Journal of Vascular Surgery最新文献

{"title":"Computed tomography-based anatomical suitability of an Endo-Bentall prosthesis for ascending aortic aneurysms.","authors":"Mustafa Aldag, Petroula Nana, Giuseppe Panuccio, José I Torrealba, Niklas Schofer, Konstantinos Spanos, Yskert von Kodolitsch, Jens Brickwedel, Till Joscha Demal, Christian Detter, Tilo Kölbel","doi":"10.1016/j.jvs.2024.10.084","DOIUrl":"10.1016/j.jvs.2024.10.084","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the suitability of a coronary-branched ascending aortic endograft, paired with aortic valve (AV) prosthesis (Endo-Bentall), for the endovascular repair of ascending aortic aneurysms.</p><p><strong>Methods: </strong>Preoperative ≤1 mm computed tomography angiographies of consecutive patients managed with Bentall procedure or ascending aortic replacement and AV reconstruction/replacement, in a single institution (from January 1, 2008, to December 31, 2023), were retrospectively analyzed. Dedicate software was used to assess (1) vascular access, (2) proximal landing zone, (3) coronary artery anatomy, and (4) distal landing. Eligibility criteria for Endo-Bentall were ≥8 mm iliac arteries, without severe calcification/tortuosity, proximal landing with an 18- to 29-mm aortic annulus diameter, ≥10 mm annulus-coronary ostium distance, no mechanical AV, absence of coronary grafts in the ascending aorta, no left ventricle thrombus, coronary arteries ≥3 mm wide and ≥10 mm long, with no anatomical abnormalities, ostial stent or stenosis, and ≥20 mm long and ≤38 mm wide distal landing zone within the ascending aorta or applicability of branched endovascular arch repair.</p><p><strong>Results: </strong>Twenty-nine patients (55.2% females) were included. All patients had adequate proximal landing zone in terms of annulus diameter (median, 25 mm; interquartile range [IQR], 5 mm). Two (6.8%) had inadequate iliac access (external iliac artery <8 mm). Two patients (6.8%) had a mechanical AV. Twenty-six patients (89.6%) had adequate landing zone for stenting of the left main coronary artery (median diameter, 5.2 mm; IQR, 1.8 mm) and 28 (96.6%) had adequate right coronary artery landing (median diameter, 4.1 mm; IQR, 1 mm). The left main coronary artery and right coronary artery were located at 5:00 minute and 10:50 minute clock positions, respectively. Three patients (20.7%) had an adequate distal landing zone within the ascending aorta. The remaining were suitable for extension with a branched arch device. According to the predefined criteria, 75.9% of patients were anatomically suitable for Endo-Bentall.</p><p><strong>Conclusions: </strong>Three out of four patients with ascending aortic aneurysms may be considered as anatomically eligible for endovascular treatment with an Endo-Bentall prosthesis.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a preoperative frailty screening and optimization pathway for vascular surgery patients is associated with decreased 30-day readmission.","authors":"Shernaz S Dossabhoy, Stephanie Rose Manuel, Farishta Yawary, Tara Lahiji-Neary, Nathalie Cheng, Lisa Cianfichi, Ani Bagdasarian, Elizabeth L George, Julianna G Marwell, Jason T Lee, Ronald L Dalman, Cliff Schmiesing, Shipra Arya","doi":"10.1016/j.jvs.2024.11.018","DOIUrl":"10.1016/j.jvs.2024.11.018","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Frailty is characterized by decreased physiological reserve and vulnerability to adverse events in the presence of a stressor such as surgery. We prospectively implemented a preoperative frailty screening and optimization pathway for patients undergoing vascular surgery and assessed its impact on postoperative outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;As part of an ongoing quality improvement initiative, surgical frailty was assessed prospectively in all patients undergoing inpatient surgery using the Risk Analysis Index (RAI). Baseline data were collected from May to July 2022. Frail patients (RAI score of ≥37) were referred to an anesthesia optimization clinic, nutrition consultation, and case management evaluation in the intervention phase (August 2022 to July 2023). Primary outcomes were postoperative hospital length of stay, 30-day readmission, and 30-day mortality. Secondary outcomes included intensive care unit (ICU) admission, ICU length of stay, discharge disposition, and nonhome discharge. Two-way analyses compared frail vs nonfrail patients and preintervention vs postintervention groups using the Student t test or Wilcoxon rank-sum test for continuous variables and the χ&lt;sup&gt;2&lt;/sup&gt; or Fisher's exact test for categorical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of all patients scheduled for elective inpatient vascular surgery procedures at a single institution (n = 225), 216 completed frailty screening (mean age, 72 years; 68.5% male; 54.6% White; mean RAI, 