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Purpose: To determine whether a correlation exists between chronic cerebrospinal venous insufficiency (CCSVI) and multiple sclerosis (MS). Materials and Methods: A meta-analysis of the current literature was performed to evaluate the frequency of CCSVI, diagnosed by echo color Doppler criteria, in patients with MS and in normal controls. Results: In all, 19 studies were identified from January 2005 through February 2013; however, 3 studies were excluded due to duplicate data and 3 additional studies because 0 patients fulfilled CCSVI criteria in both MS and control groups. In order to improve homogeneity, 4 outlier studies were also removed from the analysis. Analysis of the remaining 9 studies demonstrated a significant correlation between CCSVI and MS (odds ratio 1.885, P < .0001) with no significant heterogeneity of the studies (I2 ¼ 18, P ¼ .279). Conclusions: The meta-analysis demonstrated a correlation between CCSVI and MS. However, there was no evidence that CCSVI has a causative role in MS. [ABSTRACT FROM AUTHOR]

Objectives: Thrombus removal has been shown to improve venous physiology in acute iliofemoral deep-venous thrombosis. Our study focuses on the contemporary application of venous thrombectomy based on data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Methods: Data submitted by over 200 hospitals to the ACS NSQIP participant use file was accessed for the years 2005-2008. The ACS NSQIP protocol provides clinically rigorous preoperative risk and 30-day outcomes for a prospective and systematic sample of vascular surgery patients. Patients were identified who had undergone venous thrombectomy through leg access (Primary procedure CPT 34421 or 34451). Demographic and clinical variables along with 30-day morbidity (1 or more of 21 defined complications) and mortality were evaluated. Secondary/concomitant procedures CPT codes were collected. Univariate analysis between groups was performed using χ 2 or T-tests with P ≤ .05 considered significant. Results: A total of 91 patients were identified who underwent primary venous thrombectomy. The mean age was 62.5 ± 15.8 y and 45 of 91 (49.5%) were female. Thirty-day mortality was 8.8% (8/91). Composite morbidity was 25.3% (23/91). Intraoperative transfusion was required in 18.7% of the patients, lower extremity fasciotomy was performed in 8.8% of the patients and an inferior vena cava (IVC) filter was placed in 2.2% of the patients. An arteriovenous anastomosis was created in only 1 patient; venous angioplasty was performed in 3.3% of the patients. Conclusions: Venous thrombectomy is associated with significant postoperative morbidity and mortality. This is at least partially due to the associated comorbidities of this patient population, approximately 1/5 in our study were ASA class 4. Most frequent causes of morbidity are pulmonary and wound infection complications. Only 2 patients had an IVC filter placed during the operation. Adjunctive procedures to assist vein patency such as arteriovenous fistula creation or venous angioplasty were infrequently performed. [ABSTRACT FROM PUBLISHER]

Gluteal aneurysms are rare entity, whose surgical or endovascular management is traditionally challenging. Infectious source being increasingly more common as the underlying etiology. We herein describe successful implementation of direct thrombin injection as another therapeutic option for these patients. [ABSTRACT FROM PUBLISHER]

Aberrant placement of vena cava filters has been documented. Only one case of intraaortic deployment, in which the filter was left at the aortic bifurcation with no adverse effects over a 4-year follow-up period, has been reported. We describe the endovascular retrieval of an intraaortic Greenfield filter using a snare and large sheath to protect the aortic intima from injury during removal of the device. [ABSTRACT FROM AUTHOR]