Incidence and predictors of gastrointestinal hemorrhage following mesenteric revascularization.

Objective: Postoperative gastrointestinal hemorrhage (GIH) following mesenteric revascularization when performed either openly (OR) or endovascularly (ER) has been clinically observed but not reported. The aim of the study is to assess the incidence and predictors of GIH in patients undergoing mesenteric revascularization.

Methods: This was a single-center retrospective review of consecutive patients treated with open or endovascular mesenteric revascularization from 2009 to 2019.

Implications and late outcomes of type II endoleaks after endovascular aneurysm repair.

Objective: Type II endoleaks (T2ELs) are the most common cause of reintervention after endovascular aneurysm repair (EVAR). Although most resolve spontaneously, the long-term implications of T2ELs remain elusive. We aim to evaluate the impact of persistent and late T2ELs on clinical outcomes after EVAR.

Cryopreserved arterial allografts vs autologous vein for arterial reconstruction in infected fields.

Objective: Peripheral arterial infections are rare and difficult to treat when an in situ reconstruction is required. Autologous vein (AV) is the conduit of choice in many scenarios. However, cryopreserved arterial allografts (CAAs) are an alternative.

The Human Acellular Vessel (HAV) as a vascular conduit for infrainguinal arterial bypass.

Autologous vein is the optimal conduit for peripheral arterial bypass surgery, a standard recently highlighted by findings from the BEST-CLI trial. The Human Acellular Vessel is a novel biologic conduit produced using regenerative medicine technologies with structural and mechanical properties like a human blood vessel. Not yet approved by the United States Food and Drug Administration, the Human Acellular Vessel is being studied as an alternative bypass conduit in patients with peripheral arterial disease, vascular injury, and those in need of arteriovenous access for hemodialysis.

Cryopreserved arterial allografts vs rifampin-soaked Dacron for the treatment of infected aortic and iliac grafts.

Objective: Aortic and iliac graft infections remain complex clinical problems with high mortality and morbidity. Cryopreserved arterial allografts (CAAs) and rifampin-soaked Dacron (RSD) are options for in situ reconstruction. This study aimed to compare the safety and effectiveness of CAA vs RSD in this setting.

Covered endovascular reconstruction of the aortic bifurcation with inferior mesenteric artery chimney for management of bilateral lower extremity tissue loss with concomitant mesenteric stenosis.

Aortoiliac occlusive disease involving mesenteric branches poses an interesting challenge. Although an open surgical approach is considered the gold standard, endovascular techniques such as covered endovascular reconstruction of the aortic bifurcation with inferior mesenteric artery chimney have been presented as alternatives for patients unfit for major surgical repair. A 64-year-old man with bilateral chronic limb-threatening ischemia and severe chronic malnutrition underwent covered endovascular reconstruction of the aortic bifurcation with inferior mesenteric artery chimney due to significant intraoperative risk.

Cryopreserved Arterial Allografts Versus Rifampin-Soaked Dacron for the Treatment of Infected Aortic and Iliac Aneurysms.

Background: Infected aortic and iliac artery aneurysms are challenging to treat. Cryopreserved arterial allografts (CAAs) or rifampin-soaked Dacron (RSD) are standard options for in situ reconstruction. Our aim was to compare the safety and effectiveness of CAA versus RSD for these complex pathologies.

Midterm Clinical Outcomes of Retrograde Open Mesenteric Stenting for Mesenteric Ischemia.

Background: Retrograde open mesenteric stenting (ROMS) has become a mainstay in treatment of mesenteric ischemia; however, follow-up in contemporary studies is limited.

Methods: A single-center retrospective review of patients undergoing ROMS from 2007 to 2020 was conducted. Demographics, presentation, and procedural details were reviewed.

Clinical presentation, operative management, and long-term outcomes of rupture after previous abdominal aortic aneurysm repair.

Objective: The aim of the present study was to evaluate the presentation trends, intervention, and survival of patients who had been treated for late abdominal aortic aneurysm rupture (LAR) after open repair (OR) or endovascular aortic aneurysm repair (EVAR).

Methods: We reviewed the clinical data from a single-center, retrospective database for patients treated for LAR from 2000 to 2020. The end points were the 30-day mortality, major postoperative complication, and survival.

