Journal of Vascular Surgery

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LEA 16. A Comprehensive Evaluation of Infrainguinal Endotherapy at Our Institution: Cost, Time, Radiation, and Outcomes

October 31, 2018 - 23:00
Infrainguinal endotherapy is a significant part of an arterial vascular surgery practice. There are a variety of endovascular tools available for the treatment of these lesions; however, there is limited consensus regarding optimal treatment. Reasons for this problem include paucity of prospective randomized data, industry-driven research, and vague specialty guidelines.

LEA 15. Role of Monocytes in the Treatment of Chronic Limb Ischemia and “Hard to Heal” Ulcers

October 31, 2018 - 23:00
The healing of chronic lesions in patients with critical limb ischemia (CLI) is not easily achievable. Both in vitro and in vivo studies have shown that plasma mononuclear cell concentrates (MNCs), injected in the ischemic site, act through a dual mechanism: antalgic and anti-inflammatory action and neoangiogenesis stimulation. This monocentric observational clinical study evaluated the safety and efficacy of MNCs in pain reduction and wound healing in patients with CLI.

LEA 14. Bilateral Lower Limb Disabling Claudication in a Young Man: Mönckeberg Arteriosclerosis, What to Do?

October 31, 2018 - 23:00
Mönckeberg arteriosclerosis is called medial calcific sclerosis, which is a form of vessel hardening due to increased calcium deposits in the tunica media layer. Its clinical significance and etiology and its relation to atherosclerosis and vascular calcification are still a matter of disagreement. Its clinical presentations and the treatment are still debatable.

LEA 13. Lutonix Drug-Coated Balloon Long Lesion Study: 24-Month Outcomes

October 31, 2018 - 23:00
The safety and effectiveness of the drug-coated balloon (DCB) have been shown in relatively short and less severe lesions. The U.S. currently approved DCBs reported a mean lesion length of 8.0 to 10.2 cm, with the majority of the lesions TransAtlantic Inter-Society Consensus (TASC) II class A and B. The safety and effectiveness in longer and more severe lesions need to be studied. This multicenter, single-arm study is designed to demonstrate the efficacy and safety of the Lutonix (Bard Peripheral Vascular, Tempe, Ariz) DCB for the treatment of long TASC II class C and D lesions (≥14 cm) in the superficial femoral artery.

LEA 12. Percutaneous Suture Technique With ProGlide: A Novel Method for Management of Vascular Access Pseudoaneurysm After Percutaneous Coronary Intervention Procedure

October 31, 2018 - 23:00
Iatrogenic femoral artery pseudoaneurysm (IFAP) is a common complication of endovascular procedures in the femoral artery for therapeutic intervention. It is reported that the incidence of IFAP is 2% to 7.7% involving peripheral intervention because of the frequent use of anticoagulant therapy and use of larger sheaths. We use the ProGlide (Abbott Vascular, Santa Clara, Calif), a percutaneous suture device, at the pseudoaneurysm neck under fluoroscopy to seal the pseudoaneurysm sac.

LEA 11. Implementation of a Multidisciplinary Team Approach in Lower Extremity Amputation Prevention Program for Diabetic Foot Ulcer Referral from Primary Health Care to a Tertiary Center Vascular Surgery Clinic: Initial Experience in an Asian Population

October 31, 2018 - 23:00
A multidisciplinary team (MDT) foot care service reduces the rates of lower extremity amputations in patients with diabetes. A key principle of this clinic is the ease and early access of a patient with an active diabetic foot ulcer to an MDT clinic service. Active management includes improvement of glycemic control and medical optimization of peripheral vascular disease risk factors, off-loading advice, wound care by a podiatrist or wound nurse, and vascular interventions. We report our early experience in the implementation of an MDT approach in a lower extremity amputation prevention program (LEAPP) for diabetic foot ulcer referral from primary care to a tertiary center vascular surgery clinic.

LEA 10. Use of Home Negative Pressure Wound Therapy in Peripheral Artery Disease and Diabetic Limb Salvage

October 31, 2018 - 23:00
Use of negative pressure wound therapy (NPWT) in peripheral artery disease (PAD) and diabetic limb salvage (DLS) improves wound healing by providing a moist wound condition, managing exudate, controlling wound bed infection, and stimulating granulation. NPWT duration may take several weeks, and home-based NPWT allows patients to recover in the community while minimizing risks of prolonged hospitalization.

LEA 9. End-of-Life Care After Major Amputation for Diabetes or Peripheral Arterial Disease

October 31, 2018 - 23:00
Major amputation in patients with diabetes and peripheral arterial disease (PAD) is associated with poor long-term survival. We sought to characterize end-of-life care in these patients.

LEA 8. Use of Negative Pressure Wound Therapy With Instillation in Diabetic Foot Wounds: Initial Experience in an Asian Population

October 31, 2018 - 23:00
The management of diabetic foot wounds is multimodal, comprising both local and systemic measures. Negative pressure wound therapy with instillation (NPWTi) is a useful adjunct in the management of diabetic foot wounds. The cyclic instillation of solutions to the wound bed is thought to augment the benefits of NPWT by decreasing wound bioburden and promoting granulation. We report our early experience using NPWTi in the management of diabetic foot wounds.

