Definition and Perception of Autonomy in Vascular Surgery Training.

Background: There is a lack of data evaluating operative autonomy within vascular surgery. This study aims to determine where discrepancies exist in the definition of autonomy between trainees and attending faculty.

Methods: An Institutional Review Board-approved, anonymous survey was e-mailed to vascular trainees and attending faculty at all Accreditation Council for Graduate Medical Education-approved vascular surgery training programs in the United States.

COVID-19: Its Impact on Delayed Management of Pre-established Chronic Conditions.

Chronic venous insufficiency (CVI) is a common condition affecting the venous system, typically arising in the setting of increased venous pressure and impaired blood return secondary to weakened valves or damaged veins. Diabetes mellitus causes impaired circulation, neuropathy, impaired healing, and increased susceptibility to infection. Because diabetes and CVI are interconnected, ulcerations can progress to necrotizing fasciitis if not treated promptly and appropriately.

Giant Renal Cell Carcinoma (RCC): A Case Report of Delayed Diagnosis and Management.

Renal cell carcinoma (RCC) is the most common type of kidney cancer. It typically presents with macroscopic hematuria, weight loss, and or a palpable flank mass. Diagnosis of this disease involves imaging techniques such as abdominal ultrasound and CT scans.

Conservative Management of Postoperative Urinary Leak and Intra-Abdominal Abscess.

Ureteral injury is a rare occurrence in medical practice. Most cases encountered stem from blunt trauma or are iatrogenic, occurring during open abdominal or pelvic surgery and laparoscopic procedures. Prompt diagnosis of ureteral injury allows clinicians to avoid complications including ureteral strictures, abscess, renal failure, sepsis, and loss of the ipsilateral kidney.

Extra-anatomic bypass can treat renovascular hypertension due to atherosclerotic atypical aortic coarctation.

Atypical aortic coarctation causing high-grade descending thoracic aortic stenosis secondary to calcified atherosclerosis is rare. We have described the case of a 75-year old man with uncontrolled renovascular hypertension secondary to this etiology. His unique anatomy meant he was not a candidate for endovascular management and his multiple comorbidities meant he was high risk for open thoracoabdominal surgery.

Percutaneous, Antegrade Access of the Superficial Femoral Artery can be Safely Used in Procedures for the Treatment of Lower Extremity Limb Ischemia.

Background: Recent studies have shown that antegrade access for treatment of infrainguinal peripheral vascular disease is associated with decreased radiation exposure and contrast use without a significant increase in access complication, although data are limited on antegrade superficial femoral artery (SFA) access for larger sheath sizes. We aim to describe a single institution's contemporary experience with percutaneous antegrade SFA access.

Methods: A retrospective review of percutaneous, infrainguinal endovascular interventions for arterial occlusive disease at a major academic institution was conducted between 2018 and 2020.

Leadership skills curriculum development for residents and fellows: A needs-assessment.

Background: Non-technical skills (NTS) curricula have demonstrated success in surgical residencies. The purpose of this study is to examine the need for a structured leadership curriculum at our institution.

Methods: A needs-assessment survey analyzing the importance of leadership domains, previously validated by Kazley et al.

Intracoronary delivery of recombinant TIMP-3 after myocardial infarction: effects on myocardial remodeling and function.

Ischemia-reperfusion (IR) and myocardial infarction (MI) cause adverse left ventricular (LV) remodeling and heart failure and are facilitated by an imbalance in matrix metalloproteinase (MMP) activation and the endogenous tissue inhibitors of metalloproteinase (TIMPs). We have identified that myocardial injections of recombinant TIMP-3 (rTIMP-3; human full length) can interrupt post-MI remodeling. However, whether and to what degree intracoronary delivery of rTIMP-3 post-IR is feasible and effective remained to be established.