NESVS24. Younger Patients Have Worse Outcomes After Peripheral Vascular Interventions for Aortoiliac Occlusive Disease
The options for treatment of aortoiliac occlusive disease (AIOD) are suprainguinal bypass (SIB) and peripheral vascular intervention (PVI). Whereas PVI is currently more commonly used, the choice of intervention is often dictated by the patient ’s age and comorbidities. We compared the association of the patient’s age with 1-year major adverse limb event (MALE)-free survival (MFS) and reintervention-free survival (RFS) among patients undergoing different treatments for AIOD. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Mohammad H. Eslami, William P. Robinson, Denis V. Rybin, Gheorghe Doros, Jeffrey J. Siracuse, Jens Eldrup-Jorgensen, Alik Farber Tags: Abstract from the 2018 New England Society for Vascular Surgery Annual Meeting Source Type: research

NESVS25. Most Patients Are Eligible for Transcarotid Revascularization Despite Its Anatomic Restrictions
Transcarotid artery revascularization (TCAR) has emerged as an alternative to transfemoral carotid artery stenting (CAS). We evaluated how many patients with carotid stenosis would qualify for TCAR on the basis of anatomic criteria. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Patric Liang, Winona Wu, Chun Li, Thomas F.X. O ’Donnell, Nicholas J. Swerdlow, Rens R.B. Varkevisser, Mark C. Wyers, Marc L. Schermerhorn Tags: Abstract from the 2018 New England Society for Vascular Surgery Annual Meeting Source Type: research

NESVS26. Safety and Efficacy of Venous Ablation in Octogenarians
Venous ablation (VA) is the recommended treatment of superficial venous insufficiency affecting lower extremities. The safety and efficacy of the procedure in octogenarians have not been well studied. We postulate that VA in octogenarians is as safe and effective as in younger age groups. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Afsha Aurshina, Yawei Zhang, Haoran Zhuo, Jonathan Cardella, Kristine Orion, Bauer Sumpio, Timur P. Sarac, Cassius I. Ochoa Chaar Tags: Abstract from the 2018 New England Society for Vascular Surgery Annual Meeting Source Type: research

The imperative need to identify stroke risk stratification models for patients with asymptomatic carotid artery stenosis
The optimal management of patients with asymptomatic carotid stenosis (ACS) is controversial. The study by Klarin et  al1 provides important novel information that challenges the theory claiming that medical treatment (MT) alone is adequate for the management of all patients with ACS and that prophylactic carotid endarterectomy is not justified in any of these patients.2 Klarin et al1 showed that 112 of 219 pat ients (50%) with radiographically confirmed first-ever carotid-related strokes did actually receive antiplatelet therapy before their stroke, and 121 of 219 patients (55%) received lipid-low...
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Kosmas I. Paraskevas, Jean-Baptiste Ricco Tags: Letter to the Editor Source Type: research

John R. (Jack) Hoover, April 22, 1929 to May 22, 2018
John R. “Jack” Hoover was a remarkable man who was in charge of the marketing team for medical products at W. L. Gore beginning in 1975. Over the years, he developed close personal and professional relationships with many of the leading vascular surgeons in the United States and around the world. By lea ding W. L. Gore to support—without asking anything in return —the clinical and research activities of vascular surgeons, he managed to transform the relationship between vascular surgery and industry into one of close partnership. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Donald Lass, Peter Gloviczki, Peter F. Lawrence Tags: In memoriam Source Type: research

Treatment of thoracoabdominal aortic disease in patients with connective tissue disorders
Aneurysmal degeneration of the entire aorta is common in patients with connective tissue disorders (CTDs). Potential treatment options of these aneurysms include open repair and endovascular repair. Our objective herein was to review available evidence for different approaches to treatment of thoracoabdominal aortic disease in patients with CTDs. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Natalia O. Glebova, Duke E. Cameron, James H. Black Tags: Review article Source Type: research

