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https://www.readbyqxmd.com/read/29105577/comparative-assessment-of-patient-outcomes-with-intraluminal-or-subintimal-crossing-of-infrainguinal-peripheral-artery-chronic-total-occlusions
#1
Ananya Kondapalli, Haekyung Jeon-Slaughter, Hua Lu, Hao Xu, Houman Khalili, Anand Prasad, Ehrin J Armstrong, Emmanouil S Brilakis, Subhash Banerjee
This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications...
November 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/29102747/endoscopic-versus-open-great-saphenous-vein-harvesting-for-femoral-to-popliteal-artery-bypass
#2
Aleem K Mirza, Kendall Stauffer, Mark D Fleming, Randall De Martino, Gustavo Oderich, Manju Kalra, Peter Gloviczki, Thomas Bower
OBJECTIVE: Conflicting data exist on outcomes of open vein harvest (OVH) and endoscopic vein harvest (EVH) for infrainguinal bypass. The purpose of this study was to compare outcomes between OVH and EVH in femoral to popliteal artery bypasses. METHODS: A retrospective review was performed of all patients undergoing common femoral to popliteal artery bypass with great saphenous vein between January 1997 and June 2014. Bypasses using arm or composite vein were excluded, as were those performed for popliteal artery aneurysms or trauma...
November 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29066242/estimating-risk-of-adverse-cardiac-event-after-vascular-surgery-using-currently-available-online-calculators
#3
Danielle A Moses, Lily E Johnston, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
BACKGROUND: The decision to proceed with vascular surgical interventions requires evaluation of cardiac risk. Recently, several online risk calculators were created to predict outcomes and to lead to a more informed conversation between surgeons and patients. The objective of this study was to compare and further validate these online calculators with actual adverse cardiac outcomes at a single institution. METHODS: All patients from January 2011 through December 2015 undergoing carotid endarterectomy (CEA), infrainguinal lower extremity bypass, open abdominal aortic aneurysm (AAA) repair, and endovascular aneurysm repair (EVAR) on the vascular surgical service were included using the Society for Vascular Surgery Vascular Quality Initiative database at our health system...
October 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29037346/contemporary-outcomes-of-elective-iliocaval-and-infrainguinal-venous-intervention-for-post-thrombotic-chronic-venous-occlusive-disease
#4
Johnathon C Rollo, Steven M Farley, Juan Carlos Jimenez, Karen Woo, Peter F Lawrence, Brian G DeRubertis
BACKGROUND: Patients with iliofemoral deep venous thrombosis are at risk for development of post-thrombotic syndrome. Iliac vein stenting has been shown to significantly improve clinical outcomes in patients with venous outflow obstruction, although many studies include a heterogeneous population with several different venous pathologic processes. Our objective was to evaluate the results of iliocaval and infrainguinal venous intervention for venous outflow obstruction due to post-thrombotic chronic venous occlusive disease...
November 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29032905/analysis-of-wound-healing-time-and-wound-free-period-as-outcomes-after-surgical-and-endovascular-revascularization-for-critical-lower-limb-ischemia
#5
Jin Okazaki, Daisuke Matsuda, Kiyoshi Tanaka, Masaru Ishida, Sosei Kuma, Koichi Morisaki, Tadashi Furuyama, Yoshihiko Maehara
BACKGROUND: Traditional end points, such as amputation-free survival, used to assess the clinical effectiveness of lower limb revascularization have shortcomings because they do not account independently for wound nonhealing and recurrence or patient survival. Wound healing process and maintenance of a wound-free state after revascularization were not well-studied. The aim of this study was to elucidate the long-term clinical course of ischemic wounds after revascularization. We focused on initial wound healing process as well as the maintenance of a wound-free state after achievement of wound healing...
October 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28975777/the-evolving-role-of-drug-coated-balloons-for-the-treatment-of-complex-femoropopliteal-lesions
#6
Grigorios Korosoglou, Michael Lichtenberg, Sultan Celik, Joachim Andrassy, Marianne Brodmann, Martin Andrassy
INTRODUCTION: Conventional therapies for transcatheter treatment of patients with infrainguinal obstructive disease remain compromised by high restenosis rates. Drug-coated balloons (DCB) offer a novel therapeutic alternative targeting the source of neo-intimal hyperplasia, without the need for a permanent endovascular scaffold and their inherent limitations. EVIDENCE ACQUISITION: A systematic research of the medical databases (Pubmed) has been conducted for this up-to-date review...
