Journal of Vascular Surgery

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TOI 10. An Audit of “Vascular Trauma” Cases in a Tertiary-Level Hospital in Pakistan

October 31, 2018 - 23:00
Experience with vascular trauma from developing parts of the world is limited. In Pakistan, the incidence of automobile accidents and civilian violence has followed a rising trend. A 2-year audit was carried out to determine the etiology, pattern of injury, treatment, and associated morbidity of vascular trauma in our population.

TOI 9. A Rare Case of Bilateral External Iliac Artery Thrombosis due to Endofibrosis in a 33-Year-Old Female Triathlete

October 31, 2018 - 23:00
External iliac artery endofibrosis is a rare disease predominantly affecting young, male elite performance athletes. The disease is characterized by fibrosis and hypertrophy of the intimal layer of the arterial wall and is likely due to multiple factors, including “kinking” during repetitive hip flexion, psoas muscle hypertrophy compressing the artery, excessive and tortuous vessel length, and increased cardiac output with adaptive hypertension. These high-performance athletes typically present with unilateral lower extremity claudication at peak exercise.

TOI 8. Takayasu Arteritis: Panarterial Involvement: A Challenge to Offer Cure as a Vascular Surgeon

October 31, 2018 - 23:00
Takayasu arteritis is a rare disease. We report a case of Takayasu arteritis in a patient who was being treated for a long time for uncontrolled hypertension without proper investigation, which resulted in a cerebrovascular accident twice.

TOI 7. Case Report: Endovascular Management of Ruptured Superior Mesenteric Artery Aneurysm

October 31, 2018 - 23:00
Superior mesenteric artery aneurysms are a rare but life-threatening condition. We report the case of a 54-year-old man with ruptured superior mesenteric artery (SMA) aneurysm treated by an endovascular technique.

TOI 6. Heart in Abdomen: Challenge to Deal With Pseudoaneurysm of Superior Mesenteric Artery With Tetralogy of Fallot

October 31, 2018 - 23:00
A 28-year-old man underwent total correction of tetralogy of Fallot in 2003. He was diagnosed with infective endocarditis 2 months before and received treatment in a cardiac unit. After discharge, he developed periumbilical pain associated with early satiety and decreased appetite.

TOI 5. Use of a Next-Generation Decellularized Dermal Allograft as a Cost-Effective Treatment of Acute and Chronic Wounds

October 31, 2018 - 23:00
The number of individuals with chronic wounds in the United States continues to grow, with millions of people affected yearly, placing a huge financial burden on our health care system. In addition, acute wounds in patients with multiple comorbidities threaten patients’ quality of life and ability to perform activities of daily living. The use of a next-generation decellularized dermal allograft (DDA) can significantly decrease healing times, therefore improving patients’ quality of life as well as reducing the overall economic cost.

TOI 4. Endovascular Treatment of Tracheoinnominate Artery Fistula

October 31, 2018 - 23:00
The tracheoinnominate artery fistula (TIAF) is a critical complication of tracheostomy with a reported incidence of 0.1% to 1%. It is highly lethal even in the presence of initially successful management. The intimate relationship of the innominate artery and the trachea explains the fistula formation. A high index of clinical suspicion is needed to make the diagnosis in a patient with peristomal bleeding or hemoptysis. The traditional treatment has been open surgery, but the new results of endovascular surgery and the patient’s critical condition support endovascular treatment.

TOI 3. Brachial Artery Open Access for Endovascular Interventions

October 31, 2018 - 23:00
As endovascular therapy becomes increasingly complex, adjunct techniques such as upper extremity arterial access facilitate visceral branch interventions. The purpose of this study was to assess the usefulness of brachial artery surgical access in endovascular intervention.

TOI 2. Underutilization of Artificial Intelligence by Vascular Specialists

October 31, 2018 - 23:00
Despite ever-increasing levels of evidence from hypothesis-driven clinical trial research and consensus-driven intersocietal publications to help guide decision-making among vascular specialists, a large number of vascular disease states have wide-ranging and sometimes disparate therapeutic approaches. Setting aside open surgical, endovascular, hybrid, and medical management therapies, a number of complex vascular disease states would be well served by improved predictions for probability of successful management.

TOI 1. Effect of Normobaric Oxygen Therapy on Wound Healing in Patients With Minor Tissue Loss from Critical Limb Ischemia: A Randomized Clinical Trial

October 31, 2018 - 23:00
The objective of this study was to evaluate the effect of normobaric oxygen therapy on wound healing in patients who presented with minor tissue loss from critical limb ischemia.

