Early clinical experience and comparison between percutaneous and surgical arteriovenous fistula.

Background: Percutaneous arteriovenous fistula (pAVF) has been recently developed as an alternative to surgical AVF (sAVF). We report our experience with pAVF in comparison with a contemporaneous sAVF group.

Methods: Charts of all 51 patients with pAVF performed at our institution were analyzed retrospectively, in addition to 51 randomly selected contemporaneous patients with sAVF (2018-2022) with available follow-up.

Adductor canal syndrome after lesser trochanter avulsion fracture in a 19-year-old.

A rare cause of limb ischemia in young patients, adductor canal syndrome, can be debilitating and result in functional impairment. Diagnosis and treatment may be delayed due to this vascular disease's rarity in young people and because the presenting symptoms can overlap with other more common causes of leg pain in young athletes. Here, authors discuss a young athletic patient with a history of year-long claudication.

Continuous fish muscle cell line with capacity for myogenic and adipogenic-like phenotypes.

Cell-cultivated fish offers the potential for a more ethical, sustainable, and safe seafood system. However, fish cell culture is relatively understudied in comparison to mammalian cells. Here, we established and characterized a continuous Atlantic mackerel (Scomber scombrus) skeletal muscle cell line ("Mack" cells).

Improved outpatient medical visit compliance with sociodemographic discrepancies in vascular telehealth evaluations.

Objective: The COVID-19 (coronavirus disease 2019) pandemic has led to a rapid expansion in the use of telemedicine across all medical fields but has also exposed telehealth care disparities with differing access to technology across racial and ethnic groups. The objective of our study was to investigate the effects of telehealth on vascular visit compliance and to explore the effects of sociodemographic factors on vascular surgery outpatient telehealth usage during the COVID-19 pandemic.

Methods: Consecutive patients who had undergone an outpatient vascular surgery evaluation between February 24, 2020 (the launch of our telemedicine program) and December 31, 2020, were reviewed.

In vitro Insect Fat Cultivation for Cellular Agriculture Applications.

Cell-cultured fat could provide important elements of flavor, nutrition, and texture to enhance the quality and therefore expand consumer adoption of alternative meat products. In contrast to cells from livestock animals, insect cells have been proposed as a relatively low-cost and scalable platform for tissue engineering and muscle cell-derived cultured meat production. Furthermore, insect fat cells have long been cultured and characterized for basic biology and recombinant protein production but not for food production.

Alternative autologous and biologic conduits have worse outcomes than prosthetic grafts for infrainguinal bypass in patients with chronic limb-threatening ischemia.

Objective: Single segment great saphenous vein (GSV) is the preferred conduit in infrainguinal bypass. Alternative autologous conduits (AAC) and nonautologous biologic conduits (NABC) are thought to be a better alternative to traditional prosthetic conduits (PC) in the absence of GSV. In this study we analyzed the outcomes of these alternative conduits in lower extremity bypasses (LEB) in patients with chronic limb-threatening ischemia.

Institutional trends over a decade in catheter-directed interventions for pulmonary embolism.

Objective: Catheter-directed interventions (CDIs) are commonly performed for acute pulmonary embolism (PE). The evolving catheter types and treatment algorithms impact the use and outcomes of these interventions. This study aimed to investigate the changes in CDI practice and their impact on outcomes.

Management of Acute Pulmonary Embolism in a Patient with Sickle Cell Anemia Using Catheter-Directed Thrombolysis.

The efficacy of thrombolytic therapy in submassive pulmonary embolism (PE) management is lacking, particularly in specific patient subgroups. The current case report demonstrates the use of catheter-directed thrombolysis (CDT) therapy in conjunction with standard systemic anticoagulation in a patient with sickle cell disease presenting with a submassive PE and chronic thrombus burden. CDT may potentially play a role in the management of submassive PE in sickle cell patients.

Propofol administration during catheter-directed interventions for intermediate-risk pulmonary embolism is associated with major adverse events.

Objective: Catheter-directed interventions (CDIs) have been increasingly used for selected patients with acute intermediate-risk (submassive) pulmonary embolism (sPE) to prevent decompensation, mortality, and potentially long-term sequelae. The purpose of the present study was to determine whether the choice of anesthetic during these interventions has an effect on the postprocedural outcomes.

Methods: Patients who had undergone CDI for acute sPE from 2009 to 2019 were identified and grouped according to the intraprocedural use of propofol.

Catheter directed interventions for pulmonary embolism: current status and future prospects.

: Catheter directed interventions (CDIs) have evolved over the past decade in an attempt to reduce the complications of systemic thrombolysis, while providing equivalent therapeutic benefits.: CDIs include a wide array of catheters that incorporate ultrasound technology, the infusion of thrombolytics through multi-side hole catheters and suction thrombectomy systems. We present a contemporary review summarizing the different catheter directed interventions currently available for acute PE, their indications, technical considerations, clinical effectiveness, complication rates and long-term outcomes.

Maturation of arteriovenous fistulas in patients with ventricular assist devices.

Objective: Postoperative renal dysfunction necessitating hemodialysis after implantation of ventricular assist devices presents a challenge with respect to establishment of hemodialysis access. Lack of pulsatile flow has led to concerns that arteriovenous fistulas will not mature. This study aims to evaluate arteriovenous fistula as a method of hemodialysis.

Role of nutritional indices in predicting outcomes of vascular surgery.

