Journal of Vascular Surgery

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Updated: 9 hours 6 min ago

Characterizing tissue perfusion after lower extremity intervention using two-dimensional color-coded digital subtraction angiography

June 21, 2017 - 00:00
Digital subtraction angiography (DSA) of the peripheral arterial vasculature provides lumenographic information but only a qualitative assessment of blood flow. The ability to quantify adequate tissue perfusion of the lower extremities would enable real-time perfusion assessment during DSA of patients with peripheral arterial disease (PAD). In this study, we used a novel real-time imaging software to delineate tissue perfusion parameters in the foot in PAD patients.

Adapting to a total endovascular approach for complex aortic aneurysm repair: Outcomes after fenestrated and branched endovascular aortic repair

June 21, 2017 - 00:00
This study reports the feasibility of adopting a total endovascular approach for the treatment of complex abdominal aortic aneurysms (AAAs) at a European aortic center and compares the short- and midterm results against those from large and multicenter studies.

Management of wide-based renal artery aneurysms using noncovered stent-assisted coil embolization

June 17, 2017 - 00:00
This study describes the safety and midterm efficacy of a noncovered stent-assisted embolization (SAE) technique in treating patients with wide-base renal artery aneurysms (RAAs).

Role of language discordance in complication and readmission rate after infrainguinal bypass

June 16, 2017 - 00:00
Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients.

Carotid occlusion is associated with more frequent neurovascular events than moderately severe carotid stenosis

June 16, 2017 - 00:00
Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asymptomatic carotid artery stenosis (CS).

Surgical personalities, surgical burnout, and surgical happiness

June 14, 2017 - 00:00
Individuals who have experienced professional success share several traits, which likely enabled them to reach that success. DeLong and DeLong1 identified several of these characteristics. These high achievers are considered to be driven, result and task oriented, motivated, competitive, and passionate; they crave positive feedback and truly engage in the pursuit of excellence. These qualities are positive but taken in the extreme can actually be antithetical to the goals of high achievers. When driven individuals must trample others to complete their own goals, their rewards become less meaningful.

Management and outcomes of symptomatic abdominal aortic aneurysms during the past 20 years

June 14, 2017 - 00:00
We compared the management of patients with symptomatic, unruptured abdominal aortic aneurysms (AAAs) treated at a tertiary care center between two decades. This 20-year period encapsulated a shift in surgical approach to aortic aneurysms from primarily open to primarily endovascular, and we sought to determine the effect of this shift in the evaluation, treatment, and clinical outcomes of patients with symptomatic AAA.

Introduction of arteriovenous grafts with graft insertion anastomosis for hemodialysis access

June 14, 2017 - 00:00
An arteriovenous bridging graft is a viable option for patients with compromised arteries or veins because of advanced age or diabetes. Arteriovenous graft with graft insertion anastomosis (AVGI) is the novel technique for graft-vein anastomosis where the prosthesis is inserted into the vein, and the anastomosis is performed on the surface of the prosthesis. This study assessed the short-term and long-term results of AVGI to clarify the efficacy of this technique.

Durability of a low-profile stent graft for thoracic endovascular aneurysm repair

June 8, 2017 - 00:00
The introduction of lower profile endografts expanded the application of aortic endovascular repair. However, evidence about their durability is still scarce. The objective of this study was to assess longer term durability of the Zenith Alpha Thoracic Stent Graft (Cook Inc, Bloomington, Ind) after thoracic endovascular aortic repair.

Comparison of outcomes for short-neck and juxtarenal aortic aneurysms treated with the Nellix endograft versus conventional endovascular aneurysm sealing

June 8, 2017 - 00:00
The objective of this study was to evaluate the results of the off-label use of the Nellix endograft (Endologix, Irvine, Calif) for the treatment of short-neck aneurysms and juxtarenal aortic aneurysms (JAAs) compared with the outcomes of patients with infrarenal abdominal aortic aneurysms treated in accordance with the manufacturer's instructions for use.

Predictors of 30-day postoperative major adverse clinical events after carotid artery stenting: An analysis of the procedure-targeted American College of Surgeons National Surgical Quality Improvement Program

June 5, 2017 - 00:00
Information about carotid artery stenting (CAS) is largely derived from clinical trials, consensus statements, and outcomes comparisons between CAS and carotid endarterectomy. Given these limitations, the goal of this study was to identify risk factors for adverse outcomes after CAS among hospitals participating in the CAS-targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP).

