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Journal of Vascular Surgery

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https://www.readbyqxmd.com/read/29784569/use-of-the-zenith-fenestrated-platform-to-rescue-failing-endovascular-and-open-aortic-reconstructions-is-safe-and-technically-feasible
#1
S Keisin Wang, Natalie A Drucker, Alan P Sawchuk, Gary W Lemmon, Michael C Dalsing, Raghu L Motaganahalli, Michael P Murphy, Andres Fajardo
OBJECTIVE: Proximal neck dilation is a serious long-term complication directly causing the failure of endovascular aneurysm repair (EVAR) and open surgical repair (OSR) of abdominal aortic aneurysms. However, the implantation of a fenestrated device presents the opportunity for proximal extension of the aortic reconstruction into a healthy segment while maintaining patency of the visceral vessels. The objective of this investigation was to report perioperative and follow-up outcomes using the Zenith Fenestrated (ZFEN; Cook Medical, Bloomington, Ind) aortic stent system in salvaging previous aortic repairs undergoing type IA endoleak or aneurysmal degeneration of the proximal neck...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29784568/assessment-of-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-using-the-national-surgical-quality-improvement-program-procedure-targeted-data-set
#2
Hanaa Dakour-Aridi, Nawar Z Paracha, Satinderjit Locham, Besma Nejim, Mahmoud B Malas
OBJECTIVE: Open aortic repair (OAR) is associated with higher risk of mortality compared with endovascular aneurysm repair (EVAR). The aim of this study was to compare failure to rescue (FTR) after major predischarge complications in patients undergoing OAR and EVAR. METHODS: Patients who underwent OAR or EVAR in the American College of Surgeons National Surgical Quality Improvement Program between 2011 and 2015 were selected. Patients with ruptured aneurysm and those with type IV thoracoabdominal aneurysms were excluded...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29784567/short-term-results-of-left-subclavian-artery-salvage-in-blunt-thoracic-aortic-injury-with-short-proximal-landing-zones
#3
Edvard Skripochnik, David Novikov, Thomas J Bilfinger, Shang A Loh
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) is the standard treatment of blunt thoracic aortic injury (BTAI). The concept of seal was derived from the treatment of aneurysms and has been adopted for BTAI. Given the location of injury in BTAI, left subclavian artery (LSA) coverage is sometimes necessary. In these often healthier aortas, a shorter proximal landing zone may be acceptable and beneficial in avoiding some complications. Current practice patterns vary, and long-term effects of LSA coverage remain unknown...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29784566/preoperative-point-of-care-ultrasound-and-its-impact-on-arteriovenous-fistula-maturation-outcomes
#4
Sajjid Hossain, Amit Sharma, Luc Dubois, Guy DeRose, Audra Duncan, Adam H Power
OBJECTIVE: Duplex ultrasound as a preoperative assessment tool in the clinic may help identify anatomic factors predictive of fistula maturation. Preoperative point-of-care ultrasound (POCUS) offers surgeons an alternative to routine formal vein mapping as it can be performed by the operator during the initial clinic visit. We sought to determine the impact of POCUS as an adjunct to physical examination on arteriovenous fistula maturation. METHODS: All consecutive patients undergoing first-time dialysis access creation from December 2007 to December 2014 were retrospectively reviewed...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29779962/implementation-of-drug-eluting-stents-for-the-treatment-of-femoropopliteal-disease-provides-significant-cost-to-system-savings-in-a-single-state-outpatient-simulation
#5
Natalie Domenick Sridharan, Nathan Liang, Darve Robinson, Efthymios Avgerinos, Edith Tzeng, Michel S Makaroun, Rabih A Chaer, Mohammad H Eslami
OBJECTIVES: Initial data on drug-eluting stents (DES) shows that they may increase the durability of endovascular treatment of superficial femoral artery disease compared with traditional bare metal stents (BMS). Observed decreased target lesion revascularization (TLR) rates have potential for cost savings despite an increased initial cost. The purpose of this study was to run a simulation model of progressive transition from BMS to DES over 5 years evaluating the overall cost impact of that transition...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29779961/patient-satisfaction-with-the-consent-discussion-is-not-improved-by-showing-patients-their-computed-tomography-or-angiography-images-before-they-undergo-vascular-surgery
#6
Dominic LeBlanc, Adam H Power, Guy DeRose, Audra Duncan, Luc Dubois
OBJECTIVE: Patient-based decision aids and other multimedia tools have been developed to help enrich the preoperative discussion between surgeon and patient. Use of these tools, however, can be time-consuming and logistically challenging. We investigated whether simply showing patients their images from preoperative computed tomography (CT) or angiography would improve patients' satisfaction with the preoperative discussion. We also examined whether this improved the patient's understanding and trust and whether it contributed to increased preoperative anxiety...
