JVS-vascular insights最新文献

{"title":"Impact of vascular resident involvement on operative variables and outcomes in endovascular aneurysm repair","authors":"Nicholas Reitsma BHK ,&nbsp;Sally H.J. Choi MD ,&nbsp;Gary K. Yang PhD, MD","doi":"10.1016/j.jvsvi.2025.100230","DOIUrl":"10.1016/j.jvsvi.2025.100230","url":null,"abstract":"<div><h3>Objective</h3><div>Our objective was to determine how operative variables and patient outcomes differ for endovascular aneurysm repair (EVAR) done with and without trainees.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent elective infrarenal EVARs with bifurcated endograft between October 1, 2017, and September 30, 2022, was carried out. The presence of vascular residents, patient demographics and comorbidities, intraoperative variables, and postoperative clinical outcomes were tabulated. Operative variables and patient outcomes were compared between cases with and without trainees using the Student <em>t</em> test. A multivariate analysis of fluoroscopic measures was also carried out using body mass index (BMI) as a covariate.</div></div><div><h3>Results</h3><div>A total of 148 patients were included in the study with 53 cases taking place with trainees and 95 without. There were no statistically significant differences in patient demographics or comorbidities between the groups. Cases with trainees had significantly longer surgical time (84 ± 5 minutes vs 71 ± 3 minutes; <em>P</em> &lt; .01), fluoroscopy time (19 ± 1 minutes vs 14 ± 1 minutes; <em>P</em> &lt; .001), and higher volumes of contrast (86 ± 6 mL vs 72 ± 3 mL, <em>P</em> = .02). When correcting for body mass index, cases with trainees still had longer fluoroscopy times (<em>P</em> &lt; .01). There was also a trend toward greater radiation doses with trainees (531 ± 74 mGy vs 381 ± 53 mGy; <em>P</em> = .10). The presence of trainees did not significantly impact patient outcomes such as mortality, length of stay, or postoperative complications.</div></div><div><h3>Conclusions</h3><div>The presence of vascular residents at EVARs increased surgical and fluoroscopy time despite the presence of two attending surgeons. This finding should be considered when optimizing trainee education while minimizing radiation exposure and its impact on patient care.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One surgeon’s travails with the transition from private practice to hospital employment","authors":"Dipankar Mukherjee MD, FACS, DFSVS, RPVI","doi":"10.1016/j.jvsvi.2025.100192","DOIUrl":"10.1016/j.jvsvi.2025.100192","url":null,"abstract":"<div><h3>Objective</h3><div>Practice models for vascular surgeons entering the workforce have a menu to choose from. Typically, these choices are: (1) hospital employed; (2) private practice model; and (3) academic practice.</div></div><div><h3>Methods</h3><div>I present the point of view of a hospital-employed physician. Having spent many years in private practice before becoming a hospital-employed physician.</div></div><div><h3>Results</h3><div>I am able to evaluate the advantages and disadvantages of both models.</div></div><div><h3>Conclusion</h3><div>The purpose of this article is to inform the graduating vascular surgeons of the career choices that are available and help them make the best decision in this regard.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100192"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and 30-day mortality of aortitis among Medicare beneficiaries undergoing unruptured abdominal aortic aneurysm repair","authors":"Benjamin D. Pollock PhD, MSPH ,&nbsp;Razvan M. Chirila MD ,&nbsp;Annette M. Danks MBA ,&nbsp;Jennifer B. Cowart MD","doi":"10.1016/j.jvsvi.2024.100178","DOIUrl":"10.1016/j.jvsvi.2024.100178","url":null,"abstract":"<div><h3>Background</h3><div>The <em>US News &amp; World Report'</em>s Best Hospitals Procedures and Conditions ratings aim to assess hospital performance for routine inpatient care. Aortitis is a complicating factor for abdominal aortic aneurysm (AAA) repair, but aortitis diagnoses are not currently an exclusion criteria for the AAA repair rating. We assessed 30-day mortality among patients with aortitis during AAA repair to determine whether aortitis should be an exclusion criterion.</div></div><div><h3>Methods</h3><div>We used the Medicare Beneficiary Summary File and Inpatient Limited Data Sets from January 1, 2019, to December 1, 2022. We included all encounters for AAA repair with a diagnosis code for unruptured AAA. We excluded encounters with a diagnosis code for ruptured AAA. We calculated the prevalence of aortitis (defined using <em>International Classification of Diseases</em>, 10th edition, codes) in this population, and used log-linear regression to compare the age- and sex-adjusted risk of 30-day mortality in patients with aortitis vs those without aortitis. We reported the adjusted risk ratio and 95% confidence interval.