Journal of Vascular Surgery

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AAN 11. Endovascular Aneurysm Sealing With Chimney Grafts—Outcomes from the First 77 Cases at a Single Institution

October 31, 2018 - 23:00
Chimney grafts are placed parallel to an aortic stent graft to maintain perfusion through visceral branches. When they are used in combination with conventional endovascular aneurysm repair (EVAR), there is a significant risk of type I endoleak due to “guttering.” In combination with endovascular aneurysm sealing (EVAS), this risk is likely to be reduced because the polymer within the endobags conforms to the shape of the chimney stents while maintaining a proximal seal at the aneurysm neck. EVAS with chimney stents (ChEVAS) may therefore represent an alternative to fenestrated EVAR for the treatment of juxtarenal abdominal aortic aneurysms.

AAN 10. Factors Associated With Spinal Cord Ischemia After Treatment of Complex Aortic Aneurysms With Fenestrated or Branched Devices

October 31, 2018 - 23:00
The aim of our study was to analyze the incidence of spinal cord ischemia (SCI) in patients treated with fenestrated (F-EVAR) and branched endovascular aneurysm repair (B-EVAR) and to identify risk factors associated with this complication.

AAN 8. Open Repair of Proximal Abdominal Aneurysms Analyzed According to the Anatomy, Clamping Site, and Theoretical Fenestrated Endovascular Design

October 31, 2018 - 23:00
The objective of this study was to report our experience with open repair of hostile-necked juxtarenal, pararenal, and suprarenal aortic aneurysms (proximal abdominal aortic aneurysms) and to stratify the results according to the equivalent endovascular repair.

AAN 7. Internal Iliac Artery Flow Preservation With Iliac Branch Device During Endovascular Repair of Aortoiliac Aneurysms: Single Center Experience

October 31, 2018 - 23:00
Iliac branch devices (IBDs) have become a popular option to preserve internal iliac artery (IIA) flow in patients with ectatic or aneurysmal common iliac arteries during endovascular aneurysm repair. This study aimed to assess the outcomes with the use of this device in a single-center setting.

AAN 6. Transcaval Embolization of Type II Endoleak After Infrarenal and Fenestrated/Branched Endovascular Aneurysm Repair

October 31, 2018 - 23:00
Type II endoleaks are frequent after endovascular aneurysm repair (EVAR). Although mostly dissolving during follow-up, secondary rupture can occur as a persistent type II endoleak may lead to aneurysm sac growth. We aimed to investigate the outcomes of transcaval embolization (TCE) after infrarenal and fenestrated/branched EVAR.

AAN 5. Internal Iliac Artery Sacrifice During Endovascular Aneurysm Repair

October 31, 2018 - 23:00
We aimed to assess the safety of internal iliac artery (IIA) coverage during endovascular aneurysm repair (EVAR).

AAN 4. A 14-Year Single-Center Review of Inflammatory Abdominal Aortic Aneurysm Repair

October 31, 2018 - 23:00
The objective of this study was to review our experience with the contemporary management of inflammatory abdominal aortic aneurysms (IAAAs) involving either open surgery (OS) or endovascular aneurysm repair (EVAR).

AAN 3. Fenestrated and Branched Endovascular Repair of Aortic Arch Pathology

October 31, 2018 - 23:00
Operative management of aortic arch disease remains a complex challenge and an area that poses significant obstacles to a totally endovascular approach. The aim of this study was to report the outcomes of custom-made fenestrated and branched endovascular aortic repair involving the arch (fEVARA and bEVARA) in our aortic center.

AAN 2. Early Experience With a Novel Thoracic Stent Design for the Prevention of Distal Stent Graft-Induced New Entry Tears (d-SINE)

October 31, 2018 - 23:00
Distal oversizing is proposed as a contributing factor to distal stent graft-induced new entry tears, especially in managing the complications of aortic dissection. However, distal radial force can only be partially reduced by a tapered design or the use of distal restrictive stents or stent grafts. We report our early outcomes with a disease-specific, factory-modified Zenith Alpha thoracic stent graft (Cook Medical, Bloomington, Ind). Dissection-specific features include no proximal barbs; >20 cm in length and substantially tapered (custom-made, but usually by 10 mm); reduced radial force in the second and third distal stents and removal of the final stent, leaving 30 mm of unsupported graft; and an “endovascular elephant trunk.”

AAN 1. Early and Midterm Outcomes of a Custom-Made Occluding Device Based on the Najuta Endograft in Chronic Aortic Dissection

October 31, 2018 - 23:00
Persistent flow through a false lumen in chronic aortic dissection leads to extensive dilation of the lumen with aging. To prevent aneurysm rupture, step-by-step graft replacement of the dilated aortic aneurysm segment is the most reliable procedure. However, multistage invasive surgery is limited to younger patients. A less invasive method of closing proximal entry tears using transcatheter stent graft implantation has recently been attempted. However, this procedure does not shrink dilated false lumens to expected levels.