TAA17. Double-Barreled and Branched Endografting for Thoracoabdominal Aortic Aneurysm: The Hexapus Technique

October 31, 2018 - 23:00
To treat thoracoabdominal aortic aneurysm, we introduced a novel hexapus technique by double-barreled cannon stenting with two abdominal bifurcated stent grafts landing at the descending thoracic aorta, following two pairs of parallel stent grafts through bilateral axillary arteries from each of the contralateral limbs to visceral arteries and extension of ipsilateral limbs to iliac arteries (Fig 1). The creation of six branches resembles a hexapus.

TAA16. In Vitro Evaluation of Balloon-Expandable Chimney Grafts in a Silicone Model With Pulsatile Pumping System and Use of Computed Tomography Angiography

October 31, 2018 - 23:00
The objective of this study was to test and to compare the in vitro performance of balloon-expandable covered stents having the indication for use in renal arteries as chimney grafts.

TAA15. Aortic Multilayer Stenting in Extreme Vascular Emergencies

October 31, 2018 - 23:00
Multilayer stent for aortic aneurysm and dissection repair is still under debate. Nevertheless, in some extreme cases, it may serve at least as a default when other endovascular solutions as well as open surgical repair are not feasible.

TAA14. A Computational Analysis of Different Methodologies for Revascularization of the Left Subclavian Artery

October 31, 2018 - 23:00
Overstenting of the left subclavian artery (LSA) in zone 2 thoracic endovascular aortic repair (TEVAR) may cause left arm ischemia and impede cerebral blood flow. To overcome this issue, two surgical options are available: (1) left common carotid artery (LCCA) to LSA bypass and (2) branched endovascular repair with LSA branched stent graft. This work studies the hemodynamic outcomes of both surgical approaches and the role of the circle of Willis anatomy using patient-specific computational fluid dynamics (CFD) analyses.

TAA13. Treatment of Aortic Arch Diseases With Three Fenestrated Stent Grafts of In Situ Fenestration and Prefenestration

October 31, 2018 - 23:00
The objective of this study was to summarize the recent experience and outcomes of total endovascular repair of complex aortic arch diseases with three fenestrated stent grafts of in situ fenestration and prefenestration.

TAA12. Distal Pseudoaneurysm due to Late Stent Graft-Induced New Entry After Thoracic Endovascular Aortic Repair With Bolton Endograft: A Single-Center Analysis

October 31, 2018 - 23:00
Distal pseudoaneurysm (DPA), due to late stent graft-induced new entry, has a negative impact on long-term aortic remodeling and could be an under-recognized but potentially life-threatening complication after thoracic endovascular aortic repair (TEVAR). We retrospectively analyzed 100 consecutive patients who underwent TEVAR using Bolton Relay Plus or Relay NBS endograft (Terumo Aortic, Somerset, NJ) at our institute from January 2013 to May 2018 to evaluate risk factors of aortic DPA expansion.

TAA11. Pushing the Limits of Proximal Sealing Zone for Emergency Thoracic Endovascular Aortic Repair by Periprocedural Combined Embolization for Acute Thoracic Aortic Aneurysm Rupture: In the Middle of the Night

October 31, 2018 - 23:00
Inadequacy of a proximal landing zone (zone 3 or 4) is often a limitation for thoracic endovascular aortic repair (TEVAR), particularly in acute situations. We present a completely new technique of tackling this issue during emergency TEVAR for a ruptured aneurysm of the descending thoracic aorta encroaching on the lesser curvature of the arch.

TAA10. Total Supra-Aortic Trunk Coverage With New-Generation Multilayer Stents for Complex Aortic Diseases

October 31, 2018 - 23:00
We present the results of up to 36-month follow-up after complete coverage of supra-aortic trunks with new-generation multilayer stents for complex aortic diseases. A total of 29 patients with complex aortic diseases underwent thoracic endovascular aortic repair with multilayer flow modulator (MFM) stents (type A and B aortic dissection and thoracoabdominal aneurysms). All patients had the aortic arch entirely covered with the MFM stent. The primary objective was to assess whether total coverage of all cerebral vessels may lead to a neurologic event in the first 30 days after intervention.

TAA9. Type B Acute Aortic Dissections: Best Medical Treatment Versus Endovascular Approach

October 31, 2018 - 23:00
In a period of 8 years, we retrospectively analyzed 155 patients with aortic thoracic disease, identifying 79 type B dissections. Forty-three cases had arrived to our institution as acute aortic syndrome.

TAA8. Aortic Epithelioid Angiosarcoma After Endovascular Treatment of Descending Aortic Ulcer

October 31, 2018 - 23:00
Aortic epithelioid angiosarcoma is a rare disease. We report a case of epithelioid angiosarcoma of the abdominal aortic wall after endovascular treatment of descending aortic ulcer.