Journal of Vascular Surgery

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Invited commentary

August 1, 2018 - 00:00
Repair of popliteal artery aneurysms has recently received great attention. With endovascular and open options available, there is great interest in defining which approach and type of repair are best suited for the individual patient. In the article “Femoral artery transposition is a safe and durable option for the treatment of popliteal artery aneurysms,” Bounkong et al propose another open option.1 In 67 patients with popliteal artery aneurysms and inadequate ipsilateral saphenous vein, the ipsilateral superficial femoral artery (SFA) was used to repair the aneurysmal popliteal segment, with the transposed SFA being replaced by a prosthetic graft.

Invited commentary

August 1, 2018 - 00:00
The authors report the results of their appropriately powered, randomized, controlled trial comparing the use of the VIABAHN covered stent graft with balloon angioplasty alone for clinically significant venous outflow stenoses (>50%) in 6-mm polytetrafluoroethylene arteriovenous hemodialysis accesses. Their data suggest that the stent grafts were associated with a higher technical success rate (>30% residual stenosis), a higher postintervention primary patency rate, a lower restenosis rate (as documented by angiography), and a longer primary patency rate duration.

Invited commentary

August 1, 2018 - 00:00
This study analyzed the effect of black race on carotid endarterectomy (CEA) outcomes in the United States from the Vascular Quality Initiative (VQI) registry. It included 57,622 CEA patients, 2909 (5%) of whom were black. Of the 54,713 white patients, 30% were symptomatic vs 34% of black patients. Blacks had a higher vascular disease burden and were less likely to be operated on in high-volume hospitals and by high-volume surgeons. Black symptomatic patients underwent surgery more often in <2 weeks after the index neurologic event (47% vs 40%).

Invited commentary

August 1, 2018 - 00:00
Okadome et al have published a very exciting paper exploring how aging and bubR1 affect neovascular recovery in a mouse model of hindlimb ischemia. Decreased BubR1 expression has been reported to promote rapid aging in animal models, but this is the first report of a phenotype in the vasculature. The authors are to be commended for their diligence in accomplishing a survivable model of “early” aging. After reading this article, I must confess to have drunk Kool-Aid that BubR1 impairs vascular regeneration and that this is most profound in aged but not yet old animals.

Invited commentary

August 1, 2018 - 00:00
“Crosstalk” is the clinical or physiologic observation that a stimulus to one organ (or cell) leads to a response elsewhere. The method of communication can simply be through mediators released into the bloodstream or transmitted directly by the regional nervous system. However, signals can also be indirectly sent using intermediate steps to relay the message to the target organ. These multistep cascades are the most difficult to understand, and none is more exemplary than the kidney's ability to change the body's blood pressure.

An anomalous adventure of type I proatlantal artery

August 1, 2018 - 00:00
A 68-year-old man presented for vascular review after two carotid territory transient ischemic attacks with left-sided weakness. His medical history included transient ischemic attacks, smoking, and hypercholesterolemia. Carotid duplex ultrasound revealed slow resistive flow in the right common carotid artery and trickle flow in the right internal carotid artery (ICA) with low-velocity flow in the distal right ICA. Computed tomography angiography showed a short proximal occlusion of the right ICA (A).

Discussion

July 17, 2018 - 00:00
W. Charles Sternbergh III, (New Orleans, La). Dr Scali and colleagues from the University of Florida present an impressive 15-year experience with 82 patients undergoing open mesenteric bypass for acute mesenteric ischemia (AMI). This series is most notable for a self-professed strong institutional preference for supraceliac-based antegrade bypass, used in three-quarters of patients, and of those patients undergoing antegrade bypass, the large majority (68%) had bypasses to both the superior mesenteric artery (SMA) and the celiac or hepatic artery.

Thirty-year trends in aortofemoral bypass for aortoiliac occlusive disease

July 9, 2018 - 00:00
Endovascular intervention has supplanted open bypass as the most frequently used approach in patients with aortoiliac segment atherosclerosis. We sought to determine whether this trend together with changing demographic and clinical characteristics of patients undergoing aortobifemoral bypass (ABFB) for aortoiliac occlusive disease (AOD) have an association with postoperative outcomes.

