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Infrainguinal

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https://www.readbyqxmd.com/read/29773431/preoperative-frailty-assessment-predicts-loss-of-independence-after-vascular-surgery
#1
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/29772315/long-term-durability-of-infrainguinal-endovascular-and-open-revascularization-for-disabling-claudication
#2
Sikandar Z Khan, Mariel Rivero, Gregory S Cherr, Linda M Harris, Maciej L Dryjski, Hasan H Dosluoglu
OBJECTIVE: Infrainguinal revascularization for disabling claudication (DC) is frequently performed but long term results are still unknown. In this study, we compared clinical outcomes of infrainguinal endovascular (EV) and open interventions for DC following failure of medical management. METHODS: 194 patients with DC (Rutherford category 3) who had open (n=53) or EV (n=141) interventions were grouped as Open-GSV (n=21), Open-Prosthetic (n=32), EV- AB (TASCII A & B) (n=48) and EV-CD (TASCII C & D) (n=93)...
May 14, 2018: Annals 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
#3
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/29698517/retraction-percutaneous-aspiration-thrombectomy-for-arterial-thromboembolism-during-infrainguinal-endovascular-recanalization
#4
(no author information available yet)
No abstract text is available yet for this article.
2018: PloS One
https://www.readbyqxmd.com/read/29682114/infrainguinal-lesion-of-peripheral-artery-disease-and-levels-of-%C3%AF-3-polyunsaturated-fatty-acids-in-peripheral-artery-disease
#5
Tomoaki Iwasaki, Toshiya Nishibe, Yumiko Ohya, Shigeru Inoue, Hitoshi Ogino
Background : Recently, reduced serum levels of ω-3 polyunsaturated fatty acids (PUFAs) including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have been focused upon as newly recognized risk factors for peripheral artery disease (PAD). The present study investigated the association between disease location and serum levels of ω-3 PUFAs in patients with PAD. Methods : We retrospectively analyzed the data of patients at Tokyo Medical University between August 2011 and November 2015. The subjects included 98 patients who were categorized into two groups: those with (n=72) and without infrainguinal lesions (n=26)...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29615358/outcomes-of-infrageniculate-retrograde-versus-transfemoral-access-for-endovascular-intervention-for-chronic-lower-extremity-ischemia
#6
Ashraf G Taha, Adham N Abou Ali, George Al-Khoury, Michael J Singh, Michel S Makaroun, Efthymios D Avgerinos, Rabih A Chaer
OBJECTIVE: Retrograde infrageniculate access is an alternative treatment strategy for patients who have failed to respond to antegrade endovascular intervention. This study compares the outcomes of infrageniculate retrograde arterial access with the conventional transfemoral access for the endovascular management of chronic lower extremity ischemia. METHODS: This was a retrospective single-center review of retrograde endovascular intervention (REI) from 2012 to 2016...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29615349/assessment-of-extracellular-matrix-related-biomarkers-in-patients-with-lower-extremity-artery-disease
#7
Anna Hernández-Aguilera, Signe Holm Nielsen, Cristina Bonache, Salvador Fernández-Arroyo, Vicente Martín-Paredero, Montserrat Fibla, Morten A Karsdal, Federica Genovese, Javier A Menendez, Jordi Camps, Jorge Joven
BACKGROUND: The prevalence of lower extremity artery disease (LEAD) is high (20%-25%) in the population older than 65 years, but patients are seldom identified until the disease is advanced. Circulating markers of disease activity might provide patients with a key opportunity for timely treatment. We tested the hypothesis that measuring blood-specific fragments generated during degradation of the extracellular matrix (ECM) could provide further insight into the pathophysiologic mechanism of arterial remodeling...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29610445/dissections-in-peripheral-vascular-interventions-a-proposed-classification-using-intravascular-ultrasound
#8
Nicolas W Shammas, James T Torey, W John Shammas
Dissections following interventions in the infrainguinal arteries occur very frequently and are mostly under-appreciated on angiographic imaging. Media and external elastic lamina injury can contribute to loss of patency, and intravascular ultrasound (IVUS) can identify this type of injury. The circumference of injury also has been proposed to be a predictor of outcome. We therefore propose a classification combining depth of injury from intima to adventitia with circumference of dissection. This classification exhibits six dissection grades (A1, A2, B1, B2, C1, and C2) as seen on IVUS (the "iDissection" classification)...
