Impact of Care Fragmentation after Major Lower Extremity Amputation.

Background: Care fragmentation (CF) is a known risk factor for unplanned readmission, morbidity, and mortality after surgery. The goal of this study was to evaluate the impact of CF on outcomes of major lower extremity amputation for peripheral vascular disease.

Methods: Health-care Cost and Utilization Project Database for NY (2016) and MD/FL (2016-2017) were queried using International Classification of Diseases 10thedition to identify patients who underwent above the knee-, through the knee-, and below the knee-amputation for peripheral vascular disease.

Analysis of a Novel Inpatient Acute Limb Ischemia Alert System.

Objectives: Acute limb ischemia (ALI) is a surgical emergency that generally develops in the outpatient setting. Hospitalized patients are also at risk for acute limb ischemia, but their presentation may be atypical or altered by medical therapy. Our institution developed an alert system to facilitate the prompt recognition and treatment of ALI that occurs in the inpatient population.

Repeated Endovascular Interventions Are Worthwhile, Even After Thrombosis, to Maintain Long-Term Use of Autogenous Dialysis Fistulas.

Objectives: Patients often require multiple access re-interventions to improve fistula patency and the overall usable lifespan of autogenous arteriovenous fistula (aAVF). There is no consensus on the appropriate number of re-interventions after which an access should be abandoned and new access placed. We evaluated whether repeated endovascular interventions for failing/failed aAVF are worthwhile or futile.

Outcomes of laparoscopic-assisted ERCP in gastric bypass patients at a community hospital center.

Background: Obesity is a prevalent issue in today's society, increasing the number of gastric weight loss surgeries (Bowman et al. in Surg Endosc. https://doi.

Active Tobacco Use in Patients with Claudication Does Not Affect Outcomes after Endovascular Interventions.

Background: With the advent of endovascular procedures, the indications for intervention in claudicants have become less strict. Many interventionalists, however, will not intervene in patients with lifestyle-limiting claudication unless they have discontinued tobacco use. Many patients are unable to comply with this goal, and there is little published evidence to suggest that continued tobacco use results in poorer outcomes.

Rare Case of Acute Type B Dissection Causing Complete Collapse of EVAR Stent.

We describe a unique case of an acute type B aortic dissection in a patient with a history of a previously placed infrarenal aortic stent for an abdominal aortic aneurysm. The patient presented with a hypertensive emergency and left lower extremity ischemia, and imaging revealed complete collapse of the previously placed stent graft with extension into the iliac limbs. He underwent emergent endovascular intervention.

Successful Use of Orbital Atherectomy as an Adjunct in Treating Extensively Calcified Mesenteric Artery Lesions.

Background: To describe the use of orbital technique of atherectomy as an adjunct to successful angioplasty and stent placement of the superior mesenteric artery (SMA).

Case Report: The technique is demonstrated in a 68-year-old man with critical SMA stenosis. The SMA was cannulated with 0.