Journal of Vascular Surgery

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Outcomes of Hemodialysis Vascular Access in Patients Initiating Dialysis With a Tunneled Catheter

September 1, 2018 - 00:00
The objective of this study was to determine factors that influence time to removal of tunneled hemodialysis catheter (THC), probability of repeated vascular access creation, and time to repeated vascular access.

Leukocyte Phenotype Is Altered in Peripheral Arterial Disease

September 1, 2018 - 00:00
Peripheral arterial disease (PAD) is characterized by low-grade systemic inflammation. Monocytes and monocyte-derived macrophages (MDMs) play a central role in vascular inflammation and its resolution. We hypothesize that impaired resolution in PAD contributes to adverse clinical outcomes.

Leukocyte Phenotype Is Altered in Peripheral Arterial Disease

September 1, 2018 - 00:00
Peripheral arterial disease (PAD) is characterized by low-grade systemic inflammation. Monocytes and monocyte-derived macrophages (MDMs) play a central role in vascular inflammation and its resolution. We hypothesize that impaired resolution in PAD contributes to adverse clinical outcomes.

Arteriovenous Fistulas Recruited With Regional Anesthesia Have Comparable Functional Outcomes

September 1, 2018 - 00:00
Regional anesthesia-induced vasodilation increases the proportion of patients with venous anatomy suitable for an arteriovenous fistula (AVF). The functional outcomes of AVFs initially small for size on preoperative duplex ultrasound vein mapping (2.4 mm) that are recruited under regional anesthesia have not been clearly defined. We aimed to evaluate reintervention rates and functional outcomes of AVFs recruited after induction of regional anesthesia.

Arteriovenous Fistulas Recruited With Regional Anesthesia Have Comparable Functional Outcomes

September 1, 2018 - 00:00
Regional anesthesia-induced vasodilation increases the proportion of patients with venous anatomy suitable for an arteriovenous fistula (AVF). The functional outcomes of AVFs initially small for size on preoperative duplex ultrasound vein mapping (2.4 mm) that are recruited under regional anesthesia have not been clearly defined. We aimed to evaluate reintervention rates and functional outcomes of AVFs recruited after induction of regional anesthesia.

Management of Moderate Thoracic Blunt Aortic Injuries in Patients With Intracranial Hemorrhage

September 1, 2018 - 00:00
Thoracic blunt aortic injuries (TBAIs) are the second most common cause of death due to blunt trauma in the United States. Patients with minimal injuries do not require surgical repair; patients with severe injuries are treated emergently. Moderate aortic injuries are repaired in a semielective fashion; the optimal management of moderate TBAI patients and associated intracranial hemorrhage (ICH) is unknown. We sought to analyze the management and outcomes of patients presenting with concomitant moderate TBAI and ICH.

Management of Moderate Thoracic Blunt Aortic Injuries in Patients With Intracranial Hemorrhage

September 1, 2018 - 00:00
Thoracic blunt aortic injuries (TBAIs) are the second most common cause of death due to blunt trauma in the United States. Patients with minimal injuries do not require surgical repair; patients with severe injuries are treated emergently. Moderate aortic injuries are repaired in a semielective fashion; the optimal management of moderate TBAI patients and associated intracranial hemorrhage (ICH) is unknown. We sought to analyze the management and outcomes of patients presenting with concomitant moderate TBAI and ICH.

Experienced Operators Achieve Superior Primary Patency and Wound Complication Rates With Endoscopic Great Saphenous Vein Harvest Compared With Open Harvest in Lower Extremity Bypasses

September 1, 2018 - 00:00
Previous 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 with experience, improved patency can be achieved.

Experienced Operators Achieve Superior Primary Patency and Wound Complication Rates With Endoscopic Great Saphenous Vein Harvest Compared With Open Harvest in Lower Extremity Bypasses

September 1, 2018 - 00:00
Previous 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 with experience, improved patency can be achieved.

A Reliable Method for Renal Volume Measurement and Its Application in Fenestrated Endovascular Aneurysm Repair

September 1, 2018 - 00:00
Renal volume has been shown to decline in the sixth decade of life and beyond. We sought to assess the inter-rater reliability for manually measuring renal volume using computed tomography and to assess the change in renal volume over time as it relates to fenestrated endovascular aneurysm repair (FEVAR).

