Outcomes of Transcarotid Artery Revascularization and Carotid Endarterectomy at a Single Institution.

Background: Carotid endarterectomy (CEA) and carotid artery stenting (CAS) are accepted revascularization modalities to treat carotid artery stenosis. Higher incidences of perioperative adverse neurological events and death have been reported in patients with transfemoral CAS. Transcarotid artery revascularization (TCAR) is a newer operative technique that involves direct transcervical carotid access, mitigating aortic arch manipulation and minimizing the risk of embolic stroke via cerebral blood flow reversal.

Common femoral vein stent placement in a frozen abdomen causing acute limb ischemia.

A 73-year-old woman was admitted for left groin bleeding through an open wound near a fungating left inguinal mass from advanced anal carcinoma. The interventional radiology service placed left iliac vein and common femoral vein stents as there was concern for communication and involvement of the left common femoral vein with the open wound, contributing to groin hemorrhage. After the procedure, the patient developed limb ischemia related to mass effect of the stent on the left common femoral vein stent artery.

Vascular Complications in Extracoporeal Membrane Oxygenation.

Venoarterial extracorporeal membrane oxygenation is a rescue therapy in patients with severe cardiopulmonary failure. Often, cannulation is done emergently and the femoral vessels are most readily accessible for venous and arterial access. Unfortunately, complications with arterial femoral access can lead to devastating complications, primarily related to limb ischemia.

Arterial protocol including prophylactic distal perfusion catheter decreases limb ischemia complications in patients undergoing extracorporeal membrane oxygenation.

Objective: Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complications (10%-70%). This study evaluates the results of a distal limb perfusion arterial protocol designed to reduce associated complications.

Modified Appleby Procedure with Arterial Reconstruction for Locally Advanced Pancreatic Adenocarcinoma: A Literature Review and Report of Three Unusual Cases.

Background: Pancreatic body and tail ductal adenocarcinomas are often diagnosed with local vascular invasion of the celiac axis (CA) and its various branches. With such involvement, these tumors have traditionally been considered unresectable. The modified Appleby procedure allows for margin negative resection of some such locally advanced tumors.

Incidence and severity of pancreatogenic diabetes after pancreatic resection.

Background: While many patients experience prolonged survival after pancreatic resection for benign or malignant disease, the long-term risk of pancreatogenic diabetes mellitus (DM) remains poorly characterized.

Methods: One thousand one hundred seven patients underwent pancreatectomy at Thomas Jefferson University between 2006 and 2013. Attempts were made to contact all living patients by telephone and a DM-focused questionnaire was administered.

Venous cystic adventitial disease of the common femoral vein.

Venous adventitial cystic disease is a rare condition with few reports previously described. We report the case of a 39-year-old female who presented with left lower extremity edema, acutely exacerbated by exercise. Imaging revealed a hypoechoic mass posterior to her left common femoral vein.

Preparation and technical considerations for percutaneous cannulation for veno-arterial extracorporeal membrane oxygenation.

Background: The most frequent limb complications from peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done.

Technique: Percutaneous cannulation with a distal perfusion port was performed in all patients.