Journal of Vascular Surgery

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Updated: 3 hours 24 min ago

Fifteen Year Results of Radiofrequency Ablation, Using VNUS Closure, for the Abolition of Truncal Venous Reflux in Patients with Varicose Veins

October 1, 2017 - 00:00
Endovenous thermal ablation (EVTA) of varicose veins was introduced in the late 1990s with radiofrequency ablation (RFA) using the VNUS Closure device. The results of the original VNUS Closure device for the abolition of truncal venous reflux at 15 years are reported.

A Pilot Study of Femoropopliteal Artery Revascularisation with a Low Dose Paclitaxel Coated Balloon: Is Predilatation Necessary?

October 1, 2017 - 00:00
The objective was to compare 2 year outcomes in patients treated with or without predilatation prior to drug coated balloon (DCB) angioplasty for symptomatic femoropopliteal lesions.

Long Non-coding RNA–mRNA Correlation Analysis Reveals the Potential Role of HOTAIR in Pathogenesis of Sporadic Thoracic Aortic Aneurysm

October 1, 2017 - 00:00
Long non-coding RNA (lncRNA) play important roles in many diseases. However, their roles in sporadic thoracic aortic aneurysm (STAA) are unclear. Therefore, the objective of this study was to construct an lncRNA–mRNA network and dissect lncRNAs that might contribute to the pathogenesis of STAA.

Renal Complications after EVAR with Suprarenal Versus Infrarenal Fixation Among All Users and Routine Users

October 1, 2017 - 00:00
Previous studies comparing endografts with suprarenal and infrarenal fixation for endovascular abdominal aortic aneurysm repair (EVAR) have found conflicting results and did not account for differences in patient selection. This study aims to evaluate the differences in outcomes among surgeons who routinely use either suprarenal or infrarenal fixation, as well as all surgeons in the Vascular Study Group of New England (VSGNE).

Very Urgent Carotid Endarterectomy is Associated with an Increased Procedural Risk: The Carotid Alarm Study

October 1, 2017 - 00:00
The aim of the Carotid Alarm Study was to compare the procedural risk of carotid endarterectomy (CEA) performed within 48 hours with that after 48 hours to 14 days following an ipsilateral cerebrovascular ischaemic event.

Bypass Surgery With Heparin-Bonded Grafts for Chronic Lower Limb Ischemia

October 1, 2017 - 00:00
Heparin-bonded grafts showed comparable results to autologous vein in terms of graft patency and survival but lower limb salvage rates.

Administration of Adult Human Bone Marrow-Derived, Cultured, Pooled, Allogeneic Mesenchymal Stromal Cells in Critical Limb Ischemia Due to Buerger's Disease: Phase II Study Report Suggests Clinical Efficacy

October 1, 2017 - 00:00
Intramuscular administration of bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (BMMSC) at a dose of 2 million cells/kg showed clinical benefit and may be the best regimen in patients with CLI due to Buerger's disease. However, further randomized controlled trials are required to confirm the most appropriate dose.

Effect of Blood Pressure Lowering Medications on Leg Ischemia in Peripheral Artery Disease Patients: A Meta-Analysis of Randomized Controlled Trials

October 1, 2017 - 00:00
This study suggests that antihypertensive treatment does not worsen but may improve leg ischemia in peripheral artery disease (PAD) patients. Larger multicenter trials with longer antihypertensive treatment periods are required to clarify the effect of antihypertensives on leg ischemia in PAD patients.

Evacetrapib and Cardiovascular Outcomes in High-Risk Vascular Disease

October 1, 2017 - 00:00
Although the cholesteryl ester transfer protein inhibitor evacetrapib had favorable effects on established lipid biomarkers, treatment with evacetrapib did not result in a lower rate of cardiovascular events than placebo among patients with high-risk vascular disease.

Recombinant Adeno-Associated Virus Vector Carrying the Thrombomodulin Lectin-Like Domain for the Treatment of Abdominal Aortic Aneurysm

October 1, 2017 - 00:00
These findings corroborate the therapeutic potential of the TM lectin-like domain in AAA. The attenuation of angiotensin II-infused AAA by one-time delivery of rAAV-TMD1 provides a proof of concept validation of its application as potential gene therapy for aneurysm development.

Mynx Vascular Closure Device in Arterial Endovascular Procedures

October 1, 2017 - 00:00
Use of vascular closure devices has a low rate of bleeding complication, device failure, and need for operative repair. Bleeding is associated with increased age, interventional procedure, and end-stage renal disease. Mynx, Perclose, and Angio-Seal have similar rates of complications. Use of these devices are a safe option for groin vessel closure.

