Journal of Vascular Surgery

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Malpractice litigation in the endovascular era

February 3, 2018 - 23:00
The standard of care in the treatment of vascular disease continues to evolve as endovascular therapies develop. Currently, it is unclear how medical malpractice litigation has adapted to the “endovascular era.” This retrospective case review is the most comprehensive analysis to date of malpractice actions involving endovascular procedures performed by vascular surgeons (VSs), interventional radiologists (IRs), interventional cardiologists (ICs), and cardiothoracic surgeons (CTSs).

Identification of optimal device combinations for the chimney endovascular aneurysm repair technique within the PERICLES registry

February 3, 2018 - 23:00
The ideal stent combination for chimney endovascular aneurysm repair remains undetermined. Therefore, we sought to identify optimal aortic and chimney stent combinations that are associated with the best outcomes by analyzing the worldwide collected experience in the PERformance of chImney technique for the treatment of Complex aortic pathoLogiES (PERICLES) registry.

Natural history of spontaneous isolated celiac artery dissection after conservative treatment

February 3, 2018 - 23:00
Optimal treatment of spontaneous isolated celiac artery dissection (SICAD) is not well established because the natural history of this rare disease is poorly understood. We analyzed the natural history of patients who underwent conservative treatment.

Rationale and design of the Clinical and Histologic Analysis of Mesenchymal Stromal Cells in AmPutations (CHAMP) trial investigating the therapeutic mechanism of mesenchymal stromal cells in the treatment of critical limb ischemia

February 3, 2018 - 23:00
Currently, there are no accepted nonsurgical therapies that improve the delivery of blood-derived nutrients to patients with critical limb ischemia. Here, we describe the ongoing phase 1/2 Clinical and Histologic Analysis of Mesenchymal Stromal Cells in AmPutations (CHAMP) trial, which will provide crucial evidence of the safety profile of mesenchymal stromal cells (MSCs) and explore their therapeutic mechanisms in the setting of critical limb ischemia requiring below-knee amputation (BKA).

Osteopontin may be a driver of abdominal aortic aneurysm formation

February 3, 2018 - 23:00
Previous in vitro and animal studies have suggested that osteopontin (OPN), an inflammatory extracellular matrix protein, is involved in the formation and growth of abdominal aortic aneurysms (AAAs). However, the mechanism by which this occurs continues to be nebulous. The relationship between OPN and inflammation-suppressing lymphocytes present in the human AAA condition was investigated and presented herein.

Use of a primary carotid stenting technique does not affect perioperative outcomes

February 3, 2018 - 23:00
Primary carotid stenting (PCS) has been shown to be feasible and safe in small series, but real-world outcomes in a large multicenter data set have yet to be explored. We aimed to compare outcomes for PCS (PCS+) vs conventional carotid artery stenting (CAS) with angioplasty (PCS−) using a national database.

Implementation of a virtual vascular clinic with point-of-care ultrasound in an integrated health care system

February 2, 2018 - 23:00
Using secured videoconferencing technologies, telemedicine may replace traditional clinic visits, save patients' time and travel, and improve use of limited surgeon and facility resources. We report our initial experience of the remote clinical encounter (RCE) by evaluating vascular surgery patients.

Percutaneous axillary artery access for endovascular interventions

February 2, 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 viability of axillary artery percutaneous access in endovascular repair.

Institutional experience with the Zenith Fenestrated aortic stent graft

February 2, 2018 - 23:00
The Zenith Fenestrated (ZFEN; Cook Medical, Bloomington, Ind) aortic stent graft system was approved for commercial use by the Food and Drug Administration in April 2012. We report our single-center experience of 100 consecutive patients treated with the ZFEN platform from October 2012 to March 2017.

Natural history and management of renal artery aneurysms in a single tertiary referral center

February 2, 2018 - 23:00
Although renal artery aneurysms (RAAs) are uncommon, several large reports have been published indicating their benign natural history. The objective of our study was to review our single-center experience managing this disease entity.

