Journal of Vascular Surgery

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Simulation training streamlines the real-life performance in endovascular repair of ruptured abdominal aortic aneurysms

November 25, 2018 - 23:00
Difficulties in distributing endovascular experience among all operating room (OR) personnel prevented full-scale use of endovascular aneurysm repair (EVAR) in emergencies. To streamline the procedure of EVAR for ruptured aneurysm (rEVAR) and to provide this method even to unstable patients, we initiated regular simulation training sessions.

Response of the popliteal artery to treadmill exercise and stress positioning in patients with and without exertional lower extremity symptoms

November 25, 2018 - 23:00
Functionally limiting exertional lower extremity pain and neurologic symptoms are commonly encountered in military and civilian settings. Exertional muscle compression of the popliteal artery (PA) and tibial nerve in the proximal calf (the “popliteal outlet”) can be associated with these symptoms but is rarely investigated as a cause. Exertional ankle-brachial index (EABI) and dynamic PA ultrasound imaging may be suitable to screen for this syndrome of “functional” popliteal entrapment, but neither has been rigorously studied.

Extending endovascular aneurysm repair to more patients without better outcomes

November 25, 2018 - 23:00
This study quantifies the survival and outcomes associated with endovascular aneurysm repair (EVAR) patients treated in two eras. We hypothesized that both end points will improve over time.

Survival prediction in patients with chronic limb-threatening ischemia who undergo infrainguinal revascularization

November 25, 2018 - 23:00
Accurate survival prediction critically influences decision-making in caring for patients with chronic limb-threatening ischemia (CLTI). The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL) trial demonstrated that in patients who survived >2 years, there was a significant advantage to infrainguinal bypass compared with endovascular intervention, which increased with time. Validated survival models for patients with CLTI are lacking.

Impact of time to repair on outcomes in patients with lower extremity arterial injuries

November 25, 2018 - 23:00
Six hours has long been considered the threshold of ischemia after peripheral artery injury. However, there is a paucity of evidence regarding the impact of operative delays on morbidity and mortality in patients with lower extremity arterial injuries.

Discussion

November 25, 2018 - 23:00
Dr Melissa L. Kirkwood (Dallas, Tex). I would like to commend the authors on an excellent paper evaluating sex-based differences in survival in patients undergoing endovascular aneurysm repair. I would like to thank Dr Shutze for sending me the manuscript well in advance of the meeting and to thank the Southern Association for Vascular Surgery program committee for allowing me to comment.

Sex as an independent risk factor for long-term survival after endovascular aneurysm repair

November 25, 2018 - 23:00
Several vascular surgical procedures, including repair of abdominal aortic aneurysms (AAAs), show poorer outcomes for women than for men. We evaluated the impact of sex-based demographic differences on survival after endovascular aneurysm repair (EVAR).

Anatomic predictors for late mortality after standard endovascular aneurysm repair

November 22, 2018 - 23:00
Abdominal aortic aneurysm (AAA) management involves a decision process that takes into account anatomic characteristics, surgical risks, patients' preferences, and expected survival. Whereas larger AAA diameter has been associated with increased mortality after both standard endovascular aneurysm repair (EVAR) and open repair, it is unclear whether survival after EVAR is influenced by other anatomic characteristics. The purpose of this study was to determine the importance of baseline anatomic features on survival after EVAR.

Single-center experience with an inner branched arch endograft

November 22, 2018 - 23:00
Whereas open repair is the “gold standard” for most aortic arch diseases, a subgroup of patients might benefit from an endovascular approach. The introduction of branched stent grafts with dedicated design to address the challenges of the ascending aorta and the aortic arch has opened an entirely new area of treatment for these patients. We investigated the early outcomes of branched thoracic endovascular aortic repair (b-TEVAR) in various types of disease of the aortic arch.

