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Journal of Vascular Surgery

Melissa L Kirkwood, Gary M Arbique, Jeffrey B Guild, Katie Zeng, Yin Xi, John Rectenwald, Jon A Anderson, Carlos Timaran
OBJECTIVE: Radiation to the interventionalist's brain during fluoroscopically guided interventions (FGIs) may increase the incidence of cerebral neoplasms. Lead equivalent surgical caps claim to reduce radiation brain doses by 50% to 95%. We sought to determine the efficacy of the RADPAD (Worldwide Innovations & Technologies, Lenexa, Kan) No Brainer surgical cap (0.06 mm lead equivalent at 90 kVp) in reducing radiation dose to the surgeon's and trainee's head during FGIs and to a phantom to determine relative brain dose reductions...
March 12, 2018: Journal of Vascular Surgery
Hanfei Tang, Xiao Tang, Weiguo Fu, Jianjun Luo, Zhenyu Shi, Lixin Wang, Fei Liu, Daqiao Guo
OBJECTIVE: Coil embolization is one of the most common endovascular approaches to treatment of renal artery aneurysms (RAAs). The purpose of this retrospective study was to compare complications, mortality, and morbidity associated with sac packing, coil trapping, and inflow occlusion. METHODS: The records of all patients with RAAs treated with coil embolization at our center from June 2003 to May 2017 were retrospectively reviewed. Demographics of the patients, aneurysm characteristics, management strategies, perioperative and long-term outcomes, and complications were analyzed...
March 12, 2018: Journal of Vascular Surgery
Gang Fang, Bin Chen, Weiguo Fu, Daqiao Guo, Xin Xu, Junhao Jiang, Jianjun Luo, Zhihui Dong
OBJECTIVE: Endovascular treatment (ET) is being increasingly used for splenic artery aneurysms (SAAs), but systematic treatment strategies have not been defined. We set out to investigate the optimal strategies for ET of complicated SAAs (CSAAs). METHODS: CSAAs were classified into three types: type I, rupture or impending rupture; type II, at the origin of the splenic artery; and type III, having an aberrant splenic artery from the splenomesenteric trunk (type IIIA) or celiacomesenteric trunk (type IIIB)...
March 9, 2018: Journal of Vascular Surgery
Miriam Elisabeth Uhlmann, Corinna Walter, Fadi Taher, Markus Plimon, Jürgen Falkensammer, Afshin Assadian
OBJECTIVE: Because of its minimally invasive nature, percutaneous femoral access for endovascular aneurysm repair (pEVAR) is currently undergoing rapid popularization. Compared with surgical cutdown for femoral access (cEVAR), it offers the advantage of faster recovery after surgery as well as a reduction in wound complications. Despite proposed advantages, the method is largely considered uneconomical because of its reliance on costly closure devices. METHODS: There were 50 patients undergoing EVAR who were enrolled in this randomized prospective single-center trial...
March 8, 2018: Journal of Vascular Surgery
Charles S Briggs, Joshua A Sibille, Halim Yammine, Jocelyn K Ballast, William Anderson, Tzvi Nussbaum, Timothy S Roush, Frank R Arko
OBJECTIVE: Endovascular aneurysm repair (EVAR) has been shown to reduce mortality in the emergent repair of ruptured abdominal aortic aneurysms (AAAs). However, long-term survival data for this group of patients are lacking with contemporary endovascular endografts. The purpose of this study was to evaluate both 30-day mortality rates and 1-year survival in patients undergoing emergent EVAR in a 43-facility hospital system with a quaternary referral center with an established ruptured aneurysm protocol...
March 8, 2018: Journal of Vascular Surgery
Amir A Ghaffarian, Ragheed Al-Dulaimi, Larry W Kraiss, Mark Sarfati, Claire L Griffin, Brigitte K Smith, Graham Donald, Benjamin S Brooke
OBJECTIVE: Arteriovenous (AV) fistulas are the preferred hemodialysis access for patients with end-stage renal disease, although multiple interventions are typically needed to maintain patency. When AV fistulas thrombose, however, there is debate as to whether open thrombectomy should be attempted, particularly for salvage of upper arm fistulas. This study was designed to evaluate outcomes after open thrombectomy of upper arm and forearm AV fistulas compared with AV grafts. METHODS: We identified all patients who underwent an open thrombectomy procedure for a thrombosed AV fistula or graft at a single academic medical center between January 2006 and March 2017...