MACRA for the community practice vascular surgeon
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) established the Quality Payment Program (QPP), which shifts Medicare from a fee-for-service to a pay-for-performance program. In 2018, clinicians or groups with more than $90,000 in Part B allowed charges or more than 200 Part B beneficiaries are required to participate in the QPP.1 There are two participation options: Merit-based Incentive Payment System (MIPS) and Advanced Alternative Payment Models. Providers who do not meet minimum 2018 participation requirements will experience a 5% penalty in 2020 Medicare reimbursements. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Clifford M. Sales, Paul W. White, Jill Rathbun, Karen Woo Tags: Under the macrascope Source Type: research

A meta-analysis of randomized trials comparing bovine pericardium and other patch materials for carotid endarterectomy
The objective of the present study was to compare the different patch materials that are currently available (synthetic vs venous vs bovine pericardium) in terms of short- and long-term outcomes. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Pavlos Texakalidis, Stefanos Giannopoulos, Nektarios Charisis, Spyridon Giannopoulos, Theofilos Karasavvidis, George Koullias, Pascal Jabbour Tags: Review article Source Type: research

Cerebral Hyperperfusion Syndrome After Carotid Artery Stenting: A Systematic Review and Meta-analysis
Cerebral hyperperfusion syndrome (CHS) is a preventable cause of stroke after carotid endarterectomy (CEA). There are currently no pooled data available on the incidence of CHS after carotid artery stenting (CAS). The aim of this review was to assess the relevance of CHS in the procedural stroke rate following CAS. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: A.E. Huibers, J. Westerink, E.E. de Vries, A. Hoskam, H.M. den Ruijter, F.L. Moll, G.J. de Borst Tags: Selected Abstract from the September Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research

Mid-term Migration and Device Failure Following Endovascular Aneurysm Sealing with the Nellix Stent Graft System – a Single Centre Experience
Endovascular aneurysm sealing (EVAS) with the Nellix stent graft system is a novel concept in the management of abdominal aortic aneurysm (AAA) that aims to reduce the prevalence of all endoleaks following endovascular repair. There are few data describing the longer-term durability of this approach. The aim was to report the longer-term outcomes following EVAS in a single centre. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: S.C. Harrison, A.J. Winterbottom, P.A. Coughlin, P.D. Hayes, J.R. Boyle Tags: Selected Abstract from the September Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research

Single Stage Hybrid Repair for DeBakey Type I Aortic Dissection in High Risk Patients
To evaluate the efficacy of the less invasive hybrid zone 0 (Z0) total aortic arch repair (HAR, ascending repair  + complete debranching + thoracic endovascular aortic repair [TEVAR]) without deep hypothermic circulatory arrest in management of DeBakey type I aortic dissection (IAD). The adverse outcome was defined as a single composite endpoint comprising peri-operative mortality, permanent neurological d eficit, and renal failure necessitating haemodialysis at discharge. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: H. Lin, Y. Du, C. Yu, X. Qian, X. Sun, C. Tian, Y. Meng, H. Pei, C. Wang, P. Liu, X. Guo, M. Ma, Q. Chang Tags: Selected Abstract from the September Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research

International Variations in Amputation Practice: A VASCUNET Report
To study international differences in incidence and practice patterns as well as time trends in lower limb amputations related to peripheral arterial disease and/or diabetes mellitus. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: C.-A. Behrendt, B. Sigvant, Z. Szeberin, B. Beiles, N. Eldrup, I.A. Thomson, M. Venermo, M. Altreuther, G. Menyhei, J. Nordanstig, M. Clarke, H.C. Rie ß, M. Björck, E.S. Debus Tags: Selected Abstract from the September Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research