April 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29576404/treatment-outcomes-in-diabetic-patients-with-chronic-limb-threatening-ischemia
#9
Patric Liang, Peter A Soden, Sara L Zettervall, Katie E Shean, Sarah E Deery, Raul J Guzman, Allen D Hamdan, Marc L Schermerhorn
OBJECTIVE: There are conflicting reports about outcomes after infrainguinal bypass for chronic limb-threatening ischemia (CLTI) in patients with diabetes. We compared perioperative outcomes between patients with and patients without diabetes in the current era. METHODS: The National Surgical Quality Improvement Program vascular module, 2011 to 2014, was used to identify patients undergoing infrainguinal revascularization for CLTI. Patients with and without diabetes were compared in terms of presentation, comorbidities, operative approach, and 30-day outcomes...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29530886/hyperacute-monocyte-gene-response-patterns-are-associated-with-lower-extremity-vein-bypass-graft-failure
#10
Jonathan P Rehfuss, Kenneth M DeSart, Jared M Rozowsky, Kerri A O'Malley, Lyle L Moldawer, Henry V Baker, Yaqun Wang, Rongling Wu, Peter R Nelson, Scott A Berceli
BACKGROUND: Despite being the definitive treatment for lower extremity peripheral arterial disease, vein bypass grafts fail in half of all cases. Early repair mechanisms after implantation, governed largely by the immune environment, contribute significantly to long-term outcomes. The current study investigates the early response patterns of circulating monocytes as a determinant of graft outcome. METHODS: In 48 patients undergoing infrainguinal vein bypass grafting, the transcriptomes of circulating monocytes were analyzed preoperatively and at 1, 7, and 28 days post-operation...
March 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29523437/active-smoking-in-claudicants-undergoing-lower-extremity-bypass-predicts-decreased-graft-patency-and-worse-overall-survival
#11
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
https://www.readbyqxmd.com/read/29522872/external-validation-and-evaluation-of-reliability-of-the-farp-2-score-to-predict-early-graft-failure-after-infrainguinal-bypass
#12
Mazlum Sahin, Helin El
AIM: To evaluate the accuracy of the FARP2 scoring system in predicting early graft failure after infrainguinal bypass surgery (IBS). METHODS: Patient charts which underwent IBS between January 2014 and January 2017 , in two tertiary academic centers were evaluated retrospectively. In follow ups, one week after operation, detailed physical examination was done and doppler ultrasonography was performed one month after operation and integrity of the graft was evaluated...
March 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29506947/the-impact-of-current-smoking-on-outcomes-after-infrainguinal-bypass-for-claudication
#13
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
https://www.readbyqxmd.com/read/29501899/covered-stent-treatment-of-a-chronically-thrombosed-popliteal-artery-aneurysm-in-the-setting-of-critical-limb-ischemia-following-multiple-failed-bypass-operations
#14
Lauren A Huntress, Naiem Nassiri
Endovascular salvage of failed surgical bypasses has been scantly reported for treatment of infrainguinal occlusive disease. Although catheter-directed thrombolysis and/or mechanical thromboembolectomy have been the mainstay of endovascular salvage of previous bypass grafts, native vessel recanalization remains seldom attempted. Herein, we present a unique approach to native vessel recanalization of a chronically thrombosed popliteal artery aneurysm for nonhealing distal ulceration.
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29491227/pathophysiological-significance-of-velocity-based-microvascular-resistance-at-maximal-hyperemia-in-peripheral-artery-disease
#15
Kuniyasu Ikeoka, Shiro Hoshida, Tetsuya Watanabe, Yukinori Shinoda, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Keisuke Ueno, Yasushi Sakata
AIM: Maximal hyperemic response, leading to examination of microvascular resistance in lower-limb lesions is not well understood. This study aimed to investigate the infrainguinal arterial physiological response through a hyperemic condition and the pathophysiological significance of microvascular resistance in peripheral artery disease. METHODS: Sixteen limbs with focal stenosis of the superficial femoral artery (SFA) and 16 control limbs were analyzed. We assessed the fractional flow reserve (FFR), vascular flow reserve (VFR), and hyperemic microvascular resistance (h-MR) of the SFA with a pressure/Doppler flow sensor-tipped combination guidewire before and after endovascular therapy (EVT)...
