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Response to Commentary on “The Relationship Between Vein Diameters, Clinical Severity, and Quality of Life: A Systematic Review”

We refer to the invited commentary by Bellmunt-Montoya and Escribano.1 We thank them for their evaluation of our review,2 and agree that patients suffering from chronic venous disease should be assessed holistically, with symptoms and their associated impact on quality of life considered in the intervention decision making process. It is also clear that they agree with the results of our review regarding vein diameter not being an appropriate measure to determine individuals requiring venous intervention.

Dissection Level Within Aortic Wall Layers is Associated with Propagation of Type B Aortic Dissection: A Swine Model Study

Haemodynamic and geometric factors play pivotal roles in the propagation of acute type B aortic dissection (TBAD). The aim of this study was to evaluate the association between dissection level within all aortic layers and the propagation of acute TBAD in porcine aorta.

Factors Associated with Failed Conservative Management in Symptomatic Isolated Mesenteric Artery Dissection

The aim of this study was to assess factors associated with conservative management failure in patients with symptomatic isolated mesenteric artery dissection.

Frailty and functional outcomes after open and endovascular procedures for patients with peripheral arterial disease: A systematic review

Journal of Vascular Surgery - July 19, 2019 - 00:00
Frailty has been associated with postoperative complications and mortality across surgical specialties, including vascular surgery. However, the influence of frailty on postoperative functional outcomes is unclear. We sought to determine the influence of frailty on functional outcomes after open or endovascular vascular procedures in patients with peripheral arterial disease.

No Complaints on the Validity of Karbase

Once again, we are presented with an example of a registry with excellent external and internal validity.1 Excellent external validity tells us that in the end, surgeons are motivated to enter cases and procedures into a registry, and good internal validity tells us that they even fill in the information correctly. In the current validation carried out in Denmark, the seven hospitals that were included in the detailed validation covered 51% of the carotid and 78% of the aortic procedures performed in the entire country.

The Impact of Endovascular Aneurysm Repair on Long Term Renal Function Based on Hard Renal Outcomes

Over the short term endovascular aneurysm repair (EVAR) is associated with superior outcomes compared with open repair; however, the progression of renal function after EVAR remains unknown because of the use of inconsistent reporting measures. The aim was to define long term renal decline following elective EVAR using estimated glomerular filtration rate (eGFR).

Risk assessment of significant upper extremity arteriovenous graft infection in the Vascular Quality Initiative

Journal of Vascular Surgery - July 18, 2019 - 00:00
Infectious complications of arteriovenous grafts (AVGs) are a major source of morbidity. Our aim was to characterize contemporary risk factors for upper extremity AVG infection.

Review of serum biomarkers in carotid atherosclerosis

Journal of Vascular Surgery - July 18, 2019 - 00:00
Carotid artery atherosclerotic stenosis is a preventable major cause of stroke, but there is still a need for definition of high-risk plaque in asymptomatic patients who might benefit from interventional therapies. Several image markers are recommended to characterize unstable plaques. The measurement of serum biomarkers is a promising method to assist in decision making, but the lack of robust evidence in the carotid environment burdens their potential as a standard of care. The goal of this review was to offer an updated state-of-the-art study of available serum biomarkers with clinical implications, with focus on those that may predict carotid symptom development.

Treatment of aortic and peripheral prosthetic graft infections with bovine pericardium

Journal of Vascular Surgery - July 18, 2019 - 00:00
Graft infections are rare but serious complications of vascular operations. The aim of this study was to evaluate the results of in situ reconstruction with bovine pericardium in infected aortic and peripheral vessel fields.

Reinterventions in the modern era of thoracic endovascular aortic repair

Journal of Vascular Surgery - July 18, 2019 - 00:00
Using a national data set, we sought to describe the population of patients and the nature and timing of reinterventions after thoracic endovascular aortic repair (TEVAR) by aortic disease as well as their impact on survival.

Outcomes of open repair of postdissection abdominal aortic aneurysms

Journal of Vascular Surgery - July 18, 2019 - 00:00
Evidence to guide management of postdissection abdominal aortic aneurysms (PDAAA) is lacking. This study describes the outcomes of open repair of PDAAA.

Diabetes, dysglycemia, and vascular surgery

Journal of Vascular Surgery - July 18, 2019 - 00:00
Abnormalities in glucose metabolism are common in patients with arterial disease. Chronic hyperglycemia and insulin resistance contribute to the complexity of vascular disorders. They also overlap with the effects of perioperative hyperglycemia on adverse perioperative outcomes. We provide an overview of the pathophysiologic consequences of dysglycemia and the evidence behind glycemic control in patients undergoing vascular surgery.

The obsession with metrics in contemporary health care

Journal of Vascular Surgery - July 18, 2019 - 00:00
Serving as the Recorder for this Association for 5 years and as President for the past year has certainly been the greatest honor in my professional life. I thank all of you for allowing me this experience. As I look out and consider all of my friends and mentors in the Southern Association for Vascular Surgery and I consider the previous individuals to hold the Presidency, I feel very undeserving but at the same time very blessed. Many of you deserve this position much more than I do.

A systematic review and meta-analysis of endovascular versus open surgical repair for the traumatic ruptured thoracic aorta

Journal of Vascular Surgery - July 18, 2019 - 00:00
The purpose of this study was to compare clinical outcomes between open repair and thoracic endovascular aortic repair (TEVAR) in traumatic ruptured thoracic aorta.

Efficacy of intra-arterial catheter-directed thrombolysis for popliteal and infrapopliteal acute limb ischemia

Journal of Vascular Surgery - July 18, 2019 - 00:00
The purpose of this study was to examine the efficacy and safety of catheter-directed thrombolysis (CDT) for first-line treatment of popliteal and infrapopliteal acute limb ischemia.

Giant abdominal aortic aneurysm of uncommon etiology due to Behçet disease

Journal of Vascular Surgery - July 18, 2019 - 00:00
Behçet disease is a multisystem disorder presenting with recurrent oral and genital ulcerations as well as with ocular involvement. Vascular involvement can occur in up to 50% of affected patients. Arterial aneurysms are often multiple and are characterized by a saccular configuration with increased risk of unexpected rupture, thrombosis, and aneurysm recurrence. Here we report a case of giant infrarenal abdominal aortic aneurysm in a 34-year-old man with Behçet disease who underwent aneurysmorrhaphy and aortobifemoral bypass.

A systematic review and meta-analysis of endovascular juxtarenal aortic aneurysm repair demonstrates lower perioperative mortality compared with open repair

Journal of Vascular Surgery - July 18, 2019 - 00:00
The objectives of the present study were to summarize and pool the available data from studies that had directly compared endovascular and open repair of juxtarenal aortic aneurysms.

Systematic review and meta-analysis of the association between intraluminal thrombus volume and abdominal aortic aneurysm rupture

Journal of Vascular Surgery - July 18, 2019 - 00:00
Intraluminal thrombus (ILT) is present in most abdominal aortic aneurysms (AAAs), although its role in AAA progression is controversial.

Discussion

Journal of Vascular Surgery - July 18, 2019 - 00:00
Dr Patrick Ryan (Nashville, Tenn). That was a great presentation, I've never done that operation. One question of follow-up: Do you shunt in these cases? How could you shunt?

Improving midterm results justify the continued use of bare-metal stents for endovascular therapy for chronic mesenteric ischemia

Journal of Vascular Surgery - July 18, 2019 - 00:00
The objective of this study was to evaluate the contemporary results of interventions in the celiac axis (CA) and superior mesenteric artery (SMA) for chronic mesenteric ischemia (CMI) and factors associated with patency and symptom-free survival.
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