Factors associated with postoperative renal dysfunction and the subsequent impact on survival after open juxtarenal abdominal aortic aneurysm repair

November 22, 2018 - 23:00
Renal dysfunction is a well-described complication of open juxtarenal abdominal aortic aneurysm repair, but the associated risk factors and corresponding impact on survival are not well described.

Predictors of perioperative and late survival in octogenarians undergoing elective endovascular abdominal aortic repair

November 22, 2018 - 23:00
The appropriateness of endovascular aneurysm repair (EVAR) of uncomplicated abdominal aortic aneurysm depends on the risk-benefit ratio, particularly in elderly patients with short life expectancy. The aim of this study was to assess the efficacy of EVAR in >80-year-old patients by evaluating their postoperative survival and analyzing the possible predictors of late mortality.

Risk factors for early and late mortality after fenestrated and branched endovascular repair of complex aneurysms

November 22, 2018 - 23:00
The objective of this study was to evaluate outcomes after fenestrated and branched endovascular aneurysm repair (F-BEVAR) performed in high-risk patients to treat pararenal (PR) aneurysms and thoracoabdominal aortic aneurysms (TAAAs) and to identify those patients likely to benefit from this treatment.

Discussion

November 16, 2018 - 23:00
Dr Matthew Smeds (Little Rock, Ark). You had mentioned that the people who had these findings of hyperglycemia were more likely to be smokers, to be obese, or to have other significant risk factors. Did you somehow try to control for that?

Poor glycemic control is a strong predictor of postoperative morbidity and mortality in patients undergoing vascular surgery

November 16, 2018 - 23:00
Hyperglycemia is a common occurrence in patients undergoing cardiovascular surgery. It has been identified in several surgical cohorts that improved perioperative glycemic control reduced postoperative morbidity and mortality. A significant portion of the population with peripheral arterial disease suffers from the sequelae of diabetes or metabolic syndrome. A paucity of data exists regarding the relationship between perioperative glycemic control and postoperative outcomes in vascular surgery patients.

Attrition rates in integrated vascular and cardiothoracic surgery residency and fellowship programs

November 15, 2018 - 23:00
Attrition in surgical programs remains a significant problem resulting in trainee dissatisfaction and wasted time and educational dollars. Attrition rates in general surgery training programs approximate 5% per year (30% cumulative). Attrition rates in cardiovascular surgery training for the traditional vascular surgery fellowship (VSF), the vascular surgery residency (VSR), and the corresponding programs in cardiothoracic surgery have yet to be described, although they are assumed to be similar to those associated with general surgery training.

Information for readers

October 31, 2018 - 23:00
Communications regarding original articles and editorial management should be addressed to Peter Gloviczki, MD, and Peter F. Lawrence, MD, Editors, Journal of Vascular Surgery, 633 N. St. Clair, 22nd Floor, Chicago, IL 60611; telephone: 603-523-2222; fax: 312-334-2320; e-mail: JVASCSURG@vascularsociety.org. Information for authors appears in the January and July issues, at www.jvascsurg.org, and at jvs.editorialmanager.com. Authors should consult this document before submitting manuscripts to this Journal.

Information for authors

October 31, 2018 - 23:00
Complete information for authors and editorial policies are available in the January and July issues, at our Web site www.jvascsurg.org, or at our Editorial Manager Web site at jvs.editorialmanager.com. An abbreviated checklist for manuscript submission follows. Manuscripts that are accepted for publication become the property of the Journal of Vascular Surgery®, which is copyrighted by the Society for Vascular Surgery®. They may not be published or reproduced in whole or in part without the written permission of the author(s) and the Journal.

Contents

October 31, 2018 - 23:00

Editorial Board

October 31, 2018 - 23:00

LEO 8. Diabetic Foot Limb Salvage: A Series of 809 Attempts and Predictors for Endovascular Limb Salvage Failure

October 31, 2018 - 23:00
The objective of this study was to review patients’ characteristics and outcomes of inpatient diabetic foot limb salvage and to identify risk factors predicting endovascular limb salvage failure.