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E Gándara, D Hammond, S Nagpal
CLINICAL VIGNETTE: Despite being the most common antithrombotic strategy in trials comparing venous with prosthetic grafts, the use of vitamin K antagonists (VKAs) to improve the outcome of venous bypass remains the subject of debate. In this systematic review, evidence supporting the use of VKAs for improving venous patency following infrainguinal venous bypass is provided. CLINICAL QUESTION: A 67 year old man with lifestyle limiting claudication underwent a successful infrainguinal venous bypass...
July 2016: European Journal of Vascular and Endovascular Surgery
John S Ikonomidis, Niv Ad, Gabriel S Aldea, Michael Argenziano, Aubrey C Galloway, Robert C Hagberg, Robert L Kormos, Jennifer S Lawton, Tomislav Mihaljevic, T Brett Reece, Elaine E Tseng
BACKGROUND: Many cardiothoracic surgeons supplement their case volume through the performance of vascular surgical procedures. Information regarding this practice is not well defined. METHODS: In January of 2013, a survey was conducted of The Society of Thoracic Surgeons (STS) membership to assess the performance of vascular operations by cardiothoracic surgeons. RESULTS: The overall response rate was 8.7%. Of the surgeons practicing vascular surgery, 60% were aged 45 to 64 years and 92% were male...
August 2016: Annals of Thoracic Surgery
Jason T Wiseman, Sara Fernandes-Taylor, Sandeep Saha, Jeffrey Havlena, Paul J Rathouz, Maureen A Smith, K Craig Kent
OBJECTIVE: The aim of this study was to determine whether endovascular or open revascularization provides an advantageous approach to symptomatic peripheral arterial disease (PAD) over the longer term. SUMMARY OF BACKGROUND DATA: The optimal revascularization strategy for symptomatic lower extremity PAD is not established. METHODS: We evaluated amputation-free survival, overall survival, and relative rate of subsequent vascular intervention after endovascular or open lower extremity revascularization for propensity-score matched cohorts of Medicare beneficiaries with PAD from 2006 through 2009...
February 22, 2016: Annals of Surgery
Sanaz Amin, Ana-Catarina Pinho-Gomes, David P Taggart
Early and late graft occlusion remains a significant complication of coronary artery bypass grafting. Transit time flowmetry is the most commonly used imaging technique to assess graft patency intraoperatively. Although the value of transit time flowmetry for intraoperative quality control of coronary anastomosis is well established, its standard variables for predicting eventual graft failure remain controversial. This review readdresses the issue of intraoperative transit time flowmetry, with a particular emphasis on defining cutoff values for standard variables and correlating them with the ability to predict midterm and long-term graft patency for arterial and venous conduits...
May 2016: Annals of Thoracic Surgery
Ann D Smith, Alexander T Hawkins, Maria J Schaumeier, Marit S de Vos, Michael S Conte, Louis L Nguyen
OBJECTIVE: Despite patent vein bypass grafts, some patients with critical limb ischemia (CLI) receive major amputations. We analyzed the predictive factors leading to major amputation in the presence of patent lower extremity bypass (LEB) grafts. METHODS: Data from the Project of Ex-Vivo vein graft Engineering via Transfection III (PREVENT III), a large prospective randomized trial of 1404 patients who underwent LEB with vein graft for CLI, were queried for outcomes...
May 2016: Journal of Vascular Surgery
J J van Netten, L V Fortington, R J Hinchliffe, J M Hijmans
OBJECTIVE: Lower limb amputation is often associated with a high risk of early post-operative mortality. Mortality rates are also increasingly being put forward as a possible benchmark for surgical performance. The primary aim of this systematic review is to investigate early post-operative mortality following a major lower limb amputation in population/regional based studies, and reported factors that might influence these mortality outcomes. METHODS: Embase, PubMed, Cinahl and Psycinfo were searched for publications in any language on 30 day or in hospital mortality after major lower limb amputation in population/regional based studies...
February 2016: European Journal of Vascular and Endovascular Surgery
Faisal Aziz, Erik B Lehman, Amy B Reed
OBJECTIVE: Hospital readmissions after surgical operations are considered serious complications and have an impact on health care-associated costs. The Centers for Medicare and Medicaid Services strongly encourage identification and ramification of factors associated with hospital readmissions after operations. Despite advances in endovascular surgery, lower extremity arterial bypass remains the "gold standard" treatment for severe, symptomatic peripheral arterial disease. The purpose of this study was to retrospectively review the factors associated with hospital readmission after lower extremity bypass surgery...
