Journal of Vascular Surgery

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IP111. A Role for Intravascular Ultrasound as an Adjunct to Therapeutic Decision-Making During Carotid Artery Stenting

June 1, 2018 - 00:00
Carotid artery stenting (CAS) continues to be an important treatment modality for patients deemed at high risk for carotid endarterectomy. The utility of intravascular ultrasound (IVUS) in carotid intervention is not well characterized. The purpose of this study was to review our results of CAS in veteran patients and to evaluate the effect of IVUS on periprocedural events and long-term outcomes.

IP109. The Learning Curve of Transcarotid Artery Revascularization

June 1, 2018 - 00:00
Transcarotid artery revascularization (TCAR) is a relatively new procedure that involves access to the proximal cervical common carotid artery (CCA), cerebral blood flow reversal as neuroprotection, and stent delivery. The purpose of this study was to describe the learning curve of TCAR.

IP107. Hemodynamic Events During Carotid Stenting Are Associated with Significant Periprocedural Stroke

June 1, 2018 - 00:00
This study evaluates the risk attributable to the hemodynamic events that occur during carotid angioplasty and stenting (CAS) and the impact that preprocedural and prophylactic medications have on mitigating this risk in a large, population-based cohort of patients.

IP105. Severity and Outcomes of Perioperative Stroke After Carotid Artery Stenting and Carotid Endarterectomy: Analysis of a National Database

June 1, 2018 - 00:00
Different randomized trials have shown an excess of minor strokes in patients assigned to carotid artery stenting (CAS) compared with those assigned to carotid endarterectomy (CEA), with no difference in rates of disabling stroke or death between the two approaches. We sought to assess the severity and impact of perioperative stroke after CEA and CAS using a real-world national data set.

IP103. A Significant Number of Patients Who Suffer a Perioperative Stroke After Carotid Endarterectomy Experience Significant Disability

June 1, 2018 - 00:00
Although modern rates of perioperative stroke after carotid endarterectomy (CEA) have been shown to be low, the degree of disability after a stroke is unclear. Our goal was to assess the degree of disability of perioperative stroke after CEA in patients without perioperative impairment.

IP101. Identification of Predictors of High-Grade Restenosis After Carotid Endarterectomy in a Multicenter National Database

June 1, 2018 - 00:00
Restenosis after carotid endarterectomy (CEA) is clinically challenging. Level I evidence has shown reduction in restenosis rates with patch closure during CEA. In 2010, the Vascular Study Group of New England, a regional quality improvement initiative, reported an increase in the use of patching between 2003 and 2008 in the Northeast region that was associated with a slight decrease in clinically significant restenosis at <1 year after conventional CEA. This study reflects on more recent practice patterns and identifies predictors of CEA restenosis using a large national database.

IP099. Regional Anesthesia for Carotid Endarterectomy Protects Against Cranial Nerve Injury

June 1, 2018 - 00:00
Optimal anesthesia for carotid endarterectomy remains controversial. We evaluated and compared short-term outcomes after carotid endarterectomy with general anesthesia (GA) or regional anesthesia (RA).

IP097. Results from an Italian Multicentric Registry on Combined Carotid Endarterectomy and Cardiac Surgery∗

June 1, 2018 - 00:00
The objective of this study was to evaluate perioperative results of combined carotid endarterectomy (CEA) and cardiac surgery in a retrospective multicentric registry.

IP095. Severe Tandem Carotid Lesions in an Irradiated Field with Tracheostomy and Contralateral Carotid Occlusion and Contraindication to Carotid Artery Stenting

June 1, 2018 - 00:00
This is a case report and literature review of a patient with severe tandem carotid lesions in an irradiated field after radical neck dissection with tracheostomy, contralateral carotid occlusion, and contraindication to carotid artery stenting.

IP093. Early Experience With the Octopus Endovascular Strategy in the Management of Thoracoabdominal Aneurysms

June 1, 2018 - 00:00
The octopus endovascular strategy involves placement of a bifurcated graft in the thoracic segment of a thoracoabdominal aneurysm (TAAA) to facilitate deployment of multiple parallel covered stents for visceral perfusion. We reviewed our early outcomes of the octopus TAAA repair strategy.

IP089. Gut Bacteria Influence the Growth of Abdominal Aortic Aneurysms in Mice

June 1, 2018 - 00:00
The goal of this study was to determine whether highly collagenolytic bacteria introduced to the gut microbiome induce abdominal aortic aneurysm in mice.

