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A protocol was instituted in August 2009 which included a dedicated team with easy accessibility to referring hospitals to streamline the care pathway for patients with RAAA. A prospective data base was established to record the door to treatment time for patients. Besides patient demographics, mode of transfer, various timelines including time spent at the referring facility to diagnosis, transfer time, wait time at the receiving hospital and overall time were analyzed. A comparative analysis using two �Csample Wilcoxon test was then made between patients who were treated prior to group 1 (January 2008-August 2009) and after group 2 (August 2009-November 2010) implementation of protocol. In group 1 there were 26 patients while group 2 included 36 patients accounting for a 55% increase in patients treated with RAAA. There was no difference Oxacillin in the age, mode of transfer. While all the patients in group 1 were treated with open procedures, selleck screening library 36% patients in group 2 were treated with endovascular repair. Table 1 shows the results of comparative analysis of various timelines. There was a statistical difference with reduction in the overall door �Ctreatment time after the implementation of the protocol. While various therapeutic interventions have improved the outcome for patients with ruptured aortic aneurysms, provision of timely care is equally important. The observations from our study identify the need for dedicated protocols which enable early recognition by increasing awareness, effective communication, and rapid transfer to centers caring for patients with ruptured aneurysms. The study also suggests the need to have a common protocol for process improvement at the national level and creation of centers treating ruptured aortic aneurysms. ""Most reports of femoral-femoral bypass (FFB) were published before the era of endovascular intervention. This study examines the utilization and IPI-145 in vivo impact of adjunctive endovascular intervention on FFB in contemporary practice. We reviewed 253 FFB performed in 247 patients between 1984 and 2010. Primary endpoints including graft patency, primary assisted patency, limb salvage and survival were assessed using Kaplan-Meier life table analysis. Univariate and multivariate analyses were performed to determine predictors of primary endpoints. The indication for FFB included claudication(27% n=69) and critical limb ischemia(72% n=184). Forty-eight patients were treated urgently for acute ischemia. Mean follow-up was 5.6(��5.5) years. Over the study interval, adjunctive iliac stent placement increased significantly from 0% to 54% (p-trend