Journal of Vascular Surgery

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Role of nutritional indices in predicting outcomes of vascular surgery

24 March 2019 - 11:00pm
Malnutrition is frequent among vascular surgery patients, given their age, chronic comorbidities, and poor functional status, and it is believed to increase their operative risk. We aimed to assess the combined use of recent significant weight loss (>10% body mass) and serum albumin levels as a nutritional status index to predict outcomes.

Moderate-pain versus pain-free exercise, walking capacity, and cardiovascular health in patients with peripheral artery disease

24 March 2019 - 11:00pm
Supervised exercise training (walking) is recommended in patients with intermittent claudication, both as a means to improve symptoms (walking distance and quality of life [QoL]) and as a means to improve general cardiovascular health (including vascular function and heart rate variability [HRV]). Our aim was to compare two types of supervised training (moderate-pain and pain-free walking) with comparable intensity based on heart rate, in terms of walking capacity, QoL, vascular function, biomarkers, and HRV in patients with intermittent claudication.

The GORE TAG conformable thoracic stent graft with the new ACTIVE CONTROL deployment system

24 March 2019 - 11:00pm
The aim of this study was to describe single-center intraoperative details and early outcome of the new GORE TAG conformable stent graft with ACTIVE CONTROL (C-TAG ACTIVE CONTROL; W. L. Gore & Associates, Flagstaff, Ariz).

Branding vascular surgery should start with Why

19 March 2019 - 11:00pm
First and foremost, I want to thank you for the privilege of serving as Eastern Vascular Society (EVS) president. To see my name on the same list as the past presidents is humbling and the greatest honor of my professional life. The opportunity to work and collaborate with the EVS executive council, committee chairs, and members has been nothing short of an incredible personal and professional experience, one that I will forever cherish and hold dear to my heart. Even though we have shared friendships for years, this year was very special for me in that it allowed me to get to know many of my colleagues at a much more personal level, for which I am indebted.

Associations of nutritional status and muscle size with mortality after open aortic aneurysm repair

18 March 2019 - 11:00pm
Open surgical repair (OSR) for abdominal aortic aneurysms is a more invasive approach than endovascular aneurysm repair but has more enduring results and may lead to a lower reintervention rate. Therefore, strict selection of patients should be based on assessments of both early and late outcomes. The controlling nutritional status (CONUT) score and skeletal muscle mass index (SMI) have been reported as indicators of nutritional status and muscle size, respectively. The aim of this study was to identify prognostic factors, including sarcopenia and nutritional status, for early and late outcomes.

The forearm arteriovenous graft between the brachial artery and the brachial vein as a reliable dialysis vascular access for patients with inadequate superficial veins

16 March 2019 - 11:00pm
The arteriovenous fistula (AVF) is recommended as the preferred hemodialysis access. However, placing an AVF in all patients may result in poor access outcomes and increased central venous catheter (CVC) use because of increased comorbid conditions, age, and suboptimal vessels. In patients with inadequate superficial veins for AVFs, the use of the brachial veins for creation of forearm arteriovenous grafts (AVGs) has received limited attention. This retrospective study aimed to evaluate outcomes of forearm brachial-brachial AVGs (BB-AVGs) placed in patients with poor superficial veins.

Why randomized controlled trials do not always reflect reality

12 March 2019 - 11:00pm
Randomized controlled trials (RCTs) constitute level I evidence and are used as the backbone of guidelines and recommendations for treatment. Although RCTs are theoretically the studies of choice for the assessment of the effectiveness of health care interventions, these trials (and their interpretation) may sometimes result in erroneous conclusions, erroneous therapeutic decisions, and incorrect recommendations. We aimed to check the applicability of the results of RCTs to everyday practice.

The natural history of type B aortic dissection in patients with PRKG1 mutation c.530G>A (p.Arg177Gln)

10 March 2019 - 11:00pm
The c.530G>A (p.Arg177Gln) mutation in PRKG1 has been shown to be associated with thoracic aortic aneurysms and dissections. This rare mutation accounts for an estimated 1% of nonsyndromic heritable thoracic aortic disease. We sought to describe the clinical presentation of type B aortic dissection (TBAD), management, and outcomes in patients with this mutation.

Cardiovascular morbidity and mortality after aortic dissection, intramural hematoma, and penetrating aortic ulcer

10 March 2019 - 11:00pm
The nonaortic cardiovascular morbidity and mortality of patients with aortic dissection (AD), intramural hematoma (IMH), and penetrating aortic ulcer (PAU) is unknown. We aimed to define the rates of cardiovascular (CV) events in a cohort of patients with newly diagnosed AD, IMH, and PAU.

iTalian RegIstry of doUble inner branch stent graft for arch PatHology (the TRIUmPH Registry)

10 March 2019 - 11:00pm
The objective of this study was to assess early and midterm results after endovascular aortic arch repair using a double inner branch stent graft (DIBSG) in patients with aortic arch aneurysm or dissection unfit for open surgery.

