Journal of Vascular Surgery

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Remote iliac artery endarterectomy with selective stent use at the proximal dissection zone in TransAtlantic Inter-Society Consensus C and D lesions

October 23, 2018 - 23:00
Remote iliac artery endarterectomy (RIAE) is a challenging technique in the treatment of arterial occlusive disease. The impact of proximal transection zone stenting on patency rates is still unclear.

Repair of descending thoracic aortic aneurysms with Ankura Thoracic Stent Graft

October 23, 2018 - 23:00
The aim of the study was to present the results for patients with atherosclerotic aneurysm of the descending thoracic aorta (DTA) treated with a novel thoracic stent graft.

Comparative outcomes of vascular access in patients older than 70 years with end-stage renal disease

October 23, 2018 - 23:00
The advantage of arteriovenous fistulas (AVFs) in older patients requiring dialysis is controversial. We reviewed our vascular access experience in patients ≥70 years of age (older group) compared with younger patients.

Prospective assessment of health-related quality of life after endovascular repair of pararenal and thoracoabdominal aortic aneurysms using fenestrated-branched endografts

October 23, 2018 - 23:00
The objective of this study was to investigate changes in health-related quality of life (QOL) in patients treated for pararenal aortic aneurysms (PAAs) and thoracoabdominal aortic aneurysms (TAAAs) with fenestrated-branched endovascular aneurysm repair (F-BEVAR).

A population-based analysis of endovascular aortic stent graft therapy in patients with liver cirrhosis

October 23, 2018 - 23:00
Endovascular aneurysm repair (EVAR) and thoracic endovascular aortic repair (TEVAR) are effective and minimally invasive treatments for high-risk surgical candidates. However, information about the management of EVAR and TEVAR in liver cirrhosis (LC) is lacking. The aim of our study was to evaluate outcomes after EVAR and TEVAR in patients with LC.

Association of frailty index with perioperative mortality and in-hospital morbidity after elective lower extremity bypass

October 23, 2018 - 23:00
The frailty index has been linked to adverse outcomes after surgical procedures. In this study, we evaluated the association between frailty index and outcomes after elective lower extremity bypass (LEB) for lower extremity ischemia.

Image fusion using the two-dimensional-three-dimensional registration method helps reduce contrast medium volume, fluoroscopy time, and procedure time in hybrid thoracic endovascular aortic repairs

October 23, 2018 - 23:00
The objective of this study was to evaluate the effect of image fusion (IF) technology in thoracic endovascular aortic repair (TEVAR) on reducing radiation exposure (dose and time), amount of injected iodinated contrast medium needed, and procedure time.

The financial value of vascular surgeons as operative consultants to other surgical specialties

October 23, 2018 - 23:00
Vascular surgeons provide assistance to other surgical specialties through planned and unplanned joint operative cases. The financial impact to the hospital of vascular surgeons as consultants in this context has yet to be quantified. We sought to quantify the financial value of services provided by consulting vascular surgeons in the performance of joint operative procedures, both planned and unplanned.

Outcomes of basilic vein transposition versus polytetrafluoroethylene forearm loop graft as tertiary vascular access

October 23, 2018 - 23:00
Radial-cephalic arteriovenous fistula and brachial-cephalic arteriovenous fistula are the first and second choices for creating vascular access in dialysis patients as recommended by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Basilic vein transposition or use of a forearm (polytetrafluoroethylene [PTFE]) loop graft is recommended thereafter. The aim of this study was twofold: first, to compare the outcomes and patency rates of patients treated with a basilic vein transposition with those of patients treated with a PTFE loop; and second, to identify patient-related factors of influence on patency rates.

Impact of proximal seal zone length and intramural hematoma on clinical outcomes and aortic remodeling after thoracic endovascular aortic repair for aortic dissections

October 23, 2018 - 23:00
Thoracic endovascular aortic repair (TEVAR) has become standard treatment of complicated type B aortic dissections (TBADs). Whereas adequate proximal seal is a fundamental requisite for TEVAR, what constitutes “adequate” in dissections and its impact on outcomes remain unclear. The goal of this study was to describe the proximal seal zone achieved with associated clinical outcomes and aortic remodeling.

