Impact of Housing Status on Surgical Management and Inpatient Outcomes of Chronic Limb-Threatening Ischemia in the United States.

Background: Chronic limb-threatening ischemia (CLTI) represents the most severe form of peripheral artery disease. While previous studies have focused on gender and racial disparities, there is lack of evidence regarding the impact of housing status. The aim of this analysis was to identify disparities in inpatient management and outcomes of CLTI based on housing status.

Traumatic Aortic Disruption Index is Associated with Mortality and Urgency of Stent Grafting in Blunt Thoracic Aortic (Grade 3) Injuries.

Background: Delayed stent grafting for blunt thoracic aortic injuries (BTAIs) is current standard of care. However, given the heterogeneity of pseudoaneurysm presentations, it is currently unclear which severe BTAIs require more urgent intervention. We hypothesize that a Traumatic Aortic Disruption Index (TADI) calculation based on sagittal computed tomography angiography imaging measurements would correlate with urgency of stent grafting.

Endovascular repair of bilateral common iliac artery aneurysms using intraoperative positioning system.

Intraoperative positioning system (IOPS; Centerline Biomedical, Inc) is a novel technology that allows for real-time intravascular navigation of endovascular devices using an electromagnetic field. In this report, we describe the use of IOPS for effective treatment of bilateral common iliac artery aneurysms with endovascular aortoiliac repair using iliac branch endoprostheses. Our experience suggests that this technology has the potential to reduce radiation and contrast use in endovascular procedures, although its application is currently limited.

Long-Term Outcomes of Open and Endovascular Axillosubclavian Interventions After Traumatic Injury Reveal High Rates of Limb Dysfunction.

Background: Arterial axillosubclavian injuries (ASIs) are currently managed with open repair (OR) and endovascular stenting (ES). The long-term prognosis of patients with these and associated brachial plexus injuries is poorly understood. We hypothesize that OR and ES for ASI have similar long-term patency rates and that brachial plexus injuries would confer high long-term morbidity.

The Impact of Implementing a Diabetic Limb-Preservation Program on Amputation Outcomes at an Academic Institution in a Majority-Minority State.

Diabetic foot osteomyelitis may precede major limb amputations and lengthy hospital admission. These complications impact patients' morbidity and mortality. Healthcare institutions with dedicated limb-preservation teams realize reduced amputation rates and improved quality of care.

The effect of preoperative embolization on surgical outcomes for carotid body tumor resection.

Objective: Compare the effects of preoperative embolization for carotid body tumor resection on surgical outcomes to carotid body tumor resections without preoperative embolization.

Methods: Single-center retrospective review of all consecutive patients who underwent carotid body tumor resection from 2001 to 2019. Surgical outcomes with emphasis on operative time (estimated blood loss and cranial nerve injury) of patients undergoing carotid body tumor resection following preoperative embolization were compared to those undergoing resection alone using unpaired Student's -test and Fisher's exact test.

Initial Outcomes Following Introduction of Percutaneous Arteriovenous Fistula Program with Comparison to Historical Surgically Created Fistulas.

Background: Recently, there has been an abundance of encouraging data regarding the creation of percutaneous arteriovenous fistulas. Despite promising data regarding their clinical maturation, a paucity of data exists which provides direct comparison between percutaneously created AVFs (pAVF) and open surgically created AVFs (sAVF). This study has 2 primary objectives: First, to compare clinical outcomes of pAVFs to sAVFs, with emphasis on clinical maturation and frequency of postoperative interventions to facilitate maturation.

Protocolized use of catheter-directed thrombolysis and echocardiography is highly effective in reversing acute right heart dysfunction in severe submassive pulmonary embolism patients.

Objective: The objective of this study was to evaluate the efficacy of protocolized use of catheter-directed thrombolysis and echocardiography in submassive pulmonary embolism patients.

Methods: A retrospective study at a single institution of 28 patients that presented with submassive pulmonary embolism from July 2016 to September 2019 was performed. All patients were diagnosed using chest computed tomography demonstrating a pulmonary embolism and abnormal right ventricular to left ventricular ratio.

Hoarseness Caused by a Penetrating Proximal Descending Thoracic Aortic Ulcer and Pseudoaneurysm.

We present a case of an 87-year-old female with new-onset hoarseness of unclear etiology. Imaging demonstrated a penetrating aortic ulcer (PAU) in the proximal descending thoracic aorta with an associated pseudoaneurysm that enlarged to a depth of 32 mm over 2 years. This patient was diagnosed with hoarseness being secondary to left recurrent laryngeal nerve (LRLN) palsy, a variant of Ortner syndrome.

Same-Day ICU Discharge in Selected Patients With Severe Submassive Pulmonary Embolism Treated With Catheter-Directed Thrombolysis.

A retrospective review from July 2016 to April 2018 was performed of 23 patients with submassive pulmonary embolism (PE) who received catheter-directed thrombolysis (CDT). Five (22%) of the 23 patients were discharged the same day from the intensive care unit (ICU) following thrombolysis completion. Their presentation, hospital courses, complications, and follow-up are reviewed.

Spontaneous inferior mesenteric arteriovenous fistula as a cause of severe portal hypertension and cardiomyopathy.

Inferior mesenteric artery (IMA) and inferior mesenteric vein (IMV) fistulas or malformations are extremely rare, with only 36 cases reported. Low incidence and nonspecific clinical signs and symptoms make mesenteric arteriovenous fistulas difficult to diagnose. We describe a case of a primary IMA-IMV fistula.

