecutive studies. Measurements were performed twice by each reader, in random order, and included 8 parameters (5 diameters and 3 lengths). Each observer performed a complete set of 60 studies. Intra-observer and interobserver variability for every WS was assessed. Measurements were evaluated using Bland-Altman analysis, correlation coefficients (r), and concordance correlation coefficients (CCC [95% confidence interval (CI)]). Results: A high overall agreement between repeated measurements for both observers was obtained (r=0.989; CCC=0.988 [0.982–0.992] and r=0.998; CCC=0.996 [0.994–0.997], for observers 1 and 2, respectively). However, reproducibility for individual parameters was excellent for observer 2 and only moderate for observer 1. A high overall agreement was obtained for interobserver concordance (r=0.987; CCC=0.986 [0.982–0.989]). When analyzing for individual parameters, greatest interobserver differences were found at CLL measurement of the diameter of aortic neck (WS2) and bifurcation (WS1 and WS2) as well as iliac diameter in all 3 WS for both CLL and MPR. Similar differences were observed in paired comparison between WS when involving these parameters. Careful inspection of Bland-Altman charts revealed some cases of disagreement between WS and observers that would affect decision making on graft selection, changing the neck diameter to a different size, in 2 cases when measuring with WS1, and iliac diameter in 4 cases (2 of them with WS1 and 2 with WS2). Greatest discordance was observed regarding ipsilateral iliac length affecting 7 measurements that would lead to change the length of the selected limb graft (2 with WS1, 3 with WS2, and 2 with WS3). Conclusions: Although a high agreement between different observers using different WS for AAA measurements is to be expected, small differences may lead to the selection of a different graft size. The use of a single software by experienced users, and double check by a different one, may be advisable. Clinical Impact Influence of inter and intraobserver variability in CT measurements during planning of endovascular aneurysm repair (EVAR) has been extensively reviewed. However, its impact in graft selection (final choose of diameter and lengths) has been scarcely analyzed. The results of this study suggest that, although a high agreement between different observers using different workstations for AAA measurements is to be expected, small differences may lead to the selection of a different graft size. The use of a single software by experienced users, and double check by a different one, may be advisable.