Journal of Vascular Surgery

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Contents

July 1, 2019 - 00:00

Editorial Board

July 1, 2019 - 00:00

Critical review and evidence implications of paclitaxel drug-eluting balloons and stents in peripheral artery disease

July 1, 2019 - 00:00
A recent meta-analysis identified increased 2- to 5-year mortality associated with paclitaxel-eluting balloons and stents when they are used to treat peripheral artery disease. The history of the development of paclitaxel, its mechanism of action, and its use in the coronary and peripheral circulation are reviewed in this special communication. In addition, inferences are made to place these findings in perspective and to explain them in light of presently available information, and proposals regarding end points and open access to data are put forth to minimize risk of such developments in the future.

Bursting the drug-eluting balloon bubble for femoropopliteal disease might be premature

July 1, 2019 - 00:00
The femoropopliteal (FP) artery has been recognized as the most susceptible anatomic location for peripheral arterial disease.1 It has been accepted that endovascular approaches should be undertaken in the first instance for patients who warrant intervention.2 The use of drug-coated balloons (DCBs) and drug-eluting stents (DESs) has increased in popularity owing to the results of randomized controlled trials (RCTs) that have demonstrated a reduction in vascular restenosis.3 Paclitaxel is considered to exert the most potent antirestenotic effect in the management of FP steno-occlusive disease.

Merit-Based incentive payment system year 3 quality reporting options

July 1, 2019 - 00:00
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program, which requires physicians who bill Medicare to participate in 2019 in 1 of 2 ways to avoid a 7% reimbursement penalty in 2021: the merit-based incentive payment system (MIPS) or the advanced alternative payment models (APMs). Currently, no vascular APMs have been approved. Thus, providers who are not part of a large multispecialty APM will likely participate through the MIPS. In 2019, the quality category of MIPS will account for 45% of the final score, with a number of reporting options.

Vascular surgery needs millennials!

July 1, 2019 - 00:00
It has been an amazing honor to be the Forty-seventh President of the Society for Clinical Vascular Surgery (SCVS). I started coming to this meeting my first year in practice circa 1999 and believe I have been to every meeting since. I first attended the SCVS when I worked at the University of Michigan. At the time, no one from the University of Michigan really came to the SCVS annual meeting. However, when I attended the SCVS annual meeting as a young faculty member, I was drawn to it mainly because of the great energy from the other young people who participated in it.

EVAR Approach for Abdominal Aortic Aneurysm With Horseshoe Kidney: A Multicenter Experience

July 1, 2019 - 00:00
A multicenter retrospective review was conducted between January 2004 and December 2013.

Diagnosis and Management of Carotid Free-Floating Thrombus: A Systematic Literature Review

July 1, 2019 - 00:00
A review was performed of MEDLINE, Embase, and manually for references from 1960 to June 2017.

Spinal Cord Deficit After 1114 Extent II Open Thoracoabdominal Aortic Aneurysm Repairs

July 1, 2019 - 00:00
A single-institution retrospective review was performed between 1991 and 2017.

Nationwide Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta in Civilian Trauma

July 1, 2019 - 00:00
A retrospective analysis was conducted of a national multi-institutional database (American College of Surgeons Trauma Quality Improvement Program) between 2015 and 2016.

Long-term Outcomes of Stenting and Endarterectomy for Symptomatic Carotid Stenosis: A Preplanned Pooled Analysis of Individual Patient Data

July 1, 2019 - 00:00
A pooled analysis was conducted of four randomized controlled trials with patients randomly assigned between November 2000 and July 2008.

Open Versus Fenestrated Endovascular Repair of Complex Abdominal Aortic Aneurysms

July 1, 2019 - 00:00
This is a retrospective review of prospectively gathered data from the Vascular Quality Initiative between 2012 and 2018.

Excessive tortuosity of the iliac arteries is an indication for open abdominal aortic aneurysm repair

July 1, 2019 - 00:00
A 75-year-old morbidly obese man presented with increasing diameter of a known abdominal aortic aneurysm (AAA) and right common iliac artery aneurysm. He was diagnosed with these aneurysms at the age of 69 years while undergoing computed tomography for evaluation of pancreatic cancer. At the time of diagnosis, the AAA diameter was 3.9 cm. His past medical history was significant for hypertension and hyperlipidemia. He was observed with serial aortoiliac duplex ultrasound scans. By November 2018 (6 years after the original diagnosis), the AAA diameter increased to 6.3 cm and the right common iliac artery diameter increased to 3 cm.

