Journal of Vascular Surgery

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Updated: 40 min 58 sec ago

Fenestrated endovascular aneurysm repair is associated with lower perioperative morbidity and mortality compared with open repair for complex abdominal aortic aneurysms

40 min 58 sec ago
The Zenith Fenestrated Endovascular Graft (ZFEN; Cook Medical, Bloomington, Ind) has expanded the anatomic eligibility of endovascular aneurysm repair (EVAR) for complex abdominal aortic aneurysms (AAAs). Current data on ZFEN mainly consist of single-institution experiences and show conflicting results. Therefore, we compared perioperative outcomes after repair using ZFEN with open complex AAA repair and infrarenal EVAR in a nationwide multicenter registry.

Using bifurcated endoprosthesis after iliac artery recanalization for concomitant abdominal aortic aneurysm and chronic total occlusions of access routes

40 min 58 sec ago
Concurrent abdominal aortic aneurysm (AAA) and unilateral iliac occlusion is a challenge in the implantation of bifurcated stent grafts (BFGs). The endovascular approach is less invasive than open surgery; the aortouni-iliac (AUI) graft with crossover femorofemoral bypass (CFFB) has many problems associated with extra-anatomic reconstruction. We attempted endovascular aneurysm repair (EVAR) using BFGs in such cases and evaluated the outcomes.

Discussion

40 min 58 sec ago
Dr Nathan Orr (Lexington, Ky). I would like to congratulate the authors on an excellent presentation and manuscript as they begin to sort through the incidence and characteristics of secondary aortic interventions after thoracic endovascular aortic repair (TEVAR) for type B aortic dissections. As you have just heard, secondary aortic interventions are commonly required in this cohort, with an overall incidence of 27%. Further, this is fairly consistent for all comers, with relatively few predictors of increased incidence.

Implications of secondary aortic intervention after thoracic endovascular aortic repair for acute and chronic type B dissection

40 min 58 sec ago
Thoracic endovascular aortic repair (TEVAR) has become a mainstay of therapy for acute and chronic type B aortic dissection (TBAD). Dynamic aortic morphologic changes, untreated dissected aorta, and persistent false lumen perfusion have significant consequences for reintervention after TEVAR for TBAD. However, few reports contrast differences in secondary aortic intervention (SAI) after TEVAR for TBAD or describe their influence on mortality. This analysis examined incidence, timing, and types of SAI after TEVAR for acute and chronic TBAD and determined their impact on survival.

Endograft migration after thoracic endovascular aortic repair

40 min 58 sec ago
The objective of this study was to evaluate the incidence, timing, and potential risk factors of late endograft migration after thoracic endovascular aortic repair (TEVAR).

Addition of proximal intervention to carotid endarterectomy increases risk of stroke and death

40 min 58 sec ago
Adding ipsilateral, proximal endovascular (IPE) intervention to carotid endarterectomy (CEA) for the treatment of tandem bifurcation and supra-aortic trunk disease is controversial. Some suggest that this combined strategy (CEA + IPE) confers no risk over isolated CEA (ICEA). Others disagree, reserving CEA + IPE for symptomatic patients. Using the Vascular Quality Initiative (VQI), this study assessed the effect of adding IPE to CEA on stroke and death risk. We further weighed CEA + IPE outcomes in the context of symptomatic status and Society for Vascular Surgery guidelines.

Cost-effectiveness analysis of endovascular versus open repair of abdominal aortic aneurysm in a high-volume center

February 14, 2019 - 23:00
Endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is the standard treatment for anatomically suitable patients. EVAR has been associated with a lower perioperative morbidity and mortality compared with open surgical repair (OSR) at the expense of increased reinterventions and costs. We aimed to compare the outcomes of EVAR and OSR for elective AAA repair. The primary end point was cost per QALY at 3 years. Secondary end points were perioperative morbidity and mortality; freedom from reintervention; length of hospital, high-dependency unit, and intensive care unit stay; and freedom from all-cause mortality.

Analysis of the retrograde tibial artery approach in lower extremity revascularization in an office endovascular center

February 14, 2019 - 23:00
The objective of this study was to evaluate the safety and efficacy of a retrograde tibial approach in revascularization of lower extremities for treatment of ischemia in anatomically challenging patients.

Long-term outcome of sac filling with fibrin sealant after endovascular aneurysm repair of abdominal aortic aneurysm with challenging aortic neck anatomy

February 14, 2019 - 23:00
A retrospective single-center study is reported here to assess the safety and long-term effectiveness of applying a fibrin sealant (FS) sac-filling strategy to eliminate type IA endoleak (TIAE) after endovascular aneurysm repair (EVAR) of abdominal aortic aneurysm.