A Reliable Method for Renal Volume Measurement and Its Application in Fenestrated Endovascular Aneurysm Repair

September 1, 2018 - 00:00
Renal volume has been shown to decline in the sixth decade of life and beyond. We sought to assess the inter-rater reliability for manually measuring renal volume using computed tomography and to assess the change in renal volume over time as it relates to fenestrated endovascular aneurysm repair (FEVAR).

Preoperative Testing Among Patients Undergoing Arteriovenous Fistula Surgery

September 1, 2018 - 00:00
The creation of an arteriovenous fistula (AVF) for hemodialysis access is a low-risk procedure. It is often time sensitive, as avoidance of central venous catheters (CVCs) and their complications is paramount. Thus, the role of preanesthesia testing (PAT) is debatable, particularly if it delays surgery for further workup. We sought to determine the value and potential adverse impact of PAT.

Preoperative Testing Among Patients Undergoing Arteriovenous Fistula Surgery

September 1, 2018 - 00:00
The creation of an arteriovenous fistula (AVF) for hemodialysis access is a low-risk procedure. It is often time sensitive, as avoidance of central venous catheters (CVCs) and their complications is paramount. Thus, the role of preanesthesia testing (PAT) is debatable, particularly if it delays surgery for further workup. We sought to determine the value and potential adverse impact of PAT.

Variation in Center-Level Frailty Burden and Its Impact on Long-Term Survival in Patients Undergoing Repair for Abdominal Aortic Aneurysms

September 1, 2018 - 00:00
Frailty is increasingly recognized as a key determinate in predicting postoperative outcomes. Centers may see patients who are more frail, potentially accounting for poorer outcomes in hospital comparisons that may not be captured in risk adjustment. We aimed to evaluate the variability in frailty burden among centers in the Vascular Quality Initiative database and to determine the effect of frailty on long-term mortality in patients undergoing abdominal aortic aneurysm (AAA) repair.

Variation in Center-Level Frailty Burden and Its Impact on Long-Term Survival in Patients Undergoing Repair for Abdominal Aortic Aneurysms

September 1, 2018 - 00:00
Frailty is increasingly recognized as a key determinate in predicting postoperative outcomes. Centers may see patients who are more frail, potentially accounting for poorer outcomes in hospital comparisons that may not be captured in risk adjustment. We aimed to evaluate the variability in frailty burden among centers in the Vascular Quality Initiative database and to determine the effect of frailty on long-term mortality in patients undergoing abdominal aortic aneurysm (AAA) repair.

Factors Associated With Microembolization After Carotid Intervention

September 1, 2018 - 00:00
Microembolization after carotid artery stenting (CAS) and carotid endarterectomy (CEA) has been documented and may confer risk for neurocognitive impairment. Patients undergoing stenting are known to be at higher risk for microemoblization. In this prospective cohort study, we compare the microembolization rates for patients undergoing CAS and CEA and patient and perioperative characteristics that may be associated with microembolization.

Factors Associated With Microembolization After Carotid Intervention

September 1, 2018 - 00:00
Microembolization after carotid artery stenting (CAS) and carotid endarterectomy (CEA) has been documented and may confer risk for neurocognitive impairment. Patients undergoing stenting are known to be at higher risk for microemoblization. In this prospective cohort study, we compare the microembolization rates for patients undergoing CAS and CEA and patient and perioperative characteristics that may be associated with microembolization.

Initial Open Versus Endovascular Treatment and Subsequent Limb Loss After Primary Minor Amputation

September 1, 2018 - 00:00
Studies of major amputation after initial minor amputation are limited; rates of subsequent major amputation range from 14% to 34%, with a limited understanding for associated comorbidities and time to subsequent amputation. We sought to determine major amputation rates for patients who undergo initial minor amputation and to determine which factors are associated with limb preservation with open vs endovascular treatment.

Initial Open Versus Endovascular Treatment and Subsequent Limb Loss After Primary Minor Amputation

September 1, 2018 - 00:00
Studies of major amputation after initial minor amputation are limited; rates of subsequent major amputation range from 14% to 34%, with a limited understanding for associated comorbidities and time to subsequent amputation. We sought to determine major amputation rates for patients who undergo initial minor amputation and to determine which factors are associated with limb preservation with open vs endovascular treatment.

Financial Analysis of Fenestrated Endovascular Aortic Aneurysm Repair at a High-Volume Medical Center

September 1, 2018 - 00:00
The objective of this study was to examine hospital finances and physician reimbursement associated with fenestrated endovascular aneurysm repair (FEVAR) for complex aortic disease at a high-volume aortic center. Costs and reimbursement for FEVAR were compared with those for open repair, and their trends were analyzed over time.