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Journal of Vascular Surgery

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https://www.readbyqxmd.com/read/28526560/limb-flexion-induced-axial-compression-and-bending-in-human-femoropopliteal-artery-segments
#1
William Poulson, Alexey Kamenskiy, Andreas Seas, Paul Deegan, Carol Lomneth, Jason MacTaggart
BACKGROUND: High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations are poorly characterized. The goal of this study was to quantify axial compression and bending of human FPAs that are placed in positions commonly assumed during the normal course of daily activities...
May 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28526559/a-single-nucleotide-polymorphism-of-cyclin-dependent-kinase-inhibitor-1b-p27-kip1-associated-with-human-vein-graft-failure-affects-growth-of-human-venous-adventitial-cells-but-not-smooth-muscle-cells
#2
Richard D Kenagy, Shinsuke Kikuchi, Lihua Chen, Errol S Wijelath, Andrew B Stergachis, John Stamatoyannopoulos, Gale L Tang, Alexander W Clowes, Michael Sobel
BACKGROUND: Cyclin-dependent kinase inhibitor 1B (p27(Kip1)) is a cell-cycle inhibitor whose -838C>A single nucleotide polymorphism (rs36228499; hereafter called p27 SNP) has been associated with the clinical failure of peripheral vein grafts, but the functional effects of this SNP have not been demonstrated. METHODS: Human saphenous vein adventitial cells and intimal/medial smooth muscle cells (SMCs) were derived from explants obtained at the time of lower extremity bypass operations...
May 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28506478/metformin-treatment-does-not-affect-the-risk-of-ruptured-abdominal-aortic-aneurysms
#3
Katrine L Kristensen, Anton Pottegård, Jesper Hallas, Lars M Rasmussen, Jes S Lindholt
OBJECTIVE: Diabetes counteracts formation and rupture of abdominal aortic aneurysms, possibly through arterial matrix accumulation. Use of metformin, on the other hand, reduces arterial accumulation of matrix molecules. Consequently, we hypothesized that metformin treatment may reverse the protective role of diabetes on the development and course of aneurysms, that is, that metformin would be associated with aneurysm rupture among individuals with diabetes. METHODS: Using nationwide Danish registry data, we performed a nested case-control study on the association between long-term use of metformin and ruptured abdominal aortic aneurysm (RAAA)...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28506477/medical-therapy-and-intervention-do-not-improve-uncomplicated-isolated-mesenteric-artery-dissection-outcomes-over-observation-alone
#4
Jacob W Loeffler, Hideaki Obara, Naoki Fujimura, Paul Bove, Daniel H Newton, Sara L Zettervall, Andre S van Petersen, Robert H Geelkerken, Kristofer M Charlton-Ouw, Sherene Shalhub, Niten Singh, Arnaud Roussel, Natalia O Glebova, Michael P Harlander-Locke, Warren J Gasper, Misty D Humphries, Peter F Lawrence
OBJECTIVE: Isolated dissection of the mesenteric vessels is rare but increasingly recognized. This study aimed to evaluate patient characteristics, primary treatment, and subsequent outcomes of mesenteric dissection using multi-institutional data. METHODS: All patients at participant hospitals between January 2003 and December 2015 with dissection of the celiac artery (or its branches) or dissection of the superior mesenteric artery (SMA) were included. Patients with an aortic dissection were excluded...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#5
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28506475/a-novel-perfused-porcine-simulator-for-teaching-aortic-anastomosis-increases-resident-interest-in-vascular-surgery
#6
Peter B Bartline, Jennie O'Shea, James M McGreevy, Michelle T Mueller
OBJECTIVE: This report describes a novel simulator, euthanized pigs on cardiopulmonary bypass, and validates this simulator with a controlled trial in general surgery residents learning aortic anastomosis. We evaluated this novel simulator with the following hypothesis: our porcine perfused simulator is as good as or better than the standard rubber tubing, low-fidelity models used for vascular anastomotic training. METHODS: Euthanized pigs were placed on cardiopulmonary bypass, creating a perfused, ex vivo model on which to perform surgical procedures...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502552/bifurcated-bifurcated-aneurysm-repair-is-a-novel-technique-to-repair-infrarenal-aortic-aneurysms-in-the-setting-of-iliac-aneurysms
#7
Susanna Hewon Shin, Benjamin Ware Starnes
BACKGROUND: Up to 40% of abdominal aortic aneurysms (AAAs) have coexistent iliac artery aneurysms (IAAs). In the past, successful endovascular repair required internal iliac artery (IIA) embolization, which can lead to pelvic or buttock ischemia. This study describes a technique that uses a readily available solution with a minimally altered off-the-shelf bifurcated graft in the IAA to maintain IIA perfusion. METHODS: From August 2009 to May 2015, 14 patients with AAAs and coexisting IAAs underwent repair with a bifurcated-bifurcated approach...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502551/variation-in-hospital-costs-and-reimbursement-for-endovascular-aneurysm-repair-a-vascular-quality-initiative-pilot-project
