Home care nursing after elective vascular surgery: an opportunity to reduce emergency department visits and hospital readmission.

Background: Events occurring outside the hospital setting are underevaluated in surgical quality improvement initiatives and research.

Objective: To quantify regional variation in home care nursing following vascular surgery and explore its impact on emergency department (ED) visits and hospital readmission.

Methods: Patients who underwent elective vascular surgery and were discharged directly home were identified from population-based administrative databases for the province of Ontario, Canada, 2006-2015.

Vascular Thoracic Outlet Syndrome.

Two distinct terms are used to describe vascular thoracic outlet syndrome (TOS) depending on which structure is predominantly affected: venous TOS (due to subclavian vein compression) and arterial TOS (due to subclavian artery compression). Although the venous and arterial subtypes of TOS affect only 3% and <1% of all TOS patients respectively, the diagnostic and management approaches to venous and arterial TOS have undergone considerable evolution due to the recent emergence of minimally invasive endovascular techniques such as catheter-directed arterial and venous thrombolysis, and balloon angioplasty. In this review, we discuss the anatomical factors, etiology, pathogenesis and clinical presentation of vascular TOS patients.

Blunt traumatic subclavian vein pseudoaneurysm.

Subclavian and upper extremity venous pseudoaneurysms are rare and poorly understood. We present the case of a 45-year-old woman with a right subclavian vein pseudoaneurysm that formed after blunt trauma to the upper chest and shoulder. The patient was managed successfully with surgical excision through a supraclavicular approach.