</div></div><div><h3>Results</h3><div>There were 51,508 AAA repair encounters. The prevalence of aortitis was 2.3% (1167/51,508); 30-day mortality occurred in 37/1167 (3.2%) encounters with an aortitis diagnosis vs 998/50,341 (2.0%) without aortitis (adjusted risk ratio, 1.50; 95% confidence interval,1.09-2.07; <em>P</em> = .01).</div></div><div><h3>Conclusions</h3><div>AAA repair with concurrent aortitis should be excluded from quality outcome measures.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100178"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extravascular supported arteriovenous fistulas reduced the need for interventions to support maturation and time to achieve two-needle cannulation for end-stage kidney disease patients in a multicenter US study","authors":"Mohamad A. Hussain MD, PhD ,&nbsp;C. Keith Ozaki MD ,&nbsp;David Nation MD ,&nbsp;Jason Burgess MD ,&nbsp;Dirk M. Hentschel MD ,&nbsp;C.Steven Settle MD ,&nbsp;John F. Lucas MD ,&nbsp;Ellen Dillavou MD ,&nbsp;Alik Farber MD, MBA","doi":"10.1016/j.jvsvi.2025.100205","DOIUrl":"10.1016/j.jvsvi.2025.100205","url":null,"abstract":"<div><h3>Objective</h3><div>This study sought to assess the functional outcomes of arteriovenous fistulas (AVFs) created with VasQ, a permanent, surgically-implanted extravascular scaffold made of nitinol, and compare it with outcomes of unsupported AVFs in patients with end-stage kidney disease (ESKD).</div></div><div><h3>Methods</h3><div>The VasQ US Pivotal Study was a prospective, single-arm, multicenter study that enrolled patients eligible for radiocephalic and brachiocephalic AVF creation from 2018 through 2019 to evaluate the safety and efficacy of creating AVFs with VasQ support. For this study, VasQ trial sites were invited to participate in a retrospective chart review for a comparative analysis of patients who underwent the creation of unsupported AVFs. Control patients were identified from a time period immediately before study initiation, using the same inclusion and exclusion criteria as the Pivotal Study. Patient follow-up records were prohibited from review before inclusion into the control cohort to minimize ascertainment bias. Outcomes evaluated included functional AVF success, time to first use, and rate of fistula abandonment, and interventions to support maturation before first use. A multivariate analysis was performed to compare outcomes between VasQ supported and unsupported (control) AVFs.</div></div><div><h3>Results</h3><div>Six VasQ US Pivotal Study sites participated, which provided 104 ESKD patients: 52 VasQ AVFs and 52 controls. Groups were well-matched for baseline parameters, including vessel diameter and AVF location. VasQ AVFs experienced a significant decrease in median time to first use (56 days vs 85 days; <em>P</em> = .04). Additionally, significantly fewer interventions to support maturation were needed in VasQ AVFs (0.25 per patient vs 0.63 per patient; <em>P</em> = .002). More VasQ AVFs achieved functional success without the assistance of interventions to support maturation at 3 months (46% vs 23%; <em>P</em> = .013) and 6 months (65% vs 45%; <em>P</em> = .03). Multivariate analysis demonstrated that implantation of VasQ was significantly associated with greater odds for 3- and 6-month unassisted functional success after AVF creation (adjusted odds ratio [aOR], 2.95 [95% confidence interval (CI), 1.23-7.43; <em>P</em> = .018], and aOR, 2.44 [95% CI, 1.09-5.61; <em>P</em> = .031], respectively), and lower odds for needing reinterventions (aOR, 0.40; 95% CI, 0.16-0.96; <em>P</em> = .045).</div></div><div><h3>Conclusions</h3><div>Creation of VasQ AVFs was associated with greater unassisted functional success, an overall lower maturation procedure rate, and shorter time to first use when compared with well-matched control AVFs created by the same surgeons. Improvement in these key functional outcomes should translate directly into clinically meaningful benefits for patients with ESKD.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100205"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study protocol for a novel perioperative mind-body intervention for peripheral vascular interventions","authors":"C.Y. Maximilian Png MD ,&nbsp;Gloria Y. Yeh MD, MPH ,&nbsp;Anahita Dua MD, MBA, MPH ,&nbsp;Abhisekh Mohapatra MD ,&nbsp;Junaid Y. Malek MD ,&nbsp;Nikolaos Zacharias MD ,&nbsp;James H. Balcom MD ,&nbsp;Sunita D. Srivastava MD ,&nbsp;Matthew J. Eagleton MD","doi":"10.1016/j.jvsvi.2025.100199","DOIUrl":"10.1016/j.jvsvi.2025.100199","url":null,"abstract":"<div><h3>Background</h3><div>A novel mind-body intervention (MBI) targeting vascular surgery patients undergoing peripheral vascular interventions (PVIs) under procedural sedation and analgesia (PSA) was recently developed, but has yet to be clinically tested. An exploratory randomized controlled trial is planned to test the novel intervention in patients undergoing PVIs under PSA.</div></div><div><h3>Methods</h3><div>Patients undergoing PVIs under PSA by vascular surgeons across four hospitals in Massachusetts and New Hampshire will be screened for enrollment. Exclusion criteria include urgent or emergent procedures, prior ipsilateral lower extremity amputations (including digit amputations) and non-English speakers. 