October 2, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#7
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
September 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28951156/black-patients-present-with-more-severe-vascular-disease-and-a-greater-burden-of-risk-factors-than-white-patients-at-time-of-major-vascular-intervention
#8
Peter A Soden, Sara L Zettervall, Sarah E Deery, Kakra Hughes, Michael C Stoner, Philip P Goodney, Ageliki G Vouyouka, Marc L Schermerhorn
BACKGROUND: Although many studies have demonstrated racial disparities after major vascular surgery, few have identified the reasons for these disparities, and those that did often lacked clinical granularity. Therefore, our aim was to evaluate differences in initial vascular intervention between black and white patients. METHODS: We identified black and white patients' initial carotid, abdominal aortic aneurysm (AAA), and infrainguinal peripheral artery disease (PAD) interventions in the Vascular Quality Initiative (VQI) registry from 2009 to 2014...
September 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28950783/safety-and-effectiveness-of-the-phoenix-atherectomy-system-in-lower-extremity-arteries-early-and-midterm-outcomes-from-the-prospective-multicenter-ease-study
#9
Thomas Davis, Venkatesh Ramaiah, Khusrow Niazi, Hans Martin Gissler, Tami Crabtree
Objectives To evaluate the novel Phoenix Atherectomy System as percutaneous treatment of de novo and restenotic infrainguinal arterial lesions. Methods This prospective, multicenter, nonrandomized investigational device exemption trial was conducted across 16 US and German centers between August 2010 and April 2013. Intention-to-treat enrollment was 128 patients (mean age: 71.8 years, 59% male) with 149 lesions (mean length: 34 mm, mean diameter stenosis: 89.5%), and the primary analysis per-protocol population consisted of 105 patients with 123 lesions...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28947228/outcomes-after-first-time-lower-extremity-revascularization-for-chronic-limb-threatening-ischemia-between-patients-with-and-without-diabetes
#10
Jeremy D Darling, Thomas C F Bodewes, Sarah E Deery, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The effect of diabetes type and insulin dependence on short- and long-term outcomes after lower extremity revascularization for chronic limb-threatening ischemia (CLTI) warrants additional study and more targeted focus. We sought to address this paucity of information by evaluating outcomes in insulin-dependent and noninsulin-dependent patients after any first-time revascularization. METHODS: We reviewed all limbs undergoing first-time infrainguinal bypass grafting (BPG) or percutaneous transluminal angioplasty with or without stenting (PTA/S) for CLTI at our institution from 2005 to 2014...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28943485/results-of-infrageniculate-bypasses-using-the-profunda-femoris-artery-as-inflow-source
#11
Giulio Illuminati, Francesco G Calio', Giulia Pizzardi, Rocco Pasqua, Federica Masci, Francesca Frezzotti, Piergaspare Palumbo, Francesco Vietri
BACKGROUND: When the common femoral artery is not accessible for infrainguinal bypass grafting, the profunda femoris artery (PFA) can be a valuable alternative inflow source for distal arterial revascularization. The purpose of this retrospective study was to evaluate the results of infrageniculate bypass grafting via the PFA as inflow source for critical limb ischemia. METHODS: Between 1994 and 2016, 68 patients, 51 men of a mean age of 74 years, underwent an infrageniculate arterial bypass grafting for critical limb ischemia, using the PFA as inflow site...
September 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-vs-endovascular-intervention-after-previous-failed-bypass-redo-lower-extremity-bypass-superior-to-endovascular-intervention
#12
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior lower extremity bypass but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day Major Adverse Limb Events (MALE) and Major Adverse Cardiovascular Events (MACE) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28878099/distal-cuff-occlusion-a-novel-simple-approach-for-distal-embolic-protection-in-peripheral-vascular-intervention
#13
Shwan Jalal, Jihad A Mustapha, Howard S Rosman, Rajendra H Mehta, Thomas P Davis
AIM: To evaluate the feasibility, effectiveness, and safety of the cuff-occlusion method for distal embolic protection in peripheral artery disease. METHODS AND RESULTS: We evaluated 61 patients who underwent peripheral vascular intervention (PVI) for infrainguinal lesion at a single center where a blood pressure cuff occlusion method for distal embolic protection was utilized during the procedure. Primary endpoint included incidence of distal embolization, acute limb ischemia, or emergency limb amputation...
September 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28877308/incidence-of-myocardial-infarction-after-high-risk-vascular-operations-in-adults
#14
Yen-Yi Juo, Aditya Mantha, Ramin Ebrahimi, Boback Ziaeian, Peyman Benharash
Importance: Advances in perioperative cardiac management and an increase in the number of endovascular procedures have made significant contributions to patients and postoperative myocardial infarction (POMI) risk following high-risk vascular procedures. Whether these changes have translated into real-world improvements in POMI incidence remain unknown. Objective: To examine the temporal trends of myocardial infarction (MI) following high-risk vascular procedures...