A Systematic Review and Meta-analysis of Thrombotic Events Following Endovenous Thermal Ablation of the Great Saphenous Vein
A systematic review and meta-analysis was performed to determine the incidence of thrombotic events following great saphenous vein (GSV) endovenous thermal ablation (EVTA). (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: D.A. Healy, S. Kimura, D. Power, A. Elhaj, Y. Abdeldaim, K.S. Cross, G.T. McGreal, P.E. Burke, T. Moloney, B.J. Manning, E.G. Kavanagh Tags: Selected Abstract from the September Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research

Radiation Dose Reduction During EVAR: Results from a Prospective Multicentre Study (The REVAR Study)
To evaluate radiation exposure in standard endovascular aneurysm repair (EVAR) using intra-operative guidance with pre-operative computed tomographic angiography (CTA) fusion and strict ALARA guidelines in a modern hybrid room. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: A. Hertault, R. Rhee, G.A. Antoniou, D. Adam, H. Tonda, H. Rousseau, A. Bianchini, S. Haulon Tags: Selected Abstract from the September Issue of the European Journal of Vascular and Endovascular Surgery Source Type: research

Outcomes After Angiography With Sodium Bicarbonate and Acetylcysteine
Double-blind, placebo controlled, randomized trial (PRESERVE trial: Prevention of Serious Adverse Events Following Angiography) between February 2013 – March 2017. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: S.D. Weisbord, M. Gallagher, H. Jneid, S. Garcia, A. Cass, S.S. Thwin, T.A. Conner Tags: Sodium bicarbonate and acetylcysteine do not prevent renal injury associated with arteriography in high-risk patients Source Type: research

Repair of Thoracic and Thoracoabdominal Mycotic Aneurysms and Infected Aortic Grafts Using Allograft
Single-center retrospective review between January 1, 2006 and December 31, 2016. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: J.S. Corvera, D. Blitzer, H. Copefland, D. Murphy, P.J. Hess, S.T. Pillai, J.W. Fehrenbacher Tags: Cryopreserved allografts are the best choice to treat infected thoracic aortas and grafts Source Type: research

Effects of Carotid Calcification on Restenosis After Carotid Artery Stenting: A Follow-Up Study With Computed Tomography Angiography
Single-center retrospective review between July 2002 and June 2012. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: C.H. Kim, J.S. Kang, W.S. Ryu, C.H. Sohn, B.W. Yoon Tags: Calcification is associated with recurrent stenosis after carotid artery stenting Source Type: research

Collected Transatlantic Experience From the PERICLES Registry: Use of Chimney Grafts to Treat Post-EVAR Type IA Endoleaks Shows Good Midterm Results
Retrospective analysis of PERICLES registry including 13 U.S. and European vascular centers between January 2008 and December 2014. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: S. Ronchey, S. Fazzini, S. Scali, G. Torsello, P. Kubilis, F. Veith Tags: Chimney grafts to treat type IA endoleaks give good midterm results Source Type: research

Carotid Artery Stent Placement and Carotid Endarterectomy: A Challenge for Urgent Treatment After Stroke: Early and 12-Month Outcomes in a Comprehensive Stroke Center
Single-center retrospective review between January 2013 and July 2015. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: A. Rocco, F. Sallustio, N. Toschi, B. Rizzato, J. Legramante, A. Ippoliti Tags: Carotid artery stenting and carotid endarterectomy are both useful treatments soon after moderate or major strokes Source Type: research

Drug-Eluting Stents Show Similar Patency Rates as Prosthetic Bypass in Patients With Femoropopliteal Occlusion in a Randomized Trial
Multicenter, prospective, randomized trial at six hospitals in Finland with patients entered between 2011 and 2014. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: P. Bjorkman, T. Auvinen, H. Hakovirta, P. Romsi, J. Turtiainen, H. Manninen Tags: Drug-eluting stents may replace stent grafts and prosthetic bypasses for femoropopliteal artery occlusions – well, maybe not yet Source Type: research

