Journal of Vascular Surgery

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Long-term Results of Carotid Stenting and Risk Factors in Patients With Severe Carotid Artery Stenosis Undergoing Subsequent Cardiac Surgery

February 28, 2019 - 23:00
This was a prospective observational single-center study between 1997 and 2011.

Statins Reduce Abdominal Aortic Aneurysm Growth, Rupture, and Perioperative Mortality: A Systemic Review and Meta-Analysis

February 28, 2019 - 23:00
This study is a retrospective review of Cochrane CENTRAL database, MEDLINE, and Embase through June 15, 2018.

Transfemoral Carotid Artery Stents Should Be Used With Caution in Patients With Asymptomatic Carotid Artery Stenosis

February 28, 2019 - 23:00
This study is a retrospective review of the Vascular Quality Initiative between 2005 and 2017.

Gene Therapy for Peripheral Arterial Disease

February 28, 2019 - 23:00
This study is a retrospective review of Cochrane Vascular Specialized Register, MEDLINE Ovid, Embase Ovid, CINAHL, and AMED through November 27, 2017.

Regarding “The Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm”

February 28, 2019 - 23:00
In the 2018 Society for Vascular Surgery guidelines regarding the care of patients with an abdominal aortic aneurysm (AAA) by Chaikof et al,1 there is a recommendation regarding the level of the proximal anastomosis of an infrarenal AAA open repair. The authors recommend performing the anastomosis as close to renal arteries as possible. They support that performing the anastomosis within healthy aorta is important to minimize the risk of future aneurysmal degeneration. Definitely, an endograft has to be anchored on a good length of normal size aorta just below the lowest renal artery to achieve optimal fixation and decrease the incidence of migration and endoleak.

Reply

February 28, 2019 - 23:00
The 2018 Society for Vascular Surgery practice guidelines on the care of patients with an abdominal aortic aneurysm notes that, should an open surgical repair be required, “performing the proximal anastomosis within healthy aorta is important to minimize the risk of aneurysmal degeneration at or above the graft.” The guidelines formally recommend “performing the proximal aortic anastomosis as close to the renal arteries as possible.” Dr Lazaris notes that this may be too restrictive for those patients that present with a healthy aortic neck of normal dimension and of substantial length.

Regarding “Financial implications of coding inaccuracies in patients undergoing elective endovascular abdominal aortic aneurysm repair”

February 28, 2019 - 23:00
The article published in April 2018 by Ayub et al1 revealed substantial lost billing opportunities from miscoding of admissions for elective endovascular aneurysm repair. This finding echoes results found through a study at our tertiary vascular center.

Overview of evidence on risk factors and early management of acute carotid stent thrombosis during the last two decades

February 28, 2019 - 23:00
Acute carotid stent thrombosis (ACST) occurring in the first hours after the procedure is an exceedingly rare complication of carotid artery stenting, but it is potentially devastating. This review aimed to evaluate current literature, identifying all reported cases during the last two decades, with the final purpose of reporting predictive factors and early management.

Postanesthesia ultrasound facilitates creation of more preferred accesses without affecting access survival

February 28, 2019 - 23:00
The results of preoperative ultrasound (pre-US) vein mapping for hemodialysis access creation can be affected by environmental and clinical factors, such as ambient temperature, acute illness, recent phlebotomy, and hypovolemia. These factors may inadvertently exclude otherwise viable veins as options for access creation. We hypothesized that repeating the ultrasound vein mapping immediately preoperatively after anesthesia administration (post-US) identifies additional veins not appreciated by pre-US, thereby altering the operative plan and producing more preferred accesses, particularly more forearm accesses.

Invited commentary

February 28, 2019 - 23:00
With 827 consecutive post-carotid endarterectomy completion arteriograms, Dr Wieker and colleagues detected 57 (6.9%) defects requiring immediate surgical revision. One in 14 of their cases required reopening of the artery! Despite their significant incidence of defects requiring immediate revision, the authors' overall results are superb (0.2%, 0.5%, and 0.6% 30-day mortality, stroke, and transient ischemic attack rates, respectively), and immediate revision was not associated with worse outcomes.

General anesthesia is associated with reduced early failure among patients undergoing hemodialysis access

February 28, 2019 - 23:00
Despite recent reports of improved patency with regional anesthesia (RA), general anesthesia (GA) remains the most common choice for anesthesia for patients undergoing arteriovenous fistula (AVF) or arteriovenous graft (AVG) creation, with nearly 85% utilization. Previous studies of the effect of anesthesia type on outcomes have been conducted through single institutions or a national database with poor granularity for vascular-specific data. Given the high variability of practice patterns and the high prevalence of end-stage renal disease requiring access creation, further study of the impact of anesthesia choice during AVF or AVG creation is warranted.

Thirty-day outcomes from the Society for Vascular Surgery Vascular Quality Initiative thoracic endovascular aortic repair for type B dissection project

February 28, 2019 - 23:00
The purpose of the Society for Vascular Surgery Vascular Quality Initiative thoracic endovascular aortic repair (TEVAR) for dissection project is to assess the effectiveness of TEVAR for type B dissection by evaluation in a prospective quality improvement registry. Here we describe the project cohort and 30-day outcomes of TEVAR for both acute dissection (AD) and chronic dissection (CD) patients and focus specifically on outcomes of uncomplicated AD patients based on timing of treatment.