Updates on the Utilization of Percutaneous Deep Vein Arterialization in End-Stage Peripheral Arterial Disease.

Progressive peripheral artery disease, especially in the tibial and pedal vessels, can severely limit the interventions that vascular surgeons and interventionalists can provide to patients. End-stage peripheral arterial disease is often described as a disease where there are no distal targets available in the foot. Traditionally, amputation has been the only option for these patients.

Management and Treatment of Tandem Carotid Lesions.

Background: Tandem lesions of the proximal aortic branch vessels and carotid bifurcation are uncommon. While management strategies vary, a hybrid approach of carotid endarterectomy with retrograde common carotid artery (CCA) or innominate artery (IA) stenting has become a mainstay of treatment. The purpose of this article was to provide a review of the literature, discuss alternative treatment modalities, and highlight technical considerations of the hybrid approach.

Appropriate Use Criteria Committees: The professional society role in the development and implementation of Appropriate Use Criteria.

Vascular surgeons have the ability to manage and intervene on numerous vascular diseases of both the arterial and venous systems. With the growing number of interventions available as endovascular technology evolves, it is important to determine when a procedure is safely indicated for a vascular surgery patient. Appropriate Use Criteria (AUC) offer synthesized clinical information and practice standards that can aid clinicians in making these management decisions.

A hybrid endovascular and open approach to rare thyrocervical trunk and subclavian pseudoaneurysms complicated by embolic brachial artery occlusion.

Subclavian and thyrocervical trunk pseudoaneurysms are rare pathologies and even more so when they occur simultaneously. Treatment of these vascular injuries can be done endovascularly or with open surgery. We present a novel two-stage, hybrid open and endovascular approach to the management of a healthy 41-year-old man with no personal or family history of connective tissue disorders, who presented with subclavian branch and thyrocervical trunk pseudoaneurysms complicated by brachial artery occlusion.

Single Center Outcomes of Percutaneous Deep Vein Arterialization in Patients with End-Stage Peripheral Artery Disease.

Peripheral artery disease (PAD) can present as chronic limb threatening ischemia (CLTI) with ischemic pain and tissue loss. Progression of distal disease can lead to a "no option" or end-stage disease without traditional open or endovascular revascularization due to lack of pedal targets. Innovations in endovascular technology allow for the use of percutaneous deep vein arterialization (pDVA) to treat patients with CLTI.

Understanding and addressing varying perceptions of autonomy.

Recently, there has been a major shift in the concept of resident autonomy in the operating room. As a result, surgical residents' independence has decreased during their training years. This change has been secondary to multiple factors, including fragmented attending resident interactions, hospital demands for productivity, operating room efficiency, and the public's perception of resident participation in surgery.

Technological Advances to Address the Challenging Abdominal Aortic Aneurysm Neck.

There have been significant technologic advances in endovascular aortic therapies since the introduction of conventional infrarenal endovascular aortic aneurysm repair (EVAR). These advances have sought to address the weaknesses of conventional EVAR- particularly the difficult or "hostile" infrarenal aortic aneurysm neck. We review anatomical features that create a hostile neck and the most recent advancements to overcome these limitations.

Panel composition and disparities in the topics of presentation in vascular surgery conferences.

Background: Previous studies identified gender disparities in surgical conference presenters and moderators. We sought to assess disparities in the representation of women in terms of speakers and moderators, but with particular emphasis on panels and topics of discussion at vascular surgery conferences.

Methods: Data regarding presenters and moderators from the Southern Association of Vascular Surgery, Western Vascular Society, Vascular and Endovascular Surgical Society, Society for Clinical Vascular Surgery, and Society for Vascular Surgery conferences was obtained from online meeting archives and via email correspondence.

Targeted muscle reinnervation: A narrative review of a novel tool for the management of neuropathic pathology in major lower extremity amputations.

Objective: The purpose of this narrative review is to provide the vascular surgery community with updated recommendations and information regarding the use of Targeted Muscle Reinnervation (TMR) for both the prevention and treatment of chronic pain and phantom limb pain occurring in patients after undergoing lower extremity amputation for peripheral artery disease.

Methods: Current available literature discussing TMR is reviewed and included in the article in order to provide a succinct overview on the indications, clinical applications, and surgical technique for TMR. Additionally, early studies showing favorable long-term results after TMR are discussed.

Treatment of a descending thoracic mycotic aneurysm secondary to disseminated aspergillosis infection with thoracic endovascular aortic repair.

Mycotic aortic aneurysms are a rare and potentially fatal aortic pathology. Advancements in vascular technology have allowed endovascular repair to be a durable and less invasive option for the treatment of mycotic aortic aneurysms. We have presented the case of a 51-year-old man with a mycotic aneurysm of the descending thoracic aorta secondary to chronic, disseminated aspergillosis infection after liver transplantation.

