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https://www.readbyqxmd.com/read/28625669/role-of-language-discordance-in-complication-and-readmission-rate-after-infrainguinal-bypass
#1
Elica Inagaki, Alik Farber, Jeffrey Kalish, Jeffrey J Siracuse, Clara Zhu, Denis V Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28618851/crush-deformation-of-a-balloon-expandable-stent-implanted-in-an-infrainguinal-bypass-graft
#2
Nida Ahmed, Rym El-Khoury, Moustafa N Sabri, John V White, Chad E Jacobs, Lewis B Schwartz
A 59-year-old man with critical claudication underwent left femoro-anterior bypass grafting, which was uneventful. The graft was tunneled medially across the knee, then anterior to the tibia. His symptoms recurred 1 year later and he was found to have critical stenosis of the vein graft just proximal to the anterior tibial arterial anastomosis. This was treated with scaffolded balloon angioplasty and implantation of a coronary, zotarolimus-eluting balloon-expandable stent, which was also uneventful. However, his claudication again recurred 1 year later...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28612417/length-and-pressure-matter-expediting-evidence-based-progress-in-femoropoliteal-intervention
#3
EDITORIAL
Arka Chatterjee, William B Hillegass
Preprocedural lesion length and ankle-brachial indices (ABI) synergistically predict 12-month patency and repeat revacularization in claudicants treated with bare metal nitinol stents for femoropopliteal disease. This predictive length-ABI model will permit broader evidence-based indirect comparisons of newer femoropopliteal approaches such as drug eluting balloon treatment with or without atherectomy. The length-ABI model is a step to supplement and supplant randomized controlled trials with indirect comparisons as the necessary evidence source expediting innovation and optimizing personalized endovascular therapy for infrainguinal obstructive peripheral arterial disease...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28574037/-diagnostic-significance-of-the-color-duplex-scanning-in-estimation-of-the-arteries-state-at-different-stages-of-infrainguinal-reconstructions
#4
I E Timina, I I Piatkova, A E Zotikov, Z A Adyrkhaev
AIM: The study was aimed at assessing diagnostic possibilities of duplex scanning (DS) of lower limb arteries, used as 'ultrasonographic angiography' in patients presenting with critical ischaemia for appropriately planning complicated infrainguinal reconstructions at stages of surgical management, including dynamic follow up in the postoperative period. PATIENTS AND METHODS: We examined a total of 30 patients. Of these, 14 patients composed the control group and 16 patients with critical ischaemia of lower limb arteries who underwent 8 external iliac-tibial and 8 femorotibial bypass graftings with a relieving arteriovenous fistula and application of a venous cuff according to the type of 'St...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28555191/percutaneous-mechanical-thrombectomy-using-rotarex%C3%A2-s-device-in-acute-limb-ischemia-in-infrainguinal-occlusions
#5
Samuel Heller, Jean-Claude Lubanda, Petr Varejka, Miroslav Chochola, Pavel Prochazka, David Rucka, Sylvie Kuchynkova, Johana Horakova, Ales Linhart
PURPOSE: To evaluate the effectiveness of percutaneous mechanical thrombectomy using Rotarex S in the treatment of acute limb ischemia (ALI) in infrainguinal occlusions in a retrospective study of patients treated in our institution. METHODS: In this study, we identified a total of 147 ALI patients that underwent mechanical thrombectomy using Rotarex S at our institution. In 82% of the cases, percutaneous thrombectomy was used as first-line treatment, and for the remainder of the cases, it was used as bailout after ineffective aspiration or thrombolysis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28507439/infrainguinal-open-reconstruction-a-review-of-surgical-considerations-and-expected-outcomes
#6
REVIEW
Sevan R Komshian, Kimberly Lu, Steven L Pike, Jeffrey J Siracuse
Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0-5...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28502888/prospective-study-of-postoperative-glycemic-control-with-a-standardized-insulin-infusion-protocol-after-infrainguinal-bypass-and-open-abdominal-aortic-aneurysm-repair
#7
Andrea M Steely, Lisa Smith, Peter W Callas, Muriel H Nathan, Julie E Lahiri, Andrew C Stanley, Georg Steinthorsson, Daniel J Bertges
INTRODUCTION: The aim of this study was to examine the effect of moderate postoperative glycemic control in diabetic and non-diabetic patients undergoing infrainguinal bypass (INFRA) or open abdominal aortic aneurysm (OAAA) repair. METHODS: In a single center prospective study, we investigated postoperative glycemic control using a standardized insulin infusion protocol after elective INFRA (n=53, 62%) and OAAA (n=33, 38%) between January 2013 and March 2015. The primary endpoint was optimal glycemic control, defined as having ≥85% of blood glucose values within the 80-150mg/dL target range...
