Journal of Vascular Surgery

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Updated: 8 hours 52 min ago

Endovascular treatment results and risk factors for complications of body and extremity arteriovenous malformations

March 31, 2019 - 23:00
The objective of this study was to investigate the factors associated with the complication rate and treatment outcomes of arteriovenous malformations (AVMs) during a 20-year period.

Age but not sex is associated with higher risk of in-hospital stroke or death after carotid artery stenting in symptomatic and asymptomatic carotid stenosis

March 31, 2019 - 23:00
The aim of this study was to analyze the correlation of age and sex with the outcome after carotid artery stenting (CAS). We used the statutory nationwide quality assurance database in Germany, in which, among others, all endovascular procedures on the extracranial carotid artery are filed.

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

8 hours 52 min ago
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.

Using bifurcated endoprosthesis after iliac artery recanalization for concomitant abdominal aortic aneurysm and chronic total occlusions of access routes

8 hours 52 min ago
Concurrent abdominal aortic aneurysm (AAA) and unilateral iliac occlusion is a challenge in the implantation of bifurcated stent grafts (BFGs). The endovascular approach is less invasive than open surgery; the aortouni-iliac (AUI) graft with crossover femorofemoral bypass (CFFB) has many problems associated with extra-anatomic reconstruction. We attempted endovascular aneurysm repair (EVAR) using BFGs in such cases and evaluated the outcomes.

Discussion

8 hours 52 min ago
Dr Nathan Orr (Lexington, Ky). I would like to congratulate the authors on an excellent presentation and manuscript as they begin to sort through the incidence and characteristics of secondary aortic interventions after thoracic endovascular aortic repair (TEVAR) for type B aortic dissections. As you have just heard, secondary aortic interventions are commonly required in this cohort, with an overall incidence of 27%. Further, this is fairly consistent for all comers, with relatively few predictors of increased incidence.

Implications of secondary aortic intervention after thoracic endovascular aortic repair for acute and chronic type B dissection

8 hours 52 min ago
Thoracic endovascular aortic repair (TEVAR) has become a mainstay of therapy for acute and chronic type B aortic dissection (TBAD). Dynamic aortic morphologic changes, untreated dissected aorta, and persistent false lumen perfusion have significant consequences for reintervention after TEVAR for TBAD. However, few reports contrast differences in secondary aortic intervention (SAI) after TEVAR for TBAD or describe their influence on mortality. This analysis examined incidence, timing, and types of SAI after TEVAR for acute and chronic TBAD and determined their impact on survival.

Endograft migration after thoracic endovascular aortic repair

8 hours 52 min ago
The objective of this study was to evaluate the incidence, timing, and potential risk factors of late endograft migration after thoracic endovascular aortic repair (TEVAR).

Branding vascular surgery should start with Why

March 19, 2019 - 23:00
First and foremost, I want to thank you for the privilege of serving as Eastern Vascular Society (EVS) president. To see my name on the same list as the past presidents is humbling and the greatest honor of my professional life. The opportunity to work and collaborate with the EVS executive council, committee chairs, and members has been nothing short of an incredible personal and professional experience, one that I will forever cherish and hold dear to my heart. Even though we have shared friendships for years, this year was very special for me in that it allowed me to get to know many of my colleagues at a much more personal level, for which I am indebted.

Associations of nutritional status and muscle size with mortality after open aortic aneurysm repair

March 18, 2019 - 23:00
Open surgical repair (OSR) for abdominal aortic aneurysms is a more invasive approach than endovascular aneurysm repair but has more enduring results and may lead to a lower reintervention rate. Therefore, strict selection of patients should be based on assessments of both early and late outcomes. The controlling nutritional status (CONUT) score and skeletal muscle mass index (SMI) have been reported as indicators of nutritional status and muscle size, respectively. The aim of this study was to identify prognostic factors, including sarcopenia and nutritional status, for early and late outcomes.

The forearm arteriovenous graft between the brachial artery and the brachial vein as a reliable dialysis vascular access for patients with inadequate superficial veins

March 16, 2019 - 23:00
The arteriovenous fistula (AVF) is recommended as the preferred hemodialysis access. However, placing an AVF in all patients may result in poor access outcomes and increased central venous catheter (CVC) use because of increased comorbid conditions, age, and suboptimal vessels. In patients with inadequate superficial veins for AVFs, the use of the brachial veins for creation of forearm arteriovenous grafts (AVGs) has received limited attention. This retrospective study aimed to evaluate outcomes of forearm brachial-brachial AVGs (BB-AVGs) placed in patients with poor superficial veins.

