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https://www.readbyqxmd.com/read/29317447/improving-1-year-outcomes-of-infrainguinal-limb-revascularisation-a-population-based-cohort-study-of-104-000-patients-in-england
#1
Katriina Heikkila, David C Mitchell, Ian M Loftus, Amundeep S Johal, Sam Waton, David A Cromwell
Background -The availability and diversity of lower limb revascularisation procedures have increased in England in the past decade. We investigated whether these developments in care have translated to improvements in patient pathways and outcomes. Methods -Individual-patient records from Hospital Episode Statistics (HES) were used to identify 103 934 patients who underwent endovascular (angioplasty) or surgical (endarterectomy, profundaplasty or bypass) lower limb revascularisation for infrainguinal peripheral artery disease (PAD) in England between January 2006 and December 2015...
January 9, 2018: Circulation
https://www.readbyqxmd.com/read/29288558/aggressive-infrainguinal-revascularization-in-renal-transplant-patients-is-justifiable
#2
Rebecca Craig-Schapiro, Besma Nejim, Isibor Arhuidese, Mahmoud B Malas
While studies demonstrate poor outcomes of lower extremity revascularization in end-stage renal disease patients, little is known about results in renal transplant patients. We analyzed 2-year primary patency and limb salvage outcomes and associated risk factors of transplant (N=202) and non-transplant patients (N=25,274) in the Vascular Quality Initiative database undergoing infrainguinal bypass from 2003-2016. Multivariable Cox regression analysis and coarsened exact matching with many-to-one were employed...
December 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29276108/sex-based-outcomes-of-lower-extremity-bypass-surgery-in-hemodialysis-patients
#3
Isibor Arhuidese, Amber Kernodle, Besma Nejim, Satinderjit Locham, Caitlin Hicks, Mahmoud B Malas
OBJECTIVE: The objective of this study was to compare conduit use and surgical outcomes of hemodialysis-dependent men and women after open lower extremity bypass surgery. METHODS: Using the United States Renal Data System, we studied all hemodialysis patients in the United States who underwent infrainguinal bypass surgery between January 1, 2006, and December 31, 2011. Univariate methods (χ2, analysis of variance) were employed to compare patient and bypass characteristics between men and women...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29248242/plasma-microbiome-modulated-indole-and-phenyl-derived-metabolites-associate-with-advanced-atherosclerosis-and-postoperative-outcomes
#4
Cori A Cason, Kyle T Dolan, Gaurav Sharma, Ming Tao, Rohan Kulkarni, Irene B Helenowski, Brendan M Doane, Michael J Avram, Mary M McDermott, Eugene B Chang, C Keith Ozaki, Karen J Ho
OBJECTIVE: Multiple studies have shown that gut microbes contribute to atherosclerosis, and there is mounting evidence that microbial metabolism of dietary nutrients influences pathophysiology. We hypothesized that indole- and phenyl-derived metabolites that originate solely or in part from bacterial sources would differ between patients with advanced atherosclerosis and age- and sex-matched controls without clinically apparent atherosclerosis. METHODS: Plasma from the advanced atherosclerosis cohort (n = 100) was from patients who underwent carotid endarterectomy, open infrainguinal leg revascularization, or major leg amputation for critical limb ischemia...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29242066/external-polytetrafluoroethylene-reinforcement-of-varicose-autologous-vein-grafts-in-peripheral-bypass-surgery-produces-durable-bypass-function
#5
Achim Neufang, Christine Espinola-Klein, Savvas Savvidis, Walther Schmiedt, Alicia Poplawski, Christian Friedrich Vahl, Bernhard Dorweiler
OBJECTIVE: Use of autologous veins as peripheral bypass graft may become critical in the presence of significant varicose degeneration of the harvested vein. External support of such dilated veins with standard polytetrafluoroethylene (PTFE) prostheses was recommended as an option to use these veins for peripheral bypass. A single-center experience with this technique regarding long-term graft function, secondary reinterventions, and potential graft degeneration is presented. METHODS: Between January 1995 and January 2006, there were 54 patients with varicose veins who underwent 57 consecutive infrainguinal vein bypass operations with PTFE reinforcement in 57 limbs...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29227173/changes-in-platelet-function-with-inflammation-in-patients-undergoing-vascular-surgery
#6
Bartosz Olechowski, Vikram Khanna, Mark Mariathas, Alexander Ashby, Richard T Dalton, Ian Nordon, Nicola Englyst, Scott Harris, Zoe Nicholas, Kala Thayalasamy, Michael Mahmoudi, Nick Curzen
The role of platelets in ischaemic events is well established. Aspirin represents the default antiplatelet and blocks the metabolism of arachidonic acid (AA) at the cyclo-oxygenase enzyme (COX). AA is commonly used as a test of response to aspirin, but recent data raise uncertainty about the validity of this approach. Specifically, in some patients AA-induced clotting is not suppressed, but the level of COX-dependent AA metabolite, thromboxane B2 (TXB2) is negligible. Furthermore, AA-induced whole blood clotting varies dynamically in individuals, who are aspirin responsive according to TXB2 levels...
