Journal of Vascular Surgery

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Updated: 11 hours 4 min ago

Descending thoracic aortic mural thrombus presentation and treatment strategies

July 25, 2017 - 00:00
Thoracic aortic mural thrombus (TAMT) of the descending aorta is rare but can result in dramatic embolic events. Early treatment is therefore crucial; however, there is not a consensus on ideal initial treatment.

Aneurysmal degeneration of type B aortic dissections after thoracic endovascular aortic repair: A systematic review

July 20, 2017 - 00:00
Promising results of thoracic endovascular aortic repair (TEVAR) in patients with complicated type B aortic dissection (TBAD) have been well documented. However, whereas early results have led many to hypothesize a benefit of TEVAR in uncomplicated patients, the natural history of TEVAR after the treatment of TBAD has yet to mature. In this review, we evaluated the available data to investigate whether longer term TEVAR warrants enthusiasm for all comers with TBAD.

Potential of circulatory procalcitonin as a biomarker reflecting inflammation among South Indian diabetic foot ulcers

July 20, 2017 - 00:00
Diabetic foot ulcer (DFU), the major complication associated with diabetes mellitus, has been shown to precede amputation in up to 90% of cases. Recent data reveal that procalcitonin (PCT) is a valid marker for the diagnosis of bacterial infections compared with traditional markers like white blood cell count, C-reactive protein levels, and erythrocyte sedimentation rate in DFU patients. Furthermore, cytokines are proposed to act as modulators and mediators for the expression and release of PCT into the circulation.

Brachial vein transposition is a promising ultimate upper limb autologous arteriovenous angioaccess despite its many pitfalls

July 18, 2017 - 00:00
The objective of this study was to retrospectively evaluate the possibility of using the brachial veins despite their deep location, small caliber, and thin wall.

Discussion

July 17, 2017 - 00:00
Ali F. AbuRahma (Charleston, WVa). This study analyzed a large number of patients (4326) who had contralateral carotid occlusion, of whom 3274 underwent carotid endarterectomy (CEA) and 1052 had carotid artery stenting (CAS) to study the effect of contralateral carotid artery occlusion on the clinical outcome of both CEA and CAS. As indicated by the speaker, this topic is somewhat controversial, with several studies reporting different results. As the audience is probably aware, some randomized carotid trials have shown that contralateral carotid artery occlusion may adversely impact the outcome of CEA; however, over a decade ago, we analyzed our experience from a randomized carotid trial on both perioperative and late stroke rates of CEA with contralateral carotid occlusion, which showed no difference between patients with or without carotid occlusion.

Restrictive bare stent prevents distal stent graft-induced new entry in endovascular repair of type B aortic dissection

July 13, 2017 - 00:00
Distal stent graft-induced new entry (SINE) can occur after thoracic endovascular aortic repair (TEVAR) of type B aortic dissection. This study investigated the mechanism of distal SINE and its prevention using a restrictive bare stent (RBS) technique.

Thirty-day outcomes after fenestrated endovascular repair are superior to open repair of abdominal aortic aneurysms involving visceral vessels

July 13, 2017 - 00:00
Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs.

Performance of acoustic radiation force impulse ultrasound imaging for carotid plaque characterization with histologic validation

July 13, 2017 - 00:00
Stroke is commonly caused by thromboembolic events originating from ruptured carotid plaque with vulnerable composition. This study assessed the performance of acoustic radiation force impulse (ARFI) imaging, a noninvasive ultrasound elasticity imaging method, for delineating the composition of human carotid plaque in vivo with histologic validation.

Asymptomatic carotid stenosis is associated with cognitive impairment

July 13, 2017 - 00:00
Cerebrovascular risk factors (eg, hypertension, coronary artery disease) and stroke can lead to vascular cognitive impairment. The Asymptomatic Carotid Stenosis and Cognitive Function study evaluated the isolated impact of asymptomatic carotid stenosis (no prior ipsilateral or contralateral stroke or transient ischemic attack) on cognitive function. Cerebrovascular hemodynamic and carotid plaque characteristics were analyzed to elucidate potential mechanisms affecting cognition.

Factors affecting operative time and outcome of carotid endarterectomy in the Vascular Quality Initiative

July 13, 2017 - 00:00
Prior studies have suggested a relationship between operative (Op) time and outcome after major vascular procedures. This study analyzed factors associated with Op time and outcome after carotid endarterectomy (CEA) in the Vascular Quality Initiative (VQI) registry.