March 2016: Journal of Vascular Surgery
Jeffrey D Crawford, Gregory J Landry, Gregory L Moneta, Erica L Mitchell
OBJECTIVE: Aortobifemoral graft (ABFG) infections presenting with apparent single-limb involvement can be managed with unilateral graft limb excision or complete graft removal. This study aimed to identify outcomes of unilateral graft limb excision for infected ABFGs and factors predictive of subsequent contralateral or main body graft limb infection. METHODS: A retrospective review of patients treated with unilateral graft limb excision for infection of an isolated limb of an ABFG from 2001 to July 2014 was performed...
February 2016: Journal of Vascular Surgery
K Heyer, E S Debus, L Mayerhoff, M Augustin
OBJECTIVE/BACKGROUND: International studies show conflicting results regarding the frequency of lower limb amputations over time. However, published data are often based on event related amputation frequencies per year, on hospital statistics or on regional surveys. Thus, they do not allow population based statements. The present study assesses the population based epidemiology of amputations in Germany. METHODS: Secondary analyses of 80 German statutory health insurance companies with 4 million insurants nationwide in 2012 were performed...
December 2015: European Journal of Vascular and Endovascular Surgery
Benjamin A Lipsky, Javier Aragón-Sánchez, Mathew Diggle, John Embil, Shigeo Kono, Lawrence Lavery, Éric Senneville, Vilma Urbančič-Rovan, Suzanne Van Asten, Edgar J G Peters
No abstract text is available yet for this article.
January 2016: Diabetes/metabolism Research and Reviews
Chalotte Winther Nicolajsen, Maja Holch Dickenson, Jacob Budtz-Lilly, Nikolaj Eldrup
OBJECTIVE: Little is known about acute peripheral arterial thrombosis in patients with concomitant cancer. Small studies suggest that revascularization in this patient group is associated with thrombosis and increased risk of amputation and death. We investigated the frequency of cancer in patients operated on for acute peripheral arterial thrombosis and the long-term risk of amputation, mortality, myocardial infarction, and stroke in a national cohort. METHODS: This was a prospective case/noncase study comprising all Danish citizens undergoing vascular surgery for acute arterial thrombosis from 1986 to 2012 with up to 26 years of follow-up...
December 2015: Journal of Vascular Surgery
Stavros K Kakkos, Konstantinos O Papazoglou, Ioannis A Tsolakis, George Lampropoulos, Spyros I Papadoulas, Pavlos N Antoniadis
OBJECTIVES: Open surgical repair (OSR) of inflammatory abdominal aortic aneurysms (IAAAs) can have significant morbidity. The aim of the present investigation was to compare IAAA outcome after OSR and endovascular aneurysm repair (EVAR) and perform a meta-analysis of the literature. METHODS: Twenty-seven patients with an intact IAAA operated on during a 21-year period were included. RESULTS: Nine patients were managed with EVAR and 18 with OSR...
July 2015: Vascular and Endovascular Surgery
Victor J Davila, William Stone, Audra A Duncan, Emily Wood, William D Jordan, Nicholas Zea, W Charles Sternbergh, Samuel R Money
OBJECTIVE: Single-center experiences with the treatment of infected endografts after endovascular aortic repair (I-EVAR) have been reported. We performed a multicenter review of the surgical care of these patients to elucidate short-term and long-term outcomes. METHODS: A retrospective analysis of all EVAR explants from 1997 to 2014 at four institutions was performed. Patients with I-EVAR undergoing surgical treatment were reviewed. Data were obtained detailing preoperative demographics, and postoperative morbidity and mortality...
October 2015: Journal of Vascular Surgery
Vincent Ziza, Ludovic Canaud, Thomas Gandet, Nicolas Molinari, William Alonso, Robin Chastan, Pascal Branchereau, Eric Picard
OBJECTIVE: Critical limb ischemia (CLI), the most advanced form of peripheral arterial disease, is associated with strikingly high morbidity and mortality rates. Autogenous single-segment great saphenous vein (GSV) remains the optimal conduit for infrainguinal revascularization. Unfortunately, GSV is unavailable in up to 20% of patients. There is no consensus about the alternative graft that should be used for infragenicular bypass grafting when the GSV is unavailable. Currently, there are no outcome data for cold-stored venous allograft use in regard to recent safety and efficacy objective performance goals described by the Society for Vascular Surgery...
