Journal of Vascular Surgery

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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.

Antegrade Superficial Femoral Access for Lower Extremity Arterial Disease Is a Safe and Effective Technique

August 1, 2019 - 00:00
Antegrade superficial femoral artery (SFA) access for peripheral interventions is an underused technique in the treatment of infrainguinal arterial occlusive disease. This study examined the safety and effectiveness of antegrade SFA access in the outpatient setting.

Antegrade Superficial Femoral Access for Lower Extremity Arterial Disease Is a Safe and Effective Technique

August 1, 2019 - 00:00
Antegrade superficial femoral artery (SFA) access for peripheral interventions is an underused technique in the treatment of infrainguinal arterial occlusive disease. This study examined the safety and effectiveness of antegrade SFA access in the outpatient setting.

Real-World Results of Atherectomy From International Classification of Diseases, Tenth Revision Medicare Billing Codes Do Not Resemble Registry Data for Atherectomy

August 1, 2019 - 00:00
There has been noted and relentless growth of atherectomy for peripheral artery disease (PAD) since 2011, when the Centers for Medicare and Medicaid Services allowed reimbursement. Reimbursement was based on favorable registry data. The primary objective of this analysis was to examine whether registry results match real-world amputation rates for atherectomy from current International Classification of Diseases, Tenth Revision (limb-specific) Medicare billing data.

The Evolution of Open Abdominal Aortic Aneurysm Repair at a Tertiary Care Center

August 1, 2019 - 00:00
The characteristics of and indications for open abdominal aortic aneurysm (AAA) repair have evolved over time. We evaluated these trends through the experience at a tertiary care academic center.

The Evolution of Open Abdominal Aortic Aneurysm Repair at a Tertiary Care Center

August 1, 2019 - 00:00
The characteristics of and indications for open abdominal aortic aneurysm (AAA) repair have evolved over time. We evaluated these trends through the experience at a tertiary care academic center.

Simultaneous Transcarotid Revascularization With Flow Reversal and Coronary Artery Bypass Grafting

August 1, 2019 - 00:00
Optimal surgical management for patients with concomitant carotid and coronary disease remains unknown. We sought to investigate the safety of simultaneous transcarotid artery revascularization (TCAR) with the ENROUTE transcarotid neuroprotection and stent system (Silk Road Medical Inc, Sunnyvale, Calif) and coronary artery bypass grafting (CABG).

Simultaneous Transcarotid Revascularization With Flow Reversal and Coronary Artery Bypass Grafting

August 1, 2019 - 00:00
Optimal surgical management for patients with concomitant carotid and coronary disease remains unknown. We sought to investigate the safety of simultaneous transcarotid artery revascularization (TCAR) with the ENROUTE transcarotid neuroprotection and stent system (Silk Road Medical Inc, Sunnyvale, Calif) and coronary artery bypass grafting (CABG).

Carotid Artery Webs as an Atypical Cause of Ischemic Stroke; Risk Factors, Diagnosis, and Management

August 1, 2019 - 00:00
Carotid webs are a rare and difficult-to-diagnose cause of stroke. There are currently few cases reported in the existing literature. We reviewed our recent institutional experience and performed a systematic review of the literature to provide diagnostic and management recommendations.

Carotid Artery Webs as an Atypical Cause of Ischemic Stroke; Risk Factors, Diagnosis, and Management

August 1, 2019 - 00:00
Carotid webs are a rare and difficult-to-diagnose cause of stroke. There are currently few cases reported in the existing literature. We reviewed our recent institutional experience and performed a systematic review of the literature to provide diagnostic and management recommendations.

Initial Experience With the Terumo Radial to Peripheral Catheter System for Peripheral Arterial Intervention

August 1, 2019 - 00:00
Radial artery access has gained increasing acceptance as the preferred mode of arterial cannulation for coronary intervention. The advantages of less catheter site bleeding, decreased discomfort, and earlier ambulation have been demonstrated in numerous studies. Before the introduction of the Terumo Radial to Peripheral (R2P) system (Terumo Interventional Systems, Somerset, NJ), radial access had lagged behind in peripheral intervention because of the relative lack of devices long enough to reach the lower extremities.

