Journal of Vascular Surgery

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CAR 6. Dual Antiplatelet Therapy and Clopidogrel “Resistance” in Carotid Stenting: Preliminary Results

October 31, 2018 - 23:00
Dual antiplatelet therapy (DAPT) using acetylsalicylic acid (ASA, 75-325 mg daily) associated with a thienopyridine (either clopidogrel 75 mg daily or ticlopidine 250 mg twice a day) is strongly recommended by the international guidelines for patients undergoing carotid artery stenting (CAS) to reduce perioperative neurologic events. The phenomenon of pharmacologic "resistance” to the effect of clopidogrel, however, may occur in up to 30%. The aim of the study was to describe the prevalence of clopidogrel resistance in a case series of patients submitted to CAS and undergoing DAPT and to analyze the effectiveness and side effects of alternative antiplatelet therapies currently in use at our institution.

CAR 5. Factors Affecting Baroreceptor Function and Blood Pressure Control During Carotid Endarterectomy

October 31, 2018 - 23:00
The objective of this study was to assess the impact of carotid endarterectomy on blood pressure homeostasis and baroreflex function, with reference to the presence or absence of significant contralateral carotid artery disease. We conducted a 2-year prospective study of 80 patients undergoing carotid endarterectomy for >70% symptomatic stenoses. Results were combined with anatomic and physiologic studies of carotid baroreceptors performed at the same center.

CAR 4. Transcranial Cerebral Oximetry as Neuromonitoring During Carotid Endarterectomy

October 31, 2018 - 23:00
Cross-clamp ischemia during carotid endarterectomy can be prevented with carotid shunts in vulnerable patients identified by cerebral monitoring. We evaluated transcranial cerebral oximetry for selective shunt use in 654 patients.

CAR 3. Comparative Analysis of Transfemoral and Transradial Approaches in Endovascular Treatment of Carotid Artery Stenosis

October 31, 2018 - 23:00
The objective of this study was to estimate the safety, effectiveness, and economic importance of the transradial approach in comparison with the transfemoral one.

CAR 2. Results of Carotid Artery Stenting in a Belgian “Real-World” Practice

October 31, 2018 - 23:00
Carotid artery stenting (CAS) is a valuable solution for the treatment of carotid artery stenosis in a population of patients at high risk for carotid endarterectomy (CEA). This high-risk population includes patients with recurrent stenosis after CEA, high/low lesion, contralateral laryngeal nerve palsy, previous radical neck surgery, cervical radiation therapy, and tracheostomy. In the European Society for Vascular Surgery guidelines, however, the authors were concerned about the death and stroke rates of CAS in “real-world” practice.

CAR 1. Carotid Endarterectomy for Asymptomatic Carotid Artery Stenosis: Can We Predict Who Will Need Intensive Care Unit Postoperative Care?

October 31, 2018 - 23:00
All asymptomatic patients benefit from 3 to 6 hours of neurologic and intra-arterial blood pressure (BP) monitoring after carotid endarterectomy (CEA). However, only a minority of patients will require routine postoperative monitoring in a high-dependency unit or intensive care unit (HDU/ICU). The aim of this paper was to identify preoperative and intraoperative predictors of HDU/ICU postoperative monitoring need.

LEV 10. Single-Session Femoral-Popliteal Venoplasty for Infrainguinal Obstruction

October 31, 2018 - 23:00
Obstruction of the femoral-popliteal (FP) axis can be the underlying disease alone or occur in combination with iliac veins. Currently, there are limited options for such patients. This pilot study evaluated the safety and efficacy of a single-session FP venoplasty (SSFPV) with local infusion of tissue plasminogen activator (tPA) using a novel percutaneous transluminal angioplasty balloon.

LEV 9. Causes of Recurrent Varicose Vein After Endovenous Laser Ablation Therapy Confirmed by Three-Dimensional Computed Tomography Venography and Duplex Ultrasound

October 31, 2018 - 23:00
The objective of this study was to determine the cause and anatomic patterns of recurrent varices after endovenous laser ablation (EVLA).

LEV 8. Inframalleolar Access for Endovascular Treatment of Venous Insufficiency Ulcers

October 31, 2018 - 23:00
Routinely, the venous access point in endovenous treatment of venous ulcers is above the ulcer, around the knee area. We present our experience using inframalleolar access.

LEV 7. Location of Venous Leg Ulcer as a Predictor of Poor Healing

October 31, 2018 - 23:00
There are several factors that influence venous hypertension, which can result in disagreement in the literature regarding risk factors for delayed wound healing. The objective of this study was to identify whether the locations of venous leg ulcers (VLUs) can be an independent risk factor for determining a poor healing rate compared with other common risk factors.

LEV 6. Klippel-Trénaunay Syndrome: A Case Report and Literature Review

October 31, 2018 - 23:00
We present a case of Klippel-Trénaunay syndrome (KTS), a rare, sporadic vascular malformation characterized by its clinical triad of port-wine stains, varicosities, and limb hypertrophy.