October 2015: Journal of Vascular Surgery
Bahar Golchehr, Rombout Kruse, Laurens A van Walraven, Mare M A Lensvelt, Clark J Zeebregts, Michel M P J Reijnen
OBJECTIVE: Self-expanding covered stents for superficial femoral artery (SFA) occlusive disease have undergone an evolution during the years. Early results of the latest generation, the heparin-bonded Viabahn (W. L. Gore & Associates, Flagstaff, Ariz) with a contoured proximal edge, were promising, with reported 1-year primary patency rates of 73% to 78% in long lesions. The aim of this study was to present the 3-year outcome of the heparin-bonded Viabahn for SFA occlusive disease. METHODS: All patients treated with a heparin-bonded Viabahn in three centers between April 2009 and December 2011 were included in the study and retrospectively analyzed...
October 2015: Journal of Vascular Surgery
David Shemesh, Ilya Goldin, Jamal Hijazi, Ibrahim Zaghal, Daniel Berelowitz, Anthony Verstandig, Oded Olsha
OBJECTIVE: Prosthetic grafts continue to be required for hemodialysis access when the options for native fistulas have been exhausted. The inferior long-term patency of grafts makes the possibility of preventing occlusion with heparin-bonded grafts an attractive alternative. We carried out a prospective randomized study to compare the patency of standard grafts with heparin-bonded grafts. METHODS: Patients with end-stage renal failure requiring a prosthetic access were randomized to receive either a standard expanded polytetrafluorethylene (ePTFE) graft or a heparin-bonded ePTFE graft...
July 2015: Journal of Vascular Surgery
Michael S Conte, Frank B Pomposelli, Daniel G Clair, Patrick J Geraghty, James F McKinsey, Joseph L Mills, Gregory L Moneta, M Hassan Murad, Richard J Powell, Amy B Reed, Andres Schanzer, Anton N Sidawy
Peripheral arterial disease (PAD) continues to grow in global prevalence and consumes an increasing amount of resources in the United States health care system. Overall rates of intervention for PAD have been rising steadily in recent years. Changing demographics, evolution of technologies, and an expanding database of outcomes studies are primary forces influencing clinical decision making in PAD. The management of PAD is multidisciplinary, involving primary care physicians and vascular specialists with varying expertise in diagnostic and treatment modalities...
March 2015: Journal of Vascular Surgery
Mohammad H Eslami, Denis Rybin, Gheorghe Doros, Alik Farber
OBJECTIVE: Open (OPAR) and endovascular (EPAR) repair are both used to treat popliteal artery aneurysm (PAA). We assessed outcomes of both modalities in the treatment of asymptomatic PAAs. METHODS: Vascular Quality Initiative (VQI) databases (2010 to 2013) were queried for patients undergoing asymptomatic PAA repair using OPAR and EPAR. The groups were compared with respect to demographics, medical history, and procedural characteristics. Outcomes of interest were length of stay (LOS), major adverse limb events (MALE), MALE or perioperative death (MALE-POD), and loss of primary patency compared using Kaplan-Meier estimates...
March 2015: Journal of Vascular Surgery
H P Ebben, J H Nederhoed, R J Lely, M R Meijerink, B B van der Meijs, W Wisselink, K K Yeung, A W J Hoksbergen
OBJECTIVE: To evaluate the efficacy and bleeding complications associated with a low-dose thrombolysis protocol for thromboembolic lower extremity arterial occlusions. DESIGN: A retrospective cohort study. MATERIALS AND METHODS: A retrospective analysis was performed using data from all consecutive patients who underwent catheter-directed, intra-arterial thrombolysis for thromboembolic lower extremity arterial occlusions between January 2004 and May 2013...
November 2014: European Journal of Vascular and Endovascular Surgery
Aparna Swaminathan, Sreekanth Vemulapalli, Manesh R Patel, W Schuyler Jones
Peripheral artery disease affects over eight million Americans and is associated with an increased risk of mortality, cardiovascular disease, functional limitation, and limb loss. In its most severe form, critical limb ischemia, patients are often treated with lower extremity (LE) amputation (LEA), although the overall incidence of LEA is declining. In the US, there is significant geographic variation in the performing of major LEA. The rate of death after major LEA in the US is approximately 48% at 1 year and 71% at 3 years...
2014: Vascular Health and Risk Management
2016-05-13 04:26:30
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