30 patients will be enrolled and randomized 1:1 to either a perioperative MBI on the day of surgery (n = 15), or a standard of care control (n = 15). There would be no restriction on anesthesia practice, and collected data will include perioperative pain and sedation requirements and qualitative feedback from both the patients and perioperative staff.</div></div><div><h3>Conclusions</h3><div>This protocol delineates a pilot randomized controlled trial to test the feasibility and acceptability of a novel perioperative MBI for patients undergoing PVIs under PSA.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100199"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential long-term hospital-level economic impact of anticoagulation alone vs endovascular treatment in patients with deep vein thrombosis-related leg ulcers","authors":"Lorena De Marco Garcia MD","doi":"10.1016/j.jvsvi.2024.100160","DOIUrl":"10.1016/j.jvsvi.2024.100160","url":null,"abstract":"<div><h3>Objectives</h3><div>Endovascular treatments for deep vein thrombosis (DVT) have shown effectiveness at rapidly restoring flow, which may help to decrease chronic venous disease (CVD) and venous leg ulcer (VLU) incidence. However, data describing such long-term outcomes are sparse. We analyze the location of thrombus at the incident acute DVT event in patients who subsequently developed VLUs. Further, we establish a model to estimate the long-term hospital level economic impact associated with endovascular DVT treatment compared with the standard of care, anticoagulation (AC).</div></div><div><h3>Methods</h3><div>This analysis consisted of a single-center retrospective chart review and hypothetical cost model. Patients were identified by <em>International Classification of Diseases,</em> 10th edition clinical modification, codes, chart, and imaging review. The economic model evaluated a hypothetical cohort of 100 patients through three distinct health care phases: initial DVT management, a period of worsening CVD symptoms, and long-term VLU wound care. Model parameters were derived from prior literature. Patients were simulated to receive endovascular treatment or AC over a period of 12 years. Cumulative costs were estimated assuming 20%, 40%, 50% (base case), 60%, and 80% effectiveness of endovascular treatment to prevent worsening CVD symptoms and VLU development.</div></div><div><h3>Results</h3><div>In total, 73 patients were identified and included. Incident DVTs were iliofemoral-popliteal in 4 of 73 (5.5%), isolated femoropopliteal in 43 of 73 (58.9%), femoropopliteal with below-the-knee-involvement in 11 of 73 (15.1%), and isolated below the knee in 15 of 73 (20.5%). The median initial DVT event occurred in July 2020 (interquartile range, June 2018 to January 2022) and the median time to VLU onset was 466 days (interquartile range, 51-1190 days). Per patient long-term cost estimates were $100,186 for AC and $100,100, $80,245, $70,318, $60,391, and $40,536 for endovascular treatment that is 20%, 40%, 50%, 60%, and 80% effective, respectively. The initial cost benefit compared with AC was anticipated at 11.4, 3.7, 2.8, 2.3, and 1.9 years for endovascular treatment that is 20%, 40%, 50%, 60%, and 80% effective, respectively.</div></div><div><h3>Conclusions</h3><div>This retrospective analysis identified a high incidence of femoral and below DVTs associated with VLU development, with little iliac involvement. Identifying at-risk patients with DVT is crucial for decreasing chronic complications; current technologies can treat femoropopliteal or more proximal disease effectively. Additionally, the hypothetical economic model suggests that endovascular DVT treatments could provide long-term savings if demonstrated to moderately decreasing VLU incidence.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143096040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of CellerateRX Surgical Powder utility in reducing groin complications after femoral exposure","authors":"Vy C. Dang BS ,&nbsp;Eric K. Peden MD ,&nbsp;Trisha Roy MD, PhD ,&nbsp;Alan B. Lumsden MD ,&nbsp;Linda Le MD ,&nbsp;Charudatta S. Bavare MD ,&nbsp;Sohaib K. Mhaidi MD ,&nbsp;Maham Rahimi MD, PhD","doi":"10.1016/j.jvsvi.2024.100165","DOIUrl":"10.1016/j.jvsvi.2024.100165","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Vascular procedures involving groin incisions for femoral exposure often have complications that delay wound healing. These complications include but are not limited to the development of seromas, hematomas, skin necrosis, or infection requiring reintervention leading to readmission, increased length of stay, and increased morbidity and mortality, including limb loss. In this non-concurrent cohort study, we evaluate the usefulness of CellerateRX Surgical Powder in preventing postoperative groin complications. We compare the outcomes of groin incisions that received standard surgical wound care and those in which