Predictors of in-hospital adverse events after endovascular aortic aneurysm repair

February 14, 2019 - 23:00
Endovascular aneurysm repair (EVAR) offered outstanding survival benefit but at the expense of cost, periodic radiographic monitoring, and higher reinterventions rates. Perioperative complications, although rare, can occur after EVAR, contributing to longer hospitalization, higher cost, and significant comorbidity and mortality. Therefore, the aim of this study was to identify the predictors of in-hospital events (IHEs) after elective EVAR.

Perivascular adipose tissue modulates carotid plaque formation induced by disturbed flow in mice

February 14, 2019 - 23:00
Emerging evidence shows that perivascular adipose tissue (PVAT) is crucially involved in inflammation and cardiovascular diseases. However, controversial results have been reported regarding the effect of PVAT in atherosclerosis. This study aimed to determine the role of PVAT in disturbed blood flow (d-flow)-induced carotid plaque formation.

A systematic review and meta-analysis of the effects of supervised exercise therapy on modifiable cardiovascular risk factors in intermittent claudication

February 14, 2019 - 23:00
Cardiovascular events, such as myocardial infarction and stroke, contribute significantly to the prognosis of patients with peripheral artery disease. Therefore cardiovascular risk reduction is a vital element of treatment in patients with intermittent claudication (IC). The cardiovascular risk is largely determined by modifiable risk factors, which can be treated with medical care and lifestyle adjustments, such as increasing physical activity. The objective of this study was to determine the effects of supervised exercise therapy (SET) on modifiable cardiovascular risk factors in IC patients.

Risk of emergent carotid endarterectomy varies by type of presenting symptoms

February 14, 2019 - 23:00
The timing of carotid revascularization in symptomatic patients is a matter of ongoing debate. Current evidence indicates that carotid endarterectomy (CEA) within 2 weeks of symptoms is superior to delayed treatment. However, there is little evidence on the outcomes of emergent CEA (eCEA). The purpose of this study was to compare outcomes of emergency eCEA vs nonemergent CEA (non-eCEA), stratified by type of presenting symptoms.

Safety of transfer, type of procedure, and factors predictive of limb salvage in a modern series of acute limb ischemia

February 14, 2019 - 23:00
The primary objective was to evaluate the safety of transfer, type of procedure, and factors associated with limb salvage in patients with acute limb ischemia (ALI) treated at a quaternary referral center.

Effects of a novel hydrogen sulfide prodrug in a porcine model of acute limb ischemia

February 14, 2019 - 23:00
Previous studies have shown that hydrogen sulfide (H2S) exerts potent proangiogenic properties under in vitro conditions and in rodent models. We sought to determine whether a novel H2S prodrug promotes peripheral revascularization in a swine model of acute limb ischemia (ALI).

Results of retrograde open mesenteric stenting for acute thrombotic mesenteric ischemia

February 14, 2019 - 23:00
Acute mesenteric ischemia (AMI) is an emergent event with a high mortality rate; survivors have high rates of intestinal failure. Restoration of blood flow using endovascular or surgical revascularization is associated with better outcome in terms of survival rate and intestinal resection. Retrograde open mesenteric stenting (ROMS), which is a hybrid technique, combines two benefits: prompt blood flow restoration with an endovascular approach and inspection and resection of the small bowel. The aim of the study was to assess the results of ROMS in thrombotic AMI in a retrospective multicenter study.

Peripheral artery reconstructions using cryopreserved arterial allografts in infected fields

February 4, 2019 - 23:00
Cryopreserved human arterial allografts are a recognized acceptable alternative for vascular reconstruction when other traditional conduits are either unavailable or contraindicated. We reviewed our experience using cryopreserved arterial allografts for peripheral artery reconstructions in contaminated and infected surgical fields.

Durability of open surgical repair of type I-III thoracoabdominal aortic aneurysm

February 4, 2019 - 23:00
Early outcomes and late mortality after open repair of extent I to III thoracoabdominal aortic aneurysms (TAAAs) are described, but late graft and aortic events are seldom detailed. This study investigated long-term aortic and graft outcomes as these data are increasingly important as endovascular repair matures.

Statin use improves limb salvage after intervention for peripheral arterial disease

January 31, 2019 - 23:00
Statin use is recommended in all patients with peripheral arterial disease (PAD) owing to its morbidity and mortality benefits. However, the effect of statin use on limb salvage in patients with PAD after intervention is unclear. We examined the effect of statin use on limb salvage and survival among patients with PAD undergoing surgical or endovascular intervention.

The state of complex endovascular abdominal aortic aneurysm repairs in the Vascular Quality Initiative

January 31, 2019 - 23:00
Endovascular repair of complex abdominal aortic aneurysms has become increasingly common, but reports have mostly been limited to single centers and single devices.