November 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28870681/the-association-of-venous-thromboembolism-chemoprophylaxis-timing-on-venous-thromboembolism-after-major-vascular-surgery
#15
Danielle C Sutzko, Patrick E Georgoff, Andrea T Obi, Mark A Healy, Nicholas H Osborne
OBJECTIVE: Venous thromboembolism (VTE) is reported to occur in up to 33% of patients undergoing major vascular surgery. Despite this high incidence, patients inconsistently receive timely VTE chemoprophylaxis. The true incidence of VTE among patients receiving delayed VTE chemoprophylaxis is unknown. We sought to identify the association of VTE chemoprophylaxis timing on VTE risk, postoperative transfusion rates, and 30-day mortality and morbidity in patients undergoing major open vascular surgery...
September 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28856423/longitudinal-cracking-with-a-guidewire-tail-for-extremely-calcified-lesions-in-infrainguinal-arteries-picking-technique
#16
Osami Kawarada, Teruo Noguchi, Satoshi Yasuda
PURPOSE: To report a percutaneous intravascular cracking with a guidewire tail (PICKING) technique to longitudinally crack the underlying calcification and facilitate the balloon catheter passage for the treatment of severely calcified chronic occlusions in the infrainguinal artery. MATERIALS AND METHODS: Three patients underwent PICKING technique between November 2014 and March 2017. The PICKING technique with the stiff tail of 0.018-inch guidewire in the straight configuration was considered in cases of failed passage of the smallest balloon catheter because of the underlying severely calcified occlusion following passage of 0...
August 30, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28845831/early-rehabilitative-treatment-after-infrainguinal-lower-limb-bypass-surgery
#17
Ettore Carlisi, Patrick Caspani, Paola Morlino, Maria Teresa Bardoni, Claudio Lisi, Maurizio Bejor, Elena Dalla Toffola
BACKGROUND AND AIM OF THE WORK: Functional activity may remain limited in patients affected by critical limb ischemia, despite successful infrainguinal lower limb bypass surgery (ILLBS). The aim of the work was to evaluate the impact of a rehabilitative intervention on postoperative ambulatory status and pain. METHODS: In an observational study, data were collected on 34 patients undergoing ILLBS for critical limb ischemia or end-stage peripheral arterial disease...
August 23, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28844470/high-hemoglobin-a1c-associated-with-increased-adverse-limb-events-in-peripheral-arterial-disease-patients-undergoing-revascularization
#18
Shipra Arya, Zachary O Binney, Anjali Khakharia, Chandler A Long, Luke P Brewster, Peter W Wilson, William D Jordan, Yazan Duwayri
OBJECTIVE: Diabetes and peripheral arterial disease (PAD) are independently associated with increased risk of amputation. However, the effect of poor glycemic control on adverse limb events has not been studied. We examined the effects of poor glycemic control (high hemoglobin A1c level) on the risk of amputation and modified major adverse limb events (mMALEs) after lower extremity revascularization. METHODS: Patients undergoing PAD revascularization who had hemoglobin A1c (HbA1c) levels available within 6 months were identified in the Veterans Affairs database of 2003 to 2014 (N = 26,799)...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28844467/patient-selection-and-perioperative-outcomes-of-bypass-and-endovascular-intervention-as-first-revascularization-strategy-for-infrainguinal-arterial-disease
#19
Thomas C F Bodewes, Jeremy D Darling, Sarah E Deery, Thomas F X O'Donnell, Alexander B Pothof, Katie E Shean, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: The optimal initial revascularization strategy remains uncertain for patients with peripheral arterial disease. The purpose of this study was to evaluate current nationwide selection and perioperative outcomes of patients undergoing bypass or endovascular intervention for infrainguinal disease in those with no prior ipsilateral revascularization. METHODS: Patients undergoing nonemergent first-time infrainguinal revascularization were identified in the Targeted Vascular module of the National Surgical Quality Improvement Program (NSQIP) for 2011 to 2014 and stratified by symptom status (chronic limb-threatening ischemia [CLTI] or claudication)...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28838590/infrainguinal-wound-infections-in-vascular-surgery-an-antiquated-challenge-without-a-modern-solution
#20
REVIEW
Brittany Aicher, Patrick Curry, Luqman Croal-Abrahams, Scarlett Hao, Richa Kalsi, Nandakumar Menon, Charles Drucker, Donald Harris, Shahab Toursavadkohi, Robert Crawford, Sarah Rosenberger
Surgical site infections (SSIs) have always complicated recovery after surgery, being associated with increased cost of hospitalization, length of stay, and mortality. The most significant measure to reduce the incidence of SSI was the standardization of prophylactic antibiotic administration in patients undergoing surgical procedures. Since then, countless measures have been proposed to improve rates of SSI and patient outcome, but few have been as efficacious as prophylactic antibiotics. Therefore, SSI continues to plague clinicians and patients in modern health care...
September 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
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