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Journal of Vascular Surgery

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https://www.readbyqxmd.com/read/27889286/computational-fluid-analysis-of-symptomatic-chronic-type-b-aortic-dissections-managed-with-the-streamliner-multilayer-flow-modulator
#1
Florian Stefanov, Sherif Sultan, Liam Morris, Ala Elhelali, Edel P Kavanagh, Violet Lundon, Mohamed Sultan, Niamh Hynes
OBJECTIVE: Managing symptomatic chronic type B aortic dissection (SCTBAD) by the Streamliner Multilayer Flow Modulator (SMFM) stent (Cardiatis, Isnes, Belgium) is akin to provisional structural support to induce complete attachment of the dissection flap, but with the ability of aortic remolding. This study investigated the SMFM's capability to enact healing of SCTBAD. METHODS: Clinical data for 12 cases comprising preoperative and postoperative treatment of SCTBAD were obtained from a multicenter database hosted by the Multilayer Flow Modulator Global Registry, Ireland...
November 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27889285/aberrant-left-vertebral-artery-transposition-and-concomitant-carotid-subclavian-bypass-for-treatment-of-acute-intramural-hematoma-with-thoracic-endovascular-aortic-repair
#2
Sheila N Blumberg, Mark A Adelman, Thomas S Maldonado
Aberrant left vertebral artery (LVA) origin off the aortic arch is an uncommon anatomic variant. Treatment of the thoracic aortic pathology that necessitates its coverage has not been described. We present a patient with an acute intramural hematoma with a dominant LVA originating from the aortic arch. A LVA-to-carotid artery transposition with shunt placement, carotid-to-subclavian bypass, and thoracic endovascular aortic repair were performed. The patient recovered uneventfully, without any evidence of stroke...
November 23, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887858/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-diabetic-wound-healing
#3
Nasibeh Vatankhah, Younes Jahangiri, Gregory J Landry, Robert B McLafferty, Nabil J Alkayed, Gregory L Moneta, Amir F Azarbal
OBJECTIVE: The neutrophil-to-lymphocyte ratio (NLR) has been used as a surrogate marker of systemic inflammation. We sought to investigate the association between NLR and wound healing in diabetic wounds. METHODS: The outcomes of 120 diabetic foot ulcers in 101 patients referred from August 2011 to December 2014 were examined retrospectively. Demographic, patient-specific, and wound-specific variables as well as NLR at baseline visit were assessed. Outcomes were classified as ulcer healing, minor amputation, major amputation, and chronic ulcer...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887857/a-potential-contribution-of-dipeptidyl-peptidase-4-by-the-mediation-of-monocyte-differentiation-in-the-development-and-progression-of-abdominal-aortic-aneurysms
#4
Hsin-Ying Lu, Chun-Yao Huang, Chun-Ming Shih, Yi-Wen Lin, Chein-Sung Tsai, Feng-Yen Lin, Chun-Che Shih
OBJECTIVE: Abdominal aortic aneurysms (AAAs) are characterized by the destruction of elastin and collagen in the media and adventitia. Dipeptidyl peptidase-4 (DPP-4, an adipokine known as CD26) influences cell signaling, cell-matrix interactions, and the regulation of the functional activity of incretins in metabolic and inflammatory disorders. Although the role of DPP-4 in AAA evolution has been demonstrated, the underlying mechanisms of DPP-4-regulated AAA development remains unknown...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887856/preoperative-thoracic-false-lumen-branches-relate-to-aortic-remodeling-after-thoracic-endovascular-aortic-repair-for-debakey-iiib-aortic-dissection
#5
Yang Yang Ge, Wei Guo, Nick Cheshire, Xiao Ping Liu, Xin Jia, Jiang Xiong, Xiao Hui Ma, Hong Peng Zhang
