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FEVAR is a safe and effective procedure in octogenarians at high and standard risk for open repair and those who are not eligible for standard endovascular aneurysm repair. Octogenarians have a similar technical success and low major adverse events similar to patients younger than 80 years.

increased when siRNA was complexed with PEI. The amount of siRNA adsorbed generally appeared greater in ePET than in PTFE fabrics. Repeated dipping of ePET in siGLO Red/PEI solution significantly increased siRNA adsorption vs single dipping.Conclusions: siRNA adsorption to ePET and PTFE surfaces is significantly increased if the siRNA is complexed with PEI. Preliminary data in this study suggest that siRNA adsorbs better to ePET than PTFE. Further, repeated dipping of ePET additionally increased adsorption of siRNA to fabric. Thus, coating of ePET with siRNA/PEI may be a method to improve graft patency.Introduction and objectives: Eph-B4, the receptor tyrosine kinase that serves as the embryonic venous fate determinant, is decreased in association with the successful adaptation of surgical vein grafts to the arterial environment. Stimulation of Eph-B4 recovers the native phenotype. However, the Ephrin-B2 protein, the juxtacrine ligand for Eph-B4, is not expressed in veins; as such, the adult physiologic controller of Eph-B4 is unknown. We explored whether the mechanosensitive integrin-␤-1 molecule is an upstream regulator of Eph-B4 signaling.Methods: Eph-B4 -positive endothelial cells and Eph-B4 -negative Cos cells transfected with wild-type or mutant W804A Eph-B4 were stimulated with type I collagen and anti-integrin-␤-1 activating antibody (P4G11) and analyzed with Western blotting. Colocalization was determined using immunofluorescence. Unilateral external carotid artery ligation was performed on heterozygous integrin-␤-1 knockout (Het-B1-KO) mice. Carotid arteries were examined on day 14 and jugular veins on days 1 and 7. Veins from Het-B1-KO mice were placed as aortic interposition grafts into wild-type mice and examined at day 21.Results: Endothelial cells stimulated with collagen or P4G11 increased Eph-B4 phosphorylation. Eph-B4 and integrin-␤-1 colocalized on both endothelial cells and wild-type Eph-B4 transfected Cos cells after stimulation with collagen; mutant W804A Eph-B4 transfected cells were unable to phosphorylate Eph-B4. Het-B1-KO mice that underwent unilateral ligation of the external carotid showed aberrant vascular remodeling. Het-B1-KO vein grafts showed approximately threefold increased neointimal thickening compared with wild-type controls.Conclusions: Integrin-␤-1 is present on endothelial cells, responds to hemodynamic forces, induces Eph-B4 signaling, and modifies vessel and vein graft remodeling. These results connect hemodynamic forces to vein graft adaptation through extracellular matrix interactions. Integrin-␤-1 is an upstream regulator of Eph-B4 signaling during vein graft adaptation and may represent a novel therapeutic target with the potential to limit neointimal hyperplasia in vein grafts.

Readmission after lower extremity endovascular intervention is a serious complication. Various factors place a patient at a high risk for readmission. High body mass index, unplanned return to the operating room, insulin-dependent diabetes mellitus, noninsulin-dependent diabetes mellitus, nonsmoking status, dyspnea, dependent functional status, and emergency operation are independent risk factors for hospital readmission. Return to operating room is associated with an 8.3-fold increase in hospital readmission.

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