Journal of Vascular Surgery – October 2018 Audiovisual Summary
The paper of the month, “Preoperative risk score for the prediction of mortality after repair of ruptured abdominal aortic aneurysms,” is by Garland and co-authors from the University of Washington.1 They studied 303 patients over a 10-year period with a ruptured abdominal aortic aneurysm (AAA) and identified four vari ables (see Fig 1) from 145 collected, including age>76, creatinine>2, pH   (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Peter F. Lawrence Tags: Journal of Vascular Surgery – October 2018 Audiovisual Summary Source Type: research

Editorial Board
(Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Source Type: research

Contents
(Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Source Type: research

Information for authors
Complete information for authors and editorial policies are available in the January and July issues, at our Web site www.jvascsurg.org, or at our Editorial Manager Web site at jvs.editorialmanager.com. An abbreviated checklist for manuscript submission follows. Manuscripts that are accepted for publication become the property of the Journal of Vascular Surgery ®, which is copyrighted by the Society for Vascular Surgery®. They may not be published or reproduced in whole or in part without the written permission of the author(s) and the Journal. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Authors: Peter Gloviczki, Peter F. Lawrence Source Type: research

Information for readers
Communications regarding original articles and editorial management should be addressed to Peter Gloviczki, MD, and Peter F. Lawrence, MD, Editors, Journal of Vascular Surgery, 633 N. St. Clair, 22nd Floor, Chicago, IL 60611; telephone: 603-523-2222; fax: 312-334-2320; e-mail: JVASCSURG@vascularsociety.org. Information for authors appears in the January and July issues, at www.jvascsurg.org, and at jvs.editorialmanager.com. Authors should consult this document before submitting manuscripts to this Journal. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Source Type: research

Events of interest
News items of interest to the vascular surgeon must be received at least 8 weeks before the desired month of publication. Announcements published at no charge include those received from a sponsoring society of this Journal, those courses and conferences sponsored by state, regional, national, or international vascular surgical organizations, and university-sponsored continuing medical education courses. Send applicable events to Andrew O ’Brien, Journal Manager, at a.obrien@elsevier.com. All other news items selected for publication carry a charge of $60.00 US for each insertion, and the fee must accompany the reque...
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Source Type: research

Classified Advertising
(Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 20, 2018 Category: Surgery Source Type: research

Variability in hospital costs for carotid artery revascularization
The objective of this study was to understand drivers of cost for carotid endarterectomy (CEA) and carotid artery stenting (CAS) and to compare variation in cost among cases performed by vascular surgery (VS) with other services (OSs). (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 6, 2018 Category: Surgery Authors: Matthew W. Mell, Ning Tang, Raymond Lew, Ronald L. Dalman Tags: Clinical paper Source Type: research

Metformin prescription status and abdominal aortic aneurysm disease progression in the U.S. veteran population
Identification of a safe and effective medical therapy for abdominal aortic aneurysm (AAA) disease remains a significant unmet medical need. Recent small cohort studies indicate that metformin, the world's most commonly prescribed oral hypoglycemic agent, may limit AAA enlargement. We sought to validate these preliminary observations in a larger cohort. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - September 6, 2018 Category: Surgery Authors: Nathan K. Itoga, Kara A. Rothenberg, Paola Suarez, Thuy-Vy Ho, Matthew W. Mell, Baohui Xu, Catherine M. Curtin, Ronald L. Dalman Source Type: research

Toronto PowerWire fenestration technique to access false lumen branches in fenestrated endovascular aneurysm repair for chronic type B dissection
We present two cases of fenestrated endovascular aneurysm repair for chronic type B aortic dissection in which a renal artery from the false lumen was cannulated by creating a “neofenestration” through the dissection flap using a radiofrequency PowerWire (Baylis Medical Inc, Montreal, Quebec, Canada) technique (Toronto PowerWire fenestration technique). (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 31, 2018 Category: Surgery Authors: Steffan Frosi Stella, Thomas F. Lindsay, Kong T. Tan Source Type: research

