Background-Myocardial and renal injury commonly contribute to perioperative morbidity and mortality after abdominal aortic aneurysm repair. Remote ischemic preconditioning (RIPC) is a phenomenon whereby brief periods of ischemia followed by reperfusion in one organ provide systemic protection from prolonged ischemia. To investigate whether remote preconditioning reduces the incidence of myocardial and renal injury in patients undergoing elective open abdominal aortic aneurysm repair, we performed a randomized trial. Method and Results-Eighty-two patients were randomized to abdominal aortic aneurysm repair with RIPC or conventional abdominal aortic aneurysm repair (control). Two cycles of intermittent crossclamping of the common iliac artery with 10 minutes ischemia followed by 10 minutes reperfusion served as the RIPC stimulus. Myocardial injury was assessed by cardiac troponin I (Ͼ0.40 ng/mL), myocardial infarction by the American College of Cardiology/American Heart Association definition and renal injury by serum creatinine (Ͼ177 mol/L) according to American Heart Association guidelines for risk stratification in major vascular surgery.

Visceral artery aneurysm is an uncommon pathology, with a potential for rupture. Splenic artery aneurysms (SAA) are most commonly (60%) associated with a high mortality rate of 25% in case of aneurysm rupture. This increases disproportionately to 75% among pregnant women with fetal mortality of 95%. Although this is a rare event, because of the associated catastrophic consequences, prompt management of splenic artery aneurysms (SAA) is of prime importance. This systematic review provides up-to-date information about the management of splenic artery aneurysms in pregnancy.

Aneurysm development is multifactorial with important genetic and environmental factors. The literature supports the theory that IAAA arise from the same antigenic stimulus that is responsible for the non-IAAA, representing one extreme of an inflammatory spectrum. The results after open repair have improved and there is now little difference in the mortality between non-IAAA and IAAA repair. However, there is likely to be a role for endovascular stenting in IAAA management and this requires further study. It is clear that closer follow-up of patients after IAAA repair with either technique is necessary to monitor the inflammatory process. No evidence-based follow-up protocol exists but three to six-monthly monitoring of renal function and erythrocyte sedimentation rate (ESR) for 24 months post-repair would seem a reasonable regime.