Factors other than time predict outcomes in patients with lower extremity arterial injuries

July 1, 2019 - 00:00
After reading the article by Alarhayem et al,1 we thought to share our experience with prolonged ischemia time and its impact on extremity arterial reconstruction. For decades, vascular reconstruction following 6 hours of ischemia time has been guided by dogma and dated animal experiments.2 Even contemporary large-animal experiments aimed at redefining critical ischemia time concluded this to be <5 hours and <3 hours if accompanied by hemorrhagic shock.3 With ischemia times of 301 ± 165 minutes due to prolonged medical evacuation from the combat zone, we identified that limb salvage is compounded by multiple independent variables.

Reply

July 1, 2019 - 00:00
β-Aminopropionitrile fumarate administration induced thoracic aortic aneurysm and dissection formation in C57/BL6 mice. The incidence of thoracic aortic aneurysm and dissection was >80% (16/18), and half of the mice died of rupture (10/18).1 The incidence could be 100% with the administration of β-aminopropionitrile fumarate and angiotensin II.2

Regarding “Rapamycin prevents thoracic aortic aneurysm and dissection in mice”

July 1, 2019 - 00:00
Zhou et al1 recently reported that mechanistic target of rapamycin (mTOR) signaling is activated in β-aminopropionitrile fumarate (BAPN)-treated mice with thoracic aortic aneurysm and dissection (TAAD). Notably, they found that rapamycin could prevent TAAD formation in vivo. Inhibition of mTOR signaling, reduction of inflammatory cell infiltration, and matrix metalloproteinase 9 (MMP-9) production in tissue were used to explain the protective mechanisms of rapamycin. Consequently, they recommended strategies to inhibit the target of rapamycin pathway to treat TAAD.

The importance of establishing a framework for regional and international collaboration in the management of the diabetic foot

July 1, 2019 - 00:00
The global prevalence of diabetes mellitus continues to rise; estimates are that it will affect 350 million people (4.4% of the global population) by the year 2030.1 Associated complications of diabetes are likewise increasing.2 Diabetic foot ulceration (DFU) is complex and costly, being the most frequent cause of hospitalization in this population of patients.2,3 In Mexico, there are approximately 12 million people with diabetes mellitus, and the health care cost is 2.3% of the gross domestic product, mostly to treat complications associated with DFU.

Viva la resolution!

July 1, 2019 - 00:00
Malas et al, in their study reporting in-hospital outcomes after transcarotid artery revascularization (TCAR) vs transfemoral carotid artery stenting (TFCAS) in the Society for Vascular Surgery Vascular Quality Initiative TCAR Surveillance Project, concluded that “this is the first study to demonstrate the benefit of TCAR compared with TFCAS in real-world practice.”1 At first sight, this is welcome news, as (intuitively) it seems logical that any carotid artery stenting (CAS) innovation that avoids negotiating the aortic arch and uses temporary flow reversal for cerebral protection during stent placement has the potential to considerably reduce procedural stroke.

Reply

July 1, 2019 - 00:00
We greatly appreciate Dr Naylor's interest in our work on transcarotid artery revascularization (TCAR) with dynamic flow reversal.1 The TCAR Surveillance Project (TSP) is an ongoing project by the Society for Vascular Surgery Vascular Quality Initiative to assess the safety and effectiveness of TCAR in real-world practice. By 2024, the TSP is estimated to include 15,000 participants.

A systematic review and meta-analysis of bivalirudin application in peripheral endovascular procedures

July 1, 2019 - 00:00
The direct thrombin inhibitor bivalirudin (BIV) was shown to be superior to unfractionated heparin (UFH) in percutaneous coronary interventions for reducing procedural blood loss. The aim of this study was to compare outcome profiles of BIV and UFH in peripheral endovascular procedures (PEPs) by synthesizing the currently available data.