May 18, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29779960/comparison-of-hemodialysis-arteriovenous-fistula-blood-flow-rates-measured-by-doppler-ultrasound-and-phase-contrast-magnetic-resonance-imaging
#7
Yong He, Yan-Ting Shiu, Daniel B Pike, Prabir Roy-Chaudhury, Alfred K Cheung, Scott A Berceli
OBJECTIVE: The objective of this study was to compare blood flow rates measured by Doppler ultrasound (DUS) and phase-contrast magnetic resonance imaging (MRI) in patients having a hemodialysis arteriovenous fistula (AVF) and to identify scenarios in which there was significant discordance between these two approaches. METHODS: Blood flow rates in the proximal artery (PA) and draining vein (DV) of newly created upper extremity AVFs were measured and compared using DUS and phase-contrast MRI at 1 day, 6 weeks, and 6 months postoperatively...
May 17, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29773432/best-medical-treatment-alone-may-not-be-adequate-for-all-patients-with-asymptomatic-carotid-artery-stenosis
#8
Kosmas I Paraskevas, Frank J Veith, Jean-Baptiste Ricco
No abstract text is available yet for this article.
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#9
Graham W Donald, Amir A Ghaffarian, Farid Isaac, Larry W Kraiss, Claire L Griffin, Brigitte K Smith, Mark R Sarfati, Julie L Beckstrom, Benjamin S Brooke
OBJECTIVE: Frailty, a clinical syndrome associated with loss of metabolic reserves, is prevalent among patients who present to vascular surgery clinics for evaluation. The Clinical Frailty Scale (CFS) is a rapid assessment method shown to be highly specific for identifying frail patients. In this study, we sought to evaluate whether the preoperative CFS score could be used to predict loss of independence after major vascular procedures. METHODS: We identified all patients living independently at home who were prospectively assessed using the CFS before undergoing an elective major vascular surgery procedure (admitted for >24 hours) at an academic medical center between December 2015 and December 2017...
May 14, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29753581/preoperative-risk-score-for-the-prediction-of-mortality-after-repair-of-ruptured-abdominal-aortic-aneurysms
#10
Brandon T Garland, Patrick J Danaher, Sarasi Desikan, Nam T Tran, Elina Quiroga, Niten Singh, Benjamin W Starnes
OBJECTIVE: Even in the ruptured endovascular aneurysm repair first era, there are still patients who will not survive their ruptured abdominal aortic aneurysm (rAAA). All previously published mortality risk scores include intraoperative variables and are not helpful with the decision to operate or in providing preoperative patient and family counseling. The purpose of this study was to develop a practical preoperative risk score to predict mortality after repair of rAAA. METHODS: Data of all patients with rAAA presenting between January 1, 2002, and October 31, 2013, were collected...