Registry-Based Prospective, Active Surveillance of Medical-Device Safety

October 1, 2017 - 00:00
A strategy of prospective, active surveillance of a clinical registry rapidly identified potential safety signals among recipients of an implantable vascular-closure device with initial alerts occurring within the first 12 months of monitoring.

Growth Factors for Angiogenesis in Peripheral Arterial Disease

October 1, 2017 - 00:00
The results of this review do not support the use of growth factor therapy in patients with lower extremity peripheral vascular disease to prevent death, major limb amputation or to improve walking ability. It may decrease the rate of minor amputations and only low/very low quality data demonstrates any benefit in terms of hemodynamic improvement, ulcer healing, rest pain relief or prevention of adverse events.

What is an Advanced Alternative Payment Model?

October 1, 2017 - 00:00
The Medicare Access and Children's Health Insurance Program Reauthorization Act (MACRA) requires that providers who bill Medicare participate in the Merit-based Incentive Payment System (MIPS) or an Advanced Alternative Payment Model (AAPM) to avoid a negative payment adjustment.1 These programs represent a shift from fee-for-service payment to pay-for-“value,” with the intention of financially rewarding providers who deliver the highest-quality care that is also the most cost efficient. Under MACRA, an AAPM must meet the following criteria: (1) require participants to use certified electronic health record technology; (2) provide payment for covered professional services based on quality measures comparable to those used in the quality performance category of MIPS; and (3) either be a Medical Home Model (MHM) or require AAPM participants to bear more than a “nominal amount of financial risk.” All qualifying AAPMs must be approved by The Centers for Medicare and Medicaid Services (CMS).

An Institution-Wide Algorithm for Direct-Stick Embolization of Congenital Peripheral Venous Malformations

October 1, 2017 - 00:00
No standardized therapeutic algorithm or embolic agent of choice has yet been identified for management of congenital peripheral venous malformations (CPVMs). Treatment options and reported outcomes therefore vary widely. Herein, we present an institution-wide algorithm for management of symptomatic CPVMs using a single embolotherapeutic modality.

The Endovascular Treatment of Visceral Aneurysms: Single-Center Experience

October 1, 2017 - 00:00
Visceral artery aneurysms (VAAs) represent a pathologic condition with high mortality rates because of their high frequency of rupture and consequent fatal bleeding (22%-70%). The increased incidental detection related to frequent use of advanced imaging technology lets vascular surgeons choose between endovascular and open surgical treatment. The primary end points of this retrospective study are evaluation of technical success and periprocedural mortality rate; the first is defined as the successful exclusion of the true aneurysm from the main stream of the blood flow as confirmed by completion angiography, and the second is the mortality incidence within the first 30 days after treatment.

An Academic Tertiary Referral Center's Experience With a Vascular Surgery-Based Uterine Artery Embolization Program

October 1, 2017 - 00:00
Despite growing endovascular experience within the vascular surgery community, some catheter-based interventions, such as uterine artery embolization (UAE), remain outside the clinical scope of most vascular surgeons owing mostly to established referral patterns and limited awareness among referring colleagues. We present our experience with a vascular surgery-based, multidisciplinary UAE program at an academic tertiary referral center.

Risk Factors and Outcomes Associated With Infected Lower Extremity Prosthetic Bypasses and Patches

October 1, 2017 - 00:00
Prosthetic grafts are often used as alternative conduits in patients with peripheral vascular disease who do not have adequate autologous vein for bypass. However, prosthetic grafts carry increased risk of infection and associated increased morbidity and mortality. The goal of this study was to identify potential risk factors and subsequent outcomes associated with lower extremity prosthetic graft infections.

Contemporary Results of Surgical Management of Peripheral Mycotic Aneurysms

October 1, 2017 - 00:00
Mycotic aneurysms of the extremities occur infrequently but can cause severe life and limb complications. Traditional treatment typically includes débridement and revascularization, although ligation may be well tolerated in some patients. We reviewed our experience with these aneurysms treated with these two modalities.

The Society for Vascular Surgery Wound, Ischemia, and foot Infection Classification Predicts Wound Healing Better Than Angiosome-Directed Perfusion in Neuroischemic Diabetic Foot Wounds

October 1, 2017 - 00:00
Previous studies have shown conflicting results in the wound healing outcomes based on angiosome-directed perfusion, but none have adjusted for wound characteristics. We have previously shown that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing in neuroischemic diabetic foot ulcers (DFUs) treated by a multidisciplinary team. The aim of this study was to compare WIfI classification vs angiosome-directed perfusion as a predictor of wound healing in patients presenting with DFU and peripheral arterial disease (PAD).