Journal of Vascular Surgery

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Popliteal Aneurysm and Fistula Repair

August 1, 2018 - 00:00
This is a discussion of repair of a popliteal artery aneurysm with concurrent arteriovenous fistula thought to be secondary to chronic trauma from a knee prosthesis. This video describes the exposure of the popliteal fossa and management of a concurrent popliteal artery aneurysm and fistula. I elected to pursue a posterior approach. Both the vein and artery were controlled; the aneurysm was entered first, and the vein was repaired primarily.

Treatment of Superior Vena Cava Syndrome With Kissing Brachiocephalic Stents and Exchange of Pacemaker Leads

August 1, 2018 - 00:00
The purpose of this video was to demonstrate a collaborative multidisciplinary team approach to the treatment of a patient with complex medical history and recurrent superior vena cava (SVC) syndrome.

Open Repair of Renal Artery Aneurysm in Solitary Kidney

August 1, 2018 - 00:00
This is a presentation on renal artery aneurysm repair with saphenous vein bypass in the setting of a solitary kidney. Renal artery aneurysms are exceedingly rare at an incidence of 0.1%. I propose that an open operation for a large renal artery aneurysm can be performed with acceptable risk for renal salvage. The main challenge in the operation was dissecting free the aneurysm from the renal vein.

Cone Beam Computed Tomography-Guided Embolization Techniques

August 1, 2018 - 00:00
This video demonstrates the use of intraoperative cone beam computed tomography (CT) and image fusion for guided needle vascular access. Cone beam CT allows direct and safe puncture into the vascular structure of interest for multiple applications, including translumbar and transcaval aortic sac embolization and venous malformation embolization. Preoperative image planning and intraoperative imaging are critical for successful minimally invasive vascular interventions. This video describes the process of cone beam CT in the hybrid operative suite step by step.

Nationwide Trends in Drug-Coated Balloon and Drug-Eluting Stent Utilization in the Femoropopliteal Arteries

August 1, 2018 - 00:00
Drug-coated balloons (DCBs) and drug-eluting stents (DESs) have significantly altered treatment paradigms for femoropopliteal lesions. We aimed to describe changes in practice patterns as a result of the infusion of these technologies into the treatment of peripheral arterial disease.

Influence of a Novel Morphology-Driven Classification on Limb Salvage After Tibial Intervention for Limb-Threatening Critical Ischemia

August 1, 2018 - 00:00
Infrapopliteal interventions for limb-threatening critical ischemia can be affected by the morphology of the tibial vessels. The aim of this study was to examine the impact of a novel morphology-driven classification on the outcomes of endovascular intervention for limb-threatening critical ischemia.

Negative Pressure Wound Therapy Reduces Surgical Site Infections

August 1, 2018 - 00:00
Surgical site infection (SSI) with lower extremity incisions represents a modifiable source of major morbidity. Our institutional bundled care protocol to decrease SSI includes optimization of perioperative risk factors, dedicated wound closure trays, and voluntary use of surface negative pressure wound therapy (NPWT) devices applied over closed incisions in the operating room. This study examined the individual effect of NPWT on SSI reduction and other perioperative outcomes.

Comparison of Forearm Versus Upper Arm Basilic Transposition Arteriovenous Fistulas Demonstrates Equivalent Satisfactory Patency

August 1, 2018 - 00:00
End-stage renal disease remains a significant health problem in the United States. In accordance with Kidney Disease Outcomes Quality Initiative recommendations, attaining autogenous hemodialysis access, specifically through creation of radiocephalic, brachial-basilic, or brachial-cephalic fistulas, is preferred. The aim of this study was to determine the suitability of forearm basilic vein transposition (FBVT) fistulas as an alternative access option by comparing outcomes with those of brachial-basilic arteriovenous fistulas (BB-AVFs).

Open Versus Fenestrated Endovascular Repair of Complex Abdominal Aortic Aneurysms

August 1, 2018 - 00:00
Fenestrated endovascular aneurysm repair (FEVAR) has emerged as an alternative to open repair for treatment of complex abdominal aortic aneurysms (cAAAs), but direct comparisons between the two repair types are limited.

