This study confirms the feasibility and safety of total percutaneous endovascular AAA repair. Our preliminary results suggest that the costs paid by healthcare providers for endovascular AAA repair might not be increased with the selective use of percutaneous closure devices.

In-situ reconstruction with the silver graft confirms similarity with other modalities. The greatest advantage for the silver graft is its ease of use but the risk of reinfection remains significant.

Background The poor clinical results that are frequently reported for arteriovenous fistulae (AVF) for hemodialysis are typically due to failure of AVF maturation. We hypothesized that early AVF maturation is associated with generation of reactive oxygen species and activation of the HIF-1 pathway, potentially promoting neointimal hyperplasia. We tested this hypothesis using a previously reported mouse AVF model that recapitulates human AVF maturation. Methods Aortocaval fistulae were created in C57Bl/6 mice, and compared to sham-operated mice. AVFs or inferior vena cavas were analysed using a microarray, Amplex Red for extracellular H2O2, qPCR, immunohistochemistry, and immunoblotting for HIF-1α, and immunofluorescence for NOX-2, nitrotyrosine, HO-1 and VEGF-A. Results Oxidative stress was higher in AVF compared to control veins, with more H2O2 (p=0.007) and enhanced nitrotyrosine immunostaining (p=0.005). Immunohistochemistry and immunoblot showed increased HIF-1α immunoreactivity in the AVF endothelium; HIF-1 targets NOX-2, HO-1 and VEGF-A were overexpressed in the AVF (p<0.01). AVF expressed increased numbers of HIF-1α (p<0.0001) and HO-1 (p<0.0001) mRNA transcripts. Conclusions Oxidative stress increases in mouse AVF during early maturation, with increased expression of HIF-1α and its target genes NOX-2, HO-1 and VEGF-A. These results suggest that clinical strategies to improve AVF maturation could target the HIF-1 pathway.

The life expectancy of patients who undergo successful AAA repair is not as good as that of the age- and sex-matched general population. Late survival depends on the patients' age at the time of surgery and the existence of preoperative chronic renal failure.

The RADAR technique is associated with less juxta-anastomotic stenosis, increased maturation and patency, and fewer secondary interventions. These improved outcomes suggest that RADAR may be the preferred surgical technique to perform radial-cephalic arteriovenous fistula.