Initial Experience With the Terumo Radial to Peripheral Catheter System for Peripheral Arterial Intervention

August 1, 2019 - 00:00
Radial artery access has gained increasing acceptance as the preferred mode of arterial cannulation for coronary intervention. The advantages of less catheter site bleeding, decreased discomfort, and earlier ambulation have been demonstrated in numerous studies. Before the introduction of the Terumo Radial to Peripheral (R2P) system (Terumo Interventional Systems, Somerset, NJ), radial access had lagged behind in peripheral intervention because of the relative lack of devices long enough to reach the lower extremities.

Regional Variation in Usage of Ultrasound-Guided Access in the Vascular Quality Initiative

August 1, 2019 - 00:00
Access site complications are among the most common complications following peripheral vascular interventions. Previous studies have demonstrated a reduced rate of complications with ultrasound guided vascular access. The objective of this study is to evaluate the regional use of ultrasound guided vascular access within the Vascular Quality Initiative (VQI).

Shockwave Lithotripsy Facilitates Large-Bore Vascular Access Through Calcified Arteries

August 1, 2019 - 00:00
Excessive atherosclerotic calcification has been a major limitation in vascular access. Our objective was to explore the peripheral intravascular lithotripsy (IVL) system in the treatment of calcific access vessels during thoracic endovascular aortic repair (TEVAR), endovascular aneurysm repair (EVAR), and transcatheter aortic valve replacement (TAVR).

Endovascular Repair of Common Hepatic Artery Pseudoaneurysm After Repeated Liver Transplantation

August 1, 2019 - 00:00
Hepatic artery pseudoaneurysm is a rare but morbid complication after liver transplantation. Treatment options include ligation and endovascular embolization, followed by revascularization. We describe a new endovascular approach by stent exclusion in a high-risk patient.

Endovascular Repair of Common Hepatic Artery Pseudoaneurysm After Repeated Liver Transplantation

August 1, 2019 - 00:00
Hepatic artery pseudoaneurysm is a rare but morbid complication after liver transplantation. Treatment options include ligation and endovascular embolization, followed by revascularization. We describe a new endovascular approach by stent exclusion in a high-risk patient.

Loss to Follow-up After Endovascular Abdominal Aortic Aneurysm Repair, A Suburban Community Teaching Practice Experience

August 1, 2019 - 00:00
Patient loss to follow-up (LTF) after endovascular aneurysm repair (EVAR) is a recognized Achilles heel of this therapy with potential dire consequences. Previous studies have demonstrated LTF rates of ∼40% to 50% or more. We sought to find whether the LTF rate after EVAR in our suburban community patient population was similar and whether the causative factors were the same.

Retrograde Open Mesenteric Stenting Should Be Considered an Initial Approach to Acute Mesenteric Ischemia

August 1, 2019 - 00:00
Retrograde open mesenteric stenting (ROMS) is an alternative to traditional bypass in patients who present with acute mesenteric ischemia (AMI). However, there is a paucity of data comparing outcomes of ROMS with other open surgical approaches. This study represents the largest single-institution experience with ROMS and aims to compare outcomes of ROMS with mesenteric bypass.

Retrograde Open Mesenteric Stenting Should Be Considered an Initial Approach to Acute Mesenteric Ischemia

August 1, 2019 - 00:00
Retrograde open mesenteric stenting (ROMS) is an alternative to traditional bypass in patients who present with acute mesenteric ischemia (AMI). However, there is a paucity of data comparing outcomes of ROMS with other open surgical approaches. This study represents the largest single-institution experience with ROMS and aims to compare outcomes of ROMS with mesenteric bypass.

Aortoiliac Endarterectomy: A Modern Case Series

August 1, 2019 - 00:00
Aortoiliac endarterectomy (AIE) was historically the treatment of choice for aortoiliac occlusive disease. The advent of prosthetic grafts and endovascular interventions has led to a dramatic decrease in the number of AIEs being performed. Our goal was to analyze a modern series to determine the safety and efficacy of AIE in select patients.