Revascularization of tibial chronic total occlusions (CTO) in patients with critical limb ischemia (CLI) can be challenging and require advanced endovascular techniques. Recent literature has shown the importance of intact pedal flow and angiosome revascularization for limb salvage and effective management of foot wounds. However, these lesions are not always amenable to antegrade recanalization. Alternative options include retrograde treatment with the use of a patent pedal arch or trans-collateral retrograde revascularization (pedal-plantar loop technique) or direct retrograde tibiopedal access.
Chronic venous insufficiency (CVI) encompasses a myriad of clinical manifestations including lower extremity swelling and pain, ulcerations, and chronic skin changes such as stasis dermatitis, and lipodermatosclerosis. CVI effects greater than 25 million Americans and has a significant socioeconomic and psychosocial impact. Treatment of CVI varies depending on the etiology. For those patients with deep venous reflux, restoration of the deep venous valvular system is critical. Popliteal vein external banding is a novel technique to treat deep venous reflux.
Spontaneous visceral artery dissections (SVADs) are rare but are being identified more frequently. The most common dissections are celiac artery (CA) and superior mesenteric artery (SMA) dissections. Historically, the majority of diagnosed SVADs were associated with symptoms, including epigastric pain, bloody stool, or nausea; however, with increased cross-sectional imaging, they are being identified more commonly while asymptomatic. Typical patients are Asian males in their fifth or sixth decade of life.
Precise deployment of commercially available infrarenal endografts is key to the repair of infrarenal aortic aneurysms, particularly with short, angulated, and diseased landing zones. Coverage of important branch vessels or graft migration may require advanced endovascular techniques for rescue or conversion to open repair. Aptus endoanchor technology (Medtronic, Minneapolis, MN) allows precise adjustments after deployment of endografts and improved fixation.
On March 16, 2020, the Federal government issued the Coronavirus Guidelines for America which included recommendations for social distancing. Furthermore, Georgia issued a state-mandated shelter in place order beginning April 2, 2020 and lasting until April 30, 2020. The purpose of this study is to evaluate if government mandates for social distancing had any effects on the number of patients presenting to our urban level 1 trauma center with vascular injuries requiring operative intervention.
Leading the Vascular and Endovascular Surgery Society (VESS) has been a great honor. Our society represents many things to many people, for me its friendship, support, knowledge, and growth. While presidential addresses are a new thing for me, but do not be surprised, I may veer back to aortic surgery once or twice. Maybe just maybe, I will have other opportunities to address my colleagues en masse, but because this may be my last shot at this, I really thought hard what I could say. I worried about being to tangential, or not having enough quips to keep people interested, or just not having anything worth saying.
Endovascular management of isolated profunda femoris artery occlusive disease has not been well studied. Our aim is to analyze the outcomes of endovascular management of profunda artery occlusive disease.
Concern has been raised over potential paclitaxel-related increase in mortality following treatment with drug-coated balloons. We report mid-term and long-term patient-level mortality in three trials from our institution.