Elevational and age gradients in hawaiian montane rainforest: foliar and soil nutrients.

Soils and plants were sampled along an elevational gradient from 265-1675 m on a 133-and a 3100-year-old lava flow on Mauna Loa, Hawai'i. Soil organic matter and nutrients accumulated more rapidly at low elevation on the young flow, but reached higher levels at higher elevation on the old flow. Foliar nitrogen and phosphorus concentrations were less and specific leaf weight greater for Metrosideros polymorpha leaves collected at high versus low elevations and on the young versus the old flow. Foliar δ13C was strongly correlated with specific leaf weight across the range of sites sampled.

A contemporary review of cystic adventitial disease.

Cystic adventitial disease (CAD) is a rare vascular disorder, predominantly seen in young healthy men with minimal cardiovascular risk factors. Cystic adventitial disease can affect both arteries and veins. Patients with arterial CAD present with sudden onset or rapidly progressing claudication symptoms, and those with venous CAD present with limb swelling or very rarely deep vein thrombosis. Diagnosis is confirmed with the aid of imaging techniques such as ultrasonography, computed tomography, or magnetic resonance scan. Surgical resection or evacuation of the lesion is usually the preferred approach, with only mixed results reported for percutaneous endovascular techniques.

Endovascular treatment of isolated internal iliac artery aneurysms.

The aim of the paper is to evaluate the outcome of endovascular treatments for isolated internal iliac artery aneurysms. A systematic review of the literature using public domain databases was undertaken. All studies reporting on endovascular treatment of isolated hypogastric artery aneurysms were considered. Experience from our institution was involved in the data analysis. The primary outcome measures were technical success, perioperative, and overall mortality and morbidity. Data were extracted from 30 articles fulfilling the selection criteria, and the study cohort consisted of 55 patients having undergone treatment of 59 internal iliac artery aneurysms. Ten patients (18%) were treated on an urgent or emergency basis for a ruptured aneurysm. Technical success was achieved in 71% of the cases. The most common reason for technical failure was incomplete exclusion of the aneurysm sac. Thirty-day mortality occurred in one patient (2%). The 30-day morbidity rate was 20%, and was mostly associated with insufficiency of the pelvic circulation. One aneurysm-related death occurred during a mean follow-up period of 13 months (range 0.5-56 months). Open surgical intervention for aneurysm-related complications was required in five patients. In conclusion, endovascular treatment of isolated internal iliac artery aneurysms is an effective alternative option, with satisfactory early and mid-term results.

Stent implantation for acute iliac artery occlusions: initial experience.

PURPOSE: Treatment options for acute occlusion of the iliac arteries include surgical thrombectomy, surgical bypass, and endovascular interventions such as thrombolysis and mechanical thrombectomy with or without adjunctive angioplasty or stent implantation. Acute lesions are not usually treated by stent implantation for fear of distal embolism. The purpose of this study was to retrospectively review a single-center experience of primary iliac stent implantation for acute ischemia secondary to acute thrombosis. MATERIALS AND METHODS: Between April 2004 and August 2005, seven patients (five men and two women; mean age, 69.9 y; range, 53-93 y) underwent iliac stent implantation for the acute onset (within 12 days before presentation) of ipsilateral ischemic symptoms. Diagnostic angiography revealed occlusion of the common and external iliac arteries (n = 3) or external iliac artery (n = 4). Patients with rest pain (n = 6) were treated with unfractionated heparin. RESULTS: All acute occlusions were traversed by the guide wire with relative ease. Recanalization with stent implantation was successful in all cases without distal embolization. Five patients showed noticeable clinical improvement. Two elderly patients with isolated patent profunda segments with no demonstrable distal runoff vessels did not have long-term clinical improvement despite successful iliac recanalization. CONCLUSIONS: This small case series suggests that primary stent implantation for acute iliac occlusions with a patent common femoral artery under intravenous heparin protection may be a reasonable endovascular alternative to thrombolysis for patients who cannot tolerate the time delay to achieve thrombolysis or who have contraindications to thrombolysis. The safety of this technique may be comparable to that of primary stent implantation for chronic occlusions, but larger series would be necessary to confirm this.