TOI 11. Hybrid Repair for Dysphagia Lusoria

October 31, 2018 - 23:00
Aberrant origin of the right subclavian artery (RSA) is a rare cause of dysphagia, and in some cases, the aberrant artery can become aneurysmatic (Kommerell diverticulum). Open surgical repair is the standard approach but is a major operation. As an alternative, hybrid repair has emerged as a less invasive treatment. Our objective was to describe two different options for hybrid repair of this condition.

TOI 10. An Audit of “Vascular Trauma” Cases in a Tertiary-Level Hospital in Pakistan

October 31, 2018 - 23:00
Experience with vascular trauma from developing parts of the world is limited. In Pakistan, the incidence of automobile accidents and civilian violence has followed a rising trend. A 2-year audit was carried out to determine the etiology, pattern of injury, treatment, and associated morbidity of vascular trauma in our population.

TOI 9. A Rare Case of Bilateral External Iliac Artery Thrombosis due to Endofibrosis in a 33-Year-Old Female Triathlete

October 31, 2018 - 23:00
External iliac artery endofibrosis is a rare disease predominantly affecting young, male elite performance athletes. The disease is characterized by fibrosis and hypertrophy of the intimal layer of the arterial wall and is likely due to multiple factors, including “kinking” during repetitive hip flexion, psoas muscle hypertrophy compressing the artery, excessive and tortuous vessel length, and increased cardiac output with adaptive hypertension. These high-performance athletes typically present with unilateral lower extremity claudication at peak exercise.

TOI 8. Takayasu Arteritis: Panarterial Involvement: A Challenge to Offer Cure as a Vascular Surgeon

October 31, 2018 - 23:00
Takayasu arteritis is a rare disease. We report a case of Takayasu arteritis in a patient who was being treated for a long time for uncontrolled hypertension without proper investigation, which resulted in a cerebrovascular accident twice.

TOI 7. Case Report: Endovascular Management of Ruptured Superior Mesenteric Artery Aneurysm

October 31, 2018 - 23:00
Superior mesenteric artery aneurysms are a rare but life-threatening condition. We report the case of a 54-year-old man with ruptured superior mesenteric artery (SMA) aneurysm treated by an endovascular technique.

TOI 6. Heart in Abdomen: Challenge to Deal With Pseudoaneurysm of Superior Mesenteric Artery With Tetralogy of Fallot

October 31, 2018 - 23:00
A 28-year-old man underwent total correction of tetralogy of Fallot in 2003. He was diagnosed with infective endocarditis 2 months before and received treatment in a cardiac unit. After discharge, he developed periumbilical pain associated with early satiety and decreased appetite.

TOI 5. Use of a Next-Generation Decellularized Dermal Allograft as a Cost-Effective Treatment of Acute and Chronic Wounds

October 31, 2018 - 23:00
The number of individuals with chronic wounds in the United States continues to grow, with millions of people affected yearly, placing a huge financial burden on our health care system. In addition, acute wounds in patients with multiple comorbidities threaten patients’ quality of life and ability to perform activities of daily living. The use of a next-generation decellularized dermal allograft (DDA) can significantly decrease healing times, therefore improving patients’ quality of life as well as reducing the overall economic cost.

TOI 4. Endovascular Treatment of Tracheoinnominate Artery Fistula

October 31, 2018 - 23:00
The tracheoinnominate artery fistula (TIAF) is a critical complication of tracheostomy with a reported incidence of 0.1% to 1%. It is highly lethal even in the presence of initially successful management. The intimate relationship of the innominate artery and the trachea explains the fistula formation. A high index of clinical suspicion is needed to make the diagnosis in a patient with peristomal bleeding or hemoptysis. The traditional treatment has been open surgery, but the new results of endovascular surgery and the patient’s critical condition support endovascular treatment.

TOI 3. Brachial Artery Open Access for Endovascular Interventions

October 31, 2018 - 23:00
As endovascular therapy becomes increasingly complex, adjunct techniques such as upper extremity arterial access facilitate visceral branch interventions. The purpose of this study was to assess the usefulness of brachial artery surgical access in endovascular intervention.

TOI 2. Underutilization of Artificial Intelligence by Vascular Specialists

October 31, 2018 - 23:00
Despite ever-increasing levels of evidence from hypothesis-driven clinical trial research and consensus-driven intersocietal publications to help guide decision-making among vascular specialists, a large number of vascular disease states have wide-ranging and sometimes disparate therapeutic approaches. Setting aside open surgical, endovascular, hybrid, and medical management therapies, a number of complex vascular disease states would be well served by improved predictions for probability of successful management.