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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
#1
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
#2
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
#3
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...
September 6, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28870681/the-association-of-venous-thromboembolism-chemoprophylaxis-timing-on-venous-thromboembolism-after-major-vascular-surgery
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28835590/association-between-preoperative-frailty-and-mortality-in-patients-with-critical-limb-ischemia-following-infrainguinal-bypass-surgery%C3%A3-usefulness-of-the-barthel-index
#10
Akio Kodama, Akio Koyama, Masayuki Sugimoto, Kiyoaki Niimi, Hiroshi Banno, Kimihiro Komori
BACKGROUND: Most patients with critical limb ischemia (CLI) exhibit severe comorbidities accompanied by frailty. This study assessed and risk-stratified mortality after infrainguinal bypass (IB) in CLI and investigated the effects of frailty.Methods and Results:The study retrospectively reviewed 107 consecutive CLI patients who had undergone de novo IB due to atherosclerotic disease. Data regarding patient age, comorbidities, laboratory data, and functional status were collected; functional status was evaluated using the Barthel index (BI) and nutritional status was evaluated using albumin concentrations and body mass index (BMI)...
August 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28830706/underutilization-of-antiplatelet-and-statin-therapy-after-postoperative-myocardial-infarction-following-vascular-surgery
#11
Andrea M Steely, Peter W Callas, Patrick K Hohl, David J Schneider, Randall R De Martino, Daniel J Bertges
OBJECTIVE: The objective of this study was to investigate adherence to practice guidelines for antiplatelet and statin use after postoperative myocardial infarction (POMI) and its effect on late mortality following vascular surgery in a multicenter registry. METHODS: Antiplatelet and statin use was examined in 1749 vascular surgery procedures with POMI within the Vascular Quality Initiative (VQI) from 2005 to 2015. Our primary aim was to assess cardiac medication (CM) use at discharge, defined as (1) single antiplatelet therapy (SAPT; aspirin or P2Y12 inhibitor) or dual antiplatelet therapy (DAPT; aspirin and P2Y12 inhibitor) and (2) statin therapy...
August 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822661/preoperative-anemia-associated-with-adverse-outcomes-after-infrainguinal-bypass-surgery-in-patients-with-chronic-limb-threatening-ischemia
#12
Thomas C F Bodewes, Alexander B Pothof, Jeremy D Darling, Sarah E Deery, Douglas W Jones, Peter A Soden, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Preoperative anemia in elderly patients undergoing surgery is prevalent and associated with adverse events; however, the interaction with other risk factors in patients with chronic limb-threatening ischemia (CLTI) is not well described. The purpose of this study was to assess the association between lower hematocrit (HCT) levels on admission and postoperative outcomes after infrainguinal bypass surgery. METHODS: Patients with CLTI undergoing nonemergent infrainguinal bypass were identified in the targeted vascular module of National Surgical Quality Improvement Program (NSQIP; 2011-2014)...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822655/a-national-vascular-quality-initiative-database-comparison-of-hybrid-and-open-repair-for-aortoiliac-femoral-occlusive-disease
#13
Marco Zavatta, Matthew W Mell
OBJECTIVE: We sought to analyze the outcomes of revascularization for aortoiliac-femoral occlusive disease by comparing hybrid repair by endovascular revascularization and open common femoral endarterectomy (ER-CFE) with open aortoiliac reconstruction and CFE (OR-CFE). METHODS: Using the national Society for Vascular Surgery Vascular Quality Initiative database from 2009 to 2015, we identified all patients receiving open or endovascular revascularization of the aortoiliac system and who additionally underwent CFE...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28782109/low-vs-high-haemoglobin-trigger-for-transfusion-in-vascular-surgery-protocol-for-a-randomised-trial
#14
A Møller, H B Nielsen, J Wetterslev, O B Pedersen, D Hellemann, S Shahidi
