Journal of Vascular Surgery

BACKGROUND/PURPOSE: Several studies have shown the superiority of CEA with patch closure over primary closure. However, no definite study has shown any significant differences in clinical outcome between various types of patches. Since more vascular surgeons are utilizing pericardial patching recently, this study will analyze late clinical outcome (≥10-years) of our previously reported prospective randomized trial comparing CEA with ACUSEAL (PTFE) vs pericardial patching. PATIENT POPULATION/METHODS: 200 CEAs were randomized (1:1) to either VASCU Guard pericardial patching or ACUSEAL patching...

OBJECTIVES: Compliance with SVS clinical practice guidelines (CPGs) is associated with improved outcomes for treatment of abdominal aortic aneurysm, but this has not been assessed for carotid artery disease. The VQI registry was used to examine compliance with the SVS CPGs for management of extracranial cerebrovascular disease and its impact on outcomes. METHODS: The 2021 SVS extracranial cerebrovascular disease CPGs were reviewed for evaluation by VQI data. Compliance rates by center and provider were calculated, and the impact of compliance on outcomes was assessed using logistic regression with inverse probability-weighted risk adjustment for each CPG recommendation, allowing for clustering by center...

OBJECTIVES: Patients with chronic kidney disease (CKD) who undergo peripheral vascular interventions (PVI) with iodinated contrast are at higher risk of post-contrast acute kidney injury (PC-AKI). CO2 angiography can reduce iodinated contrast volume usage in this patient population, but its impact on PC-AKI has not been studied. We hypothesize that CO2 angiography is associated with a decrease in PC-AKI in patients with advanced CKD. METHODS: The Vascular Quality Initiative (VQI) Peripheral Vascular Interventions (PVI) dataset from 2010-2021 was reviewed...

INTRODUCTION: The purpose of this study was to evaluate the effect of directional branches (DB) bridging stent choice on target artery (TA) outcomes during fenestrated-branched endovascular repair (FB-EVAR) of complex abdominal (CAAAs) and thoracoabdominal aortic aneurysms (TAAAs). METHODS: Patients enrolled in nine prospective physician-sponsored investigational device exemption (PS-IDE) studies in the United States between 2005 and 2020 were analyzed. All patients who had at least one TA incorporated by DB using either self-expandable (SESGs), balloon-expandable (BESGs), or hybrid stent graft combinations (HSG)...

OBJECTIVE: Intravascular ultrasound (IVUS) use in lower extremity interventions is growing in popularity due to its imaging in the axial plane, superior detail in imaging lesion characteristics, and its enhanced ability to delineate lesion severity and extent compared to catheter angiogram. However, there are conflicting data regarding whether IVUS affects outcomes. The purpose of this study was to assess the effect associated with IVUS implementation in femoropopliteal interventions...

INTRODUCTION: Community distress is associated with adverse outcomes in patients with cardiovascular disease, however, its impact on clinical outcomes following peripheral vascular intervention (PVI) is uncertain. The Distressed Communities Index (DCI) is a composite measure of community distress measured at the zip code level. We evaluated the association between community distress, as measured by the DCI, and 24-month mortality and major amputation following PVI. METHODS: We used the Vascular Quality Initiative (VQI) database, linked with Medicare claims data, to identify patients who underwent initial femoropopliteal PVI between 2017 and 2018...

OBJECTIVE: This study aimed to evaluate the influence of change in ambulatory status on the prognosis of patients with chronic limb-threatening ischemia (CLTI) undergoing infrainguinal bypass surgery or endovascular therapy (EVT). METHODS: We retrospectively analyzed data from two vascular centers for patients who underwent revascularization for CLTI between 2015 and 2020. The primary endpoint was overall survival (OS), and the secondary endpoints were changes in ambulatory status and postoperative complications...

OBJECTIVE: Although the Society of Vascular Surgery (SVS) aortic injury grading system is used to depict the severity of injury in blunt thoracic aortic injury (BTAI) patients, prior literature on its association with outcomes following thoracic endovascular aortic repair (TEVAR) is limited. METHODS: We identified patients undergoing TEVAR for BTAI within the VQI between 2013-2022. We stratified patients based on their SVS aortic injury grade (grade 1: intimal tear; grade 2: intramural hematoma; grade 3: pseudoaneurysm; and grade 4: transection/extravasation)...

INTRODUCTION: The purpose of this study is to provide an updated description of demographics, technical details and clinical outcomes of 101 consecutive branch renal artery repairs in 98 patients using cold perfusion. METHODS: Single institution, retrospective analysis branch renal artery reconstructions performed between 1987 and 2019. RESULTS: Patients were predominantly Caucasian (80.6%) women (74.5%) with mean age of 46.8 ± 15.3 years...

