JOURNAL OF VASCULAR SURGERY Volume 17, Number 6 Meet&B abstracts 1121

scanning data in 22 patients with aortic aneurysms. The distance from the renal arteries to the proximal end of the aneurysm (aneurysm neck) was used, in conjunction with the aneurysm diameter from the original CT scanning data, to calibrate the dimensions of the aneurysm, the distal cuff, and the iliac arteries on the final images of the aneurysm.

The neck was longer than 20 mm (mean 26.7 2 4.1 mm) in 14 patients. In contrast, only one patient had a distal cuff longer than 20 mm (mean 4.2 of: 1.6 mm), and 14 of the others had no measurable distal cuff. There was no significant difference between aneurysm diameter in the anteroposterior direction (58.0 I 3.2 mm) and the trans- verse direction (56.4 2 3.3 mm). Aneurysm diameter correlated with aneurysm length (R = 0.79). Wide aneu- rysms were also long aneurysms. The diameter of the aortic aneurysm bore no relation to the diameter of the neck or the presence of iliac artery aneurysms. The proximal left common iliac artery deviated from the axis of the distal aorta by 38.0 t 5.8 degrees, although the right deviated by 47.8 * 5.4 degrees. One or other of the iliac arteries deviated by more than 45 degrees in 12 cases. Eleven of 44 common iliac arteries were aneurysmal. In four cases the iliac aneurysms were bilateral, in two cases only the left side was affected, and in one case only the right side was affected. Fourteen patients had no aneurysm of the common iliac arteries, and another three had segments of nondilated common iliac artery distal to iliac aneurysms.

Computerized three-dimensional reconstruction facil- itated interpretation ofanatomic information from CT scans, particularly the length of the aneurysm neck and shape of the iliac arteries. On the basis of this information we expect that few patients will have too short an aneurysm neck for endovascular aneurysm repair, but many will require a bifurcated graft for secure, hemostatic implanta- tion distally.

Aortic aneurysmal disease in females Michael F. Silane, MD, Kathleen M. Conte, RN, Gary A. Fantini, MD, and Elias Kazam, MD, The New rork Hospital-Cornell Medical Centa; New Turk, N.Y.

Aneurysmal disease in women is an uncommon prob- lem. In patients with abdominal aortic aneurysms (AAA), the male-to-female ratio is believed to be 10 to 1.

Observation of female patients with suprarenal aneu- rysms prompted this investigation to determine the inci- dence of renal and suprarenal involvement in women with abdominal aortic aneurysmal disease. All computerized transaxial tomography scans performed for any indication at a university hospital during a consecutive 12-month period were reviewed. If there was ectasia or aneurysm formation in the infrarenal aorta on the report, these films were examined in detail. Measurements were made of the infrarenal ectasia or aneurysm and of the aorta at the renal artery and celiac/hiatus levels.

A total of 4868 computerized transaxial tomography scans were reviewed. Aneurysmal disease or ectasia was found in 53 men and 22 women. In patients with aortas of 3 cm or more, the average aorta in women was 4.95 cm in

largest diameter versus 4.29 cm in men. However, in patients in whom repair might be considered (aorta 4.5 cm or larger), the women had a larger aorta (6.25 cm vs 5.67 cm,p = 0.27). Also, in this latter group, at the renal artery level the average aorta was 3.51 cm in women versus 2.76 cm @ < 0.05) in the men. If one considers a juxtarenal aorta of 3 cm or larger as possibly problematic for AAA repair, 71% of the women considered for surgical repair had a juxtarenal aorta of this size versus 29% in the men.

These data support the hypothesis that there is a higher incidence of renal level involvement of the aorta in women with infrarenal aneurysms. In women being considered for AAA repair, imaging of the juxtarenal aorta should be done before operation.

Inhibition of neointimal hyperplasia by blocking LX&- integrin with a small peptide antagonist GpmGRGD- SPCA Eric T. Choi, MD, Leslie Engel, PhD, Allan D. Callow, MD, Shaping Sun, MsSci, Jeffrey Trachtenberg, MD, Samuel Sanforo, MD, and Una S. Ryan, PhD, Washington University, St. Louis, MO.

Smooth muscle cell (SMC) accumulation in the intima or neointimal hyperplasia is the leading cause of restenosis after vascular procedures. Recent findings show that the SMC migrating from the media into the neointima is a critical step in the development of the hemodynamically compromising neointimal lesion. Moreover, integrins are thought to play a role in SMC movement. Therefore we have studied the role of one ubiquitous integrin, a,&, in SMC migration. We have demonstrated in vitro that platelet-derived growth factor-induced human SMC mi- gration is mediated by the av& integrin by use of a monoclonal antibody to the c& integrin and is RGD- dependent by use of an RGD peptide antagonist to the CY+& integrin, GpenGRGDSPCA to inhibit SMC migra- tion. We have also inhibited rabbit SMC migration with GpenGRGDSPCA to demonstrate the cross-species preser- vation of the RGD peptide sequence in SMC migration. In addition, when we administered GpenGRGDSPCA locally to rabbit carotid artery after balloon angioplasty, there was a significant reduction in the neointimal area compared with the arteries administered an inactive peptide or saline solution. Therefore we have demonstrated the significant role of the cxv& integrin in SMC migration in vitro and in neointimal hyperplasia in vivo.

Ischemic nephropathy and concomitant aortic disease: A ten-year experience Elliot L. Chaikof, MD, Robert B. Smith III, MD, Robert C. Allen, MD, Alan B. Lumsden, MD, Atef A. Salam, MD, and Thomas F. Dodson, MD, Emmy University Hospital, Atlanta, Ga.

The long-term outcome after surgical intervention for chronic renal insufficiency has not been well defined, particularly in patients with associated aortic disease. A