Journal of Vascular Surgery

Syndicate content
Journal of Vascular Surgery RSS feed.
Updated: 12 hours 36 min ago

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.

IP067. Outcomes of Surgeon-Modified Fenestrated Endografts in the Treatment of High-Risk and Acute Aortic Disease

June 1, 2018 - 00:00
The application of surgeon-modified fenestrated endografts to high-risk and acute aortic disease is desirable because of the morbid nature of open repair; however, the feasibility of this is largely unknown. We sought to describe outcomes of surgeon-modified fenestrated endovascular aneurysm repair (sm-FEVAR) for acute and high-risk aortic disease in patients who were deemed poor surgical candidates.

IP065. Five-Year Experience With Common Carotid Artery Chimney Grafts to Extend Proximal Landing Zone for Thoracic Endovascular Aortic Repair

June 1, 2018 - 00:00
Repair of aortic disease extending proximal to the left subclavian artery is challenging with few durable options. With the advent of new endovascular devices to treat aortic arch conditions, a historical comparison is required for evaluation of efficacy and safety.

IP063. Modified Frailty Index to Predict Adverse Outcomes and Mortality in Open Surgical Repair of a Ruptured Abdominal Aortic Aneurysm

June 1, 2018 - 00:00
In recent years, there has been more interest in frailty in the surgical patient and its implication for outcomes. A simplified form of the original frailty index from the Canadian Study of Health and Aging has been established as the modified frailty index (mFI) and has been used as a predictor of morbidity and mortality after surgery. In our study, we have sought to apply the mFI to open surgical repair of a ruptured abdominal aortic aneurysm.

IP061. Reporting Standards for Infrarenal Endovascular Aortic Aneurysm Repairs: Are We Adhering to the Society for Vascular Surgery Guidelines?

June 1, 2018 - 00:00
Reporting standards in clinical research allow accurate comparison between outcomes for different clinical trials. We sought to assess the proportion of published studies evaluating outcomes for elective infrarenal endovascular aneurysm repairs (EVARs) that adhered to the current Society for Vascular Surgery (SVS) reporting guidelines.

IP059. Early and Late Costs of Endovascular Abdominal Aortic Aneurysm Repair From the Endurant Stent Graft System Post Approval Study (ENGAGE PAS)

June 1, 2018 - 00:00
Endovascular aneurysm repair (EVAR) has become the standard of care for treatment of abdominal aortic aneurysms. Whereas the costs of EVAR during the index admission were shown with early randomized trials, these studies evaluated costs with early devices and had nothing to disclose regarding follow-up costs. Therefore, we present the early and late costs of EVAR from the Endurant Stent Graft System Post Approval Study (ENGAGE PAS).

IP057. Clinical Significance of Marginal Coagulopathy in Patients Undergoing Open Surgery for Abdominal Aortic Aneurysm

June 1, 2018 - 00:00
Some patients with intact abdominal aortic aneurysm (iAAA) have consumption coagulopathy without definitive diagnosis of disseminated intravascular coagulation (DIC). The objective of this study was to reveal the clinical significance of such marginal coagulopathy (namely, pre-DIC) associated with iAAA.

IP055. A Comparison of Endovascular Aneurysm Repair with EndoAnchors Versus Chimney Stent Grafts for Treatment of Short-Neck Infrarenal Abdominal Aortic Aneurysm

June 1, 2018 - 00:00
The objective of this study was to assess preoperative characteristics and to compare perioperative and 1-year outcomes for short-neck infrarenal abdominal aortic aneurysms treated with standard endovascular aneurysm repair (EVAR) plus EndoAnchors (Medtronic, Santa Rosa, Calif) vs EVAR with parallel stent grafts.