February 28, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29481930/hybrid-revascularization-combining-iliofemoral-endarterectomy-and-iliac-stent-grafting-for-transatlantic-inter-society-consensus-c-and-d-aortoiliac-occlusive-disease
#16
Juliet J Ray, Sarah A Eidelson, Charles A Karcutskie, Jonathan P Meizoso, Hilene DeAmorim, Lee J Goldstein, John Karwowski, Arash Bornak
BACKGROUND: This study examines the outcome of hybrid revascularization combining iliofemoral endarterectomy and iliac artery stenting using covered stents in TransAtlantic Inter-Society Consensus (TASC) C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS: A retrospective review was conducted in patients with TASC C and D AIOD involving the CFA and undergoing hybrid revascularization. Covered stents were used primarily...
February 24, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29459014/regional-variation-in-racial-disparities-among-patients-with-peripheral-artery-disease
#17
Thomas F X O'Donnell, Chloe Powell, Sarah E Deery, Jeremy D Darling, Kakra Hughes, Kristina A Giles, Grace J Wang, Marc L Schermerhorn
OBJECTIVE: Prior studies identified significant racial disparities as well as regional variation in outcomes of patients with peripheral artery disease (PAD). We aimed to determine whether regional variation contributes to these racial disparities. METHODS: We identified all white or black patients who underwent infrainguinal revascularization or amputation in 15 deidentified regions of the Vascular Quality Initiative between 2003 and 2017. We excluded three regions with <100 procedures...
February 16, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29455014/cilostazol-improves-wound-healing-in-patients-undergoing-open-bypass-for-ischemic-tissue-loss-a-propensity-score-matching-analysis
#18
Shinsuke Mii, Atsushi Guntani, Eisuke Kawakubo, Kiyoshi Tanaka, Ryoichi Kyuragi
BACKGROUND: Few reports have described the effects of medication on the wound healing of ischemic ulcers after revascularization. This study was conducted to investigate the effects of cilostazol on wound healing in patients who underwent infrainguinal bypass for ischemic tissue loss. METHODS: Two hundred sixty-three limbs undergoing de novo infrainguinal bypass for tissue loss from January 2004 to December 2015 were divided into 2 groups based on whether or not cilostazol was administered after surgery...
May 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29421428/cryopreserved-homografts-in-infected-infrainguinal-fields-are-associated-with-frequent-reinterventions-and-poor-amputation-free-survival
#19
S Keisin Wang, Ashley R Gutwein, Natalie A Drucker, Michael P Murphy, Andres Fajardo, Michael C Dalsing, Raghu L Motaganahalli, Gary W Lemmon
BACKGROUND: Single-length saphenous vein continues to be the conduit of choice in infected-field critical limb ischemia. However, half of these individuals have inadequate vein secondary to previous use or chronic venous disease. We reviewed our outcomes of infected-field infrainguinal bypasses performed with cryopreserved homografts (CHs), a widely accepted alternative to autogenous vein in this setting. METHODS: This is a retrospective, institutional descriptive analysis of infected-field infrainguinal revascularizations between 2012 and 2015...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29396768/the-relationship-between-medical-expenses-and-the-severity-of-peripheral-arterial-disease-in-japan
#20
Akihiko Seo, Kota Yamamoto, Atsushi Akai, Daisuke Akagi, Toshio Takayama, Katsuyuki Hoshina
The main objective is to examine whether the severity of peripheral arterial disease (PAD) affects the expenses and hospital stay of the patients who undergo bypass surgery below the inguinal ligament for PAD. Eighty consecutive patients who underwent infrainguinal bypass surgery for PAD between January 2012 and December 2014 were included in the study. Patients were divided into groups according to their critical limb ischemia (CLI) symptoms and the Wound, Ischemia, and Foot Infection (WIfI) classification...
February 2, 2018: Heart and Vessels
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