LEA 7. Efficacy of XTRACT on Atrial Fibrillation Patients With Peripheral Arterial Disease: Subset Analysis from PRISM Trial

October 31, 2018 - 23:00
We report clinical efficacy and safety on subset analysis of atrial fibrillation patients in the Case Review of the Penumbra and Indigo Systems for Mechanical Thrombectomy in the Periphery (PRISM) trial. This trial examined efficacy and safety of XTRACT (a power aspiration-based extraction technique) using the Penumbra Indigo System (Penumbra Inc, Alameda, Calif) as a frontline and secondary treatment of peripheral arterial occlusions.

LEA 6. Endovascular Repair of Popliteal Artery Aneurysm

October 31, 2018 - 23:00
The incidence of popliteal aneurysm in the general population is rare, but it is the most frequent of peripheral aneurysms. It is a serious disease that could compromise the vital and functional prognosis of the patient. Popliteal aneurysm is traditionally treated by open repair (OR); endovascular repair (ER) has become more common. The aim of this study was to compare results regarding the technical success, perioperative mortality and morbidity, patency, and limb salvage and to describe currents trends.

LEA 4. A Promising Novel Treatment for Critical Limb Ischemia and Beyond

October 31, 2018 - 23:00
Peripheral vascular disease in people with diabetes and the elderly affects principally medium- and small-caliber vessels that are less amenable to surgical intervention. Stem/progenitor cell (SPC) treatments with bone marrow-derived cells show promising outcomes in treating vascular diseases, albeit not without adverse events related to cell mobilization and collection. A unique patented treatment product of enriched endothelial progenitor cells generated from peripheral blood was developed that uses a novel 1-day technology employing dendritic cells to specifically direct potentially therapeutic SPC activity in vitro.

LEA3. Open Distal Revascularization in Chronic Kidney Disease: Is It Worthwhile?

October 31, 2018 - 23:00
The incidence of chronic kidney disease (CKD) has reached pandemic proportions across the world. Occlusive arterial disease causing critical limb ischemia and sepsis in the CKD patient is a huge clinical challenge often culminating in major amputation or mortality. Successful revascularization of these patients is challenging with added limitations due to impaired renal function, difficulties in contrast-enhanced imaging, heavily calcified arteries, and overall comorbid status.

LEA2. Outcomes of Laser Atherectomy in Complex Lesions of the Superficial Femoral Artery

October 31, 2018 - 23:00
The effectiveness of laser atherectomy in the treatment of complex arterial lesions remains poorly defined. The objective of this study was to assess outcomes of superficial femoral artery (SFA) lesions treated with laser atherectomy.

LEA1. Pilot Assessment of the Angiosome Concept by Intraoperative Fluorescence Angiography After Tibial Bypass Surgery

October 31, 2018 - 23:00
The angiosome concept as a model for decision-making in revascularization of patients with critical limb ischemia has fallen victim to a lively discussion in recent years. Therefore, the aim of this prospective pilot study was to provide further data on the angiosome concept on the level of microcirculation after tibial bypass surgery by using intraoperative fluorescence angiography.

Meta-analysis of the accuracy of contrast-enhanced ultrasound for the detection of endoleak after endovascular aneurysm repair

October 28, 2018 - 23:00
The purpose of this systematic review and meta-analysis was to investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) for detection of endoleak after endovascular aneurysm repair (EVAR).

Risk of spinal cord ischemia after fenestrated or branched endovascular repair of complex aortic aneurysms

October 28, 2018 - 23:00
The aim of our study was to analyze the incidence of spinal cord ischemia (SCI) in patients presenting with complex aortic aneurysms treated with endovascular aneurysm repair (EVAR) and to identify risk factors associated with this complication.

Systematic review of native and graft-related aortic infection outcome managed with orthotopic xenopericardial grafts

October 23, 2018 - 23:00
Limited data are available on the use of xenopericardium in the treatment of native and graft-related aortic infections. The aim of this review was to assess outcomes of neoaortic reconstruction using xenopericardium in this challenging group of patients.

Outcomes of endovascular treatments for in-stent restenosis in patients with mesenteric atherosclerotic disease

October 23, 2018 - 23:00
Mesenteric angioplasty and stenting (MAS) has surpassed open revascularization as the treatment of choice for mesenteric ischemia. Despite the lower perioperative mortality associated with MAS, the need for reintervention is not infrequent. The purpose of this study was to review the outcomes of patients treated for mesenteric artery in-stent restenosis (MAISR).

Measuring the greater curvature length of virtual stent graft can provide accurate prediction of stent graft position for thoracic endovascular aortic repair

October 23, 2018 - 23:00
The objective of this study was to assess the accuracy of predicting stent graft position for thoracic endovascular aortic repair by measuring three lengths of the virtual stent graft: smaller curvature (SC), center lumen line (CL), and greater curvature (GC).