CellerateRX Surgical Powder was applied to the surgical incision prior to primary closure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Groin incisions required for femoral exposure in vascular surgery procedures were considered. The control group included cases between 2020 and 2021. Exclusion criteria included patients &lt;18 years of age, those with a bovine allergy, those with an active groin infection, and those undergoing a repeat femoral exposure. Bilateral groin incisions were counted as two separate constituents in the overall sample. The perioperative protocol in the management of these patients included 1-hour preoperative vancomycin (15 mg/kg intravenously [IV])/ceftriaxone (2 g IV), double skin preparation with 4% chlorhexidine, hair removal with surgical clippers, Ioban, postoperative doxycycline (100 mg oral or IV twice daily for 24 hours), and negative pressure wound therapy or a muscle flap in high-risk patients. Patients between 2022 and 2023 who met the described inclusion criteria were enrolled into the experimental group. The only change to the perioperative protocol of the experimental group was the addition of CellerateRX Surgical Powder to the surgical wound before closure. Patients were followed for 6 months. The primary outcome was the number of groin complications that required return to the operating room (eg, seroma, hematoma, and infection).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The control group consisted of 136 groins, 17 (13%) of which developed complications—7 (5.1%) seromas, 2 (1.5%) hematomas, 5 (3.7%) soft tissue infections, and 3 (2.2%) skin necrosis cases. The treatment group consisted of 20 groins, 3 (15%) of which developed complications—two seromas and one soft tissue infection. A two-tailed Fisher's exact test demonstrated no statistically significant association between the presence of complications and the treatment group (&lt;em&gt;P&lt;/em&gt; = .49, α = 0.05); however, patients in the experimental cohort were found to be a higher risk group, having significantly higher prevalence of diabetes and surgeries using a prosthetic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Based on the results of this study, we cannot conclude that a packing application of CellerateRX Surgical Powder alters the risk of developing postoperative groin complications compared with standard wound care. No hematoma","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100165"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of cryopreserved and autologous vein grafts in aortic reconstruction","authors":"Nicholas Reitsma BHK ,&nbsp;Gary K. Yang MD, PhD","doi":"10.1016/j.jvsvi.2025.100229","DOIUrl":"10.1016/j.jvsvi.2025.100229","url":null,"abstract":"<div><h3>Objective</h3><div>Our objective was to determine operation duration, length of stay, and outcome differences between patients requiring aortic reconstruction with autologous vein grafts and cryopreserved vein grafts.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent aortic reconstruction using autologous vein grafts and cryopreserved vein grafts between January 1, 2012, and February 1, 2024, was completed. Patient demographics and comorbidities, presenting symptoms, and postoperative outcomes were reviewed. Operative variables and patient outcomes were compared using the Student <em>t</em> test and odds ratios. Outcome variables were further stratified by secondary injury requiring additional repair in addition to reconstruction, such as aortoenteric fistulas or damage to surrounding structures, primary vs secondary infection, type of surgical repair, and number of veins required for reconstruction.</div></div><div><h3>Results</h3><div>A total of 33 patients were included in the study, with 17 patients receiving cryopreserved grafts and 16 autologous grafts. Of these, 5 patients had primary infections, and 26 had secondary infections. There were no statistically significant differences in demographics or comorbidities between the groups. In patients requiring reconstruction with two veins, cryopreserved vein use was associated with decreased operative times, irrespective of concurrent injury (271 ± 22 minutes vs 359 ± 26 minutes; <em>P</em> &lt; .05). In uncomplicated repairs without secondary injury, cryopreserved vein reconstructions also had significantly shorter operative times (261 ± 21 minutes vs 324 ± 20 minutes; <em>P</em> &lt; .05). Cryopreserved vein use did not impact mortality or postoperative complication rates significantly up to the 2-year follow-up.</div></div><div><h3>Conclusions</h3><div>Using cryopreserved veins decreased operative time for patients without concomitant injury and in cases requiring two harvested autologous veins. Postoperative outcomes were similar between the groups.