Journal of Vascular Surgery

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Systematic Review and Meta-Analysis on the Management of Open Abdominal Aortic Graft Infections

September 1, 2019 - 00:00
Aortic graft infection (AGI) is a disastrous complication with an incidence of 0.2–6% in operated patients. With little or no high quality evidence, the best treatment option remains unclear. Therefore, the literature on the management of open abdominal AGI was systematically reviewed to determine optimal treatment.

Single Muscle Fibre Contractility Testing in Rats to Quantify Ischaemic Muscle Damage During Reperfusion Injury

September 1, 2019 - 00:00
In this study, the aim was to investigate the potential for single muscle fibre contractility (SMFC) testing to detect the extent of reperfusion injury following various reperfusion periods. The hypothesis was that force generated by muscle fibres will correlate inversely with the extent of reperfusion injury.

Effectiveness and Safety of Ultrasound Guided Lower Extremity Nerve Blockade in Infragenicular Bypass Grafting for High Risk Patients With Chronic Limb Threatening Ischaemia

September 1, 2019 - 00:00
Surgical revascularisation to accomplish limb salvage remains preferable in some patients with chronic limb threatening ischaemia (CLTI). The aim of this study was to evaluate the effectiveness and safety of ultrasound guided lower extremity nerve blockade (UGNB) in infragenicular bypass surgery (IGBS).

Five Year Outcomes of the Endurant Stent Graft for Endovascular Abdominal Aortic Aneurysm Repair in the ENGAGE Registry

September 1, 2019 - 00:00
Endovascular abdominal aortic aneurysm repair (EVAR) is commonly used to treat abdominal aortic aneurysm (AAA). However, the incidence of long-term complications and the need for re-interventions after EVAR remains a concern. Newer generation stent grafts have encouraging short and mid-term outcomes, but thorough analysis of their long-term performance is necessary.

Predictors of New Ischaemic Brain Lesions on Diffusion Weighted Imaging After Carotid Stenting and Endarterectomy: A Systematic Review

September 1, 2019 - 00:00
Peri-procedural ischaemic brain lesions on diffusion weighted imaging (DWI) after carotid endarterectomy (CEA) and carotid artery stenting (CAS) have been related to a higher chance of recurrent cerebrovascular events. This systematic review provides an overview of patient characteristics associated with increased risk of new DWI lesions.

Building a global alliance in vascular surgery

September 1, 2019 - 00:00
At the European Society for Vascular Surgery (ESVS) Annual Meeting in Budapest, Hungary, in September 2013, a landmark meeting was held that charted a new course of collaboration among the major Vascular Surgery Societies. Representatives from the ESVS, the Society for Vascular Surgery (SVS), and the World Federation of Vascular Societies (WFVS) met and agreed that the TransAtlantic Societal Consensus process no longer met the needs of defining standards of vascular care.1 The group unanimously agreed to collaboratively support the development of evidence-based guidelines to assist vascular specialists and primary care physicians around the globe with the diagnosis and treatment of patients with vascular disease.

Outcomes After Carotid Artery Stenting in Patients With Normal Neck Anatomy and Hostile Neck Anatomy Are Comparable

September 1, 2019 - 00:00
Carotid artery stenting (CAS) in patients with hostile neck anatomy (prior radiation therapy [XRT] and carotid endarterectomy [CEA]) is safe and effective, but concern remains for higher restenosis and differences in postoperative neurologic events. Our objective was to determine whether periprocedural and long-term outcomes of CAS performed in patients who have had prior XRT or CEA are comparable to those of patients with normal neck anatomy (NL).

Impact of Post-Hospital Syndrome on Outcomes of Elective Endovascular Repair of Abdominal Aortic Aneurysm

September 1, 2019 - 00:00
Post-hospital syndrome (PHS) is an acquired, transient period of health vulnerability that follows hospital admission for acute illness. It is characterized by physiologic deconditioning secondary to stressors from disruption in circadian rhythm, depletion of nutritional reserve, and pain or discomfort associated with hospitalization. PHS is reported as an independent risk factor for readmission and adverse postoperative outcomes. The aim of this study was to investigate whether PHS affects outcomes of elective endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm.

Low Albumin Level Predicts Poor Outcome After Lower Extremity Procedures for Peripheral Artery Disease

September 1, 2019 - 00:00
There are limited data evaluating the impact of preoperative albumin levels in patients undergoing vascular procedures. This study evaluated the relationship of preoperative albumin levels with outcome after lower extremity (LE) vascular procedures for peripheral artery disease (PAD).