BACKGROUND: In patients with cardiovascular disease, guidelines for administration of red blood cells (RBC) are mainly based on studies outside the vascular surgical setting with the recommendation to use a haemoglobin (hb) trigger-level lower than by guidelines from The European Society for Vascular Surgery. Restricting RBC transfusion may affect blood O2 transport with a risk for development of tissue ischaemia and postoperative complications. METHODS: In a single-centre, open-label, assessor blinded trial, 58 vascular surgical patients (> 40 years of age) awaiting open surgery of the infrarenal aorta or infrainguinal arterial bypass surgery undergo a web-based randomisation to one of two groups: perioperative RBC transfusion triggered by hb < 8 g/dl or hb < 9...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28766400/transvenous-intravascular-ultrasound-guided-endovascular-treatment-for-chronic-total-occlusion-of-infrainguinal-arteries
#15
Yasuhiro Takahashi, Taisuke Sato, Hirotake Okazaki, Ayaka Nozaki, Masato Matsushita, Masataka Kamiya, Wataru Shimizu
PURPOSE: To investigate the 1-year outcomes of transvenous intravascular ultrasound (IVUS)-guided endovascular therapy (EVT) for chronic total occlusion (CTO) of the lower extremity arteries. METHODS: Transvenous IVUS-guided EVT was performed in 44 patients (50 limbs) with CTO of the femoropopliteal arteries or tibioperoneal trunk. Treatment involved crossing a guidewire through the CTO under the guidance of both fluoroscopic and IVUS imaging, along with insertion of the IVUS catheter into a vein parallel to the target artery...
August 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28739453/modified-frailty-index-can-be-used-to-predict-adverse-outcomes-and-mortality-after-lower-extremity-bypass-surgery
#16
Tarik Z Ali, Erik B Lehman, Faisal Aziz
BACKGROUND: Frailty has been increasingly used as a prognostic indicator for various surgical operations. Patients with peripheral arterial disease represent a cohort of population with advanced medical comorbidities. The aim of this study is to correlate the postoperative outcomes after lower extremity bypass surgery with preoperative modified frailty index (mFI). METHODS: Using 2010 American College of Surgeons National Surgical Quality Improvement Program database, patients undergoing infrainguinal arterial bypass surgery were identified...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28717067/barthel-index-and-outcome-of-open-bypass-for-critical-limb-ischemia
#17
Shinsuke Mii, Atsushi Guntani, Eisuke Kawakubo, Hirofumi Shimazoe
BACKGROUND: Daily activity should be an important factor to consider when deciding on a treatment strategy for critical limb ischemia (CLI), and we hypothesized that there was a close relationship between activities of daily living (ADL) and prognosis. The aim of this study was to investigate the association between ADL and outcomes of open bypass for CLI.Methods and Results:A total of 226 patients undergoing infrainguinal bypass for CLI between January 2005 and December 2015 were reviewed...
July 15, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28715513/percutaneous-endovascular-treatment-of-infrainguinal-paod-results-of-the-psi-register-study-in-74%C3%A2-german-vascular-centers
#18
C-A Behrendt, F Heidemann, K Haustein, R T Grundmann, E S Debus
BACKGROUND: The percutaneous infrainguinal stent (PSI) register study aimed to collate all percutaneous endovascular procedures for infrainguinal peripheral arterial occlusive disease (PAOD) conducted in 74 German vascular centers between September and November 2015 (3 months). In order to obtain representative results all consecutive treatment procedures had to be submitted by the participating trial centers. MATERIAL AND METHODS: This was a prospective, nonrandomized multicenter study design...
2017: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#19
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28690998/results-of-infrainguinal-bypass-with-a-composite-graft-combining-polytetrafluoroethylene-and-vein-graft-in-absence-of-appropriate-saphenous-vein-graft
#20
Myung Jae Jin, Ui Jun Park, Hyoung Tae Kim, Young-Nam Roh
PURPOSE: Use of a composite graft combining a polytetrafluoroethylene graft with an autogenous vein is an option for limb salvage in the absence of an adequate single segment vein graft. We aimed to investigate the results of infrainguinal bypass with a composite graft. MATERIALS AND METHODS: We retrospectively reviewed 11 infrainguinal arterial bypasses on 11 limbs which underwent surgery from March 2012 to November 2016. RESULTS: Critical limb ischemia was common (63...
June 2017: Vascular Specialist International
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