May 11, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#8
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28483630/variability-in-atherosclerotic-disease-progression-within-the-infrainguinal-arterial-circulation-is-dependent-on-both-patient-and-anatomical-factors
#9
Lukasz P Zieliński, Mohammed M Chowdhury, Mathew Carter, Ben P Worsfold, Patrick A Coughlin
BACKGROUND: Studies suggest 25% of patients with symptomatic peripheral arterial disease (PAD) develop symptom progression over time yet there is minimal data related to actual atherosclerotic progression. METHODS: Patients who underwent consecutive duplex imaging of the lower limb arteries, at least 6 months apart with no intervening arterial intervention, were identified. Atherosclerotic burden was determined for both femoropopliteal (FP) and crural (CR) arterial segments utilising the Bollinger score (BoS)...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28450103/regional-variation-in-outcomes-for-lower-extremity-vascular-disease-in-the-vascular-quality-initiative
#10
Peter A Soden, Sara L Zettervall, Katie E Shean, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
BACKGROUND: Increased focus has been placed on perioperative and long-term outcomes in the treatment of peripheral artery disease (PAD), both for purposes of quality improvement and for assessment of performance at a surgeon and institutional level. This study evaluates regional variation in outcomes after treatment for PAD within the Vascular Quality Initiative (VQI). By describing the variation in practice patterns and outcomes across regions, we hope that each regionally based quality group can select which areas are most important for them to focus on as they will have access to their regional data to compare...
April 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28448207/gender-differences-in-endovascular-treatment-of-infrainguinal-peripheral-artery-disease
#11
Henrik Christian Rieß, Eike Sebastian Debus, Franziska Heidemann, Konstanze Stoberock, Reinhart T Grundmann, Christian-Alexander Behrendt
BACKGROUND: Despite ongoing research concerning comorbidities and clinical presentation of peripheral arterial disease (PAD), the issue of gender associated differences in treatment is far from being settled. PATIENTS AND METHODS: This was a prospective, non-randomized multicentre study design. All patients suffering from intermittent claudication (IC) or critical limb ischaemia (CLI) were included. RESULTS: A total of 2,798 procedures for symptomatic PAD in the infrainguinal region were recorded, with 1,696 (61...
