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Commentary
I have often said to interested trainees and students that vascular surgery is about women's health. Evidence suggests that cardiovascular disease affects women differently —the symptoms of myocardial infarction are often “atypical” in women. The number of hospital discharges for heart failure and stroke are higher in women than in men.1 When detected in women, abdominal aortic aneurysms are often anatomically unsuitable for commercially available endovascular de vices, and mortality is higher from either open or endovascular surgery.
Source: Journal of Vascular Surgery - December 20, 2021 Category: Surgery Authors: Ulka Sachdev-Ost Tags: Invited commentary Source Type: research

Effect of Perioperative Blood Transfusion in Anemic Patients Undergoing Infrainguinal Bypass
Patients who present with lower extremity ischemia are frequently anemic, and the optimal transfusion threshold for this cohort has remained controversial. We sought to evaluate the effect of blood transfusion on major adverse cardiac events (MACE), including myocardial infarction, dysrhythmia, stroke, congestive heart failure, and 30-day mortality for these patients.
Source: Journal of Vascular Surgery - August 20, 2020 Category: Surgery Authors: Cali E. Johnson, Miguel F. Manzur, Alberto J. Ortega, Li Ding, Vincent L. Rowe, Fred A. Weaver, Gregory A. Magee Source Type: research

Impact of amputation level and comorbidities on functional status of nursing home residents after lower extremity amputation
Conclusions: Elderly nursing home residents undergoing BK or AK amputation failed to return to their functional baseline within 6 months. Among frail elderly nursing home residents, higher amputation level, stroke, end-stage renal disease, poor baseline cognitive scores, and female sex were associated with inferior functional status after amputation. These factors should be strongly assessed to maintain activities of daily living and quality of life in the nursing home population.
Source: Journal of Vascular Surgery - January 9, 2014 Category: Surgery Authors: Todd R. Vogel, Gregory F. Petroski, Robin L. Kruse Tags: Clinical research studies Source Type: research

Revascularization of the External Carotid Artery and Hemodynamic Stroke: A Case Report and Literature Review
Hemodynamic strokes or transient ischemic attacks (TIA)s are often associated with episodes of hypoperfusion, such as orthostasis, heart failure, or changes in antihypertensive regimen. Herein, we describe the management of a patient with TIAs associated with the hemodynamic consequences of coughing.
Source: Journal of Vascular Surgery - November 28, 2013 Category: Surgery Authors: Shirling Tsai, Mirza S. Baig, Fatima Abrantes-Pais, R. James Valentine Tags: Abstracts from the 2014 Southern Association for Vascular Surgery Annual Meeting Source Type: research

Reply
Multiple studies have demonstrated the efficacy of transcranial Doppler (TCD)-directed dextran therapy during carotid endarterectomy (CEA). In our recent review of 6641 CEAs performed within the auspices of the Vascular Study Group of New England, we found perioperative infusion of dextran was not correlated with lower stroke rates but rather was associated with increased postoperative cardiac complications, including myocardial infarction and congestive heart failure. We concluded that there was limited clinical utility for the routine use of dextran during CEA.
Source: Journal of Vascular Surgery - October 1, 2013 Category: Surgery Authors: Tze-Woei Tan, Alik Farber Tags: Letters to the Editor Source Type: research

The need for treatment of hemodynamic instability following carotid endarterectomy is associated with increased perioperative and 1-year morbidity and mortality
The objective of this study was to evaluate the outcomes of patients after carotid endarterectomy (CEA) who developed postoperative hypertension or hypotension requiring the administration of intravenous vasoactive medication (IVMED).Methods: We examined consecutive, primary elective CEA performed by 128 surgeons within the Vascular Study Group of New England (VSGNE) database (2003-2010) and compared outcomes of patients who required postoperative IVMED to treat hyper- or hypotension with those who did not. Outcomes included perioperative death, stroke, myocardial infarction (MI), congestive heart failure (CHF), hospital l...
Source: Journal of Vascular Surgery - September 3, 2013 Category: Surgery Authors: Tze-Woei Tan, Mohammad H. Eslami, Jeffrey A. Kalish, Robert T. Eberhardt, Gheorghe Doros, Philip P. Goodney, Jack L. Cronenwett, Alik Farber, Vascular Study Group of New England Tags: Clinical research studies Source Type: research

n-3 Fatty Acids in Patients with Multiple Cardiovascular Risk Factors
In patients with multiple cardiovascular risk factors, daily treatment with n-3 fatty acids does not reduce cardiovascular mortality or morbidity. It has been suggested that n-3 polyunsaturated fatty acids derived from fish reduce the risk of cardiovascular disease through beneficial effects on arrhythmias and atherosclerotic, inflammatory, and thrombotic processes (De Caterina R, N Engl J Med 2011;364:2439-50). Indeed, benefit of n-3 fatty acids has been demonstrated to reduce cardiovascular mortality and morbidity in patients surviving myocardial infarction and in patients with heart failure (Lancet 1999;354:447-55 and ...
Source: Journal of Vascular Surgery - September 1, 2013 Category: Surgery Authors: The Risk and Prevention Study Collaborative Group Tags: Abstracts Source Type: research

