Journal of Vascular Surgery

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Open Repair of Celiac Artery Aneurysm

August 1, 2019 - 00:00
We are presenting the case of a 37-year-old woman with a history of neurofibromatosis type 1, brain tumor, and breast cancer who was found to have a 3-cm celiac artery aneurysm during workup for a mastectomy.

Open Repair of Celiac Artery Aneurysm

August 1, 2019 - 00:00
We are presenting the case of a 37-year-old woman with a history of neurofibromatosis type 1, brain tumor, and breast cancer who was found to have a 3-cm celiac artery aneurysm during workup for a mastectomy.

Patch Angioplasty Confers No Advantage After Femoral Endarterectomy

August 1, 2019 - 00:00
Patch angioplasty is commonly used after femoral endarterectomy (FEA) to avoid narrowing of the artery. Our objective was to determine whether patch angioplasty is associated with improved short-term or long-term clinical outcomes.

Patch Angioplasty Confers No Advantage After Femoral Endarterectomy

August 1, 2019 - 00:00
Patch angioplasty is commonly used after femoral endarterectomy (FEA) to avoid narrowing of the artery. Our objective was to determine whether patch angioplasty is associated with improved short-term or long-term clinical outcomes.

Open Surgical Secondary Interventions Are More Durable Than Endovascular Interventions for Lower Extremity Bypass Stenosis or Occlusion

August 1, 2019 - 00:00
Lower extremity bypasses often require secondary interventions to maintain long-term patency. Our objectives were to characterize overall effectiveness of secondary interventions to maintain or to restore bypass graft patency and to compare outcomes of open and endovascular interventions.

Acutely Expanding Symptomatic Abdominal Aortic Aneurysm With Endotension

August 1, 2019 - 00:00
A 73-year-old man with a history of abdominal aortic aneurysm status post endovascular aneurysm repair was referred to our clinic after he was noted to have an expanding aneurysmal sac on surveillance imaging. He had undergone endovascular aneurysm repair with an Endologix (Irvine, Calif) device at an outside facility 5 years ago. Three years later, he was found to have an expanding sac with suspicion of either a type III endoleak or endotension, which was treated at the outside institution with relining of the main body of the endograft with a Medtronic (Santa Rosa, Calif) stent graft.

Acutely Expanding Symptomatic Abdominal Aortic Aneurysm With Endotension

August 1, 2019 - 00:00
A 73-year-old man with a history of abdominal aortic aneurysm status post endovascular aneurysm repair was referred to our clinic after he was noted to have an expanding aneurysmal sac on surveillance imaging. He had undergone endovascular aneurysm repair with an Endologix (Irvine, Calif) device at an outside facility 5 years ago. Three years later, he was found to have an expanding sac with suspicion of either a type III endoleak or endotension, which was treated at the outside institution with relining of the main body of the endograft with a Medtronic (Santa Rosa, Calif) stent graft.

Hybrid Intervention and Open Surgical Reconstruction Carry Comparable Risk in the Treatment of Tandem Carotid Bifurcation and Proximal Disease

August 1, 2019 - 00:00
The optimal approach for the treatment of tandem carotid bifurcation and supra-aortic trunk (SAT) disease remains controversial. The hybrid technique of carotid endarterectomy (CEA) with combined ipsilateral proximal endovascular intervention (IPE) has provided an attractive, less invasive alternative to CEA with concomitant open SAT reconstruction (SATr). However, no studies have directly compared outcomes of these two approaches.

Hybrid Intervention and Open Surgical Reconstruction Carry Comparable Risk in the Treatment of Tandem Carotid Bifurcation and Proximal Disease

August 1, 2019 - 00:00
The optimal approach for the treatment of tandem carotid bifurcation and supra-aortic trunk (SAT) disease remains controversial. The hybrid technique of carotid endarterectomy (CEA) with combined ipsilateral proximal endovascular intervention (IPE) has provided an attractive, less invasive alternative to CEA with concomitant open SAT reconstruction (SATr). However, no studies have directly compared outcomes of these two approaches.

Pedal Arch Patency Is Superior in Predicting Limb Salvage for Infrapopliteal Endovascular Intervention to Tibial Vessel Complexity, WIfI Score, or Global Limb Anatomic Staging System Grade

August 1, 2019 - 00:00
Infrapopliteal endovascular intervention has been increasingly performed for limb salvage (LS), and angiosome-specific revascularization (ASR) has been proposed to be the key factor for LS. Pedal arch anatomy has been suggested to predict faster wound healing and also to determine the need for single- vs multiple-vessel tibial revascularization, but its impact on LS is still debated. Wound, Ischemia, and foot Infection (WIfI) score has been proposed as more predictive than ASR of LS, and most recently the Global Limb Anatomic Staging System (GLASS) has been introduced as a measure degree of anatomic complexity to predict limb-based patency and endovascular technical failure.