Hybrid Repair of Complex Left Subclavian Artery Injury with Partial Transection and Complete Thrombosis in an Unstable Patient following Blunt Trauma.

Blunt subclavian artery injuries are rare and are associated with high morbidity and mortality. Several case reports have suggested that endovascular repair is safe with short operative times and minimal blood loss. We report a case of a 20-year-old male patient involved in a high-speed motor vehicle collision that resulted in partial transection of left subclavian artery with complete luminal thrombosis.

Leiomyosarcoma of the Inferior Vena Cava: A Case Series and Review of the Literature.

Background: Leiomyosarcoma of the inferior vena cava (IVC) is an exceedingly rare smooth muscle sarcoma. Approximately 300 cases have been described in the literature, and further research is needed to understand the disease and guide its management. Surgery remains the only potential curative measure.

A rare cause of claudication treated with IVC reconstruction: A case report.

Introduction: Inferior vena cava (IVC) agenesis is one of rare entities of IVC anomalies which presents in young patients with unprovoked deep venous thrombosis (DVT) or unexplained bilateral lower venous insufficiency. We are presenting a case of IVC agenesis which was treated with IVC reconstruction.

Case: We describe a case of 28 years old male with painful bilateral lower extremity varicose veins and a history of right lower extremity DVT and was on anticoagulation with warfarin.

Early and long-term results of carotid endarterectomy in diabetic patients.

Purpose: To evaluate results of carotid endarterectomy (CEA) in diabetic patients in a large single-center experience.

Methods: Over a 13-year period ending in December 2008, 4305 consecutive CEAs in 3573 patients were performed. All patients were prospectively enrolled in a dedicated database.

Post-endovascular aneurysm repair patient outcomes and follow-up are not adversely impacted by long travel distance to tertiary vascular surgery centers.

Background: To determine whether patient adherence to follow-up and patient outcomes after endovascular aneurysm repair (EVAR) are affected by the distance between a patient's residence and a tertiary care treatment center.

Methods: A retrospective review of 136 consecutive patients undergoing EVAR at the New Mexico Veterans Affairs Medical Center over a 7-year period was conducted. Patients were stratified as living within a 100-mi radius of the treatment center (group 1) and those living outside this radius (group 2).

Early and long-term comparison of endovascular treatment of iliac artery occlusions and stenosis.

Objectives: This study evaluated early and long-term results of endovascular treatment of iliac artery occlusions and compared these outcomes with those in patients treated for stenotic lesions.

Methods: During a 10-year period ending in January 2010, 223 endovascular procedures to treat aortoiliac occlusive disease (PAD) were performed. All patients were prospectively enrolled in a dedicated database.

Combined carotid and cardiac surgery: improving the results.

Background: Aim of this study was to analyze our experience in the last 5 years of combined carotid and cardiac surgery.

Methods: During a 5-year period (January 2002-December 2006), 111 patients underwent combined carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) (group 1), while 1,446 patients underwent isolated CEA (group 2). Perioperative outcomes in the two groups were compared using chi(2) and Fisher's exact tests to analyze neurological deficits, cardiac events, and death at 30 days.

Alternative hybrid reconstruction for bilateral common and internal iliac artery aneurysms associated with external iliac artery occlusion.

Purpose: To describe an alternative reconstruction for bilateral common (CIA) and internal (IIA) iliac artery aneurysms associated with external iliac artery (EIA) occlusion in a patient unfit for open surgery.

Case Report: A high-risk 81-year-old man presented with contained rupture of a left CIA aneurysm in the presence of bilateral CIA and IIA aneurysms associated with complete occlusion of the left EIA and normal patency of both common femoral arteries. In an emergent procedure, the left EIA was recanalized subintimally, and the right IIA was embolized with a 14-mm Amplatzer Plug.

Carotid endarterectomy in female patients.

Objectives: To evaluate early and late results of carotid endarterectomy (CEA) in female patients in a large single center experience.

Methods: Over a 12-year period ending in December 2007, 4009 consecutive primary and secondary CEAs in 3324 patients were performed at our institution. All patients were prospectively enrolled in a dedicated database containing pre-, intra-, and postoperative parameters.

Covered stents for true subclavian aneurysms in patients with degenerative connective tissue disorders.

Purpose: To report the endovascular repair of rare true aneurysms of the subclavian artery in patients with degenerative connective tissue disorders.

Case Reports: Two patients, one with Marfan syndrome and the other with idiopathic cystic medial necrosis, presented with 3 subclavian artery aneurysms. A Wallgraft and 2 Viabahn covered stents were used to successfully exclude these aneurysms.

Technique and results of transfemoral superselective coil embolization of type II lumbar endoleak.

Objective: This study was undertaken to describe the technique of transfemoral superselective coil embolization of type II endoleak and its influence on abdominal aortic aneurysm diameter.

Methods: Over 23 months, 104 aortic stent grafts were deployed to exclude abdominal aortic aneurysms, at an academic medical center. Increase in aneurysm diameter and perigraft findings on contrast material-enhanced computed tomography scans prompted arteriography.

Comparison of nonneurological events in high-risk patients treated by carotid angioplasty versus endarterectomy.

Objective: To compare results of carotid angioplasty and stenting (CAS) with carotid endarterectomy (CEA) in high cardiac risk patients.

Methods: Patients ineligible for carotid revascularization by North American Symptomatic Carotid Endarterectomy Trial/Asymptomatic Carotid Atherosclerosis Study criteria were treated with CAS (n = 11) or CEA (n = 10).

Results: Significant numbers had cardiac (CAS 72%, CEA 60%; P = 0.