IP053. Morphometric Analysis of the Thoracic Aorta by Electrocardiography-Gated Computed Tomography in Patients With Aneurysm and Dissection of the Descending Aorta

June 1, 2018 - 00:00
We previously analyzed changes in aortic size over the cardiac cycle for patients with aortic valve stenosis but no aortic disease. In this study, we analyzed patients with descending thoracic aortic aneurysm (DTA) and DeBakey type III aortic dissection (AD).

IP051. Atrophy of the Aneurysm Wall: Observations From Secondary Expansion After Endovascular Aneurysm Repair With Type II Endoleak∗

June 1, 2018 - 00:00
Abdominal aortic aneurysm (AAA) has an age-dependent prevalence of 2% to 11% and is a leading cause of death in men aged >65 years if it is not treated surgically. Endovascular aneurysm repair (EVAR) is performed in up to 80% of elective and 90% of ruptured cases. Although reducing perioperative, early, and midterm outcomes and complications rates, the procedure is associated with specific complications requiring close follow-up, especially endoleaks. Type II endoleaks occur in up to 30% after EVAR; however, aneurysm sac expansion is rare.

IP049. Effect of Symptomatic or Ruptured Presentation on the Five-Year Rate of Reintervention After Endovascular Abdominal Aortic Aneurysm Repair in the Vascular Quality Initiative

June 1, 2018 - 00:00
Many patients who undergo endovascular aneurysm repair (EVAR) will require reintervention. It remains unclear whether patients who have EVAR for symptomatic or ruptured aneurysms are more likely to require reintervention compared with patients who have EVAR electively. The objective of this study was to compare the freedom from reintervention after EVAR of patients who have their operation performed electively vs for a symptomatic or ruptured aneurysm.

IP047. Effect of Insertion Technique and Iliac Artery Torsion on Device Rotation in Fenestrated Endovascular Aneurysm Repair

June 1, 2018 - 00:00
The objective of this study was to determine the influence of iliac artery torsion, rigidity, and operator technique on the rotation of fenestrated endovascular devices during deployment in a phantom model.

IP045. Racial Disparities in Endovascular Repair of Thoracic Aortic Aneurysm and Dissection

June 1, 2018 - 00:00
Racial disparities in open aortic aneurysm repair have been well documented, with black patients reported to suffer from inferior outcomes compared with their white counterparts. It is unclear whether these disparities extend to the less invasive thoracic endovascular aortic repair (TEVAR). We therefore sought to examine the outcomes of black vs white patients undergoing TEVAR.

IP043. Predictors of Survival in Malignant Aortic Tumors∗

June 1, 2018 - 00:00
Malignant aortic tumors are exceedingly rare. For that reason, no case series have been published so far in the literature, and a comprehensive review of clinical and therapeutic aspects is lacking. The aim of this study was to analyze all known cases of malignant aortic tumors and to identify predictors of patients’ survival.

IP041. Acute and Chronic Renal Dysfunction After Open and Endovascular Abdominal Aortic Aneurysm Repair

June 1, 2018 - 00:00
Abdominal aortic aneurysms remain an important health problem specifically for men older than 65 years. Distinct aspects of both endovascular aneurysm repair (EVAR) and open repair place patients at risk for renal dysfunction in the short and long term. Kidney injuries increase the risk of postoperative morbidity, mortality, and prolonged hospital stay. This study analyzed the incidence of acute and chronic renal dysfunction as well as contributing factors in patients after abdominal aortic aneurysm repair.

IP037. Outcomes of the First 100 Consecutive Zenith Fenestrated Endovascular Grafts at a Single Center

June 1, 2018 - 00:00
The Cook Zenith fenestrated endovascular graft (ZFEN; Cook Medical, Bloomington, Ind) is the only commercially available graft in the United States. Fenestrated endograft technology has been widely accepted as a safe and effective technique to treat more complex abdominal aortic aneurysm anatomy. Data suggest that most centers do only a small volume of cases, despite widespread training of surgeons on the procedure. We reviewed the first 100 consecutive ZFEN endografts performed at our center to evaluate this technology.