Discussion

October 23, 2018 - 23:00
Dr Fedor Lurie (Toledo, Ohio). You have identified significant differences between those two groups in this retrospective study. Do those differences reflect participating physicians' preferences, institutional protocols, or both? How much did these differences influence the study outcomes?

Outcomes of carotid-subclavian bypass performed in the setting of thoracic endovascular aortic repair

October 23, 2018 - 23:00
Subclavian artery revascularization is frequently performed in the setting of thoracic endovascular aortic repair (TEVAR). However, there is little information on the short- and long-term outcomes of patients undergoing carotid to subclavian artery bypass in this clinical setting. As such, this study sought to define the early and late outcomes associated with this procedure.

Immediate-access grafts provide comparable patency to standard grafts, with fewer reinterventions and catheter-related complications

October 23, 2018 - 23:00
No independent comparisons, with midterm follow-up, of standard arteriovenous grafts (SAVGs) and immediate-access arteriovenous grafts (IAAVGs) exist. The goal of this study was to compare “real-world” performance of SAVGs and IAAVGs.

Risk of insulin-dependent diabetes mellitus in patients undergoing carotid endarterectomy

October 23, 2018 - 23:00
There is conflicting evidence regarding the association of diabetes mellitus (DM) and insulin use with outcomes after carotid endarterectomy (CEA). Therefore, we sought to evaluate the risk of insulin-dependent DM (IDDM) and noninsulin-dependent DM (NIDDM) on 30-day outcomes after CEA.

Outcomes of upper extremity during fenestrated-branched endovascular aortic repair

October 23, 2018 - 23:00
Upper extremity (UE) access is frequently used during fenestrated-branched endovascular aortic repair (F-BEVAR) to facilitate catheterization of downgoing vessels. Limitations include risk of cerebral embolization and of UE arterial or peripheral nerve injury. The aim of this study was to assess outcomes of F-BEVAR using UE access.

Meta-analysis and meta-regression analysis of iliac limb occlusion after endovascular aneurysm repair

October 22, 2018 - 23:00
Our objective was to investigate the incidence, interventions and outcomes of iliac limb occlusion after endovascular aneurysm repair (EVAR).

Invited commentary

October 19, 2018 - 23:00
Preventing the advancement of or, better yet, reversing peripheral vascular occlusive disease could save many limbs and provide a better quality of life for our patients. The “magic bullet” of an individual agent placed locally to change the milieu sufficiently to improve collateral vascular development or to stimulate angiogenesis has not been successful to date. However, providing cells that can change the local milieu by providing a slurry of beneficial agents is more promising. Mesenchymal stem cells (MSCs) can provide stromal support and paracrine effects of potential benefit.

Invited commentary

October 19, 2018 - 23:00
Neointimal hyperplasia (NIH) is the proliferation and migration of vascular smooth muscle cells primarily in the intima, resulting in the thickening of the arterial wall and decreased arterial lumen. NIH is a significant problem after revascularization that can lead to significant graft and stent failures. Novel research investigating pathways that are responsible for NIH may provide insight into the pathophysiologic process and effective treatment options. There are currently drug-eluting stents based on paclitaxel and sirolimus, which are designed to inhibit smooth muscle cell proliferation.

Invited commentary

October 19, 2018 - 23:00
Peripheral arterial disease affects millions of Americans annually and is often treated with vein or prosthetic bypasses. Restenosis due to neointimal hyperplasia remains the Achilles heel of bypass grafts and often leads to graft failure. Neointimal hyperplasia is a complex, multifactorial disease with limited treatment options. The pathophysiologic mechanism of neointimal hyperplasia is one of underlying inflammation elaborated by a variety of cells including neutrophils, macrophages, lymphocytes, and cytokines.

Protease-activated receptors are potential regulators in the development of arterial endofibrosis in high-performance athletes

October 8, 2018 - 23:00
High-performance athletes can develop symptomatic arterial flow restriction during exercise caused by endofibrosis. The pathogenesis is poorly understood; however, coagulation enzymes, such as tissue factor (TF) and coagulation factor Xa, might contribute to the fibrotic process, which is mainly regulated through activation of protease-activated receptors (PARs). Therefore, the aim of this explorative study was to evaluate the presence of coagulation factors and PARs in endofibrotic tissue, which might be indicative of their potential role in the natural development of endofibrosis.