Trends and outcomes in endovascular and open surgical treatment of visceral aneurysms.

Objective: Visceral artery aneurysms (VAAs) are rare but often repaired because of dire consequences of rupture. This is a population-based evaluation of chronologic trends in management, risk factors, and outcomes of endovascular and open therapy.

Methods: The 2003 to 2013 Agency for Healthcare Research and Quality (AHRQ) National Inpatient Sample (NIS) database was reviewed.

Percutaneous endovascular aneurysm repair in morbidly obese patients.

Objective: Endovascular aneurysm repair (EVAR) with percutaneous femoral access (PEVAR) has several potential advantages. Morbidly obese (MO) patients present unique anatomical challenges and have not been specifically studied. This study examines the trends in the use of PEVAR and its surgical outcomes compared with open femoral cutdown (CEVAR) in MO patients.

Use of hyperspectral imaging to assess endothelial dysfunction in peripheral arterial disease.

Background: Hyperspectral imaging (HSI) is a technology that with limited training can noninvasively measure oxygenated hemoglobin (oxyHb) and deoxygenated hemoglobin concentrations in the skin to create an oxygenation map. This pilot study determined whether HSI could be used to demonstrate vascular dysfunction in the upper extremity of patients with peripheral artery disease (PAD) and coronary artery disease (CAD).

Methods: This prospective study included 93 consecutive, consented patients presenting to the vascular clinic, with and without diagnosed arterial disease, and healthy volunteers.

Explantation of infected aortic aneurysm and endograft with ascending aorta to mesenteric bypass for mesenteric ischemia.

A 65-year-old man presented with an infected perivisceral aortic aneurysm after previous treatment of an abdominal aortic aneurysm with an endograft. On presentation, he was septic and had occlusion of the celiac, superior mesenteric, inferior mesenteric, and bilateral renal arteries. He underwent a three-stage procedure: first, axillobifemoral bypass; then resection of the thoracoabdominal aorta; and finally bypass from the ascending aorta to the celiac and superior mesenteric arteries with a rifampin-soaked Gelsoft graft (Vascutek, Renfrewshire, Scotland).

New advances in limb salvage.

Critical limb ischemia (CLI) is an already significant and growing epidemiologic problem with substantial implications for patient mortality, quality of life, and healthcare costs. Considerable progress has been made in its treatment and prevention; however, poor outcomes, especially with regard to limb loss, warrant further development of treatment options. This article will examine new advances being made in the area of limb salvage for this morbid disease.

High-risk anatomic variables and plaque characteristics in carotid artery stenting.

Objectives: To determine anatomic and plaque-related risk factors for patients undergoing carotid artery stenting.

Methods: A retrospective review of patients from a prospectively maintained database undergoing carotid artery stenting at our institution between 2001 and 2010 was performed. Preoperative imaging studies (ie, ultrasound, computed tomography angiography, magnetic resonance angiography, and angiograms) were reviewed for specific anatomic criteria and plaque characteristics.

Diabetes mellitus and peripheral vascular disease: diagnosis and management.

Diabetes mellitus and peripheral artery disease are prevalent diseases throughout the world and often present simultaneously in the same patient, which has direct implications for their diagnosis and management. Refinements of existing and development of new diagnostic and treatment modalities are changing the management of these diseases. This article reviews the significant pathologic basis, history, and physical examination findings with respect to each disease and their presentation together.

Evaluation of hyperspectral technology for assessing the presence and severity of peripheral artery disease.

Background: Hyperspectral imaging is a novel technology that can noninvasively measure oxyhemoglobin and deoxyhemoglobin concentrations to create an anatomic oxygenation map. It has predicted healing of diabetic foot ulcers; however, its ability to assess peripheral arterial disease (PAD) has not been studied. The aims of this study were to determine if hyperspectral imaging could accurately assess the presence or absence of PAD and accurately predict PAD severity.