April 27, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28400219/comparative-effectiveness-of-anticoagulation-on-midterm-infrainguinal-bypass-graft-patency
#12
Nathan L Liang, Donald T Baril, Efthymios D Avgerinos, Steven A Leers, Michel S Makaroun, Rabih A Chaer
OBJECTIVE: Therapeutic anticoagulation (AC) is used clinically for prolongation of infrainguinal bypass patency, but evidence for the efficacy of this practice is conflicting. The objective of our study was to determine the association of AC with bypass graft primary patency. METHODS: Clinical and comorbid data of patients undergoing infrainguinal bypass grafts to a below-knee target with at least 1 year of follow-up performed from 2003 to 2015 were obtained from the Society for Vascular Surgery Vascular Quality Initiative...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390912/endovascular-re-intervention-for-failing-infrainguinal-bypass-grafts
#13
Kimihiro Igari, Toshifumi Kudo, Takahiro Toyofuku, Yoshinori Inoue
OBJECTIVE: Patients with lower extremity bypass grafts that develop stenosis commonly undergo endovascular treatment (EVT) procedures. This study was performed to evaluate the outcomes of EVT procedures for infrainguinal grafts with bypass at risk (BAR). METHODS: We performed a retrospective review of 24 grafts in 22 patients from July 2010 to June 2016. The demographic information of the patients and the characteristics of lesions were examined, and the outcomes with regard to the patency and survival rates were calculated...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28242402/hypoalbuminemia-predicts-perioperative-morbidity-and-mortality-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#14
Matthew R Peacock, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
BACKGROUND: Poor nutritional status has been associated with a higher risk of morbidity and mortality in general surgery patients; however, outcomes in vascular surgery patients are unclear. Our goal was to determine the effect of poor nutritional status on perioperative morbidity and mortality after lower extremity bypass (LEB). METHODS: The 2005-2012 National Surgical Quality Improvement Program was analyzed to determine associated complications, mortality, length of stay (LOS), and readmissions for patients with hypoalbuminemia (serum albumin <3...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28242396/aggressive-wound-care-by-a-multidisciplinary-team-improves-wound-healing-after-infrainguinal-bypass-in-patients-with-critical-limb-ischemia
#15
Shinsuke Mii, Kiyoshi Tanaka, Ryoichi Kyuragi, Hiroshi Ishimura, Shinsuke Yasukawa, Atsushi Guntani, Eisuke Kawakubo
BACKGROUND: A long period is generally required for ischemic ulcer to heal after revascularization. The strategy of postoperative wound care can affect wound healing. This study was conducted to investigate the degree to which aggressive wound care (AWC) by a team of multidisciplinary specialists actually shortens the time to wound healing and increases the rate of wound healing in limbs undergoing surgical bypass for ischemic tissue loss in a real clinical setting. METHODS: A total of consecutive 126 patients undergoing infrainguinal bypass for tissue loss from April 2011 to March 2015 were reviewed...
May 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28240525/infrapopliteal-calcification-patterns-in-critical-limb-ischemia-diagnostic-pathologic-and-therapeutic-implications-in-the-search-for-the-endovascular-holy-grail
#16
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
Critical limb ischemia (CLI) represents the terminal stage of peripheral arterial disease (PAD) and is characterized by multilevel and multivessel disease. Amongst patients with infrainguinal disease, approximately one third have predominantly isolated infrapopliteal disease and the remaining two thirds, a combination of femoropopliteal and infrapopliteal disease. Isolated infrapopliteal disease is mainly seen in the elderly, diabetic, or dialysis-dependent patients. These patients have higher risk of amputation and shorter amputation-free survival...
June 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#17
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
May 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28206725/the-tibiopedal-retrograde-vascular-access-for-challenging-popliteal-and-below-the-knee-chronic-total-occlusions-literature-review-and-description-of-the-technique
#18
REVIEW
Andrej Schmidt, Olaf J Bakker, Yvonne Bausback, Dierk Scheinert
In recent years, the retrograde tibiopedal approach is increasingly being used for revascularization of complex chronic total occlusions of infrainguinal arteries to bailout those cases where a guidewire was not possible to pass through the lesion from antegrade and therefore the treatment would have failed. The present popularity of this technique is in contrast to the paucity of data published so far. Nevertheless, from the reports that are available and from the authors' experience we conclude that it is not only a successful but also a safe technique...
June 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28190717/perioperative-outcomes-of-infrainguinal-bypass-surgery-in-patients-with-and-without-prior-revascularization
#19
COMPARATIVE STUDY
Thomas C F Bodewes, Klaas H J Ultee, Peter A Soden, Sara L Zettervall, Katie E Shean, Douglas W Jones, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Although an increasing number of patients with peripheral arterial disease undergo multiple revascularization procedures, the effect of prior interventions on outcomes remains unclear. The purpose of this study was to evaluate perioperative outcomes of bypass surgery in patients with and those without prior ipsilateral treatment. METHODS: Patients undergoing nonemergent infrainguinal bypass between 2011 and 2014 were identified in the National Surgical Quality Improvement Program Targeted Vascular module...
May 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#20
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
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