Asia-Pacific Consensus Statement on the Management of Peripheral Artery Disease: A Report from the Asian Pacific Society of Atherosclerosis and Vascular Disease Asia-Pacific Peripheral Artery Disease Consensus Statement Project Committee.

Background: Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic modalities, and even patient treatment response. The Asian Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD) thus coordinated the development of an Asia-Pacific Consensus Statement (APCS) on the Management of PAD.

Do thrombotic events during endovascular interventions lead to poorer outcomes in patients with severe limb ischemia?

Introduction: Intra-procedural acute thrombosis (IPAT) is a complication of endovascular procedures. We aim to identify risk factors for IPAT and compare the outcomes of patients with or without IPAT.

Methods: Paired T test and χ (2) test were used to identify risk factors and short-term outcomes.

Limb salvage in patients with peripheral arterial disease managed by endovascular first approach.

This study aims to review the outcome of patients with peripheral arterial disease (PAD) managed with endovascular first approach for revascularization in a tertiary referral center. Revascularization procedures were performed in 202 patients with 229 symptomatic limbs. Angiogram was performed in all patients except those contraindicated for contrast agent.

Central vein stenosis in an Asian hemodialysis population.

Objective And Background: Central vein stenosis occurs commonly after instrumentation of the major thoracic veins. We aimed to investigate factors that contributed to this condition in an Asian hemodialysis population, and the results of intervention.

Patients And Methods: Hemodialysis patients diagnosed with central vein stenosis between January 2003 and December 2008, were identified from the records of the National University Hospital, Singapore.

Does the introduction of a third examiner and global marking improve the generalisability of the surgical long case?

Introduction: Planning a high-stake clinical examination requires the evaluation of several psychometric and logistical variables. The authors conducted generalisability and decision studies to answer the following research questions in the context of the surgical long case: (1) Does the addition of a third examiner have any added benefit, vis-à-vis reliability, to the examination? (2) Is global marking more reliable than an itemised marking template? (3) What would be the impact on reliability if there was a reduction in the number of examinees that each panel of examiners is required to assess?

Methods: A third examiner and global marking were introduced. Separate generalisability and decision studies were carried out for both the two- and three-examiner models as well as for itemised and global scores.

Comparative outcomes of primary autogenous fistulas in elderly, multiethnic Asian hemodialysis patients.

Background: The number of elderly (≥65 years) end-stage renal disease (ESRD) patients on hemodialysis is rapidly increasing. Vascular access outcomes remain contradictory and understudied across different elderly populations. We hypothesized age might influence primary autogenous fistula use and outcomes in a predominantly diabetic multiethnic Asian ESRD population.

Outcomes of initial hemodialysis access surgery in an Asian population.

Purpose: Access-related morbidity contributes substantially to the costs of hemodialysis. The aim of this study was to examine the outcomes of initial hemodialysis access surgery at a single center in Singapore and to analyze factors which might influence survival of the surgically-created access.

Methods: Patients undergoing their first hemodialysis access operations between January 2003 and December 2007 were retrospectively identified.

Late relapse of non-typhoidal salmonella vascular graft infection after 5 years.

Salmonella bacteremia can be complicated by mycotic aneurysm with the potential for a catastrophic presentation. Treatment involves prompt surgery with debridement, extraanatomic bypass, and prolonged antibiotic therapy. Any relapse tends to occur within the 1(st) year after surgery.

Outcomes of endovascular intervention for salvage of failing hemodialysis access.

Objective: To investigate the effectiveness of endovascular balloon angioplasty to preserve the patency of failing hemodialysis arteriovenous fistulas (AVF) and prosthetic arteriovenous grafts (AVG).

Methods: Patients on hemodialysis who received endovascular intervention for access problems were retrospectively analyzed. Fistulography was performed on patients who were suspected to have access stenosis and balloon angioplasty performed in the same setting if a stenosis of ≥50% is detected.

Chronic brainstem ischemia in subclavian steal syndrome.

Subclavian steal syndrome is usually an incidental finding and rarely causes vertebrobasilar ischemia. We present a 58-year-old man who, over six months, experienced progressive slowing in both talking and walking. Cervical duplex sonography revealed severe stenosis of the right subclavian artery; fixed retrograde flow was noted in the right vertebral artery on transcranial Doppler.

Endovascular management of traumatic thoracic aortic transection.

The conventional treatment of traumatic thoracic aortic transection is open surgical repair but it is associated with high rates of morbidity and mortality, particularly in patients with multiple injuries. We reviewed our experience of endovascular repair of traumatic thoracic aortic transection. Between March 2002 and December 2007, 7 patients (male 6, female 1; mean age 40 years) with multiple injuries secondary to blunt trauma underwent endovascular stenting.

Tubular nanofiber scaffolds for tissue engineered small-diameter vascular grafts.

Quick establishment of a confluent and stable endothelial cells (ECs) layer in the lumen of vascular grafts is critical for long-term patency of small-diameter vascular grafts. The objective of the study was to fabricate tubular nanofiber scaffolds, incorporate ECs onto the lumen of the scaffolds, and establish an animal model to prove the basic concept of using the scaffolds as vascular grafts. Poly(L-lactic acid)-co-poly(epsilon-caprolactone) P(LLA-CL 70:30) tubular nanofiber scaffolds were fabricated by electrospinning onto a rotating mandrel.

Combined open and endovascular repair of acute type A aortic dissection.

A 62-year-old man with an acute Stanford type A dissection underwent successful emergent replacement of the ascending aorta. The patient was readmitted with a left pleural effusion and complex dissection in the arch and descending thoracic aorta. A hybrid surgical procedure was performed involving complete arch transposition, followed by arch and descending aortic stenting, with a good result.