Assessment of aortic wall thrombus predicts outcomes of endovascular repair of complex aortic aneurysms using fenestrated and branched endografts

June 5, 2017 - 00:00
The goal of this study was to investigate the correlation between atherothrombotic aortic wall thrombus (AWT) and clinical outcomes in patients treated by fenestrated-branched endovascular aortic repair (F-BEVAR) and present a new classification system for assessment of AWT burden.

Partial distal deployment for precise placement of the GORE Thoracic Endoprosthesis

June 2, 2017 - 00:00
The GORE TAG Thoracic Endoprosthesis (TAG) device (W. L. Gore & Associates, Flagstaff, Ariz) and the GORE Conformable TAG Thoracic Endoprosthesis (CTAG) are commonly implanted and effective stent grafts for use during thoracic endovascular aortic repair. Precise placement of the endograft is paramount during thoracic endovascular aortic repair, but like all thoracic stent grafts, maldeployment with inaccurate landing has been reported. The partial distal deployment technique describes an alteration of the TAG and CTAG deployment mechanism to allow isolated deployment of the distal half of the graft, which provides stability during deployment.

Open abdominal surgical training differences experienced by integrated vascular and general surgery residents

June 2, 2017 - 00:00
As the integrated vascular residency program reaches almost a decade of maturity, a common area of concern among trainees is the adequacy of open abdominal surgical training. It is our belief that although their overall exposure to open abdominal procedures has decreased, integrated vascular residents have an adequate and focused exposure to open aortic surgery during training.

Conical neck is strongly associated with proximal failure in standard endovascular aneurysm repair

June 2, 2017 - 00:00
Hostile proximal aortic neck (HN) challenges the suitability for standard endovascular aneurysm repair (EVAR) of patients at high risk for “open” repair. However, there has been little if any focus placed on the individual role of the “nonlength” HN features in EVAR outcomes. The aim of this study was to evaluate their individual and potentially predictive role in outcomes of EVAR under HN conditions.

Risk factors for postoperative delirium in patients undergoing vascular surgery

June 2, 2017 - 00:00
Postoperative delirium (PODE) remains a common complication after vascular surgery procedures although the exact pathogenesis remains unclear, mainly because of its multifactorial character. The aim of this systematic review was to evaluate pooled data on potential risk factors for PODE in patients undergoing vascular surgery procedures.

Electromagnetic tracking of flexible robotic catheters enables “assisted navigation” and brings automation to endovascular navigation in an in vitro study

June 2, 2017 - 00:00
Combining three-dimensional (3D) catheter control with electromagnetic (EM) tracking-based navigation significantly reduced fluoroscopy time and improved robotic catheter movement quality in a previous in vitro pilot study. The aim of this study was to expound on previous results and to expand the value of EM tracking with a novel feature, assisted navigation, allowing automatic catheter orientation and semiautomatic vessel cannulation.

Treatment strategy based on the natural course of the disease for patients with spontaneous isolated abdominal aortic dissection

June 2, 2017 - 00:00
This study aimed to determine the natural history of spontaneous isolated abdominal aortic dissection (SIAAD) and to establish an optimal management strategy for patients with SIAAD.

Young female vascular surgeons more likely to enter academia

June 2, 2017 - 00:00
In the last decade, there has been a dramatic increase in the number of women entering vascular surgery. Our goal was to evaluate the differences in career paths based on gender and to determine some of the factors that influence career decisions among young vascular surgeons.

Thoracic endovascular aortic repair with branched Inoue Stent Graft for arch aortic aneurysms

June 2, 2017 - 00:00
Thoracic endovascular aortic repair (TEVAR) for thoracic aortic aneurysms (TAAs) is in rapid expansion due to its minimal invasiveness. However, TEVAR for an arch aneurysm with a straight stent graft needs surgical reconstruction for supra-aortic vessels. A branched stent graft pioneered by Inoue (branched Inoue Stent Graft [ISG]) has been expected to resolve this problem, but its utility remains to be established in the real clinical setting. This study evaluated the long-term clinical outcome of branched ISGs for TAAs.