December 11, 2017: Platelets
https://www.readbyqxmd.com/read/29180182/perioperative-warming-oxygen-and-ilomedin-on-oxygenation-and-healing-in-infrainguinal-bypass-surgery
#7
Nathaniel Chiang, Odette A Rodda, Jamie Sleigh, Thodur Vasudevan
BACKGROUND: Perioperative adjuncts are utilized across surgical specialities with the goal of improving patient outcomes. High-dose oxygen and extended warming are shown to increase wound collagen deposition during abdominal surgery. Prostacyclin is shown to improve limb salvage and patency rate in infrainguinal bypass (IIB) surgery. This study evaluated the impact of these adjuncts on healing and perfusion post IIB surgery. METHODS: This randomized controlled study allocated patients undergoing IIB surgery into three treatment arms (perioperative high-dose oxygen, extended warming, and a synthetic prostacyclin) or a control group...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29169544/systematic-review-and-meta-analysis-of-duplex-ultrasound-surveillance-for-infrainguinal-vein-bypass-grafts
#8
REVIEW
Abd Moain Abu Dabrh, Khaled Mohammed, Wigdan Farah, Qusay Haydour, R Eugene Zierler, Zhen Wang, Larry J Prokop, M Hassan Murad
OBJECTIVE: Duplex ultrasound (DUS) surveillance of infrainguinal vein bypass grafts is widely practiced, but the evidence of its effectiveness compared with other methods of surveillance remains unclear. METHODS: Following an a priori protocol developed by the guidelines committee from the Society for Vascular Surgery, this systematic review and meta-analysis included randomized and nonrandomized comparative studies that enrolled patients who underwent infrainguinal arterial reconstruction and received DUS surveillance for follow-up compared with any other method of surveillance...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29160765/antithrombotic-treatment-in-peripheral-artery-disease
#9
Dan-Mircea Olinic, Dan Alexandru Tataru, Calin Homorodean, Mihail Spinu, Maria Olinic
This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke...
November 21, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29153533/outcomes-at-a-single-center-after-subintimal-arterial-flossing-with-antegrade-retrograde-intervention-for-critical-limb-ischemia
#10
Anish Kaushal, Graham Roche-Nagle, Kong T Tan, Elizabeth Liao, Naomi Eisenberg, George D Oreopoulos, Dheeraj K Rajan
OBJECTIVE: The subintimal arterial flossing with antegrade-retrograde intervention technique has been used to overcome antegrade recanalization failures for peripheral lower limb arterial occlusive disease. There are few outcomes published for this technique and we sought to evaluate outcomes at our institution over a 7-year period. METHODS: A retrospective review was performed of all subintimal arterial flossing with antegrade-retrograde intervention procedures of infrainguinal occlusive disease from 2009 to 2016...
November 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29105577/comparative-assessment-of-patient-outcomes-with-intraluminal-or-subintimal-crossing-of-infrainguinal-peripheral-artery-chronic-total-occlusions
#11
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
#12
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
#13
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...
January 2018: 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
#14
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
#15
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
#16
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
#17
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...
December 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
#18
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
#19
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
#20
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
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