Ambulatory Cardiology or General Internal Medicine Assessment Prior to Scheduled Major Vascular Surgery is Associated with Improved Outcomes.

Objective: To characterize the association between ambulatory cardiology or general internal medicine (GIM) assessment prior to surgery and outcomes following scheduled major vascular surgery.

Background: Cardiovascular risk assessment and management prior to high-risk surgery remains an evolving area of care.

Methods: This is population-based retrospective cohort study of all adults who underwent scheduled major vascular surgery in Ontario, Canada, April 1, 2004-March 31, 2019.

Real-World Experience With the Angio-Seal Closure Device: Insights From Manufacturer and User Facility Device Experience Database.

Purpose: Angio-Seal (Terumo Medical Corporations, Somerset, New Jersey) device is indicated for femoral arteriotomy closure. Real-world published data on complications are limited. We present 1 year of safety events involving Angio-Seal from the US Food and Drug Administration's post-market surveillance database of Manufacturer and User Facility Device Experience (MAUDE).

Typology, Severity, and Outcomes of Adverse Events Related to Angiographic Equipment-A Ten-Year Analysis of the FDA MAUDE Database.

Angiographic equipment is a key component of healthcare infrastructure, used for endovascular procedures throughout the body. The literature on adverse events related to this technology is limited. The purpose of this study was to analyze adverse events related to angiographic devices from the US Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database.

Vascular Closure Devices For Axillary Artery Access: A Systematic Review and Meta-Analysis.

Purpose: To evaluate the technical success and complication rates of vascular closure devices (VCDs) in the axillary artery.

Materials And Methods: MEDLINE and Embase were searched independently by two reviewers to identify observational studies from inception through October 2021. The following outcomes were meta-analyzed: technical success, hematoma, dissection, pseudoaneurysm, infection, and local neurological complications.

The Use of Vascular Closure Devices for Brachial Artery Access: A Systematic Review and Meta-Analysis.

Purpose: To estimate the rates of technical success and adverse events of vascular closure devices (VCDs) in the brachial artery and compare the rates of adverse events with manual compression.

Materials And Methods: MEDLINE and Embase were searched for observational studies examining VCDs in the brachial artery. Meta-analyses were performed using random effects for the following outcomes: (a) technical success, (b) hematoma at the access site, (c) pseudoaneurysm, (d) local neurological adverse events, and (e) total number of adverse events.

Percutaneous Transluminal Angioplasty for Below-the-Elbow Critical Hand Ischemia: A Systematic Review.

Purpose: To perform a systematic review assessing the safety and efficacy of percutaneous transluminal angioplasty (PTA) for treatment of critical hand ischemia (CHI) due to below-the-elbow (BTE) obstructive arterial disease.

Materials And Methods: MEDLINE and EMBASE systematic searches were performed from inception to December 2020 to identify studies assessing PTA for management of BTE obstructive arterial disease. Three independent reviewers performed abstract selection, data extraction, and quality assessment.

Three-stage approach to resection of left pancoast tumour with spinal and major vessel involvement.

Here we describe the successful outcome of a complex and challenging resection of a left-sided pancoast tumour involving the left subclavian artery and vertebral bodies. The resection was performed following neoadjuvant chemoradiotherapy in a multi-staged fashion involving multiple teams including thoracic surgery, plastic surgery, neurosurgery and vascular surgery. Each operation was less than 6 h, without complication, and the patient was discharged within 1 week of each procedure.

Overall Impact of the COVID-19 Pandemic on Interventional Radiology Services: A Canadian Perspective.

Purpose: The aim of this national survey was to assess the overall impact of the coronavirus disease 2019 (COVID-19) pandemic on the provision of interventional radiology (IR) services in Canada.

Methods: An anonymous electronic survey was distributed via national and regional radiology societies, exploring (1) center information and staffing, (2) acute and on-call IR services, (3) elective IR services, (4) IR clinics, (5) multidisciplinary rounds, (6) IR training, (7) personal protection equipment (PPE), and departmental logistics.

Results: Individual responses were received from 142 interventional radiologists across Canada (estimated 70% response rate).

Retroperitoneal Hematoma Following Elective Abdominal Aortic Aneurysm Repair: A Case Report.

Retroperitoneal hematoma formation following elective open abdominal aortic aneurysm (AAA) repair may be occult. We report a case of recurrent hypotensive episodes in the postanesthesia care unit (PACU) that were temporarily treated successfully with fluid, blood products, and vasopressors. At reoperation, active bleeding was excluded; however, upon reopening the bovine pericardial patch closure of the retroperitoneum, hematoma between the aneurysmal sac and inferior vena cava (IVC) had caused IVC compression.

Rare complication of esophageal necrosis and perforation after fenestrated endovascular aneurysm repair.

