Annals of Vascular Surgery

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Autogenous Vascular Access in American Indians

An autogenous vascular access (AVF) is the preferred choice for hemodialysis access in most patients, with lower associated morbidity, mortality and costs as compared with AV grafts and particularly hemodialysis catheters.1,2,3 Previous investigations have noted lower AVF success rates associated with various ethnicities and other factors such as diabetes, obesity and age.4,5,6 In addition, there is variation in the percentage of AVFs used for hemodialysis in different ethnic groups7.

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Initial Post-Operative Visit Absenteeism is Associated With Worse Amputation-Free Survival after Tibial Angioplasty

Tibial revascularization is often performed in the setting of critical limb ischemia and tissue loss requiring close patient monitoring in the early post-operative period for worsening gangrene and/or ischemia. Multiple studies have shown loss to follow-up is an independent risk factor for poor outcomes in several vascular procedures. Therefore, we evaluated the risk factors relating to loss to follow up against outcomes in patients undergoing tibial endovascular procedures with the hypothesis that poor post-operative visit compliance is associated with decreased amputation-free survival rates.

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Optimal Timing of Surveillance Ultrasounds in Small Aortic Aneurysms

Increasing screening for abdominal aortic aneurysms (AAA) has led to increasing identification of small AAAs. These small AAAs do not meet criteria for repair (men <5.5 cm, women <5.0cm) and are managed with serial surveillance imaging, as evidenced in multiple randomized trials.1–3 While the majority of small AAA grow relatively slowly,4 there can be substantial variation in growth rates, undetected progression in size of AAA, and potentially rupture. In previous population based studies, smoking,5,6 diabetes mellitus,5,7,8 gender5,9–11 and family history have all had an impact on the rate of aneurysm growth and rupture; however, current guidelines by the Society for Vascular Surgery lack quality evidence and provide no patient specific guidance.

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Higher Systemic Immune-Inflammation Index is associated with higher likelihood of peripheral arterial disease

: To explore the association between SII (Systemic Immune-Inflammation Index) and PAD (peripheral arterial disease) in American adults. Methods: Related data from NHANES (National Health and Nutrition Examination Survey) database (1999–2004) were collected and analyzed. PAD was diagnosed by ankle brachial index assessment. The association between SII and prevalent PAD was assessed using multivariable logistic regression.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(21)00966-3/fulltext?rss=yes

Ultrasound-Guided Cradle-Like Infiltrative Anesthesia for Percutaneous Transluminal Angioplasty of Stenotic Autogenous Arteriovenous Hemodialysis Access

Percutaneous transluminal angioplasty (PTA) is an effective treatment for autogenous arteriovenous hemodialysis access (AAVA) stenosis; however, it causes pain in most cases. Therefore, safe and effective anesthesia for PTA is required.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(21)00965-1/fulltext?rss=yes

Eversion Endarterectomy – An Alternative Approach to Occlusive External Iliac Artery disease

Contemporary vascular practice offers a range of open, endovascular and hybrid interventional options to manage iliac occlusive disease. However, controversy remains over the most appropriate means with which to approach external iliac artery (EIA) lesions, particularly in the context of long-segment iliofemoral stenosis and/or occlusion. Eversion endarterectomy is an autologous technique for EIA disease, presenting an alternative to both prosthetic bypass and endovascular approaches.1–3

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Assessment of Duplex Ultrasound Carried Out by the Vascular Surgeon After Locoregional Anesthesia for Preferred Arteriovenous Fistula Access

Preoperative vascular mapping by duplex ultrasound is required in construction of an arteriovenous fistula for hemodialysis (AVF). Due to venous vasospasm in cool temperatures and variability of the dialysis patient's blood volume, the conditions for performing this examination may be less than ideal. However, local regional anesthesia (LRA) resulting in vasodilation of the limb, can allow the use of veins considered to be of insufficient caliber during preoperative ultrasound mapping. The aim of this study was to assess the functionality of AVF when duplex ultrasound is performed by the surgeon following LRA.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(21)00948-1/fulltext?rss=yes

Underutilization of Guideline-based Abdominal Aortic Aneurysm Screening in an Academic Health System

The US Preventive Services Task Force (USPSTF) recommends a 1 time screening for AAA with ultrasonography in men aged 65-75 who have ever smoked. Our objectives were to identify the AAA screening rates in a large academic health system and assess factors associated with receipt of screening.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(21)00943-2/fulltext?rss=yes

Preoperative HbA1c and Outcomes Following Lower Extremity Vascular Procedures

Limited data exist evaluating pre-operative hemoglobin A1c (HbA1c) in patients undergoing vascular procedures for peripheral arterial disease (PAD). This study evaluated the relationship of preoperative HbA1c on outcomes after open and endovascular lower extremity (LE) vascular procedures for PAD.

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Outcomes of Autogenous Radiocephalic Versus Brachiocephalic Arteriovenous Fistula Surgery Based on Transit-Time Flowmeter Assessment: A Retrospective Study

Creating a useful fistula for hemodialysis depends on many factors and is not limited to the availability of adequate arterial inflow and superficial venous outflow. Long-term graft patency is a major challenge of arteriovenous fistula (AVF). The brachiocephalic AVF (BC-AVF), first described by Cascardo et al.,1 is the secondary vascular access procedure of choice in patients with chronic kidney disease on hemodialysis when a primary autogenous radiocephalic AVF (RC-AVF) is unavailable or fails.

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