Pedal Arch Patency Is Superior in Predicting Limb Salvage for Infrapopliteal Endovascular Intervention to Tibial Vessel Complexity, WIfI Score, or Global Limb Anatomic Staging System Grade

August 1, 2019 - 00:00
Infrapopliteal endovascular intervention has been increasingly performed for limb salvage (LS), and angiosome-specific revascularization (ASR) has been proposed to be the key factor for LS. Pedal arch anatomy has been suggested to predict faster wound healing and also to determine the need for single- vs multiple-vessel tibial revascularization, but its impact on LS is still debated. Wound, Ischemia, and foot Infection (WIfI) score has been proposed as more predictive than ASR of LS, and most recently the Global Limb Anatomic Staging System (GLASS) has been introduced as a measure degree of anatomic complexity to predict limb-based patency and endovascular technical failure.

Detection of Spinal Cord Ischemia During Endovascular Thoracoabdominal Aneurysm Repair Using Near-Infrared Spectroscopy Monitoring

August 1, 2019 - 00:00
Spinal cord ischemia (SCI) remains one of the most devastating complications from endovascular repair of thoracoabdominal aortic aneurysms (TAAAs). Several modalities are used to detect SCI intraoperatively, including motor evoked potentials (MEPs) and somatosensory evoked potentials (SSEPs); however, they are invasive and difficult to interpret. The aim of this study was to evaluate the use of near-infrared spectroscopy (NIRS) to monitor spinal cord collateral network perfusion and to detect SCI during endovascular TAAA repair (Fig).

Hemodynamic Consequences of Eversion Versus Patch Angioplasty Carotid Endarterectomy

August 1, 2019 - 00:00
Several studies have compared eversion carotid endarterectomy (ECEA) vs standard carotid endarterectomy (SCEA) technique in terms of efficacy. Studies examining postoperative blood pressure have noted a trend toward hypotension with SCEA and hypertension with ECEA. The goal of this study was to investigate whether one technique is superior to the other with respect to immediate postoperative blood pressure control, incidence of neurologic events, and length of hospital stay.

Hemodynamic Consequences of Eversion Versus Patch Angioplasty Carotid Endarterectomy

August 1, 2019 - 00:00
Several studies have compared eversion carotid endarterectomy (ECEA) vs standard carotid endarterectomy (SCEA) technique in terms of efficacy. Studies examining postoperative blood pressure have noted a trend toward hypotension with SCEA and hypertension with ECEA. The goal of this study was to investigate whether one technique is superior to the other with respect to immediate postoperative blood pressure control, incidence of neurologic events, and length of hospital stay.

Parallel Grafting Should Be Considered a First-Line Therapy for Paravisceral Aortic Aneurysms

August 1, 2019 - 00:00
Parallel grafting presents a viable method for treating patients with aortic aneurysms. The current literature is limited to mostly pararenal configurations. We examined our results in patients with superior mesenteric artery (SMA) and celiac artery involvement.

Elevated Neutrophil-Lymphocyte Ratio Predicts Mortality After Elective Endovascular Aneurysm Repair

August 1, 2019 - 00:00
The neutrophil-lymphocyte ratio (NLR), computed by dividing the absolute neutrophil count by absolute lymphocyte count, is an inexpensive inflammatory marker that incorporates the balance of the innate (neutrophil) and adaptive (lymphocyte) immune responses. The objective of this study was to determine whether preoperative NLR is associated with mortality after elective endovascular aneurysm repair (EVAR).

Elevated Neutrophil-Lymphocyte Ratio Predicts Mortality After Elective Endovascular Aneurysm Repair

August 1, 2019 - 00:00
The neutrophil-lymphocyte ratio (NLR), computed by dividing the absolute neutrophil count by absolute lymphocyte count, is an inexpensive inflammatory marker that incorporates the balance of the innate (neutrophil) and adaptive (lymphocyte) immune responses. The objective of this study was to determine whether preoperative NLR is associated with mortality after elective endovascular aneurysm repair (EVAR).

Frequency of Perigraft Hygroma After Aortic Reconstruction Using Expanded Polytetrafluoroethylene Grafts

August 1, 2019 - 00:00
The incidence of perigraft hygroma development after aortic reconstruction with expanded polytetrafluoroethylene (ePTFE) remains poorly defined and its clinical relevance questionable. This study was designed to establish the incidence of and to determine the risk factors associated with hygroma formation and its outcomes.

Frequency of Perigraft Hygroma After Aortic Reconstruction Using Expanded Polytetrafluoroethylene Grafts

August 1, 2019 - 00:00
The incidence of perigraft hygroma development after aortic reconstruction with expanded polytetrafluoroethylene (ePTFE) remains poorly defined and its clinical relevance questionable. This study was designed to establish the incidence of and to determine the risk factors associated with hygroma formation and its outcomes.

Management of Large-Bore Access Complications in the Era of Transcatheter Aortic Valve Replacement

August 1, 2019 - 00:00
Transcatheter aortic valve replacement (TAVR) has become a commonplace procedure for high-risk patient with aortic stenosis. A meta-analysis of 10,822 patients showed the rate of major vascular complications with second-generation closure devices to be 4.5%. Percutaneous approaches to arterial repairs demonstrate shorter length of stay and higher rate of direct to home discharge than with open approaches and equivalent outcomes at long-term follow-up. Our goal was to show that our vascular access strategy can decrease open repairs and improve patient outcomes.