#8
Gary W Lemmon, Dan Neal, Randall R DeMartino, Joseph R Schneider, Tej Singh, Larry Kraiss, Salvatore Scali, Apostolos Tassiopoulos, Andrew Hoel, Jack L Cronenwett
OBJECTIVE: Comparing costs between centers is difficult because of the heterogeneity of vascular procedures contained in broad diagnosis-related group (DRG) billing categories. The purpose of this pilot project was to develop a mechanism to merge Vascular Quality Initiative (VQI) clinical data with hospital billing data to allow more accurate cost and reimbursement comparison for endovascular aneurysm repair (EVAR) procedures across centers. METHODS: Eighteen VQI centers volunteered to submit UB04 billing data for 782 primary, elective infrarenal EVAR procedures performed by 108 surgeons in 2014...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502550/lower-extremity-computed-tomography-angiography-can-help-predict-technical-success-of-endovascular-revascularization-in-the-superficial-femoral-and-popliteal-artery
#9
Nathan K Itoga, Tanner Kim, Anna M Sailer, Dominik Fleischmann, Matthew W Mell
OBJECTIVE: Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. METHODS: Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502549/reimbursement-in-hospital-based-vascular-surgery-physician-and-practice-perspective
#10
Jennifer L Perri, Robert M Zwolak, Philip P Goodney, Gretchen A Rutherford, Richard J Powell
OBJECTIVE: The purpose of this study was to determine change in value of a vascular surgery division to the health care system during 6 years at a hospital-based academic practice and to compare physician vs hospital revenue earned during this period. METHODS: Total revenue generated by the vascular surgery service line at an academic medical center from 2010 through 2015 was evaluated. Total revenue was measured as the sum of physician (professional) and hospital (technical) net revenue for all vascular-related patient care...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502548/lifelong-limb-preservation-a-patient-centered-description-of-lower-extremity-arterial-reconstruction-outcomes
#11
Katie E Shean, Peter A Soden, Marc L Schermerhorn, Sara L Zettervall, Sarah E Deery, Jeremy D Darling, Allen Hamdan, Frank W LoGerfo
BACKGROUND: Life expectancy is short for patients with critical limb ischemia (CLI), many of whom may fear amputation more than death. In light of the reduced life expectancy of these patients, the traditional 5-year freedom from amputation (FFA) statistic may not accurately address their concern. We developed a more relevant patient-centered calculation of major amputation risk during a patient's remaining lifetime to better answer the question, Will I ever lose my leg? METHODS: We identified all limbs undergoing first-time intervention for CLI in a large institutional database from 2005 to 2013...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502547/carotid-artery-stenting-is-associated-with-a-higher-incidence-of-major-adverse-clinical-events-than-carotid-endarterectomy-in-female-patients
#12
Kyla M Bennett, John E Scarborough
BACKGROUND: The optimal approach to carotid revascularization in female patients with carotid artery stenosis is widely debated. Information available is largely derived from clinical trials that include only highly selected patients. The goal of this study was to compare the early clinical outcomes in women who undergo carotid artery stenting (CAS) vs carotid endarterectomy (CEA). METHODS: Female patients undergoing CAS or CEA between January 1, 2012 and December 31, 2015, and who were included in the Procedure Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for their incidence of early postoperative complications...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#13
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502545/durability-of-iliac-artery-preservation-associated-with-endovascular-repair-of-infrarenal-aortoiliac-aneurysms
#14
Behzad S Farivar, Mohammad N Abbasi, Agenor P Dias, Yuki Kuramochi, Corey S Brier, F Ezequiel Parodi, Matthew J Eagleton
OBJECTIVE: This study evaluated and compared the long-term clinical outcomes of endovascular repair of infrarenal aortoiliac aneurysms (EVAR) vs EVAR with preservation of antegrade internal iliac artery (IIA) perfusion using iliac branched devices (EVAR-IBDs). METHODS: From October 1998 to August 2015, patients with infrarenal aortoiliac aneurysmal (AIA) disease at high risk for conventional open surgery were enrolled in a prospective physician-sponsored investigational device exemption trial...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502544/first-experience-with-the-double-chimney-technique-in-the-treatment-of-aortic-arch-diseases
#15
Tun Wang, Chang Shu, Quan-Ming Li, Ming Li, Xin Li, Hao He, Alan Dardik, Jian Qiu