Predictors of acute kidney injury after infrarenal abdominal aortic aneurysm repair in octogenarians
This study aims to evaluate AKI in octogenarians after open endovascular AAA repair (OAR) and endovascular AAA repair (EVAR). (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 25, 2018 Category: Surgery Authors: Tru Dang, Hanaa Dakour-Aridi, Muhammad Rizwan, Besma Nejim, Mahmoud Malas Tags: Clinical paper Source Type: research

The impact of chronic kidney disease on lower extremity bypass outcomes in patients with critical limb ischemia
This study investigates the impact of CKD on early graft failure, postoperative complications, and mortality in patients undergoing lower extremity bypass for critical limb ischemia. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 25, 2018 Category: Surgery Authors: Vishnu Ambur, Peter Park, John P. Gaughan, Scott Golarz, Frank Schmieder, Paul Van Bemmelen, Eric Choi, Ravi Dhanisetty Tags: Clinical paper Source Type: research

Outcomes associated with hyperglycemia after abdominal aortic aneurysm repair
We evaluated the association between postoperative hyperglycemia and outcomes after abdominal aortic aneurysm (AAA) repair. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 25, 2018 Category: Surgery Authors: Yauhen A. Tarbunou, Jamie B. Smith, Robin L. Kruse, Todd R. Vogel Tags: Clinical paper Source Type: research

Molecular identity of arteries, veins, and lymphatics
Arteries, veins, and lymphatic vessels are distinguished by structural differences that correspond to their different functions. Each of these vessels is also defined by specific molecular markers that persist throughout adult life; these markers are some of the molecular determinants that control the differentiation of embryonic undifferentiated cells into arteries, veins, or lymphatics. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 25, 2018 Category: Surgery Authors: Katharine Wolf, Haidi Hu, Toshihiko Isaji, Alan Dardik Source Type: research

Splenic artery pseudoaneurysm with hemosuccus pancreaticus requiring multimodal treatment
Termed hemosuccus pancreaticus by Sandblom in 1970, hemorrhage from the pancreatic duct into the gastrointestinal tract represents a rare and challenging problem. Patients present with repeated upper gastrointestinal bleeding that is intermittent but often self-limited. In most cases, this pathophysiologic process is secondary to pancreatitis, chronic inflammation, and subsequent splenic artery pseudoaneurysm bleeding. Previously treated with open splenectomy and distal pancreatectomy, hemosuccus pancreaticus is now often managed with minimally invasive endovascular means. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 25, 2018 Category: Surgery Authors: Rhusheet Patel, Mark Girgis Source Type: research

Impact of aortic wall thrombus on late changes in renal function among patients treated by fenestrated-branched endografts
Renal function deterioration is an important determinant of mortality in patients treated for complex aortic aneurysms. We have previously determined that catheter and guidewire manipulation in diseased aortas during fenestrated-branched endovascular aneurysm repair (F-BEVAR) is associated with risk of renal function deterioration. The aim of this study was to describe the impact of atherothrombotic aortic wall thrombus (AWT) on renal function deterioration among patients treated by F-BEVAR for pararenal and extent IV thoracoabdominal aortic aneurysms. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 25, 2018 Category: Surgery Authors: Giuliano de A. Sandri, Gustavo S. Oderich, Emanuel R. Tenorio, Mauricio S. Ribeiro, Leonardo Reis de Souza, Stephen S. Cha, Thanila A. Macedo, Stephen C. Textor Tags: Clinical paper Source Type: research

Invited commentary
Cellular senescence is an important contributor to the development of atherosclerosis. The mechanisms by which senescence promotes atherosclerosis, however, remain poorly understood. This important study by Lv  et al demonstrates the causal association between reduced expression of peptidyl-prolyl cis/trans isomerase (Pin 1), increased vascular smooth muscle cell (VSMC) senescence, increased cellular senescence molecules p21 and p53, and reduced cell cycle-related cyclin-dependent kinases based on gain- and loss-of-function studies performed in vitro. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Baohui Xu Tags: From bench to bedside Source Type: research