Association between stress hormones and perioperative risk in patients with critical limb ischemia undergoing revascularization

7 March 2019 - 11:00pm
It is well known that the clinical outcome of patients with critical limb ischemia (CLI) is poor. However, the relationship between stress-related hormone levels and CLI outcome remains unclear. The aim of this study was to reveal the association of stress hormones with the risk of a perioperative major adverse cardiovascular event (pMACE) in CLI patients undergoing surgical and endovascular revascularization.

Anatomic eligibility for transcarotid artery revascularization and transfemoral carotid artery stenting

6 March 2019 - 11:00pm
Transcarotid artery revascularization (TCAR) has emerged as an alternative to transfemoral carotid artery stenting (tfCAS). We investigated the proportion of carotid arteries undergoing revascularization procedures that would be eligible for TCAR based on anatomic criteria and how many arteries at high anatomic risk for tfCAS would be amenable to TCAR.

Return of baseline kidney function after bilateral renal artery stent occlusion and treatment delay following fenestrated endografting

6 March 2019 - 11:00pm
Although renal artery restenosis and thrombotic stent occlusion are not rare occurrences, the literature suggests that prompt diagnosis and treatment are essential to preserve renal function, particularly in the setting of occlusion. We describe the case of a 75-year-old woman who underwent fenestrated endovascular aneurysm repair and experienced acute anuric renal failure requiring dialysis secondary to bilateral renal artery stent occlusion for >48 hours. She was successfully treated with revisional endovascular therapy and made a full renal recovery.

Practice patterns in arteriovenous fistula ligation among kidney transplant recipients in the United States Renal Data Systems

6 March 2019 - 11:00pm
Arteriovenous fistulas (AVF) and grafts (AVG) have been associated with significant cardiac morbidity that often improves after ligation. However, AV access ligation after kidney transplant (KT) is controversial due to concern for potential long-term allograft failure. We investigated US trends in AV access ligation after KT and the association between ligation and allograft failure.

The effect of income and insurance on the likelihood of major leg amputation

6 March 2019 - 11:00pm
Although it has been suggested that individuals of low socioeconomic status and those with Medicaid or no insurance may be more likely to have their peripheral artery disease treated by leg amputation rather than by limb-saving revascularization, it is not clear if this disparity occurs consistently on a national basis, and if it does so in a linear fashion, such that poorer individuals are at progressively greater risk for amputation.

Knowledge gap of peripheral artery disease starts in medical school

5 March 2019 - 11:00pm
Previous data suggest that physicians have suboptimal knowledge about peripheral artery disease (PAD). Our aim was to evaluate Canadian medical students' knowledge of PAD to determine if this knowledge gap exists early in medical training.

Preoperative hemoglobin A1c levels and increased risk of adverse limb events in diabetic patients undergoing infrainguinal lower extremity bypass surgery in the Vascular Quality Initiative

5 March 2019 - 11:00pm
The impact of preoperative glycemic control on the risk of adverse perioperative outcomes in diabetic patients undergoing lower extremity bypass (LEB) surgery is not well-understood. We determined whether higher preoperative hemoglobin A1c (HbA1c) levels are associated with an increased risk of major adverse limb events, major adverse cardiovascular events, and mortality in diabetic patients undergoing infrainguinal LEB.

Sarcopenia predicts mortality and adverse outcomes after endovascular aneurysm repair and can be used to risk stratify patients

5 March 2019 - 11:00pm
Endovascular aneurysm repair (EVAR) is currently the most common treatment of abdominal aortic aneurysms. Potential predictors of long-term survival after EVAR include physiologic, functional, and cognitive status, but assessments of these conditions have been difficult to standardize. Objective radiographic findings, such as skeletal muscle atrophy, or sarcopenia, may provide an additional means for selection of patients. This study investigates sarcopenia as a method to predict 1-year survival in patients undergoing EVAR.

Physical therapy management, surgical treatment, and patient-reported outcomes measures in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome

5 March 2019 - 11:00pm
To assess the results of physical therapy management and surgical treatment in a prospective observational cohort of patients with neurogenic thoracic outlet syndrome (NTOS) using patient-reported outcomes measures.

Preoperative risk score for access site failure in ultrasound-guided percutaneous aortic procedures

5 March 2019 - 11:00pm
The factors associated with access site failure after ultrasound-guided percutaneous access for aortic endograft procedures remain poorly characterized. We developed a prediction model to risk stratify patients for access site failure.