OBJECTIVE: The objective of this study was to summarize our initial experience using the double chimney technique to treat aortic arch diseases. METHODS: From December 2009 to October 2016, 23 patients with aortic arch diseases, including 20 acute aortic dissections, 2 aortic arch aneurysms, and 1 type I endoleak after thoracic endovascular aortic repair (TEVAR), were treated using a double chimney technique. An emergent operation was performed in only one patient with an acute aortic dissection for severe left lower extremity ischemia...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502543/the-association-of-carotid-revascularization-endarterectomy-versus-stent-trial-crest-and-centers-for-medicare-and-medicaid-services-carotid-guideline-publication-on-utilization-and-outcomes-of-carotid-stenting-among-high-risk-patients
#16
Gregory G Salzler, Alik Farber, Denis V Rybin, Gheorghe Doros, Jeffrey J Siracuse, Mohammad H Eslami
OBJECTIVE: Since the 2004 approval by the United States Food and Drug Administration of carotid artery stenting (CAS), there have been two seminal publications about CAS reimbursement (Centers for Medicare and Medicaid Services guidelines; 2008) and clinical outcomes (Carotid Revascularization Endarterectomy versus Stent Trial [CREST]; 2010). We explored the association between these publications and national trends in CAS use among high-risk symptomatic patients. METHODS: The most recent congruent data sets of the Nationwide Inpatient Sample (NIS) were queried for patients undergoing carotid revascularization...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502542/contemporary-evaluation-of-mortality-and-stroke-risk-after-thoracic-endovascular-aortic-repair
#17
Frances Y Hu, Zachary B Fang, Bradley G Leshnower, Yazan Duwayri, William D Jordan, Theresa W Gillespie, Ravi K Veeraswamy
OBJECTIVE: During the past decade, thoracic endovascular aortic repair (TEVAR) has increased as a treatment option for a variety of aortic pathologic processes. Despite this rise in the use of thoracic stent grafts, real-world outcomes from a robust, adjudicated, contemporary data set have yet to be reported. Previous studies have shown periprocedural mortality rates between 1.5% and 9.5% and procedure-related stroke rates of 2.3% to 8.2%. With advances in device engineering and increased experience of physicians, we hypothesized that the rates of these complications would be reduced in a more recent sample set...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502541/prolonged-stance-phase-during-walking-in-intermittent-claudication
#18
Lindy N M Gommans, Annemieke T Smid, Marc R M Scheltinga, Ernst Cancrinus, Frans A M Brooijmans, Kenneth Meijer, Joep A W Teijink
BACKGROUND: Patients with intermittent claudication (IC) tend to walk slower and consume approximately 40% more oxygen during walking compared with healthy individuals. An unfavorable locomotion pattern has been suggested to explain this metabolic inefficiency. However, detailed knowledge of gait parameters in IC is lacking. METHODS: In a cross-sectional study, the gait pattern of newly diagnosed IC patients was compared with that of healthy controls. Spatiotemporal gait parameters such as step length and duration of stance phase were obtained by a photoelectric technique (OptoGait; Microgate, Bolzano, Italy)...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502540/trends-and-outcomes-in-endovascular-and-open-surgical-treatment-of-visceral-aneurysms
#19
Jason A Chin, Adele Heib, Cassius I Ochoa Chaar, Jonathan A Cardella, Kristine C Orion, Timur P Sarac
OBJECTIVE: Visceral artery aneurysms (VAAs) are rare but often repaired because of dire consequences of rupture. This is a population-based evaluation of chronologic trends in management, risk factors, and outcomes of endovascular and open therapy. METHODS: The 2003 to 2013 Agency for Healthcare Research and Quality (AHRQ) National Inpatient Sample (NIS) database was reviewed. Cases with primary diagnosis of VAA and undergoing endovascular or open repair were identified...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502539/racial-differences-in-functional-decline-in-peripheral-artery-disease-and-associations-with-socioeconomic-status-and-education
#20
Mary M McDermott, Tamar S Polonsky, Melina R Kibbe, Lu Tian, Lihui Zhao, William H Pearce, Ying Gao, Jack M Guralnik
OBJECTIVE: The objective of this study was to determine whether blacks with lower extremity peripheral artery disease (PAD) have faster functional decline than whites with PAD. METHODS: Participants with ankle-brachial index <0.90 were identified from Chicago medical centers and observed longitudinally. Mobility impairment and the 6-minute walk were assessed at baseline and every 6 to 12 months. Mobility loss was defined as becoming unable to walk up and down a flight of stairs or to walk ¼ mile without assistance...
May 11, 2017: Journal of Vascular Surgery
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