Invited commentary
A major limitation in developing molecular therapies for critical limb ischemia has been the lack of a clinically relevant model to test efficacy. The existing animal models primarily depend on acute limb ischemia generated by femoral artery ligation or excision. These models have provided insights into cellular and molecular mechanisms that underlie collateral artery growth, primarily because young rodents collateralize quickly in response to ischemia. This trait is less helpful when trying to test potential treatments that will be effective in older, atherosclerotic, diabetic human patients. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Gale L. Tang Tags: From bench to bedside Source Type: research

Invited commentary
Autophagy is a tightly regulated, multistep intracellular process by which cytoplasmic components are packed in double-membrane vesicles, delivered to the lysosome, and ultimately degraded for energy production and nutrient recycling to maintain cell survival in unfavorable emergent conditions. Whereas autophagy is critically important for cardiovascular homeostasis, dysregulated autophagy is involved in cardiovascular pathologic processes such as atherosclerosis. Although increased autophagy has been reported in experimental and clinical abdominal aortic aneurysms (AAAs),1,2 the role that autophagy plays in AAAs remains u...
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Baohui Xu Tags: From bench to bedside Source Type: research

Abdominal aortic pseudoaneurysm eroding lumbar vertebra
A 68-year-old woman presented to the emergency department with a 15-day history of back pain. This nonsmoking patient denied any recent history of fever or symptomatic infection or foreign travel. She also denied hypertension and diabetes. The patient had no family history of aneurysm. Physical examination was unremarkable. Results of laboratory testing, including white blood cell count and erythrocyte sedimentation rate, were within normal limits. Computed tomography aortography of the abdomen showed L1-2 lumbar compression fracture, and two-thirds of the L1 and L2 vertebral bodies were eroded by aortic pseudoaneurysm (A/...
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Chao Song, Guanyu Yu, Jian Dong, Xiang Feng, Zaiping Jing Tags: Vascular images Source Type: research

Invited commentary
The diagnosis of chronic intestinal ischemia can be problematic and is most often based on a combination of clinical symptoms and imaging studies demonstrating high-grade stenosis or occlusion of the celiac and superior mesenteric arteries. In general, functional tests demonstrating physiologic abnormalities correlating with intestinal malperfusion are not used as they are not widely known or available. For many years, investigators in The Netherlands have, however, advocated use of a combination of clinical symptoms, arterial imaging studies, and functional tests of mucosal perfusion to potentially improve diagnostic accu...
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Gregory L. Moneta Tags: Clinical research study Source Type: research

Invited commentary
A federal court ordered the tobacco industry to publish information that all cigarettes cause cancer, lung disease, heart attacks, and premature death. Unfortunately, there was no legislation to inform the lay public about the perils of smoking on their vascular system. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Russell H. Samson Tags: Clinical research study Source Type: research

Invited commentary
Regarding aortic dissection, all those treating the condition understand the serious inherent risks of the problem and the value of medical therapy in reducing progression and complications from this disorder. Martin  et al, in the accompanying article, have pointed out the risks for clinicians in simply assuming medication compliance in this high-risk group of patients. In just fewer than 50 patients cared for in an aortic dissection specialty clinic, the authors used a validated, self-reported method to asse ss medication adherence among the population. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Daniel G. Clair Tags: Clinical research study Source Type: research

Invited commentary
Nullius in verba is the 1660 motto of the Royal Society and essentially means “take nobody's word for it.” This advice is pertinent to the findings of the paper by Clouse et al, who challenge currently accepted practices regarding the management of patients with tandem aortic arch branch inflow and bifurcation carotid disease. When the European Society for Vascular Surg ery was preparing its 2018 carotid guidelines,1 the available evidence was considered sufficient to support a class IIa, level C recommendation that “most proximal common carotid artery and innominate artery lesions should be con...
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: A. Ross Naylor Tags: Clinical research study Source Type: research