March 8, 2018: Journal of Vascular Surgery
Thomas S Maldonado, Nilo J Mosquera, Peter Lin, Raffaello Bellosta, Michael Barfield, Albeir Moussa, Robert Rhee, Marc Schermerhorn, Jeffrey Weinberger, Marald Wikkeling, Jan Heyligers, Frank J Veith, Ross Milner, Michel P J Reijnen
OBJECTIVE: The Gore Iliac Branch Endoprosthesis (IBE; W. L. Gore & Associates, Flagstaff, Ariz) has recently been approved by the Food and Drug Administration for treatment of common iliac artery (CIA) aneurysms. Despite early excellent results in clinical trial, none of 63 patients were treated for bilateral iliac aneurysms. The goal of this study was to examine real-world experience using the Gore IBE for bilateral CIA aneurysms. METHODS: A retrospective review of an international multicenter (16 U...
March 8, 2018: Journal of Vascular Surgery
Ali Kordzadeh, Alan Askari, Yiannis Panayiotopoulos
OBJECTIVE: It has been hypothesized that a novel measurement technique of arteriovenous ratio (AVR) index obtained from inflow (radial artery diameter) to that of outflow (cephalic vein diameter) and its application through the Bernoulli effect has no impact on the primary functional maturation (FM) of autogenous radiocephalic arteriovenous fistula (RCAVF). METHODS: A prospective consecutive single-center cohort study with intention to treat of 324 patients undergoing RCAVF during a period of 4 years was conducted...
March 8, 2018: Journal of Vascular Surgery
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
OBJECTIVE: Tibial interventions for critical limb ischemia are now commonplace. Restenosis and occlusion remain barriers to durability after intervention. The aim of this study was to examine the patient-centered outcomes of open and endovascular reintervention for symptomatic recurrent disease after a primary isolated tibial endovascular intervention. METHODS: A database of patients undergoing isolated primary lower extremity tibial endovascular interventions between 2006 and 2016 was retrospectively queried...
March 8, 2018: Journal of Vascular Surgery
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March 8, 2018: Journal of Vascular Surgery
Smita Kaushik, Warren J Gasper, Bala Ramanan, Shant M Vartanian, Linda M Reilly, Timothy A M Chuter, Jade S Hiramoto
OBJECTIVE: The purpose of this study was to evaluate the impact of prior aortic surgery on outcomes after multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal aortic aneurysms (TAAAs) and pararenal aortic aneurysms (PRAAs). METHODS: From July 2005 to October 2016, there were 153 patients who underwent elective endovascular repair of TAAA and PRAA using multibranched stent grafts. Data on demographics, procedural details, and outcomes were collected prospectively...
March 6, 2018: Journal of Vascular Surgery
Shernaz S Dossabhoy, Jessica P Simons, Kyle R Diamond, Julie M Flahive, Francesco A Aiello, Edward J Arous, Louis M Messina, Andres Schanzer
OBJECTIVE: Reinterventions after fenestrated or branched endovascular aneurysm repair (F/B-EVAR) are sometimes necessary to maintain aneurysm exclusion or endograft and target artery patency. These reinterventions are nontrivial, potentially associated with morbidity, mortality, and resource utilization. Whereas rates, types, and outcomes of reintervention after infrarenal EVAR have been well described, they have not been well described for F/B-EVAR. We sought to characterize the morbidity, mortality, and resource utilization due to reinterventions after F/B-EVAR...
March 6, 2018: Journal of Vascular Surgery
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
Louisa J D van Dijk, Leon M G Moons, Desirée van Noord, Adriaan Moelker, Hence J M Verhagen, Marco J Bruno, Ellen V Rouwet
OBJECTIVE: An isolated stenosis of the celiac artery (CA) or the superior mesenteric artery (SMA) is frequently detected in patients with abdominal complaints. The dilemma is whether these patients suffer from chronic mesenteric ischemia (CMI) and whether they will benefit from revascularization. We evaluated the long-term clinical success rates for single CA or SMA revascularization in patients with gastrointestinal symptoms and confirmed mucosal ischemia. METHODS: This was a retrospective cohort analysis of 59 consecutive patients with gastrointestinal symptoms and a single atherosclerotic mesenteric artery stenosis who were referred to our tertiary care institution between 2006 and 2010 for standardized diagnostic workup of CMI, including measurement of mucosal ischemia with visible light spectroscopy or gastric-jejunal tonometry...
