Journal of Vascular Surgery

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AA2. 64% Reduction in Readmission After Endovascular Aneurysm Repair Using Machine Learning and Big Data

31 October 2018 - 11:00pm
Readmission rates after endovascular aneurysm repair (EVAR) are an average of 15% ± 6% at 30 days. The principal reasons for readmission include wound complications, pneumonia, renal complications, sepsis, bowel obstruction, and bleeding. With increased emphasis on pay for performance and lowering of overall readmission rates by the Centers for Medicare and Medicaid Services, there is significant financial pressure to improve the quality of health care delivery and to reduce costs.

AA1. Contrast Medium-Free Approach to Patients With Abdominal Aortic Disease and Renal Insufficiency

31 October 2018 - 11:00pm
Diagnosis and endovascular treatment of abdominal aortic diseases could expose patients to worsening of renal function because of the use of iodinated contrast medium. We report a specific contrast medium-free approach to patients with abdominal aortic disease and moderate to severe renal insufficiency. The protocol includes accurate assessment of chronic kidney disease (CKD), preoperative ultrasound evaluation, intravascular ultrasound, and AFX2 endoprosthesis (Endologix, Irvine, Calif).

CAR 13. Carotid Artery Stenting in Elderly Patients

31 October 2018 - 11:00pm
We postulated that carotid artery stenting could be safely performed in elderly patients if certain anatomic and clinical markers, such as excessive vascular tortuosity, heavy concentric calcification of the lesion, and decreased cerebral reserve, were avoided. We tried to determine the influence of age on complication rates of carotid artery stenting.

CAR 12. Trends and Outcomes of Carotid Revascularization in the Chinese Population: Analysis of >1000 Cases in a Single Institution from 2002 to 2017

31 October 2018 - 11:00pm
Vast and profound changes have taken place in China during the past 3 decades. Stroke burden remains particularly high in this country, with an incidence and mortality rate of 246.8 and 114.8/100,000 people, respectively. However, the efficacy and safety of carotid endarterectomy (CEA) and carotid artery stenting (CAS) in the Chinese population are not clear. In this study, we investigated the outcomes after carotid revascularization for Chinese patients in a single institution.

CAR 11. Concentration of Specific Markers in Patients With the Subclinical Form of Atherosclerosis

31 October 2018 - 11:00pm
Stroke is the third most common cause of death and the most common reason for premature permanent invalidism. About 10% to 15% of strokes occur as the result of severe atherosclerotic malfunction of the internal carotid artery (ICA). Atherosclerosis is the main cause of carotid artery stenosis formation. However, the risk of stroke is higher in patients with soft atherosclerotic plaque. One of the options of stroke prevention, then, is a surgical treatment—carotid endarterectomy. However, the surgical benefit is not so significant in asymptomatic patients, in whom the risk of recurrent stroke in the first year after surgery is 3.2%, whereas the risk of a perioperative stroke is about 3%.

CAR 10. Endarterectomy for Acute Symptomatic Thrombotic Occlusion of the Entire Extracranial Internal Carotid Artery: A Case Report

31 October 2018 - 11:00pm
We report the case of a 60-year-old woman who was admitted with a sudden onset of numbness of the left upper extremity. Two weeks before admission, the patient presented with a right hemispheric transient ischemic attack and temporary right facial paresis.

CAR 9. Impact of Carotid Artery Stenting on Visual Functions in Patients With Different Severity of Ocular Ischemic Syndrome

31 October 2018 - 11:00pm
The objective of this study was to investigate the effects of carotid artery stenting (CAS) on ocular functions in patients with ocular ischemic syndrome (OIS).

CAR 8. International Call at VEITH Symposium for Randomized PREvention of CArotid REstenosis (PRECARE) Study by Implementation of Restenosis Risk Rate Calculator and Inflammatory Markers Analysis

31 October 2018 - 11:00pm
We have recently published that three main predictors for carotid restenosis (CR) within 1 year after carotid endarterectomy (CEA) are increased high-sensitivity C-reactive protein before CEA (6 hours), increased fibrinogen 48 hours after surgery, and not taking aspirin after CEA. A Fisher equation incorporating these predictors was created to predict CR after CEA implemented in a computer program, the carotid restenosis risk rate (3R) calculator. This program calculates whether the patient is at low or high risk for CR and displays recommended therapeutic algorithms consisting of aspirin, clopidogrel, cilostazol, and statins.

CAR 7. American Society of Anesthesiologists Classification Is a Highly Significant Predictor of Ipsilateral Stroke-Free Survival in Asymptomatic Octogenarians With Elective Internal Carotid Endarterectomy

31 October 2018 - 11:00pm
Internal carotid endarterectomy in asymptomatic patients is being discussed controversially, in particular in octogenarians. The goal of this investigation was to determine, whether recently operated on patients met the 2017 guidelines of the European Society for Vascular Surgery (ESVS) in hindsight.