Safety and efficacy of rivaroxaban compared with warfarin in patients undergoing peripheral arterial procedures

July 13, 2017 - 00:00
Rivaroxaban is a United States Food and Drug Administration-approved oral anticoagulant for venous thromboembolic disease; however, there is no information regarding the safety and its efficacy to support its use in patients after open or endovascular arterial interventions. We report the safety and efficacy of rivaroxaban vs warfarin in patients undergoing peripheral arterial interventions.

Parallel placement of Excluder legs for treatment of type IIIb endoleaks caused by fabric tear after endovascular aneurysm repair

July 11, 2017 - 00:00
A total of 576 patients underwent endovascular aneurysm repair using main body devices for treatment of abdominal aortic aneurysms or iliac artery aneurysms. During follow-up, type IIIb endoleaks caused by fabric tear occurred in six patients (1.0% [6/576]). The device used was Zenith (Cook Medical, Bloomington, Ind) in five cases and Talent (Medtronic, Santa Rosa, Calif) in one case. All endoleaks were close to the flow divider of the main body devices. The distance between the lower renal artery and the top end of the contralateral leg was 53 ± 14 mm.

Discussion

July 8, 2017 - 00:00
Dr Mitchell H. Goldman (Knoxville, Tenn). Dr Goldsmith and his colleagues from Ochsner Clinic Foundation, one of the nation's biggest hepatic transplant programs, report their experience with hepatic artery stenosis (HAS), focusing on the complications of the procedures of endovascular intervention. I want to thank Dr Goldsmith for a timely sent copy of his well-written paper.

Complications after endovascular treatment of hepatic artery stenosis after liver transplantation

July 8, 2017 - 00:00
Hepatic artery stenosis (HAS) after liver transplantation can progress to hepatic artery thrombosis (HAT) and a subsequent 30% to 50% risk of graft loss. Although endovascular treatment of severe HAS after liver transplantation has emerged as the dominant method of treatment, the potential risks of these interventions are poorly described.

Characterization of perioperative contralateral stroke after carotid endarterectomy

July 8, 2017 - 00:00
Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioperative (30-day) contralateral stroke after CEA as well as predisposing preoperative and operative factors. Its specific effect on long-term survival was interrogated.

Early outcomes of the conformable stent graft for acute complicated and uncomplicated type B aortic dissection

July 8, 2017 - 00:00
The objective of this study was to evaluate the safety, efficacy, and outcomes of the conformable thoracic endograft (Conformable TAG Thoracic Endoprosthesis [CTAG]; W. L. Gore & Associates, Flagstaff, Ariz) for acute complicated and uncomplicated type B aortic dissection (TBAD).

Outcomes for concomitant common iliac artery aneurysms after endovascular abdominal aortic aneurysm repair

July 8, 2017 - 00:00
This study evaluated the morbidity of endovascular abdominal aortic aneurysm repair (EVAR) in patients with concomitant common iliac artery aneurysm (CCIAA).

Outcomes of endovascular recanalization versus autogenous venous bypass for thromboangiitis obliterans patients with critical limb ischemia due to tibioperoneal arterial occlusion

July 8, 2017 - 00:00
This study sought to compare the outcomes of endovascular recanalization (ER) vs autogenous venous bypass (AVB) for tibioperoneal arterial occlusion in thromboangiitis obliterans patients with critical lower limb ischemia.

Predictors of cross-clamp-induced intraoperative monitoring changes during carotid endarterectomy using both electroencephalography and somatosensory evoked potentials

July 5, 2017 - 00:00
The efficacy of selective shunting during carotid endarterectomy (CEA) using intraoperative monitoring (IOM) for detection of cerebral ischemia is well established. There is mounting evidence that monitoring of both electroencephalography (EEG) and somatosensory evoked potentials (SSEPs) increases the sensitivity of cerebral ischemia detection. Predictors of cerebral ischemia requiring selective shunt placement using IOM of both EEG and SSEPs have not been previously identified.

Lower Extremity Bypass Surgery on Patients Transferred From Other Hospitals Is Associated With Increased Morbidity and Mortality

July 1, 2017 - 00:00
Multiple factors affect an interfacility transfer of patients including advanced age, need for emergency procedure and contaminated wounds. Patients who are transferred from another institution for a lower extremity bypass surgery are at a substantially higher risk for postoperative morbidity and mortality.