IP085. Effects of Statin Use on Endovascular Repair of Thoracic Aortic Aneurysm and Dissection

June 1, 2018 - 00:00
Mortality benefits of statin use in open and endovascular abdominal aortic aneurysm repair have been well documented. In this study, we sought to examine the effects of statin use on the outcomes of thoracic endovascular aortic repair (TEVAR).

IP083. Outcomes After Endovascular Aneurysm Repair with Zenith Fenestrated Endograft Versus Infrarenal Endovascular Aneurysm Repair

June 1, 2018 - 00:00
The advent of fenestrated endovascular devices expanded anatomic eligibility for endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms. The Zenith fenestrated endograft (ZFEN; Cook Medical, Bloomington, Ind) was approved by the Food and Drug Administration in 2012. We compared the perioperative outcomes of patients treated with ZFEN with those of patients treated with standard infrarenal EVAR.

IP081. National Trends for Operative Management of Uncomplicated Type B Aortic Dissection

June 1, 2018 - 00:00
Traditionally, management for uncomplicated type B aortic dissection (TBAD) has been primarily medical, focusing on blood pressure control. Recent literature supports considering thoracic endovascular aortic repair to seal the proximal entry tear, possibly decreasing long-term morbidity and mortality by favorably remodeling the aorta. We used the Nationwide Inpatient Sample (NIS) to evaluate trends in the management of uncomplicated TBAD.

IP079. Duplex Ultrasound Can Successfully Identify Endoleaks and Renovisceral Stent Patency in Patients Undergoing Complex Endovascular Aneurysm Repair

June 1, 2018 - 00:00
Duplex ultrasound (DU) is a viable alternative to computed tomography angiography (CTA) for follow-up of patients undergoing standard endovascular aneurysm repair (EVAR). However, the efficacy of DU as a follow-up modality in patients undergoing more complex reconstructions, such as fenestrated EVAR (FEVAR) and chimney EVAR (ChEVAR), is not well known. For these patients, in addition to the presence of endoleak and aneurysm growth, the sonographer must be able to identify patency of renal and visceral stents.

IP077. Two-Device Closure Method for Large-Diameter Arteriotomies in Percutaneous Endovascular Aortic Repair

June 1, 2018 - 00:00
Percutaneous endovascular aortic repairs are associated with access site complications. As endovascular devices become more sophisticated and frequently require large-bore arteriotomies, several devices and techniques have been described to aid in the percutaneous closure of arteriotomies, including collagen plug devices (Angio-Seal; Terumo Interventional Systems, Somerset, NJ) and percutaneous suture-mediated closure devices (Perclose; Abbott Vascular, Santa Clara, Calif). Two-device preclose technique using two Perclose devices has been well established.

IP075. Prevalence of Myocardial Injury After Noncardiac Surgery in Endovascular Aneurysm Repair Patients: Single-Center Analysis Using Contemporary and High-Sensitivity Troponin I Measurements∗

June 1, 2018 - 00:00
Myocardial injury after noncardiac surgery (MINS) refers to prognostically relevant myocardial injury due to ischemia that occurs during or within 30 days after noncardiac surgery (NCS). Its prognostic impact has recently been established, so that MINS has been independently associated with 30-day mortality after NCS, and any detectable cardiac troponin T (cTnT; 0.01 ng/mL) is associated with increased long-term mortality after vascular surgery. The characteristics and prognostic importance of MINS in vascular surgery patients are poorly described, and the prevalence of MINS in endovascular aneurysm repair (EVAR) patients is unknown.

IP073. Predictors and Descriptors of Readmissions After Acute Aortic Dissection

June 1, 2018 - 00:00
Readmissions after acute type A aortic dissection (AAAD) are not well described. Characterization of causes and identification of predictors of readmission could result in improved outcomes. We evaluated our experience to determine the rate and to identify risk factors for readmission after open AAAD repair managed at our institution during a decade.

IP071. Comparison of Fenestrated Endovascular and Open Surgical Repair for Suprarenal and Type IV Thoracoabdominal Aortic Aneurysms∗

June 1, 2018 - 00:00
The aim of this monocentric retrospective study was to compare outcomes of fenestrated endovascular aneurysm repair (FEVAR) and open surgical repair (OR) of suprarenal abdominal aortic aneurysms and type IV thoracoabdominal aneurysms (TAAAs).

IP069. Select Type I and Type III Endoleaks at the Completion of Fenestrated Endovascular Aneurysm Repair Are Safe to Observe

June 1, 2018 - 00:00
The Society for Vascular Surgery/American Association for Vascular Surgery reporting standards for endovascular aneurysm repair (EVAR) consider the presence of a type I or type III endoleak a technical failure. However, the nature of these endoleaks in fenestrated EVAR (FEVAR) is not well understood.