Journal of Vascular Surgery

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Updated: 11 hours 4 min ago

Minimally Invasive Infrainguinal Bypass Provides Short Length of Stay, Prompt Return to Baseline Mobility, and Low Incidence of SSI

August 1, 2017 - 00:00
Current literature in small trials shows conflicting data when comparing minimally invasive vein harvest (MIVH) and open vein harvest (OVH) bypass patency, wound infection incidence, and patient morbidity. Our institution has performed MIVH since 2003, with a consistent team of specialized endoscopic harvest assists. This study reviewed the major outcomes of MIVH infrainguinal bypass, given a predominant cohort of critical limb ischemia.

Implementation of Ruptured Aorta Centers of Excellence (RACE) Algorithm Decreases Hospital Length of Stay

August 1, 2017 - 00:00
Clinical outcomes of ruptured abdominal aortic aneurysm (rAAA) depend on prompt diagnosis and treatment by a multidisciplinary team. We designed an algorithm aimed at streamlining diagnosis and coordinating efforts at treatment. This study investigated whether implementation of the RACE (Ruptured Aorta Centers of Excellence) algorithm improved patient outcomes.

Outcomes of Gracilis Muscle Flaps in the Management of Groin Complications After Arterial Bypass with Synthetic Graft

August 1, 2017 - 00:00
This study demonstrated the outcomes of gracilis muscle flap (GMF) use in providing tissue coverage for groin complications after arterial bypass surgery with a synthetic graft.

Preoperative Ankle-Brachial Index Stratification for Patients With Peripheral Arterial Disease

August 1, 2017 - 00:00
The ankle-brachial index (ABI) is a well-accepted tool to assess severity of peripheral arterial disease (PAD). Categorization of ABI values to match clinical PAD severity (claudication, rest pain, and tissue loss) is based on limited data of a few hundred patients from 1970 and 1996. The American Heart Association guidelines recommended in 2011 to change reporting of ABIs for cardiovascular risk stratification to normal, abnormal, borderline, and noncompressible. As such, reporting categories for ABI in PAD need re-evaluation.

Clinical Outcomes After Varicose Vein Procedures in Octogenarians Within the Vascular Quality Initiative Varicose Vein Registry (VQI VVR)

August 1, 2017 - 00:00
While chronic venous insufficiency (CVI) and varicose veins (VVs) are a universally recognized problem, they are frequently underappreciated as major contributors to long-term morbidity in the elderly. Prior studies have demonstrated that CVI and VV treatments in patients aged ≥65 years have yielded an overall benefit; however, there has been little data whether octogenarians are undergoing these procedures and with what success. As such, our objectives were to (1) investigate the procedures selected and (2) examine clinical outcomes after VV procedures in elderly patients aged ≥80 years.

Decreasing Incidence of Fatal Ruptured Aortic Aneurysms in the United States

August 1, 2017 - 00:00
Ruptured aortic aneurysms (rAA) are associated with high mortality. The epidemiology of aortic aneurysms in the United States (U.S.) is largely unknown. The purpose of this study was to identify the trends of deaths due to ruptured abdominal AA (rAAA) and thoracic AA (rTAA) in the U.S.

Gait Is Improved but Not Restored in Peripheral Artery Disease Following Revascularization

August 1, 2017 - 00:00
This study determined whether revascularization improves quality of life and limb function in patients with peripheral artery disease (PAD).

Comparison of Vascular Operative Experience Between Traditional Vascular Fellowship and Vascular Integrated Residency Graduates

August 1, 2017 - 00:00
The first graduates of the vascular integrated (0+5) residency (VR) programs completed training in 2013. Since then, there have been limited data comparing their operative experience to graduates of the traditional (5+2) fellowship (VF) programs. This study compared the operative experience between graduates of these two training pathways.

Success of Atherectomy in Lower Extremity Ischemia Performed in Office-Based Laboratory

August 1, 2017 - 00:00
This study determined the safety and efficacy of infrainguinal artery atherectomy.