Fenestrated endovascular aneurysm repair (FEVAR) is a minimally invasive technique used to treat complex abdominal aortic aneurysms. We present the case of a 69-year-old man with a juxtarenal abdominal aortic aneurysm treated with FEVAR. The patient experienced postoperative dysphagia and sepsis.

Sources of Error in Interventional Radiology: How, Why, and When.

This article aims to provide an overview of the sources for error in interventional radiology (IR). Being both a procedure and an imaging-based specialty, IR has unique considerations as to how error can occur. However, compared to the surgical and medical literature, data on error in IR are lacking.

Leveraging vascular quality initiative data to improve hospital length of stay for patients undergoing endovascular aneurysm repair.

Background: The Society for Vascular Surgery Vascular Quality Initiative (SVS-SVQI) is a database that provides insight into standards of care and highlights opportunities for quality improvement by benchmarking institutional data against local, regional and national trends. Endovascular aneurysm repair (EVAR) is a frequently performed vascular operation. Postoperative length of stay in hospital (LOS) varies among institutions.

Avoiding and Managing Error in Interventional Radiology Practice: Tips and Tools.

While there are limited data on error in interventional radiology (IR), the literature so far indicates that many errors in IR are potentially preventable. Yet, understanding the sources for error and implementing effective countermeasures can be challenging. Traditional methods for reducing error such as increased vigilance and new policies may be effective but can also contribute to an "error cycle.

Diagnosis and management of right external iliac vein "sandwich": A rare cause of iliofemoral deep venous thrombosis.

Several anatomic abnormalities predispose patients to iliofemoral deep venous thrombosis, the most common of which is compression of the left iliac vein between the right common iliac artery and lumbar vertebrae, or May-Thurner syndrome. Other areas of venous compression can occur but are rare. This case report describes the presentation, diagnosis, and management of a patient with compression of the right iliac vein "sandwiched" between the right internal and external iliac arteries.

Long-term results of thigh arteriovenous dialysis grafts.

Introduction:: A proportion of hemodialysis patients exhaust all options for arteriovenous access in upper extremities. Arteriovenous thigh grafts are a potential vascular access option in such patients.

Methods:: We performed a retrospective study of all thigh arteriovenous access grafts placed between 1995 and 2015.

Transabdominal Direct Sac Puncture Embolization of Type II Endoleaks after Endovascular Abdominal Aortic Aneurysm Repair.

Purpose: To determine the efficacy and safety of transabdominal direct sac puncture embolization of type II endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).

Materials And Methods: This retrospective review included 30 patients (4 women, 26 men; mean age = 79.1 years) who underwent 33 transabdominal direct sac puncture embolization procedures for type II endoleaks after EVAR.

Hyperbaric oxygen therapy for spinal cord ischaemia after complex aortic repair - a retrospective review.

Background: Complex aortic repair (CAR) carries high rates of debilitating postoperative complications, including spinal cord injury. The rate of spinal cord deficits post-CAR is approximately 10%, with permanent paraplegia in 2.9% and paraparesis in 2.

Outcomes at a single center after subintimal arterial flossing with antegrade-retrograde intervention for critical limb ischemia.

Objective: The subintimal arterial flossing with antegrade-retrograde intervention technique has been used to overcome antegrade recanalization failures for peripheral lower limb arterial occlusive disease. There are few outcomes published for this technique and we sought to evaluate outcomes at our institution over a 7-year period.

Methods: A retrospective review was performed of all subintimal arterial flossing with antegrade-retrograde intervention procedures of infrainguinal occlusive disease from 2009 to 2016.

Successful balloon assisted percutaneous thrombin injection of right subclavian artery pseudoaneurysm.

Purpose: To report the use of a balloon catheter to facilitate percutaneous ultrasound-guided thrombin injection of a subclavian artery pseudoaneurysm.

Case Report: A 36-year-old man presented with hoarseness after the insertion of a right temporary internal jugular line. Arteriography showed a short neck right subclavian artery pseudoaneurysm.

Repair of popliteal aneurysm and spontaneous arteriovenous fistula in a patient with Marfan syndrome.

Isolated extremity arterial aneurysms remain a rare entity, and the development of a spontaneous arteriovenous fistula from such an aneurysmal segment in a young patient should prompt a search for an underlying genetic predisposition. Endovascular repair of aneurysms or arteriovenous fistulas in the popliteal artery is appropriate in select populations; however, open repair allows for a more durable reconstruction of both the arterial and any involved venous segments in patients who can tolerate the procedure.

Combined Coil Embolization and Foam Sclerotherapy for the Management of Varicose Veins.

Background: We propose a novel technique for endovenous treatment of varicose veins (VVs) using combined coil embolization and foam sclerotherapy of the great saphenous vein (GSV).

Methods: A retrospective case-series analysis on patients undergoing fluoroscopically guided coil embolization of the GSV and foam sclerotherapy of the GSV and below-knee varices at a single Canadian center.

Results: Twenty-two patients underwent the procedure on 23 legs.