Management of isolated femoropopliteal in-stent restenosis
The optimal catheter-directed therapy for femoropopliteal in-stent restenosis (ISR) remains controversial with limited durability. The natural history of untreated ISR is not well characterized. We evaluated the midterm outcomes of patients with asymptomatic isolated femoropopliteal ISR who were observed under a surveillance program. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Khalil Qato, Allan M. Conway, Laurie Mondry, Gary Giangola, Alfio Carroccio Tags: Clinical research study Source Type: research

Invited commentary
In light of the current enthusiasm for the expanded use of branched and fenestrated endovascular aneurysm repair (F/B-EVAR) of complex aortic aneurysms, we are fortunate that Dr Schanzer and his colleagues have given us some insight into the high reintervention rate of patients after F/B-EVAR. The 26% need for at least one re intervention is probably understated in this study, given the inclusion of a small number of iliac branched devices and the significant number of commercially available Cook Zenith fenestrated renal branch devices (arguably the low-hanging fruit of F/B-EVAR grafts). (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Michael Belkin Tags: Clinical research study Source Type: research

Invited commentary
The authors report their experience with the treatment of complex splenic artery aneurysms complete with a new classification scheme: type I, rupture or impending rupture; type II, at the origin of the splenic artery; and type III, aberrant splenic artery originating from the splenomesenteric or celiacomesenteric trunk. They used a variety of techniques, including combinations of occluding the inflow artery, the inflow collaterals, the aneurysm itself, and the outflow artery using either embolic coils or a covered stent. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Thomas S. Huber Tags: Clinical research study Source Type: research

John L. Ochsner, 1927-2018
Dr John Lockwood Ochsner will be remembered as a charismatic physician, a dedicated teacher, a  loving father, and a role model for the hundreds of surgeons he trained. He was revered as an innovative, energetic, and talented surgeon, performing over 12,000 operations, including the first cardiac transplant in the Gulf South. He always said he was happiest in the operating room and loved tea ching young resident surgeons. He believed that “surgery is an art as much as a science. You have to improvise almost every case – no two cases are the same – and that's where the fun of surgery comes in, making ...
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Roger T. Gregory, James S.T. Yao, Walter J. McCarthy Tags: Pioneers in vascular surgery Source Type: research

Right-Sided Axillary and Brachial Access Is Efficacious and Safe for Chimney and Snorkel Grafts
As life expectancy extends and aortic disease becomes more complex, we are faced with the challenge of treating increasingly complicated pathologic processes in an increasingly frail population. We are also challenged with treating the sequelae of prior aortic treatments. Chimney endovascular aneurysm repair (ChEVAR), although off-label, is valuable for these patients. We favor the right axillary approach because of the relative ease of access to the visceral branches and the ability of the team to work on the same side of the patient while avoiding the left-sided image intensifier. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Kira N. Long, Trissa Babrowski, Christopher Skelly, Matthew Blecha, Ross Milner Tags: Abstract from the 2018 Midwestern Vascular Surgical Society Annual Meeting Source Type: research

Transcaval Repositioning of Renal Snorkel Stent and Gutter Leak Coil Embolization
The patient is a 74-year-old man who initially had undergone endovascular aneurysm repair for a 6.4-cm infrarenal abdominal aortic aneurysm with a Cook Zenith Flex endograft (Cook Medical, Bloomington, Ind), now presenting 3 years later with a progressively enlarging 7.9-cm aneurysm, a malpositioned renal snorkel stent, and an adjacent type IA gutter endoleak. The patient previously had an attempted repair of a type IA endoleak by relining of the previous graft with a Gore Excluder device (W. L. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - August 22, 2018 Category: Surgery Authors: Stephen Serio, Jason MacTaggart Tags: Abstract from the 2018 Midwestern Vascular Surgical Society Annual Meeting Source Type: research