Patient characteristics and in-hospital outcomes of emergency carotid endarterectomy and carotid stenting after stroke in evolution

February 2, 2018 - 23:00
The objective of this study was to describe characteristics and in-hospital outcomes of patients treated with carotid endarterectomy (CEA) and carotid artery stenting (CAS) for stroke in evolution (SIE) under routine conditions in Germany.

Ethnic disparities in outcomes of patients with complicated type B aortic dissection

February 2, 2018 - 23:00
The objective of this study was to evaluate the difference in outcomes after endovascular intervention in patients with complicated type B aortic dissection (TBAD) based on ethnicity and blood pressure control.

Discussion

February 2, 2018 - 23:00
Dr Mahmoud Malas (Baltimore, Md). Congratulations on this excellent presentation! You evaluated 231 elective endovascular aneurysm repair (EVAR) patients for possible same-day discharge, yet you sent only about 40% of them home. You did not give us any information on the 60% of the cohort, the patients whom you admitted. Can you please give us an idea how you choose who stays and who goes home? Don't you think we need some sort of prediction model based on patient demographics and comorbidities, aneurysm anatomy, and procedure characteristics to figure out who can be safely discharged home on the same day of the procedure?

Safety and feasibility of endovascular aortic aneurysm repair as day surgery

February 2, 2018 - 23:00
The adoption of endovascular aneurysm repair (EVAR) during the past two decades has led to significantly shorter length of stay as well as lower hospital resource use. Currently, most patients are admitted to the hospital after EVAR; however, there are no standard observation periods, and timing of discharge is based on clinical judgment. The aim of this study was to confirm the safety and feasibility of performing EVAR as outpatient surgery.

Effects of C1 inhibitor on endothelial cell activation in a rat hind limb ischemia-reperfusion injury model

February 2, 2018 - 23:00
Ischemia-reperfusion (I/R) injury is a major clinical problem linked to vascular surgery. Currently, no drugs to prevent or to treat I/R injury are approved for clinical use. C1 inhibitor (C1 INH) is known to reduce activation of the plasma cascade systems that are involved in the pathophysiologic process of I/R injury. The aim of this study was therefore to investigate the effect of C1 INH on complement deposition and endothelial cell activation in a rat model of hind limb I/R injury.

Improved mortality in treatment of patients with endovascular interventions for chronic mesenteric ischemia

February 2, 2018 - 23:00
Chronic mesenteric ischemia (CMI) continues to be a devastating diagnosis. There is a national trend toward increased use of endovascular procedures with improved survival for the treatment of these patients. Our aim was to evaluate whether this trend has changed CMI patients' length of hospitalization and health care cost.

Preoperative antihypertensive medication intake and acute kidney injury after major vascular surgery

February 2, 2018 - 23:00
Postoperative acute kidney injury (AKI) is frequent after major vascular surgery and is associated with significant morbidity and mortality. It remains unclear whether the administration of combined oral antihypertensive medications on the day of surgery can increase the risk of postoperative AKI.

Infrarenal aortic repair with or without false lumen intentional placement of endografts for hybrid management of complex aortic dissection

February 1, 2018 - 23:00
Aortic dissection (AD) often involves the infrarenal aorta. We review our experience with open infrarenal aortic repair with or without false lumen intentional placement (FLIP) of endografts in the proximal dissected aorta as part of a hybrid strategy to treat complex AD.

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January 31, 2018 - 23:00

Correction

January 31, 2018 - 23:00
In the November 2017 issue of the Journal of Vascular Surgery, the article by van Schaik et al (van Schaik TG, Yeung KK, Verhagen HJ, de Bruin JL, van Sambeek MRHM, Balm R, Zeebregts CJ, van Herwaarden JA, Blankensteijn JD; DREAM trial participants. Long-term survival and secondary procedures after open or endovascular repair of abdominal aortic aneurysms. J Vasc Surg 2017;66:1379-89) should have listed Erik Buskens as a member of the DREAM trial participants.