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100229"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Introduction to block chain technology and potential applications in vascular surgery","authors":"Michael C. Wilkinson MD ,&nbsp;Daniel Roh BS ,&nbsp;Sharon C. Kiang MD ,&nbsp;Roger T. Tomihama MD, MBA","doi":"10.1016/j.jvsvi.2025.100262","DOIUrl":"10.1016/j.jvsvi.2025.100262","url":null,"abstract":"<div><h3>Background</h3><div>Blockchain technology (BCT) provides the capability to record data in a decentralized platform with immutable properties, preserving the authenticity and enabling the interoperability of a new kind of data-driven domain that is promising for vascular surgeons. The purpose of this article was to introduce blockchain and assess and synthesize the potential applications within vascular surgery to improve patient care.</div></div><div><h3>Methods</h3><div>The authors have analyzed the various roles of BCT for application in vascular surgery through an extensive literature review conducted in August 2024.</div></div><div><h3>Results</h3><div>This is the first published discussion of potential applications and challenges of BCT in vascular surgery, which includes an advantageous decentralized platform for data storage and surveillance image sharing and wider research capabilities to leverage artificial intelligence to improve patient outcomes Potential challenges include high installation and computing costs, social acceptance and regulatory issues, and scalability.</div></div><div><h3>Conclusions</h3><div>Utility of BCT within vascular surgery is promising. Further studies should assess the feasibility of interoperability and data integrity.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100262"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144749254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary clinician perspectives on peripheral artery disease (PAD) education and a PAD video education tool","authors":"Margaret A. Reilly MD, MS ,&nbsp;Isabel C. Cohen BS ,&nbsp;Megan E. Alagna BS ,&nbsp;Cassandra B. Iroz MS ,&nbsp;Julie K. Johnson PhD, MSPH ,&nbsp;Karen J. Ho MD","doi":"10.1016/j.jvsvi.2025.100258","DOIUrl":"10.1016/j.jvsvi.2025.100258","url":null,"abstract":"<div><h3>Objective</h3><div>The goals of this mixed-methods study were to understand: (1) the education strategies used by multidisciplinary clinicians who treat patients with peripheral artery disease (PAD); and (2) their perceptions of a PAD video education tool.</div></div><div><h3>Methods</h3><div>We conducted a single-center convergent parallel mixed-methods study of vascular surgeons, advanced practice vascular nurses, and primary care physicians focused on their current PAD education strategies. All participants completed a questionnaire to obtain information about demographics and professional practice. Semi-structured interviews were conducted before and after participants watched a 20-minute patient-centered PAD video education tool. Pre-video interviews were used to understand current education strategies. Post-video interviews were used to assess the acceptability, appropriateness, and feasibility of the video. Participants also completed a post-video questionnaire to assess the acceptability, appropriateness, and feasibility using a five-item Likert scale. Interviews were recorded and transcribed. Transcripts were analyzed using codes developed using inductive and deductive methods. Qualitative analysis was conducted in dyads to refine codes and identify overarching themes.</div></div><div><h3>Results</h3><div>There were seven participants, including two vascular surgeons, four advanced practice vascular nurses, and one primary care physician. The themes were divided into four categories: (1) perceptions of current PAD education practices; (2) barriers to education; (3) feedback on the video education tool and implementation; and (4) recommendations and goals for improved PAD education. Participants prefer individualized education tailored to perceived patient knowledge and disease course; they do not consistently state, “You have PAD” to patients; and they have difficulty understanding the effectiveness of their education techniques. Barriers to education include time pressures and disease complexity. While participants feel that the video education tool could be an effective alternative to printed education materials, challenges to video implementation include time constraints, technological barriers, and the inability for patients to ask questions. Improving PAD patient education should emphasize the need for longitudinal and multidisciplinary care.</div></div><div><h3>Conclusions</h3><div>This study of clinicians who treat PAD generates important narrative insights into the challenges of clinician-led PAD education. They value individualizing patient-centric PAD education and prioritizing opportunities for patients to ask questions but face significant pressures to deliver and evaluate the education they provide. The PAD video education tool is unlikely to replace direct discussions with patients but may be a valuable adjunctive tool.</div></div>","PeriodicalId":74034,"journal":{"name":"JVS-vascular insights","volume":"3 ","pages":"Article 100258"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}