OBJECTIVE: This study evaluated the association between thoracic false lumen branches (TFLBs; dissected thoracic branches fed by a false lumen) and distal thoracic aortic enlargement (DTAE) after thoracic endovascular aortic repair (TEVAR) for DeBakey IIIb aortic dissection. METHODS: We retrospectively analyzed the records of 67 patients with DeBakey IIIb dissection initially treated with TEVAR between January 2011 and December 2013. Preoperative and postoperative computed tomography angiography images were reviewed to evaluate the number of preoperative TFLBs and aortic diameter change after TEVAR...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887855/regional-anesthesia-as-the-anesthetic-of-choice-for-high-risk-surgical-patients-undergoing-repair-of-juxtarenal-aortic-aneurysms-with-fenestrated-stent-grafts
#6
Jesse Manunga, Jessica Titus
Juxtarenal aortic aneurysms (JAAs) have been conventionally treated using open repair with excellent results. Recent approval of fenestrated stent grafts by the United States Food and Drug Administration has given patients with JAAs an alternative for repair. However, most of these procedures are still performed under general anesthesia, making some surgeons reluctant to offer repair to a subset of patients deemed too high risk for general anesthesia. We present three patients with JAAs at high surgical risk, including one patient with a ruptured aneurysm, who were successfully treated using a fenestrated stent graft under regional anesthesia...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887854/significant-regional-variation-exists-in-morbidity-and-mortality-after-repair-of-abdominal-aortic-aneurysm
#7
Sara L Zettervall, Peter A Soden, Dominique B Buck, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs. METHODS: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014. Ruptured and intact aneurysms were evaluated separately, and the analysis of intact aneurysms was limited to infrarenal AAAs...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27887853/the-value-of-endografts-in-the-surgical-management-of-arterial-lesions-secondary-to-beh%C3%A3-et-disease
#8
Henghui Yin, Songqi Li, Mian Wang, Zuojun Hu, Jinsong Wang, Chen Yao, Guangqi Chang, Shenming Wang
BACKGROUND: This study summarizes our experience in the surgical management of arterial lesions secondary to Behçet disease (BD) and assesses the value of endografts. METHODS: Data from BD patients with arterial lesions managed surgically in our center from January 1998 to December 2015 were studied retrospectively. Surgical procedures, graft selection, graft-related complications, and retreatments were analyzed. RESULTS: We recruited 33 patients (29 men and 4 women; male-to-female ratio, 7...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876524/lower-extremity-weakness-is-associated-with-elevated-blood-and-cerebrospinal-fluid-glucose-levels-following-multibranched-endovascular-aortic-aneurysm-repair
#9
Jade S Hiramoto, Charlene Fernandez, Warren Gasper, Shant Vartanian, Linda Reilly, Timothy Chuter
OBJECTIVE: Hyperglycemia is associated with worsened clinical outcomes after central nervous system injury. The purpose of this study was to examine the association between lower extremity weakness (LEW) and the glucose levels of blood and cerebrospinal fluid (CSF) in patients undergoing multibranched endovascular aneurysm repair (MBEVAR) of thoracoabdominal and pararenal aortic aneurysms. METHODS: Blood and CSF samples were collected preoperatively, immediately after aneurysm repair, and on postoperative day 1 in 21 patients undergoing MBEVAR...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876523/quality-of-life-assessment-as-an-outcomes-measure-in-critical-limb-ischemia
#10
Olamide Alabi, Matthew Roos, Gregory Landry, Gregory Moneta
Critical limb ischemia (CLI) is a diagnosis plagued by significant comorbidity and high mortality rates. Overall survival remains poor in this population regardless of the procedure-related success as demonstrated by freedom from amputation, intervention, and patency. The literature has traditionally focused on physician-centered and lesion-centered outcomes with regards to limb salvage procedures, but there remains a relative paucity of studies of CLI patients describing patient-centered outcomes such as quality of life (QoL), independent living, and ambulation status...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876522/relative-value-unit-based-compensation-incentivization-in-an-academic-vascular-practice-improves-productivity-with-no-early-adverse-impact-on-quality
