Journal of Vascular Surgery

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Updated: 11 hours 6 min ago

Delineating the Durability Outcome Differences After Saphenous Ablation with Laser Versus Radiofrequency

August 1, 2017 - 00:00
The mechanism of delivering thermal energy (MDTE) to the vein wall much differs between endovenous laser ablation (EVLA) and radiofrequency ablation (RFA). Different MDTE may affect the durability of these procedures performed for saphenous vein insufficiency differently. Yet, whether there is a difference in long-term durability outcomes remains uncertain. This study aimed to delineate the durability outcome differences in recurrence rate and pattern.

Lower Extremity Ischemia, an Ominous Complication After Elective EVAR

August 1, 2017 - 00:00
Elective endovascular repair (EVAR) is considered to be a safe and effective intervention for abdominal aortic dissection. Although rare, ischemic complications after EVAR are highly feared. In particular, data on lower extremity ischemia (LEI) after EVAR are sparse. Our objective was to determine the impact of LEI on outcomes after elective EVAR in a national database.

Calf Muscle Oxygen Saturation and Ground Reaction Forces During Walking in Patients with Peripheral Arterial Disease

August 1, 2017 - 00:00
The gait dysfunction of patients with claudication is the product of muscle ischemia during exercise and a neuromyopathy in the affected legs. We have previously quantified this gait dysfunction using advanced biomechanical analysis. Here, we tested the hypothesis that when claudicating patients exercise, initiation of muscle hypoxia (decreased hemoglobin oxygen saturation in the calf muscle [MO2S]) produces significant worsening of the gait parameters (basic timed gait parameters and ground reaction forces [GRFs]).

Primary Stenting Is Not Necessary in Benign Central Venous Stenosis

August 1, 2017 - 00:00
This study evaluated central venous stenosis (CVS) etiologies and presentation within a vascular surgery practice. We evaluated endovascular treatment modalities and the patency rates of our interventions.

Survival After AAA Repair Is Affected by Socioeconomic Status

August 1, 2017 - 00:00
The association between socioeconomic status (SES) and outcome after abdominal aortic aneurysm (AAA) repair is largely unknown. This study aimed to determine the influence of SES on postoperative survival after either open or endovascular AAA repair.

Arteriotomy Closure Devices in EVAR, TEVAR, and TAVR: A Systematic Review and Meta-analysis of Randomised Clinical Trials and Cohort Studies

August 1, 2017 - 00:00
Cardiac and vascular surgery benefit from percutaneous interventions. Arteriotomy closure devices (ACDs) enable minimally invasive access to the common femoral artery (CFA). The objective of this review was to assess the differences between ACDs and surgical cut down (SCD) of the CFA regarding the number of complications, duration of surgery (DOS), and hospital length of stay (HLOS).

Lesson Learned with the Use of Iliac Branch Devices: Single Centre 10 Year Experience in 157 Consecutive Procedures

August 1, 2017 - 00:00
Absence of an adequate iliac seal rarely represents an absolute contraindication to endovascular abdominal aortic aneurysm repair. Iliac branch devices (IBD) are increasingly used in patients with extensive aorto-iliac aneurysmal disease, but few data are available on the long-term results of these procedures.

The Impact of System Factors on Quality and Safety in Arterial Surgery: A Systematic Review

August 1, 2017 - 00:00
A systems approach to patient safety proposes that a wide range of factors contribute to surgical outcome, yet the impact of team, work environment, and organisational factors, is not fully understood in arterial surgery. The aim of this systematic review is to summarize and discuss what is already known about the impact of system factors on quality and safety in arterial surgery.

The Consequences of Real Life Practice of Early Abdominal Aortic Aneurysm Repair: A Cost-Benefit Analysis

August 1, 2017 - 00:00
The reported 54 mm median intervention diameter for endovascular aneurysm repair (EVAR) in the Vascular Quality Initiative and European data from the Pharmaceutical Aneurysm Stabilisation Trial (PHAST) implies that in real life the majority of abdominal aortic aneurysm (AAA) repairs occur at diameters smaller than the consensus intervention threshold of 55 mm. This study explores the potential consequences of this practice.