May 9, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29753580/acceleration-of-diabetic-wound-healing-with-adipose-derived-stem-cells-endothelial-differentiated-stem-cells-and-topical-conditioned-medium-therapy-in-a-swine-model
#11
Robin F Irons, Kevin W Cahill, Deviney A Rattigan, Joseph H Marcotte, Marc W Fromer, Shaohua Chang, Ping Zhang, Eric M Behling, Kathryn C Behling, Francis J Caputo
OBJECTIVE: The purpose of our study was to investigate the effect of adipose-derived stem cells (ASCs), endothelial-differentiated ASCs (EC/ASCs), and various conditioned media (CM) on wound healing in a diabetic swine model. We hypothesized that ASC-based therapies would accelerate wound healing. METHODS: Diabetes was induced in four Yorkshire swine through intravenous injection of streptozotocin. ASCs were harvested from flank fat and cultured in either M199 or EGM-2 medium...
May 9, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29748101/results-from-the-study-to-assess-outcomes-after-endovascular-repair-for-multiple-thoracic-aortic-diseases-summit
#12
Nikolaos Tsilimparis, Sebastian Debus, Min Chen, Qing Zhou, Mary-Margaret Seale, Tilo Kölbel
OBJECTIVE: Thoracic endovascular aortic repair (TEVAR) is currently the treatment of choice for most diseases of the descending thoracic aorta. Using data from the Study to Assess Outcomes After Endovascular Repair for Multiple Thoracic Aortic Diseases (SUMMIT) study we investigated the outcomes of TEVAR for different aortic diseases and risk factors associated with the outcomes. METHODS: The SUMMIT study included aggregated data of 521 TEVAR patients from five Cook-sponsored multicenter trials evaluating thoracic endografts of the Zenith platform (William Cook Europe, ApS, Bjaeverskov, Denmark)...
May 7, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29735302/a-physician-led-initiative-to-improve-clinical-documentation-results-in-improved-health-care-documentation-case-mix-index-and-increased-contribution-margin
#13
Francesco A Aiello, Dejah R Judelson, Jonathan M Durgin, Danielle R Doucet, Jessica P Simons, Dawn M Durocher, Julie M Flahive, Andres Schanzer
INTRODUCTION: Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin...
May 4, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29706473/procedural-and-perioperative-results-in-patients-treated-with-fenestrated-endovascular-aneurysm-repair-planned-by-automated-software-in-a-physician-sponsored-investigational-device-exemption-trial-of-physician-modified-endografts
#14
Benjamin W Starnes, Billi Tatum, Niten Singh
OBJECTIVE: Fenestrated endovascular aneurysm repair (FEVAR) has been used successfully to treat patients with juxtarenal abdominal aortic aneurysms (JAAAs). Barriers to wide adoption of FEVAR include complexity in planning of fenestration locations on endografts. The purpose of this study was to validate the use of automated planning software to design fenestrated endografts and to treat patients with complex abdominal aortic aneurysms. METHODS: Patients with JAAA who were not candidates for open repair were enrolled into the automated planning arm of an ongoing investigational device exemption clinical trial and treated with FEVAR...
