Journal of Vascular Surgery

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Anatomic Suitability for Standard, “Off-the-Shelf” Thoracic Single Side-Branched Endograft in Patients With Type B Aortic Dissection

September 1, 2018 - 00:00
Treatment of type B aortic dissections with thoracic endovascular aortic repair (TEVAR) has been adopted in many centers with the goal of covering the proximal entry tear. Coverage of the left subclavian artery is commonly required to achieve a dissection-free proximal seal zone. A novel thoracic single side-branched (TSSB) endograft offers a potential off-the-shelf option to achieve total endovascular incorporation of the left subclavian artery during zone 2 TEVAR. The aim of this study was to determine what percentage of patients with type B aortic dissection who require zone 2 TEVAR meet the anatomic requirements for this device.

Anatomic Suitability for Standard, “Off-the-Shelf” Thoracic Single Side-Branched Endograft in Patients With Type B Aortic Dissection

September 1, 2018 - 00:00
Treatment of type B aortic dissections with thoracic endovascular aortic repair (TEVAR) has been adopted in many centers with the goal of covering the proximal entry tear. Coverage of the left subclavian artery is commonly required to achieve a dissection-free proximal seal zone. A novel thoracic single side-branched (TSSB) endograft offers a potential off-the-shelf option to achieve total endovascular incorporation of the left subclavian artery during zone 2 TEVAR. The aim of this study was to determine what percentage of patients with type B aortic dissection who require zone 2 TEVAR meet the anatomic requirements for this device.

Duplex Ultrasound Is a Clinically Useful Modality for Surveillance of Renal Branch Grafts After Fenestrated Endovascular Aneurysm Repair

September 1, 2018 - 00:00
The use of duplex ultrasound for surveillance after fenestrated endovascular aneurysm repair (FEVAR) is not well studied. Our objective was to further characterize normal and abnormal duplex ultrasound findings in renal branch grafts after FEVAR.

Duplex Ultrasound Is a Clinically Useful Modality for Surveillance of Renal Branch Grafts After Fenestrated Endovascular Aneurysm Repair

September 1, 2018 - 00:00
The use of duplex ultrasound for surveillance after fenestrated endovascular aneurysm repair (FEVAR) is not well studied. Our objective was to further characterize normal and abnormal duplex ultrasound findings in renal branch grafts after FEVAR.

Disease-Based Observation Cohort Study of Patients with Thoracoabdominal Aortic Aneurysm

September 1, 2018 - 00:00
Current understanding of thoracoabdominal aortic aneurysms (TAAAs) is limited to case series and administrative data describing patients selected to undergo surgical repair. Little is known about the overall cohort of patients with TAAA, specifically those not selected for repair. The purpose of this study was to describe a disease-based cohort of patients with TAAA.

Disease-Based Observation Cohort Study of Patients with Thoracoabdominal Aortic Aneurysm

September 1, 2018 - 00:00
Current understanding of thoracoabdominal aortic aneurysms (TAAAs) is limited to case series and administrative data describing patients selected to undergo surgical repair. Little is known about the overall cohort of patients with TAAA, specifically those not selected for repair. The purpose of this study was to describe a disease-based cohort of patients with TAAA.

Comparison of Bovine Carotid Xenograft Versus Expanded Polytetrafluoroethylene Grafts for Forearm Loop Hemodialysis Access

September 1, 2018 - 00:00
Forearm loop grafts are a useful option for dialysis access in patients without suitable forearm veins. Bovine carotid artery (BCA) and expanded polytetrafluoroethylene (ePTFE) grafts are commonly used for this purpose, but no data exist to support the use of one over the other in the forearm loop conformation.

Comparison of Bovine Carotid Xenograft Versus Expanded Polytetrafluoroethylene Grafts for Forearm Loop Hemodialysis Access

September 1, 2018 - 00:00
Forearm loop grafts are a useful option for dialysis access in patients without suitable forearm veins. Bovine carotid artery (BCA) and expanded polytetrafluoroethylene (ePTFE) grafts are commonly used for this purpose, but no data exist to support the use of one over the other in the forearm loop conformation.

Prognostic Implications of Diagnosing Frailty and Sarcopenia in Vascular Surgery Practice: Form Versus Function

September 1, 2018 - 00:00
Frailty and sarcopenia are related but independent conditions common in older patients that can be used to assess their ability to tolerate the stress of major vascular surgery. However, it is unclear whether frailty or sarcopenia is more predictive of surgical outcomes. We assessed the association of frailty and sarcopenia with long-term survival among patients undergoing surgical and nonsurgical management of vascular disease.

Prognostic Implications of Diagnosing Frailty and Sarcopenia in Vascular Surgery Practice: Form Versus Function

September 1, 2018 - 00:00
Frailty and sarcopenia are related but independent conditions common in older patients that can be used to assess their ability to tolerate the stress of major vascular surgery. However, it is unclear whether frailty or sarcopenia is more predictive of surgical outcomes. We assessed the association of frailty and sarcopenia with long-term survival among patients undergoing surgical and nonsurgical management of vascular disease.

