Journal of Vascular Surgery

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Surgical internal iliac artery preservation associated with endovascular repair of infrarenal aortoiliac aneurysms to avoid buttock claudication and distal type I endoleaks

June 21, 2018 - 00:00
The objective of this study was to assess outcomes of a hybrid technique for treatment of abdominal aortic aneurysm (AAA) associated with iliac aneurysm without distal neck by combining an AAA endovascular repair approach with open surgery for preservation of the internal iliac artery (IIA).

Lower extremity bypass and endovascular intervention for critical limb ischemia fail to meet Society for Vascular Surgery's objective performance goals for limb-related outcomes in a contemporary national cohort

June 21, 2018 - 00:00
In 2009, the Society for Vascular Surgery (SVS) developed objective performance goals (OPGs) to define the therapeutic benchmarks in critical limb ischemia (CLI) based on outcomes from randomized trials of lower extremity bypass (LEB). Current performance relative to these benchmarks in both LEB and infrainguinal endovascular intervention (IEI) remains unknown. The objective of this study was to determine whether LEB and IEI performed for CLI in a contemporary national cohort met OPG 30-day safety thresholds.

Emotional intelligence and the vascular surgeon

June 20, 2018 - 00:00
It has truly been an honor of a lifetime to serve this organization, first as your Secretary-Treasurer and for this past year as your President. Thank you, Dr Edwards, for your kind introduction. To paraphrase Dr Baker, I am not sure even my mother would have recognized me from your introduction. When I began attending the Southern Association for Vascular Surgery (SAVS) meetings, it was only in my wildest dreams that I ever imagined myself standing before you in this role. As we all know, success is never achieved in isolation, and I have many individuals to thank.

Ambroise Pare: Barber vascular surgeon

June 18, 2018 - 00:00
For his work in forensic pathology, pioneering surgical techniques, battlefield medicine and wound care, and developing new surgical instruments, Ambroise Paré is the best known of the barber surgeons and has been called the father of modern surgery (Fig 1). Although Paré was not the first to use a vascular ligature, as he is commonly credited, he promoted it more than any of his predecessors and contemporaries. He also developed what was likely the first vascular clamp.

Adjunctive visceral artery chimney in patients undergoing Zenith Fenestrated aortic repair

June 18, 2018 - 00:00
Visceral artery chimneys have been employed as an adjunct to endovascular aneurysm repair (EVAR) to treat short-neck infrarenal and juxtarenal aortic aneurysms for more than two decades. With the widespread introduction of fenestrated endovascular aneurysm repair by the Food and Drug Administration-approved Zenith Fenestrated endograft (ZFEN; Cook Medical, Bloomington, Ind) to the United States in 2012, clinicians gained the ability to apply the chimney technique to these custom devices for difficult anatomy.

Clinical factors that influence the cellular responses of saphenous veins used for arterial bypass

June 15, 2018 - 00:00
When an autogenous vein is harvested and used for arterial bypass, it suffers physical and biologic injuries that may set in motion the cellular processes that lead to wall thickening, fibrosis, stenosis, and ultimately graft failure. Whereas the injurious effects of surgical preparation of the vein conduit have been extensively studied, little is known about the influence of the clinical environment of the donor leg from which the vein is obtained.

Prevalence of signs of celiac axis compression by the median arcuate ligament on computed tomography angiography in asymptomatic patients

June 15, 2018 - 00:00
The increasing use of computed tomography (CT) angiography has led to more frequent diagnoses of celiac artery compression (CAC) by the median arcuate ligament (MAL). The signs of CAC by the MAL have been described as stenosis and a hook or J appearance on sagittal views. The importance of the “hook signal,” however, has not been documented by studies of the normal anatomy of the celiac axis.

A comparative analysis of long-term mortality after carotid endarterectomy and carotid stenting

June 15, 2018 - 00:00
The value of carotid intervention is predicated on long-term survival for patients to derive a stroke prevention benefit. Randomized trials report no significant difference in survival after carotid endarterectomy (CEA) vs carotid artery stenting (CAS), whereas observational studies of “real-world” outcomes note that CEA is associated with a survival advantage. Our objective was to examine long-term mortality after CEA vs CAS using a propensity-matched cohort.

Geometric analysis of ruptured and nonruptured abdominal aortic aneurysms

June 15, 2018 - 00:00
The objective of this study was to use parameters to determine the geometric differences between ruptured abdominal aortic aneurysms (AAAs) and nonruptured AAAs.

Favorable impact of thoracic endovascular aortic repair on survival of patients with acute uncomplicated type B aortic dissection

June 15, 2018 - 00:00
In uncomplicated type B aortic dissection (UTBAD), the “gold standard” has been nonoperative treatment with medical therapy, although this has been questioned by studies demonstrating improved outcomes in those treated with thoracic endovascular aortic repair (TEVAR). This study assessed long-term survival after acute UTBAD comparing medical therapy, open repair, and TEVAR.