Efficacy of thoracic endovascular stent repair for chronic type B aortic dissection with aneurysmal degeneration
This study was undertaken to determine the results of endovascular treatment of cTBAD with aneurysmal degeneration.Methods: A retrospective analysis of all patients treated for cTBAD with aneurysmal degeneration at the University of Florida from 2004 to 2011 was performed. Computed tomograms with centerline reconstruction were analyzed to determine change in aortic diameter, relative proportions of aortic treatment lengths, and false lumen perfusion status. Reintervention and mortality were estimated using life-tables. Cox regression analysis was completed to predict mortality.Results: Eighty patients underwent TEVAR for a...
Source: Journal of Vascular Surgery - April 5, 2013 Category: Surgery Authors: Salvatore T. Scali, Robert J. Feezor, Catherine K. Chang, David H. Stone, Philip J. Hess, Tomas D. Martin, Thomas S. Huber, Adam W. Beck Tags: Clinical research studies Source Type: research

Optimal selection of asymptomatic patients for carotid endarterectomy based on predicted 5-year survival
We examined factors associated with 5-year survival following CEA in patients with asymptomatic internal carotid artery (ICA) stenosis.Methods: Prospectively collected data from 4114 isolated CEAs performed for asymptomatic stenosis across 24 centers in the Vascular Study Group of New England between 2003 and 2011 were used for this analysis. Late survival was determined with the Social Security Death Index. Cox proportional hazard models were used to identify risk factors for mortality within the first 5 years after CEA and to calculate a risk score for predicting 5-year survival.Results: Overall 3- and 5-year survival af...
Source: Journal of Vascular Surgery - March 13, 2013 Category: Surgery Authors: Jessica B. Wallaert, Jack L. Cronenwett, Daniel J. Bertges, Andres Schanzer, Brian W. Nolan, Randall De Martino, Jens Eldrup-Jorgensen, Philip P. Goodney, Vascular Study Group of New England Tags: Clinical research studies Source Type: research

The impact of Centers for Medicare and Medicaid Services high-risk criteria on outcome after carotid endarterectomy and carotid artery stenting in the SVS Vascular Registry
Objective: The Centers for Medicare and Medicaid Services (CMS) require high-risk (HR) criteria for carotid artery stenting (CAS) reimbursement. The impact of these criteria on outcomes after carotid endarterectomy (CEA) and CAS remains uncertain. Additionally, if these HR criteria are associated with more adverse events after CAS, then existing comparative effectiveness analysis of CEA vs CAS may be biased. We sought to elucidate this using data from the SVS Vascular Registry.Methods: We analyzed 10,107 patients undergoing CEA (6370) and CAS (3737), stratified by CMS HR criteria. The primary endpoint was composite death,...
Source: Journal of Vascular Surgery - February 13, 2013 Category: Surgery Authors: Marc L. Schermerhorn, Margriet Fokkema, Philip Goodney, Ellen D. Dillavou, Jeffrey Jim, Christopher T. Kenwood, Flora S. Siami, Rodney A. White, SVS Outcomes Committee Tags: Clinical research studies Source Type: research

Assessing the impact of distal protection filter design characteristics on 30-day outcomes of carotid artery stenting procedures
Conclusions: The following filter design characteristics are independently significant for minimizing peri-/postprocedural AEs: higher vascular resistance, concentric in shape, greater capture efficiency, lower porosity, lower number of pores, and lower pore density. Lower porosity and smaller wall apposition were also found to be independently significant for minimization of peri-/postprocedural TIAs. This information can be used when considering the desirable design characteristics of future DPFs.)
Source: Journal of Vascular Surgery - December 20, 2012 Category: Surgery Authors: Natasha A. Loghmanpour, Gail M. Siewiorek, Kelly M. Wanamaker, Satish C. Muluk, Rabih Chaer, Mark H. Wholey, Ender A. Finol Tags: Clinical research studies Source Type: research