Assessment of International Outcomes of Intact Abdominal Aortic Aneurysm Repair over 9 Years

August 1, 2017 - 00:00
Case mix and outcomes of complex surgical procedures vary over time and between regions. This study analyses peri-operative mortality after intact abdominal aortic aneurysm (AAA) repair in 11 countries over 9 years.

Comparison of Renal Complications between Endografts with Suprarenal and Infrarenal Fixation

August 1, 2017 - 00:00
Surgeons have multiple grafts options available for the endovascular treatment of abdominal aortic aneurysm (EVAR), and some hypothesize that suprarenal fixation endografts may result in higher rates of renal complications than infrarenal endografts. This study aimed to compare the outcomes of contemporary suprarenal and infrarenal endografts.

Natural History of Aneurysmal Aortic Arch Branch Vessels in a Single Tertiary Referral Center

August 1, 2017 - 00:00
Little is known about the natural history and management of aneurysmal aortic arch branch vessels (AARBVs). The objectives of this study were to assess the natural history of AARBVs and the AARBV’s risk of rupture and to examine the outcomes of operative intervention.

The Effect of Statin Use and Intensity After Carotid Endarterectomy

August 1, 2017 - 00:00
Statin use in patients undergoing carotid endarterectomy (CEA) has been advocated for prevention of postoperative and future stroke and myocardial infarction (MI). However, the effect of duration and intensity of statin therapy on outcomes after CEA has not been investigated.

Fenestrated Repair of a Type III Thoracoabdominal Aortic Aneurysm in a Patient with Marfan Disease and Degenerated Aortic Dissection

August 1, 2017 - 00:00
Fenestrated repair of thoracoabdominal aneurysms is an acceptable alternative to open repair, especially in patients with high surgical risk. We were referred a patient with Marfan disease who had undergone several open repairs and now had a degenerated chronic aortic dissection. He refused an open operation because of his experience with multiple open repairs and opted for a fenestrated approach.

A Comparison of Specialties Participating in the BEST-CLI Trial to Specialists Treating Peripheral Arterial Disease Nationally

August 1, 2017 - 00:00
The Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI) trial compares open surgery (OPEN) and endovascular therapy (ENDO) for treatment of critical limb ischemia. This report describes the investigator specialties participating in BEST-CLI and compares them with specialists treating peripheral vascular disease (PAD) nationally.

Strategies and Outcomes for Aortic Endograft Explantation

August 1, 2017 - 00:00
Failure of endovascular aneurysm repair (EVAR) requiring open conversion remains a major challenge. We analyzed indications for repair, operative strategies, and outcomes with a focus on iliac artery degeneration after endograft removal.

Impact of Endovascular Repair on Management of Visceral Artery Aneurysms

August 1, 2017 - 00:00
Endovascular (EV) repair of visceral artery aneurysms (VAAs) has become more widespread. The purpose of this study was to evaluate the outcomes of EV repair and open repair of VAA.

Economic Evaluation of Open Bypass and Novel Endovascular Therapies for Peripheral Arterial Disease

August 1, 2017 - 00:00
During the past decade, endovascular peripheral arterial disease (PAD) therapies have steadily increased in prevalence, with newer approaches incorporating novel stent, drug-coated balloon, and atherectomy technologies. This study evaluated procedural and economic burdens associated with each treatment modality.

Disparity in Medicaid Physician Payments for Vascular Surgery

August 1, 2017 - 00:00
Medicare reimbursements are standardized nationwide on the basis of resource-dependent inputs of physician time, intensity, and practice and malpractice costs, whereas Medicaid payments are determined by individual states. Our objectives were to determine Medicaid reimbursement to physicians for common vascular procedures and to compare Medicaid payments with Medicare.

Reinterventions After Fenestrated/Branched Endovascular Aneurysm Repair

August 1, 2017 - 00:00
Fenestrated/branched endovascular aneurysm repair (F/BEVAR) reinterventions are sometimes necessary to maintain aneurysm exclusion or endograft and target artery patency. These reinterventions are nontrivial, potentially associated with morbidity, mortality, and resource utilization. Whereas rates, types, and outcomes of reintervention after infrarenal endovascular aneurysm repair have been well described, they have not been well described for F/BEVAR. We sought to characterize reinterventions after F/BEVAR.