Late Graft Failure Is Rare After Endovascular Aneurysm Repair Using the Zenith Stent Graft: Fifteen-Year Outcomes in a Cohort of High-Risk Patients

September 1, 2018 - 00:00
Device-specific data on the long-term efficacy of endovascular aneurysm repair (EVAR) are limited by the constant evolution of stent graft design. The Zenith bifurcated stent graft (Cook Medical, Bloomington, Ind) is the only one currently in use not to have undergone major structural modifications since its introduction. The purpose of this study was to report the long-term outcomes of a single-center experience of EVAR using the Zenith stent graft.

Late Graft Failure Is Rare After Endovascular Aneurysm Repair Using the Zenith Stent Graft: Fifteen-Year Outcomes in a Cohort of High-Risk Patients

September 1, 2018 - 00:00
Device-specific data on the long-term efficacy of endovascular aneurysm repair (EVAR) are limited by the constant evolution of stent graft design. The Zenith bifurcated stent graft (Cook Medical, Bloomington, Ind) is the only one currently in use not to have undergone major structural modifications since its introduction. The purpose of this study was to report the long-term outcomes of a single-center experience of EVAR using the Zenith stent graft.

Carotid Stenosis: The Impact of Frailty Syndrome on Patient Outcomes

September 1, 2018 - 00:00
Frailty confers increased risk for morbidity and mortality after operative intervention. Intervention for carotid stenosis is associated with its share of risks. The aim of this study was to assess the impact of frailty on outcomes after carotid inventions, including both carotid endarterectomy (CEA) and carotid artery stenting (CAS).

The Effect of Combining Coronary Bypass With Carotid Endarterectomy in Patients With Unrevascularized Severe Coronary Disease

September 1, 2018 - 00:00
Management of significant carotid stenosis in those with symptomatic coronary disease remains controversial. Staged and combined carotid endarterectomy (CEA) with coronary artery bypass (CAB) has been described. Yet, understanding of the additive risks of these approaches is poor. This study sought to assess outcomes in patients with clinically relevant coronary disease undergoing either isolated CEA (ICEA) or combined CEA and CAB (CCAB).

Establishing a Carotid Artery Stenosis Disease Cohort for Comparative Effectiveness Research Using Natural Language Processing

September 1, 2018 - 00:00
Investigation of asymptomatic carotid stenosis treatment is hindered by the lack of a contemporary population-based disease cohort. We describe the use of natural language processing (NLP) to identify stenosis in patients undergoing carotid imaging.

Long-Term Durability of Oakes Salvage Procedure to Preserve Forearm Dialysis Access in Patients With Failed Brescia Fistula

September 1, 2018 - 00:00
In 2002, Oakes and colleagues described a novel procedure designed to salvage the distal cephalic venous outflow of a Brescia fistula by placing a prosthetic graft between the brachial artery in the antecubital space and the cephalic vein at the wrist, allowing continued use of the wrist access. This study aimed to determine the long-term primary, primary assisted, and secondary patency rates of the brachial to distal cephalic vein Oakes procedure.

Surgical Management of Functional Popliteal Entrapment Syndrome in Athletes

September 1, 2018 - 00:00
Functional popliteal artery entrapment syndrome (FPAES) is a rare overuse condition described in physically active individuals that can be limb or performance threatening if untreated. We used provocative computed tomography angiography to guide partial debulking of the anterolateral quadrant of the medial head of the gastrocnemius muscle and reviewed outcomes of this technique in athletes.

Multivessel Tibial Revascularization Does Not Improve Outcomes in Patients With Critical Limb Ischemia

September 1, 2018 - 00:00
Single-vessel vs multivessel revascularization for critical limb ischemia (CLI) remains controversial. The purpose of this study was to evaluate single vs multiple tibial vessel interventions in patients with multivessel tibial disease.

Endovascular Reconstruction Offers Noninferior Outcomes at Reduced Cost Compared With Surgical Bypass for TransAtlantic Inter-Society Consensus II D Aortoiliac Occlusive Disease

September 1, 2018 - 00:00
The objective of this study was to compare the clinical outcomes and cost of endovascular reconstruction of occlusive and near-occlusive disease of the aortic bifurcation with surgical bypass.

Delayed Revascularization After a Trial of Conservative Therapy Is Safe and Effective for Ischemic Wounds in a Multidisciplinary Setting

September 1, 2018 - 00:00
Our group has previously shown that a high percentage of ischemic wounds in patients with peripheral arterial disease heal with conservative therapy alone. However, some patients require delayed revascularization. Our goal was to evaluate wound healing and limb salvage among patients with ischemic wounds when revascularization was necessary after a failure of conservative therapy.