Journal of Vascular Surgery

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Updated: 14 hours 12 min ago

Reply

October 1, 2017 - 00:00
Thank you for your interest and letter in response to the article “Google Maps offers a new way to evaluate claudication.”

Regarding “The role of immigrants to United States of America in the development of cardiovascular surgery”

October 1, 2017 - 00:00
I am honored and humbled to be cited in the article “The role of immigrants to United States of America in the development of cardiovascular surgery” in the May issue of Journal of Vascular Surgery.1 The article listed a number of immigrants who helped to develop cardiovascular surgery in America. However, there is one notable omission: Dr Geza de Takats of Hungary.

Regarding “Similar failure and patency rates when comparing one- and two-stage basilic vein transposition”

October 1, 2017 - 00:00
We read with great interest the systematic review and meta-analysis on basilic vein transposition (BVT) by Cooper and colleagues published recently in the Journal.1 BVT is an important vascular access type, and we would like to congratulate the authors for trying to tackle the issue of procedure staging. However, we have several comments.

Reply

October 1, 2017 - 00:00
We want to thank Kakkos and coauthors for their careful reading and critique of our meta-analysis comparing one- vs two-stage basilic vein transposition.1 We agree that there is no generally accepted standard in dealing with primary failure and subsequent reporting of fistula patency; however, we chose to include the primary failures in the denominator across all studies. Removing the primary failures from the reporting of patency rates, in our opinion, falsely increases the patency and does not reflect the reality that generally speaking, results after fistula creation are suboptimal.

Of violins, values, and the clinical vascular surgeon

October 1, 2017 - 00:00
I am humbled and deeply honored to have served as the Forty-fourth President of the Society for Clinical Vascular Society (SCVS). As a young surgeon, I was given opportunity to present clinical research and to interact with leaders in our field at the SCVS in a nonthreatening atmosphere. Many of the friendships I have with vascular surgeons began at this meeting, and I cherish them all. The mission of the SCVS is to advance the art and science of vascular surgery; to provide a forum for vascular surgeons to exchange ideas and surgical techniques; and to improve vascular health care delivery.

A systematic review and meta-analysis of factors for delirium in vascular surgical patients

October 1, 2017 - 00:00
Delirium is a common syndrome responsible for a large burden of morbidity and mortality. In surgical settings, research into risk factors for postoperative delirium has largely focused on elective orthopedic patients. We performed a systematic review and meta-analysis to evaluate the evidence surrounding risk factors for delirium in vascular surgical populations.

Invited commentary

October 1, 2017 - 00:00
The advent of isovoxel imaging has meant that surgeons are able to preview and to describe anatomic variants in surgical disease in increasingly better detail before knife touches skin. The ability to manipulate three-dimensional images has changed our approach to aortic surgery and has made complex endovascular surgery more accessible to all. This paper by Guo et al discusses multichanneled aortic dissection [MCAD] and highlights an ability to describe and to detail preoperative anatomy in a way that is now not just informative but may help further refine our understanding of the imaging phenotype of aortic dissection.

Takayasu's expression of viscerorenal aortic aneurysm with near-total infrarenal aortic occlusion

October 1, 2017 - 00:00
A 25-year-old woman with Takayasu arteritis in a quiescent state presented with postprandial abdominal pain and bilateral lower limb claudication for 6 months. Her blood pressure was 140/80 mm Hg on atenolol (25-mg tablet), and lower limb pulses were feeble with an ankle-brachial index of 0.6 in each limb. Computed tomography angiography showed multiple saccular aneurysms of Crawford type III thoracoabdominal extent, nonvisualized right kidney, and hypertrophied precious left kidney, with near-total occlusion of the infrarenal aorta and its reformation by a prominent arc of Riolan (A/Cover).

BubR1 insufficiency impairs angiogenesis in aging and in experimental critical limb ischemic mice

September 30, 2017 - 00:00
Budding uninhibited by benzimidazole-related 1 (BubR1), a cell cycle-related protein, is an essential component of the spindle checkpoint that regulates cell division. Mice in which BubR1 expression is reduced to 10% of the normal level display the phenotypic features of progeria. However, the role of BubR1 in vascular diseases and angiogenesis remains unknown. To investigate the influence of BubR1 on angiogenesis, we generated a low-null-BubR1-expressing (BubR1L/−) mouse strain with reduced BubR1 expression as low as 15% of the normal level without any abnormalities in appearance.

Short and long-term readmission rates after infrainguinal bypass in a safety net hospital are higher than expected

September 28, 2017 - 00:00
Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short and long-term readmission rates after lower extremity infrainguinal bypass in this setting.

