Identifying potentially avoidable femoral to popliteal expanded polytetrafluoroethylene bypass for claudication using cross-site blinded peer review.

Objective: The surgical treatment of claudication can be associated with significant morbidity and costs. There are growing concerns that some patients proceed to interventions without first attempting evidence-based nonoperative management. We used a direct, cross-site, blinded expert review to evaluate the appropriateness of the surgical treatment of claudication.

Underutilization of medical management of peripheral artery disease among patients with claudication undergoing lower extremity bypass.

Objective: First-line treatment of peripheral artery disease (PAD) involves medical therapy and lifestyle modification. Multiple professional organizations such as the Society for Vascular Surgery and the American Heart Association/American College of Cardiology make Class I recommendations for medical management including antiplatelet, statin, antihypertensive, and cilostazol medications, as well as lifestyle therapy including exercise and smoking cessation. Although evidence supports up-front medical and lifestyle management prior to surgical intervention, it is unclear how well this occurs in contemporary clinical practice.

Incidental Pathogenic Fibrin-Associated Diffuse Large B-cell Lymphoma Found During Aorto-Biiliac Bypass.

Fibrin-associated diffuse large B-cell lymphoma (FA-DLBCL) is in and of itself a rare entity and is a subset of the Epstein-Barr virus (EBV)-associated lymphoma. Due to its indolent course, FA-DLBCL is generally an incidental finding on histopathological examinations. We present the first reported case of FA-DLBCL found within a native aortic thrombus during an aorto-biiliac bypass.

Hypothenar hammer syndrome and repair of ulnar artery aneurysm in a patient without history of trauma.

The patient is a 50-year-old male with a history of tobacco use presented for evaluation of pulsatile right-hand mass. The patient was employed as a barber but had no known history of trauma or injury. He was diagnosed with hypothenar hammer syndrome and underwent excision of ulnar artery aneurysm with reconstruction of ulnar artery with interposition saphenous vein graft.

Endovascular Intervention of a Mycotic Pseudoaneurysm of Accessory Left Hepatic Artery Arising from the Left Gastric Artery Presenting Secondary to Clostridium difficile Colitis: A Case Report.

Hepatic artery aneurysms have an estimated incidence of approximately 0.002%, of which one half are pseudoaneurysms (PsAs). These typically occur following trauma or liver transplant and are often asymptomatic.

If not now, when? Prescription of evidence-based medical therapy prior to hospital discharge increases utilization at 6 months in patients with symptomatic peripheral artery disease.

We evaluated the impact of the prescription of evidence-based medical therapy (EBMT) including aspirin (ASA), beta-blockers (BB), ACE-inhibitors or angiotensin receptor blockade (ACE/ARB), and statins prior to discharge after peripheral vascular intervention (PVI) on long-term medication utilization in a large multi-specialty, multicenter quality improvement collaborative. Among patients undergoing coronary revascularization, use of the component medications of EBMT at hospital discharge is a major predictor of long-term utilization. Predictors of EBMT use after PVI are largely unknown.