Endovascular vs open repair of ruptured abdominal aortic aneurysms with hostile neck anatomy.

Objective: Aneurysm neck anatomy in ruptured abdominal aortic aneurysms (rAAAs) is often complex, limiting the feasibility of endovascular repair (EVAR). The objective of this study was to compare the outcomes of EVAR and open surgical repair (OSR) for treatment of rAAAs in patients with hostile neck anatomy (HNA). The secondary aim was to review the clinical characteristics and anatomic risk factors predictive of mortality.

A national census for the off-label treatment of complex aortic aneurysms.

Objective: Despite regulatory challenges, device availability, and rapidly expanding techniques, off-label endovascular repair of complex aortic aneurysms (cAAs) has expanded in the past decade. Given the lack of United States Food and Drug Administration-approved endovascular technology to treat cAAs, we performed a national census to better understand volume and current practice patterns in the United States.

Methods: Targeted sampling identified vascular surgeons with experience in off-label endovascular repair of cAAs.

Early Financial Outcomes of Physician Modified Endograft Programs Are Dictated by Device Cost.

Introduction: Physician-modified endografts (PMEGs) have been used for repair of thoracoabdominal aortic aneurysms (TAAAs) for 2 decades with good outcomes but limited financial data. This study compared the financial and clinical outcomes of PMEGs to the Cook Zenith-Fenestrated (ZFEN) graft and open surgical repair (OSR).

Methods: A retrospective review of financial and clinical data was performed for all patients who underwent endovascular or OSR of juxtarenal aortic aneurysms and TAAAs from January 2018 to December 2022 at an academic medical center.

Gore TAG thoracic branch endograft for treatment of a subacute type B aortic dissection complicated by rupture.

An 80-year-old man presented with a subacute zone 3-5 type B aortic dissection complicated by rupture and visceral and lower extremity malperfusion. He underwent emergent zone 2 repair with a Gore TAG thoracic branch endograft with inclusion of the left subclavian artery for a dominant left vertebral artery. The patient's postoperative course was uncomplicated.

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.

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.

Effect of obesity on radiation exposure, quality of life scores, and outcomes of fenestrated-branched endovascular aortic repair of pararenal and thoracoabdominal aortic aneurysms.

Background: The aim of the present study was to assess the effect of obesity on procedural metrics, radiation exposure, quality of life (QOL), and clinical outcomes of fenestrated-branched endovascular aortic repair (FB-EVAR) of pararenal and thoracoabdominal aortic aneurysms.

Methods: We reviewed the clinical data from 334 patients (236 men; mean age, 75 ± 8 years) enrolled in a prospective nonrandomized study to evaluate FB-EVAR from 2013 to 2019. The patients were classified using the body mass index (BMI) as obese (BMI ≥30 kg/m) or nonobese (BMI <30 kg/m).

Are Vascular Surgery Trainees Satisfied and are They Using the Right Factors to Choose a Training Program?

Background: Medical students and residents often evaluate training sites in vascular surgery with minimal exposure to those programs. We sought to identify factors associated with vascular surgery trainee satisfaction in relation to their current work environment and how they made their rank list.

Methods: All integrated residents and fellows currently in United States vascular training programs were queried using an anonymous electronic survey for variables of their current training environment, factors that influenced their rank order list, and satisfaction.

A Mycotic Common Iliac Artery Pseudoaneurysm of Indeterminate Etiology.

We present the unusual case of a mycotic right common iliac artery pseudoaneurysm caused by the methicillin-susceptible Staphylococcus aureus (MSSA) of indeterminate etiology in a healthy 57-year-old man with no risk factors for infection, trauma, or malignancy. The patient initially presented with worsening subacute right lower quadrant pain and was found to have a pseudoaneurysm of the right common iliac artery. Given concern for rupture on a computed tomography angiogram (CTA), he underwent exclusion of the pseudoaneurysm with a covered stent.

Common Femoral Artery Access on YouTube: What Practices are Being Shown and Who is Delivering the Message?

Objectives: Novice learners are increasingly turning to YouTube as a learning resource for surgical procedures. One example of such a procedure is common femoral artery puncture and sheath placement. Practitioners in several specialties perform this procedure to access the arterial system for angiography and intervention.