Fenestrated and Branched Endovascular Aortic Repair and Mortality at Hospitals Without Investigational Device Trials.

Importance: Fenestrated and branched endovascular aortic repairs (F/BEVAR) have been adopted by many centers. However, national trends of F/BEVAR use remain unclear, particularly at sites who perform them without an US Food and Drug Adminstration (FDA)-approved investigational device exemption (IDE).

Objective: To quantify the use of F/BEVAR in the US and to determine if mortality was different at IDE vs non-IDE sites.

Derivation and Validation of ICD-10 Codes for Identifying Incident Stroke.

Importance: Claims data with International Statistical Classification of Diseases, Tenth Revision (ICD-10) codes are routinely used in clinical research. However, the use of ICD-10 codes to define incident stroke has not been validated against expert-adjudicated outcomes in the US population.

Objective: To develop and validate the accuracy of an ICD-10 code list to detect incident stroke events using Medicare inpatient fee-for-service claims data.

Guideline-Directed Medical Therapy and Long-Term Mortality and Amputation Outcomes in Patients Undergoing Peripheral Vascular Interventions.

Background: Lack of guideline-directed medical therapy (GDMT) in patients undergoing peripheral vascular interventions (PVIs) may increase mortality and amputation risk.

Objectives: The authors sought to study the association between GDMT and mortality/amputation and to examine GDMT variability among providers and health systems.

Methods: We performed an observational study using patients in the Vascular Quality Initiative registry undergoing PVI between 2017 and 2018.

Non-guideline-compliant endovascular abdominal aortic aneurysm repair in women is associated with increased mortality and reintervention compared with men.

Objective: Sex-based disparities in surgical outcomes have emerged as an important focus in contemporary healthcare delivery. Likewise, the appropriate usage of endovascular abdominal aortic aneurysm repair (EVAR) in the United States remains a subject of ongoing controversy, with a significant number of U.S.

Summarizing causal differences in survival curves in the presence of unmeasured confounding.

Proportional hazard Cox regression models are frequently used to analyze the impact of different factors on time-to-event outcomes. Most practitioners are familiar with and interpret research results in terms of hazard ratios. Direct differences in survival curves are, however, easier to understand for the general population of users and to visualize graphically.

Comparison of specialties participating in the BEST-CLI trial to specialists treating peripheral arterial disease nationally.

Background: The Best Endovascular vs Best Surgical Therapy for Patients with Critical Limb Ischemia (BEST-CLI) trial compares open surgery and endovascular therapy for the treatment of critical limb ischemia (CLI). This report describes the types and proportion of investigators participating in BEST-CLI and determines how these compare with those specialists treating peripheral artery disease (PAD) outside of the trial.

Methods: To be credentialed to enroll in BEST-CLI, investigators must be approved by the Surgical and Interventional Management Committee to have sufficient experience and skill in the management of patients with CLI.

Significant regional variation exists in morbidity and mortality after repair of abdominal aortic aneurysm.

Objective: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs.

Methods: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014.

The natural history of type II endoleaks after endovascular aneurysm repair for ruptured abdominal aortic aneurysm.

Objective: The natural history of type II endoleak (T2EL) after endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (rAAA) remains elusive; as such, treatment guidelines are ill defined. The purpose of this study was to better delineate the natural history of T2EL after EVAR for rAAA in an effort to determine the need for reintervention and optimal surveillance.

Methods: A retrospective record review was conducted of all patients undergoing EVAR for rAAA in two large tertiary care academic vascular centers.

Regional variation exists in patient selection and treatment of abdominal aortic aneurysms.

Objective: Significant regional variation in surgical rates has been identified following multiple surgical procedures. However, limited data have examined the regional variability in patient selection and treatment of abdominal aortic aneurysms (AAAs). This study aimed to evaluate regional variation in patient selection, perioperative management, and operative approach for the repair of AAAs.

Does Rapid Diffusion of HbA1c Testing Affect Amputation Rates?

Background: The association of speed of diffusion of Hemoglobin A1C (hbA1c) testing with temporal changes in outcomes of primary importance to patients with diabetes, such as amputation, remains an issue of debate. We investigated these correlations.

Methods: We performed a retrospective cohort study of diabetics, based on Medicare fee-for-service claims data from 2002 to 2012.

Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage.

Background: The comparative effectiveness of the two treatment options (surgical clipping and endovascular coiling) for ruptured cerebral aneurysms has not been studied in real-world practice in the USA. We investigated the association between the treatment method for ruptured cerebral aneurysms and outcomes.

Methods: We performed a retrospective cohort study of elderly patients who underwent treatment for ruptured cerebral aneurysms from 2007 to 2012 using a 100% sample of Medicare fee-for-service claims data.

Safety and efficacy of patient specific intramuscular injection of HGF plasmid gene therapy on limb perfusion and wound healing in patients with ischemic lower extremity ulceration: results of the HGF-0205 trial.

Objectives: We have previously reported the results of a dose-finding phase II trial showing that HGF angiogenic gene therapy can increase TcPO2 compared with placebo in patients with critical limb ischemia (CLI). The purpose of this randomized placebo controlled multi-center trial was to further assess the safety and clinical efficacy of a modified HGF gene delivery technique in patients with CLI and no revascularization options.

Methods: Patients with lower extremity ischemic tissue loss (Rutherford 5 and 6) received three sets of eight intramuscular injections every 2 weeks of HGF plasmid under duplex ultrasound guidance.

Long-term functional results for the surgical management of neurogenic thoracic outlet syndrome.

Objective: To document long-term functional outcomes in patients treated for neurogenic thoracic outlet syndrome (NTOS).

Methods: Records of all patients undergoing treatment for NTOS at our center were reviewed. Patient demographics and co-morbidities were recorded.