There are limited data on rates of failure and airway injury with the use of airway exchange catheters. We performed a single-center retrospective analysis of airway exchange catheters to determine the incidence and associated factors for tube exchange failure and airway injury. Among 1177 cases, failed intubation during attempted tube exchange was noted in 73/527 (13.8%). Airway exchange failure rates were greatest during exchange catheter use for double-lumen tube insertion and when intubation was attempted over the catheter postoperatively. Pneumothorax was noted after 1.5% of attempted tube exchanges. Difficult tube exchange was encountered in 6 of 8 patients with pneumothorax.

distal PAD is associated with more adverse overall outcomes. The authors therefore sought to determine, through retrospective analysis of arteriograms, whether the general prognosis of PAD patients differs according to location of disease.Patients who underwent a first digital subtraction arteriogram of the lower limbs at the authors' institution between January 2000 and December 2005 were reviewed. Arterial stenoses Ͼ50% in diameter reduction were scored by two senior physicians. Up until April 2007, death, nonfatal myocardial infarction, stroke, and coronary and carotid revascularization were recorded. The primary outcome variable included all these events. There were 400 PAD patients (75% male), with a mean age of 68.3 Ϯ 12.3 years, who met qualifications for the study. Iliac disease was noted in 211 (52.8%) and infrainguinal disease in 344 (86.0%). Proximal PAD was associated with greater prevalence of male sex and smoking, whereas more distal PAD was associated with older-age diabetes, hypertension, and renal failure (P Ͻ .05). Follow up averaged 34 Ϯ 23 months. After adjustments for age, sex, cardiovascular disease history and cardiovascular disease risk factors, critical leg ischemia status and treatments, event and survival curves differed according to PAD location (P Ͻ .03). Proximal PAD was associated with the worst prognosis, with a primary outcome hazard ratio of 3.28 and a death hazard ratio of 3.18 (P Ͻ .002 vs distal PAD).Comment: This is the first study to report a poorer overall prognosis in patients with aortoiliac disease compared with those with more distal PAD. An obvious limitation of this study is that only patients undergoing angiography were included. The information was therefore primarily derived from patients with severe vascular disease where some form of intervention was contemplated. The results of this study need to be confirmed in a more general population of patients with PAD. However, if these findings are confirmed, it could result in potential additional risk stratification of PAD patients according to which lower extremity arteries are affected.

Background: In the same way that impact factor is calculated for journals, the number of citations an article receives can indicate its influence or value to a particular field. This study was designed to identify the most frequently cited articles in anesthesiology education to yield insight into which articles have been most useful for researchers in ongoing research and publication. Methods: The Web of Science database was searched to capture the top-cited articles in anesthesiology education both in anesthesiology and nonanesthesiology journals. Results were sorted by the most frequently cited. The top 40 cited articles were identified. Articles were included if they (1) related to anesthesiology or included anesthesiologists as subjects and (2) were related to the education of current or future anesthesiologists. The full text was analyzed, and themes were identified. Results: There was a total of 2923 citations of articles in anesthesiology journals and 924 citations of articles in nonanesthesiology journals. Thirty-two of 40 articles (80%) were research studies. Twenty-four of 40 (60%) were about teaching methods. Twenty-five of 40 (63%) focused on simulation, and 31 of 40 (78%) had residents as the subjects. Twenty-eight of 40 (70%) articles were about either case management (15) or learning procedures (13). Conclusions: This study identifies the most widely cited articles in anesthesiology education. Common themes included procedural learning, interventional research study designs, simulation, and studies involving residents as subjects. This article may be a resource to anesthesiology education researchers to identify what articles are widely cited by other researchers.