Trends of 30-day mortality and morbidities in endovascular repair of intact abdominal aortic aneurysm during the last decade

June 15, 2018 - 00:00
Significant research efforts have been made to improve the safety and efficacy of endovascular aneurysm repair (EVAR) in treating abdominal aortic aneurysm. This study aimed to examine the trends of perioperative outcomes of EVAR in the recent decade using a national validated database.

Imbalance of coagulation and fibrinolysis can predict vascular access failure in patients on hemodialysis after vascular access intervention

June 15, 2018 - 00:00
For patients with end-stage renal disease on hemodialysis, the durability of vascular access (VA) is still far from optimal, and access survival after intervention for access failure is an important aspect. Procoagulant status is a leading cause of access failure. Coagulation-fibrinolysis imbalance can occur in hemodialyzed patients, but the influence of the imbalance has not been fully elucidated.

Health and economic benefits of advanced pneumatic compression devices in patients with phlebolymphedema

June 15, 2018 - 00:00
Phlebolymphedema (chronic venous insufficiency-related lymphedema) is a common and costly condition. Nevertheless, there is a dearth of evidence comparing phlebolymphedema therapeutic interventions. This study sought to examine the medical resource utilization and phlebolymphedema-related cost associated with Flexitouch (FLX; Tactile Medical, Minneapolis, Minn) advanced pneumatic compression devices (APCDs) relative to conservative therapy (CONS) alone, simple pneumatic compression devices (SPCDs), and other APCDs in a representative U.S.

Long-term outcomes of standard endovascular aneurysm repair in patients with severe neck angulation

June 15, 2018 - 00:00
Severe neck angulation is associated with complications after endovascular aneurysm repair (EVAR). Newer endografts may overcome this limitation, but the literature lacks long-term results. We studied the long-term outcomes of EVAR in patients with severe neck angulation.

Strategies and outcomes for aortic endograft explantation

June 15, 2018 - 00:00
Failure of endovascular aneurysm repairs (EVARs) requiring open conversion remains a major challenge. We analyzed indications for repair, operative strategies, and outcomes with a focus on iliac artery degeneration after endograft removal.

Quantification of aortic shagginess as a predictive factor of perioperative stroke and long-term prognosis after endovascular treatment of aortic arch disease

June 15, 2018 - 00:00
Thoracic endovascular aortic repair (TEVAR) with supra-aortic debranching has recently been introduced as a treatment option for aortic arch disease. Although less invasive than open repair, TEVAR is associated with a risk of perioperative embolic stroke due to dislodgment of atherosclerotic plaque debris, especially in individuals with atheromatous degeneration of the aortic lumen. It is difficult to determine atheroma vulnerability, and there is no current method for predicting the risk of atheroembolism.

Statins reduce mortality and failure to rescue after carotid artery stenting

June 15, 2018 - 00:00
The benefit of statins has been well established in reducing morbidities and mortality after carotid endarterectomy. However, the potential advantage of statin use in patients undergoing carotid artery stenting (CAS) remains largely unknown. The purpose of this study was to evaluate the effect of statins on postoperative outcomes after CAS.

A comparison of reintervention rates after endovascular aneurysm repair between the Vascular Quality Initiative registry, Medicare claims, and chart review

June 15, 2018 - 00:00
The accurate measurement of reintervention after endovascular aneurysm repair (EVAR) is critical during postoperative surveillance. The purpose of this study was to compare reintervention rates after EVAR from three different data sources: the Vascular Quality Initiative (VQI) alone, VQI linked to Medicare claims (VQI-Medicare), and a “gold standard” of clinical chart review supplemented with telephone interviews.

Outcomes after elective abdominal aortic aneurysm repair in obese versus nonobese patients

June 7, 2018 - 00:00
Obesity is a worldwide epidemic, particularly in Western society. It predisposes surgical patients to an increased risk of adverse outcomes. The aim of our study was to use a nationally representative vascular database and to compare in-hospital outcomes in obese vs nonobese patients undergoing elective open aortic repair (OAR) and endovascular aneurysm repair (EVAR).

PC144. Socioeconomically Distressed Communities Associated With Sicker Patients and Worse Outcomes After Infrainguinal Bypass

June 1, 2018 - 00:00
Several studies have demonstrated socioeconomic status affects surgical outcomes, however analyses in vascular surgery are limited. We sought to determine if the Distressed Communities Index (DCI), a composite socioeconomic score by zip code, could predict short and long-term outcomes after infrainguinal bypass.