The Society for Vascular Surgery and the Enhanced Recovery After Surgery (ERAS®) Society formally collaborated and elected an international, multi-disciplinary panel of experts to review the literature and provide evidence-based suggestions for coordinated peri-operative care for patients undergoing infrainguinal bypass surgery for peripheral artery disease. Structured around the ERAS® core elements, 26 suggestions were made and organized into preadmission, preoperative, intraoperative, and postoperative sections...

OBJECTIVES: The objective of this study was to review the outcomes of a multidisciplinary approach to the surgical management of pediatric bone tumors with blood vessel involvement over a 14- year period. METHODS: A retrospective review was conducted of all pediatric bone tumor resections performed with the assistance of vascular surgery at our institution between January 2006 and January 2021. Inclusion criteria for the study included the presence of a vascular surgeon at the operative resection and radiographic evidence of major blood vessel involvement...

OBJECTIVE: To evaluate safety and efficacy of thoracic endovascular aortic repair (TEVAR) for acute Stanford type B aortic dissection (TBAD) with retrograde type A intramural hematoma (TAIMH). METHODS: Patients with acute TBAD with retrograde TAIMH treated with TEVAR between 1 January 2014 to 31 March 2022 were retrospectively reviewed. Aortic diameter and distance were measured using the 3D Slicer image computing platform. Patients' characteristics, procedural, in-hospital and follow-up data, and aortic remodeling were analyzed...

INTRODUCTION: Endovascular management of thoracoabdominal aneurysms (TAAA) is becoming more common. Technological advances including custom devices under the Physician-Sponsored Investigational Device Exemption (PS-IDE), physician modified devices (PMEG), and parallel stenting techniques have expanded the extent of disease that is amenable to endovascular treatment. Patients within the PS-IDE studies are a highly selected group of patients, whereas patients treated with PMEG as captured within the Society of Vascular Surgery Vascular Quality Initiative (SVS-VQI) represent a real-world experience...

OBJECTIVE: To quantify percent calcification within carotid artery plaques and assess its impact on percent residual stenosis and rate of restenosis in patients undergoing TCAR for symptomatic and asymptomatic carotid artery stenosis. METHODS: A retrospective review of prospectively collected institutional Vascular Quality Initiative (VQI) data was performed to identify all patients undergoing TCAR from December 2015 to June 2021 (n=210). Patient and lesion characteristics were extracted...

STUDY OBJECTIVE: The aim of the study is to evaluate the natural history of extracranial cervical artery dissection including comorbidities, symptoms at presentation, recurrence of symptoms, and long-term outcome following different treatment approaches. METHODS: A retrospective review of patients treated for acute cervical artery dissection was performed over a 5-year period from January 2017 to April 2022. RESULTS: 39 patients were included in the study...

OBJECTIVE: Much attention has been given to the influence of anatomic and technical factors, such as maximum AAA diameter and proximal clamp position, in open AAA repair (OSR). However, no studies have rigorously examined the correlation between site of distal anastomosis and OSR outcomes despite conventional wisdom that more proximal sites of anastomosis are preferrable when technically feasible. This study aimed to test the association between sites of distal anastomosis and clinical outcomes for patients undergoing primary elective OSR...

OBJECTIVES: Peripheral artery disease (PAD) is a worldwide epidemic that affects millions of patients, especially the elderly. It has a prevalence of 20% in individuals greater than 80 years old. Although PAD affects greater than 20% of octogenarians, information about limb salvage rates in this patient population is limited. Therefore, this study aims to understand the impact of bypass surgery on limb salvage in patients age > 80 years with critical limb ischemia. METHODS: We conducted a retrospective analysis by querying the electronic medical records at a single institution from 2016 through 2022 to identify the population of interest and analyzed their outcomes following lower extremity bypass...

BACKGROUND: Patients with chronic limb-threatening ischemia (CLTI) are at high risk for adverse limb outcomes and mortality. Using the Vascular Quality Initiative (VQI) prediction model to estimate mortality after revascularization can assist with clinical decision-making. We aimed to improve the discrimination of the 2-year VQI risk calculator by incorporating a common iliac artery (CIA) calcification score based on computed tomography (CT) scans. METHODS: This was a retrospective analysis of patients who underwent infrainguinal revascularization for CLTI from 1/2011 to 6/2020 and had a CT scan of the abdomen/pelvis 2 years before or up to 6 months after revascularization...

BACKGROUND: Previous studies have identified groups of patients with abdominal aortic aneurysm (AAA) that fall outside of currently accepted screening guidelines. Population-based studies have found AAA screening would be cost-effective at a prevalence of 0.5-1%. The goal of this study was to determine the prevalence of AAA in patients that fall outside of the current screening guidelines. In addition, we analyzed outcomes of the groups with a prevalence of greater than 1%. METHODS: Using the TriNetX Analytics Network, several patient cohorts were abstracted with a diagnosis of ruptured or unruptured AAA based on previously identified groups with potential high risk for AAA that fall outside of currently accepted screening guidelines...

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