Despite most EVAR patients being treated outside of IFU, there was no difference in outcomes with respect to all-cause mortality or aneurysm-related mortality. In addition, with the exception of perioperative blood transfusions, there was no association between IFU adherence and late-onset rupture, need for reintervention, rates of endoleak, aneurysm sac enlargement, or most other major complications.

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Routine preoperative tests that determine baseline inflammatory status may provide strong clinical utility in assessing potential risk stratification of patients for ISR after femoropopliteal stenting. Circulating WBCs, platelets, and neutrophils may be important inflammatory mediators of ISR.

No abstract

challenging to treat. The goal of this study was to describe the clinical presentation, associated imaging findings, and operative strategies for these aneurysms.Methods: A retrospective record review was performed of all patients with GDAAs or PDAAs identified through an institutional database by axial imaging between 1994 and 2014. Data on presenting symptoms, comorbid conditions, imaging findings, and outcomes after operative intervention were collected and examined.Results: We identified 11 GDAAs and 25 PDAAs in 35 patients. Mean size of the GDAAs was 31.1 mm (range, 10-60 mm), and mean size of the PDAAs was 19.1 mm (range, 10-48 mm). Fourteen patients (40%) had symptomatic aneurysms and seven patients (20%) presented with rupture. Median size of ruptured aneurysms was 20 mm (range, 10-60 mm). Axial imaging showed 20 of 25 patients (80%) with PDAAs and four of 11 patients (36%) with GDAAs had evidence of severe celiac axis stenosis or occlusion, and 11 patients (31%) had radiographic evidence of median arcuate ligament syndrome. Of 24 patients who underwent aneurysm repair, 18 (75%) were successfully treated with primary endovascular repair (coil embolization, with or without celiac stent). Endovascular therapy failed in 2 patients (8%), who required open repair, Four patients (17%) were treated with primary open repair. Overall 30-day morbidity and mortality after aneurysm repair were 29% and 4%, respectively.Conclusions: GDAAs and PDAAs are uncommon lesions that are often associated with severe celiac axis stenosis/occlusion leading to altered hemodynamics in the pancreaticoduodenal arcade. These aneurysms are prone to rupture regardless of size, and intervention is accordingly recommended for all aneurysms at presentation. Endovascular repair of these aneurysms is highly successful and should be considered as the initial operative approach.