LEV 5. A Comparison of 1470-nm Endovenous Laser Ablation and Radiofrequency Ablation in the Treatment of Great and Small Saphenous Vein Insufficiency

October 31, 2018 - 23:00
The primary treatment of varicose veins was surgery for many years, although thermal ablation techniques have become increasingly popular in recent years. Endovenous laser ablation (EVLA) and radiofrequency ablation (RAF) are safe and minimally invasive techniques used in the treatment of saphenous vein insufficiency. The objective of this study was to compare 1470-nm EVLA and RAF (VNUS ClosureFast; Covidien, Mansfield, Mass) in the treatment of patients with great and small saphenous vein insufficiency.

LEV 4. Adherence to Medical Treatment in Chronic Venous Disease in a Public Hospital in Mexico

October 31, 2018 - 23:00
The objective of this study was to determine the percentage of patients who adhere to medical treatment for chronic venous disease in a first-time visit to the vascular surgery and angiology department of the Hospital General de México “Dr Eduardo Liceaga” and to determine the principal causes of treatment abandonment.

LEV 3. Outcomes of Ultrasound-Guided Catheter-Directed Foam Sclerotherapy With or Without Perivenous Tumescent Enhancement in the Treatment of Great Saphenous Vein Reflux

October 31, 2018 - 23:00
Great saphenous vein reflux is widely managed by endovenous methods as first-line treatment. Sclerotherapy is a recommendation when other endovenous treatments are not suitable. Tumescent anesthesia is used in other endovenous thermal treatments to help with vein compression around the catheter for better contact and to prevent heat damage. In developing countries like Thailand, the costs of the standardized instruments, such as radiofrequency ablation and endovenous laser, are high. Not many patients can afford such treatments.

LEV 2. Preliminary First in Human Ultrasound-Guided High-Intensity Focused Ultrasound Treatment in Superficial Lower Limb Veins

October 31, 2018 - 23:00
High-intensity focused ultrasound (HIFU) is an alternative to surgery or other thermal methods widely used in the treatment of thyroid, breast fibroadenoma, and uterine fibroma.

LEV 1. Transilluminated Powered Phlebectomy Using Second-Generation Trivex Technology Under Tumescent Anesthesia Only: Are the Patients Satisfied With the Procedure and Its Outcome?

October 31, 2018 - 23:00
The purpose of the study was to assess the Venous Clinical Severity Score (VCSS) and patients’ satisfaction after use of the second-generation Trivex (LeMaitre Vascular, Burlington, Mass), a device used for transilluminated powered phlebectomy. The group of patients selected for the procedure in our department had legs with a large number of varices, some with previous vein surgery or a previous episode of superficial thrombophlebitis. The majority of the patients were overweight. Alternative treatments for these selected patients have suboptimal results at best.

VCI 2. A Single-Center Experience Using Intravascular Ultrasound as an Adjunct in Nutcracker Syndrome

October 31, 2018 - 23:00
The nutcracker syndrome is an uncommon condition but with high morbidity, leading even to chronic renal failure when it is not treated. Endovascular treatment is now the most popular approach, but some related complications, such as stent migration, have been described.

VCI 1. Is the Nutcracker Syndrome the Most Important Actor in the Presence and Presentation of the Pelvic Congestion Syndrome?

October 31, 2018 - 23:00
The objective of this study was to show a discrepancy in the real causes of the pelvic congestion syndrome. In our experience obtained in the Central Military Hospital, Mexico City, a hospital of the highest level in the Mexican armed forces with >700 hundred beds, we have found a great discrepancy in what has been published around the world concerning the nutcracker syndrome as the main cause of the pelvic congestion syndrome.

AVA 3. Efficacy of Staged Brachial Artery-Basilic/Brachial Vein Elevation Arteriovenous Fistula (Axillary Vein Saved)

October 31, 2018 - 23:00
Brachial artery-basilic/brachial vein (Br-Ba/Br) transposition arteriovenous fistula (AVF) has emerged as an autologous AVF, but there have been few reports on the outcomes of Br-Ba/Br elevation AVF instead of conventional transposition. We evaluated efficacy of staged Br-Ba/Br elevation AVF and compared clinical outcomes of Br-Ba and Br-Br elevation AVF.

AVA 2. Neuromuscular Electrostimulation: A New Therapeutic Option to Improve Radiocephalic Arteriovenous Fistula Maturation in End-Stage Chronic Kidney Disease Patients

October 31, 2018 - 23:00
Radiocephalic arteriovenous fistula (RCAVF) is the “gold standard” vascular access for end-stage chronic kidney disease patients. Exercises after AVF creation improve maturation. No articles regarding neuromuscular electrostimulation (NMES) in AVF maturation have been published.