#11
Nadia Awad, Francis J Caputo, Jeffrey P Carpenter, James B Alexander, José L Trani, Joseph V Lombardi
OBJECTIVE: Given the increased pressure from governmental programs to restructure reimbursements to reflect quality metrics achieved by physicians, review of current reimbursement schemes is necessary to ensure sustainability of the physician's performance while maintaining and ultimately improving patient outcomes. This study reviewed the impact of reimbursement incentives on evidence-based care outcomes within a vascular surgical program at an academic tertiary care center. METHODS: Data for patients with a confirmed 30-day follow-up for the vascular surgery subset of our institution's National Surgical Quality Improvement Program submission for the years 2013 and 2014 were reviewed...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876521/increased-risk-of-renal-dysfunction-with-percutaneous-mechanical-thrombectomy-compared-with-catheter-directed-thrombolysis
#12
Katherine L Morrow, Ann H Kim, Steven A Plato, Andrew J Shevitz, Jerry Goldstone, Henry Baele, Vikram S Kashyap
OBJECTIVE: Percutaneous mechanical thrombectomy (PMT) is regularly used in the treatment of both venous and arterial thrombosis. Although there has been no formal report, PMT has been linked to cases of reversible postoperative acute kidney injury (AKI). The purpose of this study is to evaluate the risk of renal dysfunction in patients undergoing PMT vs catheter-directed thrombolysis (CDT) for treatment of an acute thrombus. METHODS: This study is a retrospective review of all patients in a single institution with a Current Procedural Terminology code for PMT or CDT from January 2009 through December 2014...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876520/explaining-endograft-shortening-during-endovascular-repair-of-abdominal-aortic-aneurysms-in-severe-aortoiliac-tortuosity
#13
Kevin Lee, Sajjid Hossain, Maher Sabalbal, Luc Dubois, Audra Duncan, Guy DeRose, Adam H Power
OBJECTIVE: During endovascular aneurysm repair (EVAR), severely tortuous aortoiliac anatomy can alter the deployment and conformability of the endograft. The accuracy of treatment length measurements is commonly recognized to be affected by severe tortuosity. However, the exact mechanism of the postintervention length discrepancy is poorly understood. The objective of this study was to determine the mechanism of how severe aortoiliac tortuosity influences the endograft and native aorta during EVAR and its impact on the distal sealing zone...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876519/the-effect-of-body-mass-index-on-major-outcomes-after-vascular-surgery
#14
REVIEW
George Galyfos, Georgios I Geropapas, Stavros Kerasidis, Argiri Sianou, Fragiska Sigala, Konstantinos Filis
OBJECTIVE: Obesity has been associated with an increased risk for cardiovascular morbidity and mortality, although pooled evidence in patients undergoing vascular surgery are lacking. The aim of this systematic review was to evaluate the effect of body mass index (BMI) on major postoperative outcomes in patients undergoing vascular surgery. METHODS: A systematic literature review conforming to established criteria to identify eligible articles published before May 2016 was conducted...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876518/an-update-on-the-role-of-proximal-occlusion-devices-in-carotid-artery-stenting
#15
Daniel S Kassavin, Daniel G Clair
Carotid artery stenting performed with distal embolic protection devices continues to show elevated rates of periprocedural stroke, in particular with high-risk groups. This article discusses the factors associated with protection devices that may contribute to this complication, performs a literature review to assess outcomes of carotid stenting with proximal occlusion devices, and assesses the role of proximal occlusion devices in the management of patients with carotid artery stenosis.