Incomplete circle of Willis is associated with a higher incidence of neurologic events during carotid eversion endarterectomy without shunting

July 5, 2018 - 00:00
A complete circle of Willis (CoW) is considered an important collateral network to maintain blood flow during cross-clamping in carotid endarterectomy (CEA). The aim of this study was to evaluate the impact of an incomplete CoW with isolated middle cerebral artery (iMCA) on immediate neurologic events (INEs) after CEA.

A systematic review of vascular closure devices for femoral artery puncture sites

July 2, 2018 - 00:00
The aim of this review was to provide an up-to-date summarization of available Food and Drug Administration-approved vascular closure devices (VCDs) and to analyze current evidence comparing individual devices with one another and with manual compression (MC). The review includes indications for use, advantages and disadvantages, safety and efficacy, and outcomes.

Outcomes of antegrade and retrograde open mesenteric bypass for acute mesenteric ischemia

July 2, 2018 - 00:00
Acute mesenteric ischemia (AMI) is a challenging clinical problem associated with significant morbidity and mortality. Few contemporary reports focus specifically on patients undergoing open mesenteric bypass (OMB) or delineate outcome differences based on bypass configuration. This is notable, because there is a subset of patients who are poor candidates for endovascular intervention including those with flush mesenteric vessel occlusion, long segment occlusive disease, and a thrombosed mesenteric stent and/or bypass.

Occult type I or III endoleaks are a common cause of failure of type II endoleak treatment after endovascular aortic repair

July 2, 2018 - 00:00
Most type II endoleaks have a benign natural history, but 6% to 8% are associated with sac enlargement and respond poorly to treatment. Our aim was to evaluate whether these enlargements are associated with delayed or occult type I and III endoleaks.

Discussion

July 2, 2018 - 00:00
Dr H. Edward Garrett, Jr (Memphis, Tenn). I want to thank the Society for allowing me to comment on this important work that addresses a serious complication of endovascular treatment for type B aortic dissection. I also want to congratulate Dr Yammine on an excellent presentation and thank him for sending me the manuscript earlier than I have ever received one. Well done.

Complex endovascular aneurysm repair is associated with higher perioperative mortality but not late mortality compared with infrarenal endovascular aneurysm repair among octogenarians

July 2, 2018 - 00:00
As our collective experience with complex endovascular aneurysm repair (EVAR) has grown, an increasing number of older patients are being offered endovascular repair of juxtarenal aneurysms. Outcomes after complex EVAR in this older subpopulation are not well-described. We sought to specifically evaluate clinical outcomes after complex EVAR compared with infrarenal EVAR in a cohort of octogenarians.

Retrograde type A dissection after thoracic endovascular aortic repair for type B aortic dissection

July 2, 2018 - 00:00
The purpose of this study was to evaluate clinical, anatomic, and procedural characteristics of patients who developed retrograde type A dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD).

Classified Advertising

July 1, 2018 - 00:00

Journal of Vascular Surgery – July 2018 Audiovisual Summary

July 1, 2018 - 00:00
Hi, I am Peter Gloviczki from Mayo Clinic, Editor-in-Chief of the Journal of Vascular Surgery. I am happy to bring you the highlights of the very best papers we assigned to the July issue of the Journal of Vascular Surgery.

Use and impact of patient relationship modifiers on cost measurement

July 1, 2018 - 00:00
One of the goals of the Merit-based Incentive Payment System (MIPS), created by the Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA), is to improve value of patient care; that is, to achieve higher quality at lower cost. Under MIPS, eligible Medicare providers are required to submit quality data to the Centers for Medicare and Medicaid Services (CMS) that will affect future payments. In performance year 2018, the cost component accounts for 10% of the total MIPS score.

Factors that Predict Failure to Meet Merit-Based Incentive Payment System Quality Measures for Asymptomatic Carotid Endarterectomy

July 1, 2018 - 00:00
Hospital records of patients who underwent carotid endarterectomy (CEA) for asymptomatic stenosis were evaluated in the state of Florida between 2008 and 2012.

Stellarex Drug-Coated Balloon for Treatment of Femoropopliteal Arterial–The ILLUMENATE Global Study: 12-Month Results From a Prospective, Multicenter, Single-Arm Study

July 1, 2018 - 00:00
prospective, multicenter, international, single-arm study between July 2013 and June 2015 evaluating the Stellarex drug-coated balloon (DCB; Spectranetics Corp, Colorado Springs, Colo).