The Feasibility and Applicability of Percutaneous Deep Vein Arterialization in Peripheral Artery Disease.

Peripheral artery disease (PAD) can often present with chronic limb threatening ischemia (CLTI), including ischemic rest pain and severe tissue loss. Progression of PAD can lead to "no option" or end-stage disease in which there are no traditional open or endovascular interventions available for revascularization. This cohort of patients have a poor prognosis, with a major amputation rate of 40% and mortality of up to 20% at six months.

Vascular Surgeons as Expert Witnesses in Malpractice Litigation.

Background: This study investigates the role of vascular surgeons as expert witnesses in United States' malpractice claims.

Materials And Methods: We reviewed the Westlaw database from 1999 through 2014 using the search terms "vascular" and "surgeon". Case defendant, plaintiff, allegation, and verdict were compiled.

Spontaneous compartment syndrome and endovascular repair of tibioperoneal trunk pseudoaneurysm in Ehlers-Danlos syndrome.

Vascular Ehlers-Danlos syndrome is caused by mutations in the COL3A1 (collagen type III alpha-1) gene, resulting in loss of integrity of arteries and hollow organs. Patients are predisposed to dissection, aneurysm, and organ rupture. The median life expectancy is ∼51 years.

Review of Malpractice Lawsuits in the Diagnosis and Management of Aortic Aneurysms and Aortic Dissections.

Objective: Aortic aneurysms and dissections are prevalent causes of morbidity and mortality. The management of aortic pathologies may be called into question in malpractice suits. Malpractice claims were analyzed to understand common reasons for litigation, medical specialties involved, patient injuries, and outcomes.

Trends in Ethnicity, Race, and Sex Among Psychiatry and Non-psychiatry Residency Applicants, 2008-2019.

Objective: The objective of this study was to examine trends in racial/ethnic and gender representation among US psychiatry residency applicants compared with non-psychiatry applicants.

Methods: Using publicly available applicant data, racial/ethnic and gender distributions of psychiatry residency applicants from 2008 to 2019 were examined and compared with non-psychiatry residency applicants. Both longitudinal trends within both cohorts and cross-sectional, between-group differences were examined.

The 100 most cited articles in the diagnosis and management of peripheral artery disease.

Objective: Peripheral artery disease (PAD) is a highly prevalent disease that places major lifestyle limitations and mortality risk on affected individuals. As the understanding of the disease has grown in the medical community, it is unknown which literature has made the greatest impact on the knowledge of PAD. We performed a bibliometric analysis using the number of citations as an indication of impact to analyze the top 100 most influential articles on PAD management.

Thoracic Aortic Endografts: Past, Present, and Future.

Introduction: Thoracic endovascular aortic repair (TEVAR) has become first-line therapy for a wide range of thoracic aortic pathologies including traumatic thoracic aortic injury, type B aortic dissection, intramural thoracic aortic hematoma, and penetrating aortic ulcers. This study aims to analyze the progress made of thoracic stent graft devices, review the current Food and Drug Administration (FDA)-approved devices, and discuss the future technological advances.

Materials And Methods: In this paper, we will review the history of TEVAR and the development of the first iteration of devices.

Perioperative Opioid and Nonopioid Prescribing Patterns in AVF/AVG Creation.

Background: To evaluate postoperative opioid prescribing patterns in patients undergoing hemodialysis access creation.

Methods: Operative logs were reviewed to identify patients undergoing creation of arteriovenous fistula (AVF) or graft (AVG) from September 2016 to January 2018. Immediate postoperative opioid prescriptions were compared for ambulatory patients versus inpatients.

Early experience with arterial thromboembolic complications in patients with COVID-19.

Background: Little is known about the arterial complications and hypercoagulability associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We sought to characterize our experience with arterial thromboembolic complications in patients with hospitalized for coronavirus disease 2019 (COVID-19).

Methods: All patients admitted from March 1 to April 20, 2020, and who underwent carotid, upper, lower and aortoiliac arterial duplex, computed tomography angiogram or magnetic resonance angiography for suspected arterial thrombosis were included.

The Current Role of the Percutaneous Arteriovenous Fistula for Hemodialysis Access.

Dialysis is the preferred treatment for patients with end-stage renal disease (ESRD) for the removal of accumulated toxins secondary to compromised renal function. Hemodialysis has traditionally been performed via a surgically created arteriovenous fistula (AVF) or arteriovenous graft (AVG). Novel endovascular techniques have allowed for the creation of percutaneous arteriovenous fistulas for hemodialysis access.