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876517/clinical-effects-of-single-or-double-tibial-artery-revascularization-in-critical-limb-ischemia-patients-with-tissue-loss
#16
Norihiro Kobayashi, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Hideyuki Takimura, Yasunari Sakamoto, Shinsuke Mori, Yoshiaki Ito
OBJECTIVE: The achievement of single vessel inflow to the wound is an acceptable end point of peripheral vascular intervention for patients with critical limb ischemia (CLI) with tissue loss. However, CLI patients often have multitibial artery lesions. We evaluated the clinical effects of single or double tibial artery revascularization for CLI patients. METHODS: This study was conducted retrospectively in a single center. Between April 2007 and January 2015, we treated 123 CLI patients (137 limbs) who had lesions in both the anterior tibial artery and the posterior tibial artery...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876516/predictors-of-aortic-growth-in-uncomplicated-type-b-aortic-dissection-from-the-acute-dissection-stent-grafting-or-best-medical-treatment-adsorb-database
#17
Arnoud V Kamman, Jan Brunkwall, Eric L Verhoeven, Robin H Heijmen, Santi Trimarchi
BACKGROUND: The high-risk patient cohort of uncomplicated type B aortic dissections (uTBADs) needs to be clarified. We compared uTBAD patients treated with best medical treatment (BMT), with and without aortic growth, from the Acute Dissection Stent Grafting or Best Medical Treatment (ADSORB) trial database. Furthermore, we looked for trends in outcome for aortic growth and remodeling after BMT and thoracic endovascular aortic repair (TEVAR) and BMT (TEVAR+BMT). METHODS: BMT patients with available baseline and a 1-year follow-up arterial computed tomography scan were identified...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27865639/a-network-meta-analysis-of-randomized-controlled-trials-comparing-treatment-modalities-for-de-novo-superficial-femoral-artery-occlusive-lesions
#18
REVIEW
Constantine N Antonopoulos, Spyridon N Mylonas, Konstantinos G Moulakakis, Theodoros N Sergentanis, George S Sfyroeras, Andreas M Lazaris, John D Kakisis, Spyros N Vasdekis
BACKGROUND: Treatment of superficial femoral artery (SFA) lesions remains challenging. We conducted a network meta-analysis of randomized controlled trials aiming to explore the efficacy of treatment modalities for SFA "de novo" lesions. METHODS: Eleven treatments for SFA occlusive disease were recognized. We used primary patency and binary restenosis at 12-month follow-up as proxies of efficacy for the treatment of SFA lesions. RESULTS: A total of 33 studies (66 study arms; 4659 patients) were deemed eligible...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27865638/incidence-and-clinical-outcomes-of-the-slow-flow-phenomenon-after-infrapopliteal-balloon-angioplasty
#19
Takahiro Tokuda, Keisuke Hirano, Yasunari Sakamoto, Hideyuki Takimura, Norihiro Kobayashi, Motoharu Araki, Masahiro Yamawaki, Yoshiaki Ito
OBJECTIVE: This study investigated the incidence and clinical relevance of the slow-flow phenomenon after infrapopliteal balloon angioplasty. METHODS: This retrospective, single-center study included 161 consecutive patients with critical limb ischemia (173 limbs) who underwent endovascular treatment for infrapopliteal lesions between January 2012 and May 2015. The overall technical success rate was 88%. Of these lesions, 30 limbs presented with slow flow after angioplasty...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27865637/increased-risk-of-mortality-after-lower-extremity-bypass-in-individuals-with-acute-kidney-injury-in-the-vascular-quality-initiative
#20
Erica Flores, Juan Pablo Lewinger, Vincent L Rowe, Karen Woo, Fred A Weaver, David Shavelle, Leonardo Clavijo, Parveen K Garg
OBJECTIVE: The development of acute kidney injury (AKI) and its effect on prognosis after lower extremity bypass (LEB) surgery have not been well described. We determined risk factors associated with AKI in patients undergoing infrainguinal LEB surgery and whether individuals with AKI are at increased risk for cardiovascular events and mortality. METHODS: Data for 12,907 operations entered in the Vascular Quality Initiative (VQI) registry from January 2012 through April 2015 were retrospectively reviewed...
November 16, 2016: Journal of Vascular Surgery
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