Annals of Vascular Surgery

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Mannitol Use is Renal Protective in Patients with Chronic Kidney Disease Requiring Suprarenal Aortic Clamping

Mannitol is often administered during open juxtarenal or suprarenal aortic surgery to prevent ischemic injury to the kidneys. Prior evidence evaluating the benefits of intraoperative mannitol in reducing ischemia/reperfusion injury is conflicting and largely based on small, retrospective series. The aim of this study was to evaluate the effect of mannitol in preventing postoperative hemodialysis in patients undergoing open abdominal aortic aneurysm (AAA) repair where proximal control involved temporary renal ischemia.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00201-1/fulltext?rss=yes

Superficial Femoral Artery Access for Infrainguinal Antegrade Endovascular Interventions in the Hostile Groin: A Prospective Randomized Study

In a hostile groin, it may be difficult to perform antegrade endovascular procedures at the lower extremities using the ipsilateral common femoral artery as vascular access; therefore, the use of the ipsilateral superficial femoral artery (SFA) could be a useful alternative. In this study, we evaluated the feasibility and safety of ultrasound-guided SFA puncture versus traditional SFA cutdown to achieve arterial access.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00200-X/fulltext?rss=yes

The Differential Impact of Medicaid Expansion on Disparities in Outcomes Following Peripheral Vascular Intervention

Peripheral artery disease (PAD) disproportionately affects nonwhite, Hispanic/Latino, and low socioeconomic status patients, who are less likely to have insurance and routine healthcare visits. Medicaid expansion (ME) has improved insurance rates and access to care, potentially benefitting these patients. We sought to assess the impact of ME on disparities in outcomes after peripheral vascular intervention (PVI) for PAD.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00199-6/fulltext?rss=yes

Surgical Deep Vein Arterialization: Adding to the Armamentarium of Complex Limb Salvage

Patients with severe peripheral arterial disease with limited or nonexistent arterial runoff, the so-called “desert foot”, challenge efforts at limb preservation. Deep vein arterialization (DVA) involves incorporating a venous target as an outflow to achieve revascularization in these complex patients. We report outcomes in an initial series of patients undergoing DVA as a component of surgical bypass.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00179-0/fulltext?rss=yes

Migration of High Cardiac Risk Patients from Open to Endovascular Procedures is Evident within the Society for Vascular Surgery Vascular Quality Initiative

In this study, pre-operative medical complexity is estimated by the independently validated Vascular Quality Initiative VQI Cardiac Risk Index (CRI). This study aims to identify and correlate trends of CRI for open abdominal aortic aneurysm (OAR) with trends in the CRI for corresponding endovascular aortic repair (EVAR). This assessment of differences in estimated procedural risks will be used to support the theory that, patient migration is an important factor contributing to decreased POMI following open vascular procedures.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00172-8/fulltext?rss=yes

Safety And Efficacy of Drug Eluting Stents for Treatment of Transplant Renal Artery Stenosis

Transplant renal artery stenosis (TRAS) after renal transplantation is a common cause of graft dysfunction and failure. Endovascular intervention in the form of percutaneous transluminal angioplasty (PTA) and stenting has rapidly become the dominant treatment modality for the TRAS. There is a paucity of clinical data on use of drug-eluting stent (DES) for TRAS. We investigated the outcomes of patients with clinically significant TRAS undergoing DES placement.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00176-5/fulltext?rss=yes

Hypoxia Promotes Human Umbilical Vein Smooth Muscle Cell Phenotypic Switching via the ERK 1/2/c-fos/NF-κB Signaling Pathway

Vein wall hypoxia has long been suggested as a key factor for the development of varicose veins (VVs) and accumulating evidence has revealed the phenotypic transformation of vascular smooth muscle cells (VSMCs) under hypoxic conditions. However, the underlying molecular mechanisms of this process remain poorly understood. Our previous study revealed a positive correlation between c-fos expression and VSMC functional disturbance of VVs. This study aimed to further explore the role of c-fos in the phenotypic switching of VSMCs under hypoxic conditions.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00181-9/fulltext?rss=yes

Intraluminal Thrombus and Abdominal Aortic Aneurysm Complications

New techniques of computed tomography (CT) digital subtraction angiographic imaging allow to study the aortic blood flow in case of abdominal aortic aneurysm (AAA) and find unfavorable elements for a greater risk of rupture. On the other hand, the intraluminal thrombus (ILT), whose growth is facilitated by a turbulent blood flow, damages the aneurysm walls through immune-inflammatory mechanisms, connected with the release of proteases and specific metalloproteinases. Besides, the vasa vasorum thrombosis causes hypoxia in the aortic walls and, through a secondary production of oxygen reactive species, proportional oxidative stress.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00136-4/fulltext?rss=yes

Outcomes of Endovascular-First Versus Bypass-First Approach for Patients With Chronic Limb-Threatening Ischemia Using a Medicare-Linked Database

Chronic limb-threatening ischemia (CLTI) has been increasing in prevalence and remains a significant cause of limb loss and disability and a strong predictor of cardiovascular mortality. Previous studies have demonstrated that endovascular and open repair are similarly effective. These findings led to a significant increase in the adoption of the less-invasive endovascular-first (EVF) approach. However, it remains unknown whether the 2 treatment modalities have similar durability in today's real-world setting.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00183-2/fulltext?rss=yes

Vasculink iPhone Application and Risk Prediction Model for Groin Complication in Vascular Surgery

Postoperative groin complication is a common cause of morbidity in vascular surgery. Prophylactic wound adjuncts addressing this issue have been shown to reduce complications in high-risk patients, but their widespread implementation is limited by their high cost. This study introduces a risk prediction model for patients at a high risk for groin complication which can be accessed through the iPhone application, Vasculink.

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https://www.annalsofvascularsurgery.com/article/S0890-5096(22)00182-0/fulltext?rss=yes

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