Factors Associated With Postoperative Renal Dysfunction and the Subsequent Impact on Survival After Open Juxtarenal Abdominal Aortic Aneurysm Repair

August 1, 2018 - 00:00
Renal dysfunction is a well-described complication of open juxtarenal abdominal aortic aneurysm repair, but risk factors and corresponding impact on survival are not well described.

Evolving Preoperative Imaging Paradigms Before Carotid Endarterectomy

August 1, 2018 - 00:00
Different imaging modalities are available for carotid endarterectomy (CEA) planning, and the choice of imaging is in evolution. The aim of this study was to assess the association between imaging modality, presentation of the patient, and hospital CEA volume.

Multicenter Experience in Translumbar Type II Endoleak Treatment in the Hybrid Room With Needle Trajectory Planning and Fusion Guidance

August 1, 2018 - 00:00
The objective of this study was to evaluate the efficacy of treating type II endoleaks (T2Ls) after aortic endovascular repair with image guidance translumbar puncture using intraoperative cone beam computed tomography with preprocedure computed tomography angiography fusion in hybrid operating rooms.

Coronary Drug-Eluting Stents for the Treatment of Threatened Lower Extremity Bypass Grafts: A Single-Institution Case Series

August 1, 2018 - 00:00
Drug-eluting stents (DESs) are highly efficacious for interventions on coronary saphenous vein graft bypasses, with improved patency over angioplasty and bare-metal stenting. We have used these coronary stents in failing lower extremity bypass grafts with aggressive or refractory stenotic lesions and present the experience at a single institution.

Effect of Severe Anemia on Outcomes of Hemodialysis Vascular Access

August 1, 2018 - 00:00
The majority of patients undergoing hemodialysis (HD) are anemic. The severity of anemia in these patients may influence the postoperative outcomes and the durability of vascular access. Thus, the purpose of this study was to assess the role of anemia in patients undergoing HD access placement (arteriovenous graft and arteriovenous fistula).

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

August 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.

Application of a Cryogel-Coated Prosthetic Vascular Graft Material for Delivery of Targeted Gene Therapies in a Rabbit Model

August 1, 2018 - 00:00
The long-term success of prosthetic vascular grafts for revascularization in peripheral arterial disease is limited by the development of anastomotic neointimal hyperplasia. We have constructed a bioactive prosthetic graft material by coating polyethylene terephthalate (PET) with an antithrombogenic cryogel polymer layer capable of delivering biologic agents in vitro. Our goal was to evaluate our hybrid prosthetic graft material in vivo using a rabbit carotid interposition bypass model.

Effects of Endovascular First Strategy on Splice Vein Bypass Outcomes

August 1, 2018 - 00:00
Aggressive endovascular interventions for patients without adequate full-length venous conduit have gained popularity. The purpose of this study was to evaluate the outcomes of splice vein bypass (SVB) as primary treatment vs treatment after failed endovascular intervention (ESVB) for infrainguinal revascularization.

Hybrid Endovascular Exclusion of a Bleeding Innominate Artery Pseudoaneurysm in a Patient With No Open Surgical Options

August 1, 2018 - 00:00
We report a challenging case involving bleeding from a mycotic pseudoaneurysm of the innominate artery in a hostile surgical field.

Risk Factors for Mortality After Endovascular Repair for Traumatic Thoracic Aortic Injury

August 1, 2018 - 00:00
Despite high utilization of endovascular repair, traumatic thoracic aortic injury leads to significant mortality. We sought to identify risk factors and to create a risk predictive model for mortality after thoracic endovascular aortic repair (TEVAR) based on available preoperative clinical data.

Surgical Outcomes for Occluded Venous Thoracic Outlet Syndrome After Transaxillary First Rib Resection

August 1, 2018 - 00:00
Transaxillary first rib resection (TFRR) is a well-established operation in treatment of venous thoracic outlet syndrome (VTOS). The objective of this paper was to evaluate long-term outcomes of TFRR in patients with completely occluded axillosubclavian veins at clinical presentation.