CAR 6. Dual Antiplatelet Therapy and Clopidogrel “Resistance” in Carotid Stenting: Preliminary Results

31 October 2018 - 11:00pm
Dual antiplatelet therapy (DAPT) using acetylsalicylic acid (ASA, 75-325 mg daily) associated with a thienopyridine (either clopidogrel 75 mg daily or ticlopidine 250 mg twice a day) is strongly recommended by the international guidelines for patients undergoing carotid artery stenting (CAS) to reduce perioperative neurologic events. The phenomenon of pharmacologic "resistance” to the effect of clopidogrel, however, may occur in up to 30%. The aim of the study was to describe the prevalence of clopidogrel resistance in a case series of patients submitted to CAS and undergoing DAPT and to analyze the effectiveness and side effects of alternative antiplatelet therapies currently in use at our institution.

CAR 5. Factors Affecting Baroreceptor Function and Blood Pressure Control During Carotid Endarterectomy

31 October 2018 - 11:00pm
The objective of this study was to assess the impact of carotid endarterectomy on blood pressure homeostasis and baroreflex function, with reference to the presence or absence of significant contralateral carotid artery disease. We conducted a 2-year prospective study of 80 patients undergoing carotid endarterectomy for >70% symptomatic stenoses. Results were combined with anatomic and physiologic studies of carotid baroreceptors performed at the same center.

CAR 4. Transcranial Cerebral Oximetry as Neuromonitoring During Carotid Endarterectomy

31 October 2018 - 11:00pm
Cross-clamp ischemia during carotid endarterectomy can be prevented with carotid shunts in vulnerable patients identified by cerebral monitoring. We evaluated transcranial cerebral oximetry for selective shunt use in 654 patients.

CAR 3. Comparative Analysis of Transfemoral and Transradial Approaches in Endovascular Treatment of Carotid Artery Stenosis

31 October 2018 - 11:00pm
The objective of this study was to estimate the safety, effectiveness, and economic importance of the transradial approach in comparison with the transfemoral one.

CAR 2. Results of Carotid Artery Stenting in a Belgian “Real-World” Practice

31 October 2018 - 11:00pm
Carotid artery stenting (CAS) is a valuable solution for the treatment of carotid artery stenosis in a population of patients at high risk for carotid endarterectomy (CEA). This high-risk population includes patients with recurrent stenosis after CEA, high/low lesion, contralateral laryngeal nerve palsy, previous radical neck surgery, cervical radiation therapy, and tracheostomy. In the European Society for Vascular Surgery guidelines, however, the authors were concerned about the death and stroke rates of CAS in “real-world” practice.

CAR 1. Carotid Endarterectomy for Asymptomatic Carotid Artery Stenosis: Can We Predict Who Will Need Intensive Care Unit Postoperative Care?

31 October 2018 - 11:00pm
All asymptomatic patients benefit from 3 to 6 hours of neurologic and intra-arterial blood pressure (BP) monitoring after carotid endarterectomy (CEA). However, only a minority of patients will require routine postoperative monitoring in a high-dependency unit or intensive care unit (HDU/ICU). The aim of this paper was to identify preoperative and intraoperative predictors of HDU/ICU postoperative monitoring need.

LEV 10. Single-Session Femoral-Popliteal Venoplasty for Infrainguinal Obstruction

31 October 2018 - 11:00pm
Obstruction of the femoral-popliteal (FP) axis can be the underlying disease alone or occur in combination with iliac veins. Currently, there are limited options for such patients. This pilot study evaluated the safety and efficacy of a single-session FP venoplasty (SSFPV) with local infusion of tissue plasminogen activator (tPA) using a novel percutaneous transluminal angioplasty balloon.

LEV 9. Causes of Recurrent Varicose Vein After Endovenous Laser Ablation Therapy Confirmed by Three-Dimensional Computed Tomography Venography and Duplex Ultrasound

31 October 2018 - 11:00pm
The objective of this study was to determine the cause and anatomic patterns of recurrent varices after endovenous laser ablation (EVLA).

LEV 8. Inframalleolar Access for Endovascular Treatment of Venous Insufficiency Ulcers

31 October 2018 - 11:00pm
Routinely, the venous access point in endovenous treatment of venous ulcers is above the ulcer, around the knee area. We present our experience using inframalleolar access.

LEV 7. Location of Venous Leg Ulcer as a Predictor of Poor Healing

31 October 2018 - 11:00pm
There are several factors that influence venous hypertension, which can result in disagreement in the literature regarding risk factors for delayed wound healing. The objective of this study was to identify whether the locations of venous leg ulcers (VLUs) can be an independent risk factor for determining a poor healing rate compared with other common risk factors.

LEV 6. Klippel-Trénaunay Syndrome: A Case Report and Literature Review

31 October 2018 - 11:00pm
We present a case of Klippel-Trénaunay syndrome (KTS), a rare, sporadic vascular malformation characterized by its clinical triad of port-wine stains, varicosities, and limb hypertrophy.