Evaluation of paramalleolar and inframalleolar bypasses in dialysis- and nondialysis-dependent patients with critical limb ischemia

September 28, 2017 - 00:00
The aim of this study was to elucidate the efficacy of paramalleolar or inframalleolar bypass (PIMB) in hemodialysis-dependent (HD) patients with critical limb ischemia (CLI) and nonhemodialysis-dependent (NHD) patients in terms of clinical outcomes.

Multifactorial risk index for prediction of intraoperative blood transfusion in endovascular aneurysm repair

September 28, 2017 - 00:00
In some institutions, the current blood ordering practice does not discriminate minimally invasive endovascular aneurysm repair (EVAR) from open procedures, with consequent increasing costs and likelihood of blood product wastage for EVARs. This limitation in practice can possibly be addressed with the development of a reliable prediction model for transfusion risk in EVAR patients. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to create a model for prediction of intraoperative blood transfusion occurrence in patients undergoing EVAR.

Tibiodistal vein bypass in critical limb ischemia and its role after unsuccessful tibial angioplasty

September 27, 2017 - 00:00
Technical progress in angioplasty expanded its application to very distal arterial lesions of the lower extremity. In cases of unsuccessful angioplasty tibiodistal bypass surgery may be required for limb salvage. We investigated the long-term outcome of this technique in patients with critical limb ischemia. The purpose of this study was to evaluate whether tibiodistal bypasses done after unsuccessful tibial angioplasty had inferior patency, limb salvage, or survival rates compared with primary tibiodistal bypasses.

A registry-based rationale for discrete intervention thresholds for open and endovascular elective abdominal aortic aneurysm repair in female patients

September 27, 2017 - 00:00
An evidence-based consensus for a female-specific intervention threshold for abdominal aortic aneurysms (AAAs) is missing. This study aims to analyze sex-related differences in the epidemiology of ruptured AAA to establish an intervention threshold for women.

Long-term fate of renal function after open surgery for juxtarenal and pararenal aortic aneurysm

September 27, 2017 - 00:00
Although the indications for endovascular aneurysm repair for abdominal aortic aneurysm have been expanding, our primary strategy for pararenal and juxtarenal abdominal aortic aneurysm (P/JRAA) is open surgery (OS). One consequence of OS for P/JRAA is transient renal ischemia owing to renal artery clamping, which can be followed by acute kidney injury (AKI). Prior studies referred to the impact of renal ischemia on AKI, but they have rarely evaluated longer-term renal function. This study focused on a chronic renal decline (CRD) during follow-up.

Discussion

September 26, 2017 - 00:00
Kenneth J. Cherry (Charlottesville, Va). Dr Beach, Dr Eagleton, and their colleagues have written an excellent and thought-provoking paper, that could only have come from the Cleveland Clinic, and that addresses what I consider to be the most difficult clinical decision confronting vascular surgeons: to whom should we offer complex aortic surgery—endovascular as well as open—and the question's more difficult converse—from whom should we withhold intervention for reasons of comorbidity and decrepitude?

Survival affects decision making for fenestrated and branched endovascular aortic repair

September 26, 2017 - 00:00
Repair options for complex abdominal and thoracoabdominal aortic aneurysms (TAAAs) are evolving with increased experience and availability of less invasive endovascular techniques. Identifying risk factors for mortality after fenestrated and branched endovascular aortic repair (F/B-EVAR) could improve patient selection and facilitate decision making regarding who may benefit from prophylactic F/B-EVAR.

Successful use of resuscitative endovascular balloon occlusion of the aorta in the treatment of ruptured 8.5-cm splenic artery aneurysm

September 25, 2017 - 00:00
Spontaneous rupture of splenic artery aneurysm is a rare cause of acute abdomen with hemorrhagic shock that is a life-threatening surgical emergency. We report a case of a spontaneous rupture of an 8.5-cm splenic artery aneurysm managed using resuscitative endovascular balloon occlusion of the aorta (ER-REBOA Catheter; Prytime Medical Inc, Boerne, Tex) for proximal control of the aorta before laparotomy. This is a minimally invasive technique that can be used as an adjunct to massive transfusion resuscitation and laparotomy for life-threatening intraperitoneal hemorrhage.

Duplex scan and histologic assessment of acute renal injury in a kidney-kidney crosstalk swine experimental model

September 25, 2017 - 00:00
The objective of this study was to identify the effect of two left renal vasculature occlusion strategies on the duplex ultrasound-assessed rheology and histology of the contralateral kidney.

Cost-effectiveness analysis of drug-coated therapies in the superficial femoral artery

September 25, 2017 - 00:00
Drug-coated balloons (DCBs) may increase durability of endovascular treatment of superficial femoral artery (SFA) disease while avoiding stent-related risks. The purpose of this study was to use meta-analytic data of DCB studies to compare the cost-effectiveness of potential SFA treatments: DCB, drug-eluting stent (DES), plain old balloon angioplasty (POBA), or bare-metal stent (BMS).