Why randomized controlled trials do not always reflect reality

March 12, 2019 - 23:00
Randomized controlled trials (RCTs) constitute level I evidence and are used as the backbone of guidelines and recommendations for treatment. Although RCTs are theoretically the studies of choice for the assessment of the effectiveness of health care interventions, these trials (and their interpretation) may sometimes result in erroneous conclusions, erroneous therapeutic decisions, and incorrect recommendations. We aimed to check the applicability of the results of RCTs to everyday practice.

The natural history of type B aortic dissection in patients with PRKG1 mutation c.530G>A (p.Arg177Gln)

March 10, 2019 - 23:00
The c.530G>A (p.Arg177Gln) mutation in PRKG1 has been shown to be associated with thoracic aortic aneurysms and dissections. This rare mutation accounts for an estimated 1% of nonsyndromic heritable thoracic aortic disease. We sought to describe the clinical presentation of type B aortic dissection (TBAD), management, and outcomes in patients with this mutation.

Cardiovascular morbidity and mortality after aortic dissection, intramural hematoma, and penetrating aortic ulcer

March 10, 2019 - 23:00
The nonaortic cardiovascular morbidity and mortality of patients with aortic dissection (AD), intramural hematoma (IMH), and penetrating aortic ulcer (PAU) is unknown. We aimed to define the rates of cardiovascular (CV) events in a cohort of patients with newly diagnosed AD, IMH, and PAU.

iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry)

March 10, 2019 - 23:00
The objective of this study was to assess early and midterm results after endovascular aortic arch repair using a double inner branch stent graft (DIBSG) in patients with aortic arch aneurysm or dissection unfit for open surgery.

Association between stress hormones and perioperative risk in patients with critical limb ischemia undergoing revascularization

March 7, 2019 - 23:00
It is well known that the clinical outcome of patients with critical limb ischemia (CLI) is poor. However, the relationship between stress-related hormone levels and CLI outcome remains unclear. The aim of this study was to reveal the association of stress hormones with the risk of a perioperative major adverse cardiovascular event (pMACE) in CLI patients undergoing surgical and endovascular revascularization.

Anatomic eligibility for transcarotid artery revascularization and transfemoral carotid artery stenting

March 6, 2019 - 23:00
Transcarotid artery revascularization (TCAR) has emerged as an alternative to transfemoral carotid artery stenting (tfCAS). We investigated the proportion of carotid arteries undergoing revascularization procedures that would be eligible for TCAR based on anatomic criteria and how many arteries at high anatomic risk for tfCAS would be amenable to TCAR.

Return of baseline kidney function after bilateral renal artery stent occlusion and treatment delay following fenestrated endografting

March 6, 2019 - 23:00
Although renal artery restenosis and thrombotic stent occlusion are not rare occurrences, the literature suggests that prompt diagnosis and treatment are essential to preserve renal function, particularly in the setting of occlusion. We describe the case of a 75-year-old woman who underwent fenestrated endovascular aneurysm repair and experienced acute anuric renal failure requiring dialysis secondary to bilateral renal artery stent occlusion for >48 hours. She was successfully treated with revisional endovascular therapy and made a full renal recovery.

Practice patterns in arteriovenous fistula ligation among kidney transplant recipients in the United States Renal Data Systems

March 6, 2019 - 23:00
Arteriovenous fistulas (AVF) and grafts (AVG) have been associated with significant cardiac morbidity that often improves after ligation. However, AV access ligation after kidney transplant (KT) is controversial due to concern for potential long-term allograft failure. We investigated US trends in AV access ligation after KT and the association between ligation and allograft failure.

The effect of income and insurance on the likelihood of major leg amputation

March 6, 2019 - 23:00
Although it has been suggested that individuals of low socioeconomic status and those with Medicaid or no insurance may be more likely to have their peripheral artery disease treated by leg amputation rather than by limb-saving revascularization, it is not clear if this disparity occurs consistently on a national basis, and if it does so in a linear fashion, such that poorer individuals are at progressively greater risk for amputation.

Knowledge gap of peripheral artery disease starts in medical school

March 5, 2019 - 23:00
Previous data suggest that physicians have suboptimal knowledge about peripheral artery disease (PAD). Our aim was to evaluate Canadian medical students' knowledge of PAD to determine if this knowledge gap exists early in medical training.