Management of femoral-popliteal arterial occlusive disease using percutaneous treatment with a stent graft is comparable with surgical revascularization with conventional femoral-to-AK popliteal artery bypass using synthetic material up to 12 months. Longer-term follow-up would be helpful in determining ongoing efficacy.

Studies of the developing nervous system led to the general view that growth factors promote neuronal survival in a "retrograde" manner. For example, release of NGF from postsynaptic peripheral targets followed by uptake and retrograde transport by presynaptic neurons provided a widely accepted conceptual framework for the action of neurotrophins. In contrast, although presynaptic or "anterograde" influences on the survival of developing neurons have been recognized for some time, the mechanisms by which afferent input regulates the survival of postsynaptic cells have received considerably less attention. In the forebrain network for learned vocal behavior in zebra finches, lesions of a cortical region for song control, the lateral magnocellular nucleus of the anterior neostriatum (lMAN), remove presynaptic input to a motor-cortical song region, the robust nucleus of the archistriatum (RA), and cause massive RA neuron death in young birds that are entering the sensitive period for song learning. Here we report that lesions of lMAN followed by infusions of neurotrophins directly into RA completely suppress neuronal apoptosis in RA. Moreover, we show that lMAN neurons are able to transport neurotrophins in the anterograde direction to RA, that neurotrophin-like immunoreactivity is present in cells in lMAN and RA, and that neurotrophin receptor-like immunoreactivity is present in RA. Expression of neurotrophins in lMAN and RA suggests that lMAN presynaptic input could regulate RA neuron survival by synthesizing, transporting, and releasing neurotrophins anterogradely or by regulating the auto/paracrine release of neurotrophins within RA, or perhaps by both. These data provide the first in vivo demonstration that neurotrophins can prevent the death of deafferented cortical neurons, and they raise the possibility that nonretrograde signaling by neurotrophins may be a common means of promoting neuronal survival in the vertebrate telencephalon. Anterograde and auto/ paracrine neurotrophin signaling, along with the more established view that neurotrophins regulate neuron survival via retrograde mechanisms, suggests multidirectional neurotrophin signaling in the vertebrate telencephalon.

In our experience the HeRO device has performed comparably to standard AVGs and has proven superior to TDCs in terms of patency, intervention, and infection rates when compared to the peer-reviewed literature. As an alternative to catheter dependence as a means for hemodialysis access, this graft could reduce the morbidity and mortality associated with TDCs and have a profound impact on the costs associated with catheter related infections and interventions.

A 47-year-old woman complained of abdominal pain, and a computed tomography scan indicated compressive obstruction of the celiac axis and a 4-cm retropancreatic aneurysm. An angiogram identified the aneurysmal vessel as the posterior pancreaticoduodenal artery. All foregut structures were supplied by this aneurysmal vessel. Via an open approach, the inflow and outflow of the aneurysm were ligated, and blood flow to the celiac axis was reconstructed via a bypass from the supraceliac aorta. A follow-up scan indicated complete thrombosis of the aneurysm. The patient is now symptom free. Open reconstruction of the celiac axis is mandatory when ligation of a pancreaticoduodenal aneurysm results in foregut ischemia. Ligation and reconstruction can be done safely and effectively in the elective setting.

The use of thermoregulatory catheters (TRCs) in critically ill patients has become increasingly popular. TRCs have been shown to be effective in regulating patient body temperature with improved outcomes. Critically ill patients, especially multitrauma patients and those with femoral catheters, are at high risk for deep vein thrombosis (DVT). Among patients for whom chemical DVT prophylaxis is not an option, inferior vena cava (IVC) filters are often placed prophylactically. The development of intravascular ultrasound (IVUS) has allowed placement of IVC filters at the bedside for patients who are too ill for transport to the operating room or cardiac catheterization lab. After encountering several patients with occult DVT of the IVC during bedside IVC filter placement, we performed a retrospective review to determine the incidence of DVT or pulmonary embolus (PE) in patients who had been treated with a TRC at Baylor University Medical Center at Dallas. Since 2008, IVC filters have been deployed at the bedside with the use of IVUS at Baylor University Medical Center. During that same time period, 83 patients had a TRC placed for either intravascular warming or cooling during their resuscitation. Forty-seven out of 83 patients who had a TRC placed survived their injuries. Ten of 47 patients (21%) were diagnosed with DVT or PE, and 6 of these 10 (60%) were found to have caval thrombus. We present this case series as evidence that undiagnosed IVC thrombus associated with TRCs may be higher than previously suspected, given that 5 out of 10 patients who had IVUS of their IVC for prophylactic IVC filter placement, as well as one patient diagnosed with PE, were found to have caval thrombus.