28.9; 18.5% frail). Of these, 15 had surgeries cancelled, and 201 ultimately underwent surgery with 36 (17.9%) identified as frail. Overall, frail patients had significantly longer ICU (median, 4.0 days [intertquartile range (IQR), 2.5-13.5 days] vs median, 2.0 days [IQR, 1-4 days]; P = .001) and hospital length of stay (median, 2.45 days [IQR, 1.51-5.67 days] vs median, 1.23 days [IQR, 1.0-2.1 days]; P = .001), higher nonhome discharge (30.6% vs 4.2%; P &lt; .0001), and higher 30-day readmission (22.2% vs 6.7%; P = .009) compared with nonfrail patients. Comparing preintervention and postintervention groups, the 30-day readmission rates for the overall cohort decreased significantly (from 22.2% to 7.5%; P = .03). Among frail patients, there was a trend toward a reduced hospital length of stay (from 4.73 to 2.14 days), nonhome discharge (from 57.1% to 24.1%), and 30-day readmission (from 42.9% to 17.2%); however, these differences did not reach statistical significance. Overall, the 30-day mortality rate was 1.5% with all three deaths (two frail, one nonfrail) occurring during the postintervention period (0% pre vs 1.7% post; P = 1.0).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Successful implementation of a preoperative frailty screening and optimization pathway for patients undergoing elective vascular surgery led to a significant decrease in overall 30-day readmission and a trend toward reduced hospital length of stay, nonhome discharge, and 30-day readmissio","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Pedal Acceleration Time With Healing and Amputation Free Survival in Patients With Ulceration and Gangrene","authors":"O. Hart,&nbsp;K.T. Lee,&nbsp;S. Gormley,&nbsp;B. August,&nbsp;G. Abbott,&nbsp;M. Khashram","doi":"10.1016/j.jvs.2024.08.048","DOIUrl":"10.1016/j.jvs.2024.08.048","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Pages A1894-A1895"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Just because we can technically do something does not mean that we should","authors":"Alik Farber MD, MBA","doi":"10.1016/j.jvs.2024.07.100","DOIUrl":"10.1016/j.jvs.2024.07.100","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Page 1823"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REPAIRS Delphi: A UK and Ireland Consensus Statement on the Management of Infected Arterial Pseudoaneurysms Secondary to Groin Injecting Drug Use","authors":"C.S. MacLeod,&nbsp;J. Nagy,&nbsp;A. Radley,&nbsp;F. Khan,&nbsp;N. Rae,&nbsp;M.S.J. Wilson,&nbsp;S.A. Suttie,&nbsp;REPAIRS Collaborative","doi":"10.1016/j.jvs.2024.08.051","DOIUrl":"10.1016/j.jvs.2024.08.051","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Page A1895"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142700188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The anterior saphenous vein. Part 3. Systematic review of the literature and payor coverage policies. Endorsed by the American Vein and Lymphatic Society, the American Venous Forum, and the International Union of Phlebology","authors":"R. Drgastin,&nbsp;E.M. Boyle,&nbsp;N. Labropoulos,&nbsp;A. Caggiati,&nbsp;A. Gasparis,&nbsp;S. Doganci,&nbsp;M. Meissner","doi":"10.1016/j.jvs.2024.10.003","DOIUrl":"10.1016/j.jvs.2024.10.003","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Page A13"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximalization of arterial inflow with adjunctive arterial pressure measurements for management of hemodialysis access-induced distal ischemia","authors":"S. Paci,&nbsp;V. Narvaez,&nbsp;Y. Etkin","doi":"10.1016/j.jvs.2024.10.006","DOIUrl":"10.1016/j.jvs.2024.10.006","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Page A13"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Detangling sex-based disparities in acute limb ischemia outcomes—Progress is being made, but we are behind the curve","authors":"Marissa C. Jarosinski MD, MSc ,&nbsp;Thomas L. Forbes MD","doi":"10.1016/j.jvs.2024.07.097","DOIUrl":"10.1016/j.jvs.2024.07.097","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Pages 1804-1805"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Race and income do not affect ruptured abdominal aortic aneurysm treatment modality","authors":"Hao D. Pham MD","doi":"10.1016/j.jvs.2024.07.092","DOIUrl":"10.1016/j.jvs.2024.07.092","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Page 1684"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iliac transposition technique for reconstruction of aortic bifurcation in pediatric blunt abdominal aortic injury","authors":"H. Hanif,&nbsp;R. Clark,&nbsp;L. Chavez,&nbsp;R. Miskimins,&nbsp;M.A. Rana","doi":"10.1016/j.jvs.2024.10.005","DOIUrl":"10.1016/j.jvs.2024.10.005","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"80 6","pages":"Page A13"},"PeriodicalIF":3.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142699228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}