Journal of Vascular Surgery

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Contents

June 1, 2019 - 00:00

Editorial Board

June 1, 2019 - 00:00

Global Vascular Guidelines for patients with chronic limb-threatening ischemia

June 1, 2019 - 00:00
The Global Vascular Guidelines (GVGs) published in this month’s supplement of the Journal of Vascular Surgery1 are the most comprehensive clinical practice guidelines ever published on the management of patients with chronic limb-threatening ischemia (CLTI). Combined with a new systematic review and meta-analysis,2 these documents represent 5 years of work by an international team of vascular specialists, each with recognized expertise in peripheral arterial disease (PAD). The guidelines considered evidence on all therapies currently available throughout the world to treat this important global problem and the end result is a monumental work of exceptional quality.

A systematic review and meta-analysis of revascularization outcomes of infrainguinal chronic limb-threatening ischemia

June 1, 2019 - 00:00
The optimal strategy for revascularization in infrainguinal chronic limb-threatening ischemia (CLTI) remains debatable. Comparative trials are scarce, and daily decisions are often made using anecdotal or low-quality evidence.

Computational analysis of renal artery flow characteristics by modeling aortoplasty and aortic bypass interventions for abdominal aortic coarctation

May 29, 2019 - 00:00
Suprarenal abdominal aortic coarctation (SAAC) alters flow and pressure patterns to the kidneys and is often associated with severe angiotensin-mediated hypertension refractory to drug therapy. SAAC is most often treated by a thoracoabdominal bypass (TAB) or patch aortoplasty (PA). It is currently unclear what effect these interventions have on renal flow and pressure waveforms. This study, using retrospective data from a patient with SAAC subjected to a TAB, undertook computational modeling to analyze aortorenal blood flow preoperatively as well as postoperatively after a variety of TAB and PA interventions.

The association between liver fat and systemic calcified atherosclerosis

May 29, 2019 - 00:00
The association of nonalcoholic fatty liver disease (NAFLD) with systemic calcified atherosclerosis, other than the coronary arteries, has not been clearly elucidated. We investigated the association between NAFLD and calcification in eight different vascular beds.

A systematic review of distal revascularization and interval ligation for the treatment of vascular access-induced ischemia

May 29, 2019 - 00:00
Vascular access-induced ischemia remains a rare but significant complication of arteriovenous fistulas. Distal revascularization and interval ligation (DRIL) is one form of treatment. However, its collated efficacy through a systematic review is yet to be established.

Assessment of changes in stent graft geometry after chimney endovascular aneurysm sealing

May 29, 2019 - 00:00
Chimney endovascular aneurysm sealing (ch-EVAS) could potentially minimize gutter-associated endoleaks in patients with juxtarenal abdominal aortic aneurysms resulting from the use of the conformable endobags surrounding the chimney stent grafts (ch-SGs). The aim of the present study was to quantify the (non)apposition of the endobags in the proximal aortic neck, migration of the endograft stent frames, and changes in geometry of the ch-SGs during the follow-up period.

Midterm results of coronary artery bypass graft surgery after synchronous or staged carotid revascularization

May 29, 2019 - 00:00
In the absence of randomized trials, the optimal approach to managing coexisting severe carotid and coronary diseases remains controversial. The aim of this study was to present the midterm follow-up results of patients who received a coronary artery bypass graft (CABG) after carotid revascularization and to compare the risk-adjusted outcomes of two approaches to carotid revascularization in the CABG population in a single center.

Readmissions to an alternate hospital in patients undergoing vascular intervention for claudication and critical limb ischemia associated with significantly higher mortality

May 29, 2019 - 00:00
Hospital readmissions with 30 days after vascular surgical interventions have been associated with increased morbidity, mortality, and cost. Readmission rates, now a Centers for Medicare and Medicaid Services quality measure, have been studied in databases that have excluded certain payer types and states and have not accounted for readmission to a hospital different from that of the index admission. More accurate and nationally representative data are needed, because this fragmentation of care could lead to flawed conclusions.

Experienced operators achieve superior patency and wound complication rates with endoscopic great saphenous vein harvest compared with open harvest in lower extremity bypasses

May 29, 2019 - 00:00
Prior studies have suggested improved wound complication rates but decreased primary patency in lower extremity bypasses performed with endoscopic vein harvest (EVH) vs open vein harvest (OVH). We hypothesize that the inferior patency reflects the initial learning curve for EVH and that improved patency can be achieved with experience.