Assessing the Validity of Published Data on Percutaneous Transluminal Angioplasty as a Benchmark for Infrainguinal Endovascular Procedures

September 1, 2019 - 00:00
Percutaneous transluminal angioplasty (PTA) of the infrainguinal arteries was the first endovascular technique for improving lower extremity circulation. The procedure involves the inflation of a balloon-tipped catheter in stenotic or occluded vessels to improve perfusion and to increase downstream blood flow. New techniques are frequently compared with the results of PTA, making valid and robust PTA data essential. Our objective was to identify papers that present PTA outcomes and to perform a systematic review.

Autologous Stem Cell Combination Intra-arterial Infusion and Intramuscular Injection Shows Physiologic Benefit in Patients With Nonreconstructible Critical Limb Ischemia

September 1, 2019 - 00:00
The objective of this study was to assess efficacy and safety of a prepared autologous stem cell product delivered as a split dose by intra-arterial infusion and intramuscular injection in patients with critical limb ischemia.

Long-term Outcomes and Interventions of Postoperative Type IA Endoleaks After Elective Endovascular Aneurysm Repair

September 1, 2019 - 00:00
This study evaluated the incidence and long-term outcomes of postoperative type IA endoleak (PT1A) after endovascular aneurysm repair (EVAR).

The Level of Persistent False Lumen Perfusion Is Associated With Increased Aortic Size After Thoracic Endovascular Aortic Repair in Patients With Type B Aortic Dissection

September 1, 2019 - 00:00
Thoracic endovascular aortic repair (TEVAR) is frequently used to treat type B aortic dissection (TBAD). The goal of TEVAR is to induce false lumen thrombosis (FLT) and stabilize the aortic diameter. The success of TEVAR in TBAD is frequently impaired by the lack of a distal landing zone. This study aims to assess our experience with TEVAR to induce FLT and aortic remodeling in TBAD.

Sex-Related Differences in Aortic Dissection in Marfan Syndrome

September 1, 2019 - 00:00
Marfan syndrome (MFS), affecting 1 in 5000 people, is an autosomal dominant connective tissue disorder caused by FBN1 mutations encoding fibrillin 1. MFS leads to multisystem involvement, including the eye, skeleton, lung, dura, heart, and aorta. The major cause of morbidity and mortality in MFS is aortic aneurysm and dissection. The goal of our study was to explore the role of sex in the clinical characteristics and outcomes of aortic dissection in a cohort of MFS patients observed at our institution.

Impact of Targeted Sclerotherapy in Management of Refractory Venous Ulcer

September 1, 2019 - 00:00
Chronic venous ulcer healing is a challenge in some patients despite their receiving treatment. In this study, we analyzed patients who had chronic nonhealing ulcers and had injection sclerotherapy of the veins in the base and vicinity of the ulcers.

Every Day Counts: Understanding the Implication of Prolonged Length of Stay on Hospital Payments After Carotid Endarterectomy

September 1, 2019 - 00:00
There is wide variation in payments after vascular surgery procedures. Carotid endarterectomy (CEA) represents a relatively homogeneous vascular population in which to study this variation in payments. We sought to use a regional collaborative to explore hospital payments after CEA among participating hospitals.

Daytime Operation Predicts Discharge Disposition in Open Repair of Ruptured Thoracoabdominal Aortic Aneurysms

September 1, 2019 - 00:00
There is a paucity of data on outcomes of open repair for ruptured thoracoabdominal aortic aneurysms (rTAAA). The aim of our study was to determine the outcomes of open repair of rTAAA at a single high-volume center.

The Association of Plaque Morphology Using Optical Coherence Tomography and Crossing Chronic Total Occlusions of the Superficial Femoral Artery

September 1, 2019 - 00:00
The optical coherence tomography (OCT) chronic total occlusion (CTO) catheter Ocelot (Avinger Inc, Redwood City, Calif) has been used to cross TransAtlantic Inter-Society Consensus (TASC) D lesions. Studies have assessed high-risk plaques in the carotid artery, but few if any data exist evaluating OCT and plaque morphology in the superficial femoral artery (SFA). This study assessed SFA plaque morphology using OCT and lesion crossing success.

Transcarotid Artery Revascularization Is Anatomically Feasible in the Majority of Patients Eligible for Carotid Artery Stenting

September 1, 2019 - 00:00
Transcarotid artery revascularization (TCAR) has demonstrated superior stroke rates to transfemoral carotid artery stenting (TF-CAS) for treatment of carotid bifurcation disease (CBD). Flow reversal through a common carotid artery (CCA) to femoral vein shunt is used for neuroprotection during TCAR. The different accesses between TCAR and TF-CAS create separate anatomic contraindications. We sought to determine eligibility for TCAR vs TF-CAS in patients with CBD.

Racial Disparities Exist in Amputation Outcomes Associated With Critical Limb Ischemia

September 1, 2019 - 00:00
We sought to investigate whether racial or socioeconomic factors had association with need for major amputation, including recommendations for primary amputation, rather than efforts at revascularization among patients with critical limb ischemia (CLI).