April 26, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29705087/long-term-outcomes-after-repair-of-symptomatic-abdominal-aortic-aneurysms
#15
Venita Chandra, Karen Trang, Whitt Virgin-Downey, Ronald L Dalman, Matthew W Mell
OBJECTIVES: Previous studies have reported increased perioperative mortality of nonruptured symptomatic abdominal aortic aneurysms (Sx-AAA) compared with asymptomatic elective AAA (E-AAA) repairs, but no long-term-outcomes have been reported. We sought to compare long-term outcomes of Sx-AAA and E-AAA after repair at a single academic institution. METHODS: Patients receiving AAA repair for Sx-AAA and E-AAA from 1995 through 2015 were included. Ruptured AAA and suprarenal or thoracoabdominal AAA were excluded...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29705086/transaxillary-decompression-of-thoracic-outlet-syndrome-patients-presenting-with-cervical-ribs
#16
Hugh A Gelabert, David A Rigberg, Jessica B O'Connell, Sinan Jabori, Juan Carlos Jimenez, Steven Farley
OBJECTIVE: The transaxillary approach to thoracic outlet decompression in the presence of cervical ribs offers the advantage of less manipulation of the brachial plexus and associated nerves. This may result in reduced incidence of perioperative complications, such as nerve injuries. Our objective was to report contemporary data for a series of patients with thoracic outlet syndrome (TOS) and cervical ribs managed through a transaxillary approach. METHODS: We reviewed a prospectively maintained database for all consecutive patients who underwent surgery for TOS and who had a cervical rib...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29705085/interobserver-and-intraobserver-variability-in-measuring-the-tortuosity-of-the-thoracic-aorta-on-computed-tomography
#17
Chun-Ku Chen, Hsiao-Ping Chou, Chao-Yu Guo, Hsiao-Ting Chang, Ying-Yueh Chang, I-Ming Chen, Mei-Han Wu, Chun-Che Shih
OBJECTIVE: The variability in measuring the tortuosity of the thoracic aorta has not been previously studied. This study evaluated the interobserver and intraobserver variability of major methods used for measuring the tortuosity of the thoracic aorta in patients with aortic arch or descending thoracic aortic aneurysm. METHODS: This retrospective study enrolled 66 patients with aortic arch or descending thoracic aortic aneurysm who had undergone thoracic endovascular aortic repair...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29691099/influence-of-aortic-neck-characteristics-on-successful-aortic-wall-penetration-of-endoanchors-in-therapeutic-use-during-endovascular-aneurysm-repair
#18
Seline R Goudeketting, Kim van Noort, Kenneth Ouriel, William D Jordan, Jean M Panneton, Cornelis H Slump, Jean-Paul P M de Vries
OBJECTIVE: This study sought to quantify EndoAnchor (Medtronic Vascular, Santa Rosa, Calif) penetration into the aortic wall in patients undergoing endovascular abdominal aortic aneurysm repair and to assess predictors of successful penetration and its relationship to postprocedural type IA endoleak. METHODS: A subset of patients from the Aneurysm Treatment Using the Heli-FX Aortic Securement System Global Registry (ANCHOR) were included if they met the following criteria: the indication for EndoAnchor use was to treat a type IA endoleak, and postprocedure contrast-enhanced computed tomography (CT) scans of sufficient quality were available for core laboratory review...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29691098/improved-patency-after-axillofemoral-bypass-for-aortoiliac-occlusive-disease
#19
Russell H Samson, David P Showalter, Michael R Lepore, Deepak G Nair, Douglas A Dorsay, Ricardo E Morales
OBJECTIVE: Axillofemoral bypasses (AxFBs) have been used since 1962 to treat aortoiliac disease. In the past, reported patency rates (37%-76%) for these extra-anatomic grafts have been inferior to those for anatomic aortic grafting. Reported low survival rates after AxFB (40%-50%) have confirmed that these procedures have been used primarily in patients at high risk for complications from aortofemoral bypass. However, modern medical and anesthesia management, preoperative scanning, donor artery preparation, postoperative graft surveillance, and graft technology may improve outcomes after AxFB, possibly supporting expansion of its use...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29685516/retroperitoneal-hematoma-volume-is-a-good-predictor-of-perioperative-mortality-after-endovascular-aneurysm-repair-for-ruptured-abdominal-aortic-aneurysm
#20
Naoki Fujimura, Mitsuyoshi Takahara, Naoko Isogai, Hideki Yashiro, Shintaro Shibutani, Masanori Inoue, Hideaki Obara, Hidemitsu Ogino
OBJECTIVE: The objective of this study was to validate the usefulness of retroperitoneal hematoma volume as a predictor of perioperative mortality after endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA). METHODS: We retrospectively reviewed consecutive patients with rAAA who underwent the unified EVAR first protocol between 2012 and 2016 at any one of three participating institutions in Japan and were prospectively registered in a dedicated database...
April 20, 2018: Journal of Vascular Surgery
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