March 6, 2018: Journal of Vascular Surgery
Dale G Wilson, Sheena K Harris, Chandler Barton, Jeffrey D Crawford, Amir F Azarbal, Enjae Jung, Erica L Mitchell, Gregory J Landry, Gregory L Moneta
OBJECTIVE: The ankle-brachial index (ABI) is a well-established measure of distal perfusion in lower extremity ischemia; however, the ABI is of limited value in patients with noncompressible lower extremity arteries. We sought to demonstrate whether duplex ultrasound-determined tibial artery velocities can be used as an alternative to ABI as an objective performance measure after endovascular treatment of above-knee arterial stenosis. METHODS: Thirty-six patients undergoing above-knee endovascular intervention had preprocedure and postprocedure duplex ultrasound examination within 6 months of intervention...
March 6, 2018: Journal of Vascular Surgery
Raphaël Coscas, Sebastien Dupont, Sacha Mussot, Liliane Louedec, Harry Etienne, Marion Morvan, Gilles Chiocchia, Ziad Massy, Marie-Paule Jacob, Jean-Baptiste Michel
BACKGROUND: Recent evidence suggests that adaptive immunity develops during abdominal aortic aneurysm evolution. Uncertainties remain about the antigens implicated and their role in inducing rupture. Because antigens from the extracellular matrix (ECM) have been suspected, the aim of this experimental study was to characterize the role of adaptive immunity directed against antigens from the aortic ECM. METHODS: In a first step, an experimental model of abdominal aortic aneurysm rupture based on adaptive immunity against the ECM was developed and characterized...
March 5, 2018: Journal of Vascular Surgery
Jesse Manunga, Timothy Sullivan, Ross Garberich, Peter Alden, Jason Alexander, Nedaa Skeik, Jessica Titus, Elliott Stephenson, Andrew Cragg
OBJECTIVE: The objective of this study was to evaluate outcomes of patients with complex abdominal aortic aneurysms (cAAAs) treated with open repair (OR) or fenestrated/branched endovascular aneurysm repair (F/B-EVAR) from a single center. METHODS: A retrospective analysis of consecutive patients with cAAAs treated electively by OR or F/B-EVAR between January 2010 and February 2017 was conducted. Demographics of the patients, cardiovascular risk factors, procedure time, number of vessels incorporated, radiation dose, estimated blood loss, intensive care unit (ICU) length of stay (LOS), and hospital LOS were recorded...
March 3, 2018: Journal of Vascular Surgery
Kelli L Hicks, Peter H Byers, Elina Quiroga, Melanie G Pepin, Sherene Shalhub
OBJECTIVE: The contemporary practice of testing for genetically triggered aortic and arterial aneurysms and dissections is not well described. This study aimed to describe this practice at a tertiary care academic center and to ascertain the yield of testing in establishing the diagnosis in patients referred on the basis of clinical suspicion. METHODS: This is a retrospective cohort study of patients referred for vascular genetic testing at an academic medical center between 2010 and 2015...
March 3, 2018: Journal of Vascular Surgery
Corey A Kalbaugh, Nicole Jadue Gonzalez, Daniel J Luckett, Jason Fine, Thomas E Brothers, Mark A Farber, Adam W Beck, John W Hallett, William A Marston, Raghuveer Vallabhaneni
OBJECTIVE: Although smoking cessation is a benchmark of medical management of intermittent claudication, many patients require further revascularization. Currently, revascularization among smokers is a controversial topic, and practice patterns differ institutionally, regionally, and nationally. Patients who smoke at the time of revascularization are thought to have a poor prognosis, but data on this topic are limited. The purpose of this study was to evaluate the impact of smoking on outcomes after infrainguinal bypass for claudication...
March 2, 2018: Journal of Vascular Surgery
Bindu Kalesan, Thomas W Cheng, Alik Farber, Yi Zuo, Jeffrey A Kalish, Douglas W Jones, Jeffrey J Siracuse
OBJECTIVE: The care of patients undergoing thoracic endovascular aortic repair (TEVAR) can be resource intensive, which can be driven by readmissions. Our objective was to characterize index readmissions at 30, 90, and 180 days after TEVAR. METHODS: A retrospective analysis of the Nationwide Readmissions Database was performed for patients who underwent TEVAR in 2013. Multivariable analysis identified independent predictors for index readmission at 30, 90, and 180 days...
March 2, 2018: Journal of Vascular Surgery
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