Background: Malnutrition is frequent among vascular surgery patients, given their age, chronic comorbidities, and poor functional status, and it is believed to increase their operative risk. We aimed to assess the combined use of recent significant weight loss (>10% body mass) and serum albumin levels as a nutritional status index to predict outcomes.

Methods: We analyzed vascular surgery data from the American College of Surgeons National Surgical Quality Improvement Program database (2005-2012; N = 238,082) to compare operative death (in-hospital and 30-day operative death) across eight nutritional status groups based on weight loss (yes/no) and albumin category: very low albumin level (VL-Alb; <2.

Catheter-directed thrombolysis versus suction thrombectomy in the management of acute pulmonary embolism.

Background: Catheter-directed thrombolysis (CDT) is increasingly performed for acute pulmonary embolism (PE) because it is presumed to provide similar therapeutic benefits to systemic thrombolysis, while decreasing the dose of thrombolytic required and the associated risks. Contemporary suction thrombectomy (ST) devices have entered the market as minimal or no-lytic alternatives, but there is no evidence on their comparative effectiveness. This study aims to compare clinical outcomes of these two interventional alternatives.

Outcomes and predictors of failure of iliac vein stenting after catheter-directed thrombolysis for acute iliofemoral thrombosis.

Objective: Iliac vein stenting is recommended to treat venous outflow obstruction after catheter-directed thrombolysis for acute iliofemoral deep venous thrombosis (DVT). Data on the outcome of proximal and distal stent extension are limited. Proximal stent extension to the vena cava may obstruct the contralateral iliac vein, whereas distal extension below the inguinal ligament contradicts common practice for arterial stents.

Immediate-access grafts provide comparable patency to standard grafts, with fewer reinterventions and catheter-related complications.

Background: No independent comparisons, with midterm follow-up, of standard arteriovenous grafts (SAVGs) and immediate-access arteriovenous grafts (IAAVGs) exist. The goal of this study was to compare "real-world" performance of SAVGs and IAAVGs.

Methods: Consecutive patients who underwent placement of a hemodialysis graft between November 2014 and April 2016 were retrospectively identified from the electronic medical record and Vascular Quality Initiative database at two tertiary centers.

A meta-analysis of outcomes of catheter-directed thrombolysis for high- and intermediate-risk pulmonary embolism.

Objective: During the past few years, there has been a surge in the use of catheter-directed thrombolysis (CDT) for acute pulmonary embolism (PE), in the form of either standard CDT or ultrasound-assisted CDT (usCDT). This is a systematic review and meta-analysis of all published series on contemporary CDT for acute PE seeking to determine their clinical efficacy, stratifying by PE severity and CDT modality.

Methods: A comprehensive MEDLINE and Embase search was performed to identify studies that reported outcomes of CDT for acute PE published from 2009 to July 2017.

Catheter-directed interventions compared with systemic thrombolysis achieve improved ventricular function recovery at a potentially lower complication rate for acute pulmonary embolism.

Objective: Catheter-directed interventions (CDIs) are increasingly performed for acute pulmonary embolism (PE) as they are presumed to provide similar therapeutic benefits to systemic thrombolysis (ST) while decreasing the associated complications. The purpose of this study was to compare outcomes between CDI and ST.

Methods: Consecutive patients who underwent CDIs or ST for massive or submassive PE between 2006 and 2016 were identified.

Outcomes of infrageniculate retrograde versus transfemoral access for endovascular intervention for chronic lower extremity ischemia.

Objective: Retrograde infrageniculate access is an alternative treatment strategy for patients who have failed to respond to antegrade endovascular intervention. This study compares the outcomes of infrageniculate retrograde arterial access with the conventional transfemoral access for the endovascular management of chronic lower extremity ischemia.

Methods: This was a retrospective single-center review of retrograde endovascular intervention (REI) from 2012 to 2016.

Role of Venous Stenting for Iliofemoral and Vena Cava Venous Obstruction.

Venous stenting for CVD is being increasingly used as more evidence accumulates supporting the open vein hypothesis and supporting the safety, efficacy, and durability of these interventions. As such, they can be offered to patients with advanced age and complex comorbidities. Future studies should focus on reporting outcomes specific to the underlying venous pathologic condition (thrombotic vs nonthrombotic and acute vs chronic) to provide better evidence for stenting in CVD, and the outcomes of new stent design with dedicated venous indications.

Early carotid endarterectomy performed 2 to 5 days after the onset of neurologic symptoms leads to comparable results to carotid endarterectomy performed at later time points.

Background: Timing of carotid endarterectomy (CEA) after onset of neurologic symptoms remains controversial. We assessed the association of CEA timing with postoperative outcomes.

Methods: The Vascular Study Group of New England (VSGNE) database (2003-2014) was queried to identify CEA performed for symptomatic carotid stenosis during the same hospitalization.

Contemporary Role of Embolization of Solid Organ and Pelvic Injuries in Polytrauma Patients.

Abdominopelvic trauma (APT) remains a leading cause of morbidity and mortality in the 15- to 44-year-old age group in the Western World. It can be life-threatening as abdominopelvic organs, specifically those in the retroperitoneal space, can bleed profusely. APT is divided into blunt and penetrating types.

Vascular Shunts in Civilian Trauma.

Experience with temporary intravascular shunts (TIVS) for vessel injury comes from the military sector and while the indications might be clear in geographically isolated and under resourced war zones, this may be an uncommon scenario in civilian trauma. Data supporting TIVS use in civilian trauma have been extrapolated from the military literature where it demonstrated improved life and limb salvage. Few non-comparative studies from the civilian literature have also revealed similar favorable outcomes.