Surgically positioned paravertebral catheters and postoperative analgesia after open abdominal aortic aneurysm repair

May 29, 2019 - 00:00
To compare postoperative morphine equivalent intake after open abdominal aortic aneurysm (AAA) repair among analgesic modalities: systemic analgesia (SA) only with no regional anesthesia, surgically positioned paravertebral catheter (PVC), and thoracic epidural analgesia (TEA).

Benefit of multidisciplinary wound care center on the volume and outcomes of a vascular surgery practice

May 29, 2019 - 00:00
Multidisciplinary care is recommended for the treatment of patients with ischemic and diabetic wounds. In addition to integrating care from multiple specialties, outpatient wound care centers provide an opportunity for continuity and organization of care after revascularization or hospitalization. The purpose of this study was to assess changes in the practice patterns and outcomes of patients treated by a tertiary care vascular surgery practice after the introduction of an affiliated outpatient wound care center.

Fenestrated endovascular aneurysm repair is associated with lower perioperative morbidity and mortality compared with open repair for complex abdominal aortic aneurysms

May 28, 2019 - 00:30
The Zenith Fenestrated Endovascular Graft (ZFEN; Cook Medical, Bloomington, Ind) has expanded the anatomic eligibility of endovascular aneurysm repair (EVAR) for complex abdominal aortic aneurysms (AAAs). Current data on ZFEN mainly consist of single-institution experiences and show conflicting results. Therefore, we compared perioperative outcomes after repair using ZFEN with open complex AAA repair and infrarenal EVAR in a nationwide multicenter registry.

Predictors of bleeding or anemia requiring transfusion in complex endovascular aortic repair and its impact on outcomes in health insurance claims

May 27, 2019 - 00:00
This study aimed to determine predictors and outcomes associated with bleeding or anemia requiring transfusion (BAT) after fenestrated or branched endovascular aneurysm repair (FB-EVAR).

Long-term results after standard endovascular aneurysm repair with the Endurant and Excluder stent grafts

May 27, 2019 - 00:00
Many endografts are currently available for standard endovascular repair of infrarenal abdominal aortic aneurysms. Comparison of long-term outcomes between devices might aid in this decision process, but comparative data are scarce. The purpose of this study was to report long-term clinical outcomes of two commercially available endoprosthesis, the Endurant (Medtronic Vascular, Inc, Minneapolis, Minn) and the Excluder (W. L. Gore & Associates, Flagstaff, Ariz) stent grafts.

Single-session catheter-directed lysis using adjunctive power-pulse spray with AngioJet for the treatment of acute massive and submassive pulmonary embolism

May 27, 2019 - 00:00
An alternative single-session catheter-directed thrombolysis (CDT) method using adjunctive power-pulse spray (PPS) technique (with the AngioJet system; Boston Scientific, Fremont, Calif) was investigated to evaluate its safety and effectiveness in the treatment of acute massive and submassive high-risk pulmonary embolism (PE).

Patients with lower extremity dialysis access have poor primary patency and survival

May 27, 2019 - 00:00
Lower extremity arteriovenous (AV) access is an alternative when upper extremity access options have been exhausted. Our goal was to assess short- and medium-term outcomes of lower extremity hemodialysis access.

Risk prediction of 30-day mortality after lower extremity major amputation

May 27, 2019 - 00:00
Universal risk calculators may underestimate mortality risk, whereas purely observational administrative data may lack appropriate granularity to individualize risk. The purpose of this study was to create a simple risk prediction model to identify the factors associated with 30-day morality after lower extremity major amputation for ischemic vascular disease.

Test-retest reliability, agreement, and minimal detectable change in the 6-minute walk test in patients with intermittent claudication

May 27, 2019 - 00:00
Standardized walk tests are important for objective assessment of walking distance in patients with intermittent claudication (IC). The 6-minute walk test (6MWT) has been suggested to correlate more closely than testing on a treadmill with everyday ambulatory function, but its measurement properties have hardly been studied in IC. The aim of this study was to determine the test-retest reliability, agreement, standard error of measurement (SEM), and minimal detectable change of the 6MWT in patients with IC.