Outcomes of Unilateral Versus Bilateral Use of the Iliac Branch Endoprosthesis for Elective Endovascular Treatment of Aorto-iliac Aneurysms.

Purpose: The aim of the study was to evaluate outcomes after bilateral implantation of the Gore Excluder Iliac Branch Endoprosthesis (IBE) versus those achieved after unilateral implantation.

Methods: All consecutive patients electively treated in a single center for aorto-iliac aneurysm using the IBE device between January 1, 2014, and December 31, 2018, were reviewed. Early outcome measures were technical success, 30 days or in-hospital mortality, and major adverse events (MAE).

Thirty-year single-center experience with arterial thoracic outlet syndrome.

Objective: Arterial thoracic outlet syndrome (ATOS) is rare. We present our 30-year experience with the management of ATOS at a high-volume referral center.

Methods: A retrospective review of all patients who had undergone primary operative treatment for ATOS from 1988 to 2018 was performed.

Impact of Shunting Practice Patterns During Carotid Endarterectomy for Symptomatic Carotid Stenosis.

Background: We aimed to assess the effect of surgeons' shunting practice and shunt use on the early outcomes of carotid endarterectomy (CEA) in recently symptomatic patients.

Methods: We conducted a retrospective observational study based on a multicenter national prospective database. The Vascular Quality Initiative database (2010-2019) was queried for CEAs performed within 14 days after an ipsilateral stroke or transient ischemic attack.

Aneurysms of the superior mesenteric artery and its branches.

Objective: Aneurysms of the superior mesenteric artery (SMA) and its branches are rare and account for only 6% to 15% of all visceral artery aneurysms. In the present report, we have described our 30-year experience with the management of aneurysms of the SMA and its branches at a high-volume referral center.

Methods: A retrospective review of all patients with a diagnosis of an aneurysm of the SMA or one of its branches from 1988 to 2018 was performed.

Senescent cells suppress innate smooth muscle cell repair functions in atherosclerosis.

Senescent cells (SNCs) degenerate the fibrous cap that normally prevents atherogenic plaque rupture, a leading cause of myocardial infarction and stroke. Here we explored the underlying mechanism using pharmacological or transgenic approaches to clear SNCs in the mouse model of atherosclerosis. SNC clearance reinforced fully deteriorated fibrous caps in highly advanced lesions, as evidenced by restored vascular smooth muscle cell (VSMC) numbers, elastin content, and overall cap thickness.

Outcomes of balloon-expandable versus self-expandable stent graft for endovascular repair of iliac aneurysms using iliac branch endoprosthesis.

Purpose: The purpose of this study was to compare outcomes of internal iliac artery (IIA) stenting using balloon-expandable (BESG) or self-expandable stent grafts (SESG) during endovascular repair of aortoiliac aneurysms with iliac branch endoprosthesis (IBE; W. L. Gore, Flagstaff, Ariz).

Long-term fate of aortic branches in patients with aortic dissection.

Objective: Late morbidity and mortality related to aortic branches in patients with aortic dissection (AD) have not been well described. We investigated the fate of aortic branches in a population cohort of patients with newly diagnosed AD.

Methods: We used the Rochester Epidemiology Project record linkage system to identify all Olmsted County, Minnesota, residents with a diagnosis of AD from 1995 to 2015.

Surgical treatment patterns and clinical outcomes of patients treated for expanding aneurysm sacs with type II endoleaks after endovascular aneurysm repair.

Objective: Persistent type II endoleaks (T2ELs) after endovascular aneurysm repair (EVAR) with sac growth have been associated with adverse events, including rupture. Whereas intervention in the presence of aneurysm growth has become an accepted treatment paradigm for T2ELs, the efficacy and clinical success of such interventions remain unclear. Therefore, we examined the treatment patterns and clinical outcomes of patients undergoing T2EL interventions after EVAR.

Protamine use in transfemoral carotid artery stenting is not associated with an increased risk of thromboembolic events.

Background: Protamine use in carotid endarterectomy has been shown to be associated with fewer perioperative bleeding complications without higher rates of thromboembolic events. However, the effect of protamine use on complications after transfemoral carotid artery stenting (CAS) is unclear, and concerns remain about thromboembolic events.

Methods: A retrospective review was performed for patients undergoing transfemoral CAS in the Vascular Quality Initiative from March 2005 to December 2018.