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021; P=0.017, respectively), and the GA and AA genotypes had higher high-density lipid-C levels than the GG genotype. CONCLUSION Our study provides evidence that ABCG1 promoter region polymorphism rs57137919 has an influence on plasma high-density lipid-C and low-density lipid-C levels in Chinese Han population. Pseudoaneurysm of the uterine artery is a rare condition which usually occurs after a traumatic birth, Cesarean-Section, D&C (dilatation and curettage) and hysterectomy. This case is a 28-year-old female patient that presented with the chief complaint of severe urinary tract bleeding and hypovolemic shock. This patient underwent Cesarean-Section two months prior to the first presentation. After the primary examination, the patient was sent to the hybrid operation room with the primary diagnosis of uterine artery pseudoaneurysm and coil embolization was done for treating the pseudoaneurysm. Considering continued bleeding, open surgery was performed and the internal iliac artery was ligated. PURPOSE The aim of this study is to report the early and late outcomes of ultrasound-guided direct transabdominal embolization (UGDTE) of isolated type 2 endoleak (T2EL) after endovascular aortic repair (EVAR). METHODS Forty-two consecutive T2EL patients were treated between February 2000 and September 2017 by UGDTE after previous EVAR. During the study period, UGDTE was the firs-line technique implemented for treatment of T2EL. All procedures were carried out using the same pre-defined technique. Aneurysm sac size change from the index treatment, freedom from recurrent endoleak after treatment, demographics, risk factors, and procedural factors were analyzed with univariate analysis. RESULTS During the study interval, 612 patients underwent standard EVAR for AAA treatment and 111 (18,2%) developed an isolated T2EL. Of these, 42 (6,8%) consecutive patients were deemed suitable and treated with UDGT. Median imaging follow-up duration was 18,7 months. Median fluoroscopic and procedure times were 7 minutes and 58 minutes, respectively. The rate of immediate technical success was 100%. Ten patients (23,8%) underwent reintervention for recurrent T2EL. Freedom from reintervention for T2EL at 1, 2 and 4 years was 81%, 78% and 71%. No aneurysm-related mortality occurred during the follow-up period. CONCLUSION The use of UGDTE for treatment of isolated T2EL after EVAR is a safe and feasible technique when performed by experienced operators, resulting in high technical success and low complications rates in selected patients. Although being effective in obtaining T2EL exclusion, up to one third of the patients may require repeat intervention during long-term follow-up. Therefore, lifelong surveillance after the procedure is recommended. INTRODUCTION For decades, open intervention was the treatment of choice in patients requiring lower extremity revascularization. Enarodustat clinical trial In the endovascular era, however, open or endovascular revascularization are options. The implications of prior revascularization on the outcomes for subsequent revascularization are not known. In the current study, we evaluated 30-day outcomes after open lower extremity revascularization for critical limb ischemia (CLI) in those that have had previous interventions. METHODS The 2012-2017 open lower extremity bypass Participant User Data Files from the National Surgical Quality Improvement Program (NSQIP) were used to identify a cohort of patients with CLI. Patients whose operation was considered emergent were excluded from the analysis. Patients were stratified on whether they had a previous open or endovascular intervention or undergoing a primary revascularization. The primary outcome measure was 30-day major adverse limb events (MALE). Secondary outcomes included major adverse cON A prior endovascular intervention does not seem to accrue any additional short-term risk when compared to primary revascularization, suggesting an endovascular-first approach may be a safe-strategy in CLI patients. However, a prior open intervention is significantly associated with 30-day MALE in patients undergoing redo open revascularization, which may be related to the rapid decline of patients once they have exhausted their best open revascularization option. BACKGROUND The Carotid Stent Angioplasty (CAS) has been the mainly option for patients with high cardiovascular risk and carotid stenosis. The common femoral artery is still the most used access site, however, the aortic arch manipulation is a critical moment for cerebral embolization. Carotid transcervical access should be considered as a good alternative access route for CAS. Tandem lesions combining supra-aortic trunks and ipsilateral carotid bulb critical stenosis pose a great challenge for the vascular surgeon. METHODS and Purpose This was retrospective descriptive study based on medical records of our institution. We report two cases of complex cerebral vascular insufficiency and discuss therapeutic options and strategies to protect the cerebrovascular territory avoiding microembolization, as well as demonstrate an alternative and safe total endovascular approach for those cases. RESULTS We describe the approach of two complex cerebral vascular insufficiency cases. The case 01, a 63-year-old male with previous ischemic stroke, right internal carotid artery (ICA) occlusion, left ICA stenosis > 70% and critical stenosis of the origin of common carotid artery (CCA). The case 02, a 68-year-old female with previous ischemic stroke, left ICA occlusion, brachiocephalic trunk critical stenosis, hypoplastic right vertebral artery and aorto-bi-iliac chronic occlusion. In both cases reported here a challenging solution was chosen, little described in the literature, with cerebral filter protection as the first step. In addition, a literature review was performed to discuss the different approach options for tandem injuries of the supra-aortic trunk and carotid bulb. CONCLUSION Our initial experience with total endovascular treatment of complex tandem lesions of the carotid territory and supra-aortic trunks show that transcervical access, coupled with distal protection filter device on the first step, is a safe and effective technique for preventing neurological events.

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