Cerebrovascular Injuries Are Commonly Found in Acute Type B Aortic Dissections and Are Associated With Blood Pressure Derangements and Poor Outcome

August 1, 2017 - 00:00
Cerebrovascular injury (CVI) is a recognized but underappreciated complication of acute type B aortic dissection (ATBAD). This study was performed to determine risk factors for CVI associated with ATBAD and, in particular, the possible contributory role of aggressive anti-impulse therapy.

Direct Admission to a Vascular Referral Center Improves Outcomes for Patients With Acute Vascular Disease

August 1, 2017 - 00:00
Patients with acute vascular disease frequently need specialized management that may require transfer to a vascular referral center. However, interhospital transfers may delay appropriate care, favoring primary admission to a specialty center. We hypothesized that patients with acute vascular disease requiring transfer to a vascular referral center have worse outcomes than patients directly admitted for specialty acute vascular care.

Long-Term Outcomes of Surgical, Endovascular, and Hybrid Treatment of Aortoiliac Occlusive Disease in Patients Younger Than 60 Years Old

August 1, 2017 - 00:00
This study determined long-term outcomes after surgical, endovascular, and hybrid treatment of advanced aortoiliac occlusive disease (AIOD, TransAtlantic Inter-Society Consensus [TASC] classes B, C and D) in young patients.

Effect of Dialysis Catheters on AVG

August 1, 2017 - 00:00
Hemodialysis catheters (HD Cath) and arteriovenous graft (AVG) have long solidified their position the chronic kidney disease framework. Each is considered inferior to autogenous access for several reasons, yet still widely found and used in the end-stage renal disease population. This study investigated the impact of HD Cath placement as it affects new AVG placement.

Two-Year Amputation Rates Superior for Autogenous versus Nonautogenous Femoral-to-Infrapopliteal Bypasses

August 1, 2017 - 00:00
Infrapopliteal bypass interventions are critical for limb salvage in patients with distal occlusive disease. We compared outcomes after femoral-to-infrapopliteal bypass procedures with autogenous (AUTO) vein vs non-AUTO (nAUTO) conduits.

Two-Year Evaluation of Fenestrated and Parallel Branch Endografts for the Treatment of Juxtrarenal, Suprarenal, and Thoracoabdominal Aneurysms at a Single Institution

August 1, 2017 - 00:00
This study evaluated mortality, graft patency, and reintervention rates for fenestrated and parallel graft endografts for the repair of complex aortic aneurysms at a single institution.

Development of a Noncontrast Gated Aortic Computer Tomography Protocol for Aortic Screening and Surveillance

August 1, 2017 - 00:00
Computed tomography (CT) evaluation can effectively gauge the presence and size of aneurysms in both chest and abdomen. This is advantageous compared to ultrasound imaging; however, the existing CT protocols are limited by high radiation dose, risk of complication from workup of incidental findings, and high cost of radiologist interpretation time. We present a low-risk and low-cost CT protocol—the noncontrast gated aortic (NCGA) CT—that allows for evaluation of aortic aneurysm pathology.

Outcomes of Ruptured Abdominal Aortic Aneurysm Following Adoption of Endovascular Aortic Repair

August 1, 2017 - 00:00
Mortality of ruptured abdominal aortic aneurysm (RAAA) continues to be high. The use of an endovascular aortic repair (EVAR)-first strategy has been adopted as the preferred approach in some experienced centers; however, this approach remains controversial.

Success of Retrograde Tibial Artery Approach in Lower Extremity Revascularization in Office-Based Setting

August 1, 2017 - 00:00
This study evaluated the safety and efficacy of retrograde tibial approach in revascularization of lower extremity for treating ischemia in anatomically challenging patients.

Association of Postoperative Glycemic Control and Outcomes After Abdominal Aortic Aneurysm Repair

August 1, 2017 - 00:00
This study evaluated the relationship of postoperative hyperglycemia on outcomes after abdominal aortic aneurysm (AAA) repair.

Osteopontin Is Elevated in AAA and May Drive Disease Progression

August 1, 2017 - 00:00
Previous in vitro and animal studies have suggested the importance of osteopontin (OPN), an inflammatory extracellular matrix (ECM) protein, in the formation and growth of abdominal aortic aneurysms (AAAs). The relationship between OPN and the inflammatory cell phenotypes present in the human AAA condition was investigated.