Publications by authors named "Randall DeMartino"

Objective: Postoperative gastrointestinal hemorrhage (GIH) following mesenteric revascularization when performed either openly (OR) or endovascularly (ER) has been clinically observed but not reported. The aim of the study is to assess the incidence and predictors of GIH in patients undergoing mesenteric revascularization.

Methods: This was a single-center retrospective review of consecutive patients treated with open or endovascular mesenteric revascularization from 2009 to 2019.

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Background: Intervention on type B dissection frequently requires landing the proximal edge of the stent graft between the left common carotid artery and left subclavian artery (LSA). The GORE TAG thoracic branch endoprosthesis is a technology that allows LSA preservation with a single internal branch.

Methods: This study was a prospective nonrandomized single-arm clinical trial of patients with type B aortic dissection who were treated with the single-branched device.

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Article Synopsis
  • The study evaluates the performance of the Human Acellular Vessel (HAV), a new biologic option for arterial reconstructions, compared to the traditional great saphenous vein (GSV) in patients with advanced peripheral arterial disease (PAD).
  • Researchers compared outcomes in 34 patients using HAV to 88 historical patients who underwent bypass with GSV, noting demographic similarities but differences in health conditions and clinical stages.
  • Results showed that while the HAV group had a shorter operative time, the rates of major amputation-free survival and overall survival were similar between both groups, highlighting the need for further investigation.
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Article Synopsis
  • The study examined the outcomes of medically managed Type B intramural hematoma (IMH) from 1995 to 2022, focusing on the natural progression and factors influencing it.
  • Out of 104 patients, 92 were treated without surgery; results showed a 1-year survival rate of 85.8% and a 5-year rate of 61.9%, with significant differences in intervention rates between groups with isolated IMH and those with aneurysm/dissection.
  • Progression occurred in 37.9% of Group 1 (isolated IMH) and more frequently in Group 2, highlighting the importance of monitoring and potential intervention for high-risk patients.
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Objective: The aim of this study is to determine perioperative outcomes and the patency of interposition conduits for visceral arterial reconstruction in this setting.

Summary Background Data: Visceral arterial encasement in locally advanced pancreatic cancer was historically a contraindication for surgery. With modern effective neoadjuvant strategies, our recent experience has made advanced vascular resection and reconstruction feasible in selected patients.

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Article Synopsis
  • The study aimed to analyze hospital and intensive care unit stays in patients undergoing a specific vascular repair procedure for aortic aneurysms, focusing on the impact of different cerebrospinal fluid drainage (CSFD) strategies.
  • A review of 412 patients treated between 2008 and 2023 was conducted, comparing those who received prophylactic CSFD before 2020 to those who received therapeutic CSFD after 2020.
  • Results indicated a significant reduction in hospital stay duration with therapeutic drainage while maintaining similar rates of major complications and mortality between the two groups.
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A 58-year-old man presented with a right hemispheric transient ischemic attack from recurrent common carotid artery (CCA) in-stent restenosis. He had undergone prior neck radiation for carcinoma of the right tonsil and subsequent right carotid endarterectomy (10 years prior) and right CCA stenting (5 years prior), all for symptomatic radiation-induced stenosis. We performed CCA reconstruction using a transposed superficial femoral artery and pectoralis major myocutaneous flap coverage.

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Objective: Type II endoleaks (T2ELs) are the most common cause of reintervention after endovascular aneurysm repair (EVAR). Although most resolve spontaneously, the long-term implications of T2ELs remain elusive. We aim to evaluate the impact of persistent and late T2ELs on clinical outcomes after EVAR.

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Vascular graft infection (VGI) is one of the most serious complications following arterial reconstructive surgery. VGI has received increasing attention over the past decade, but many questions remain regarding its diagnosis and management. In this review, we describe our approach to VGI through multidisciplinary collaboration and discuss decision making for challenging presentations.

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Vascular graft infection (VGI) is one of the most serious complications following arterial reconstructive surgery. VGI has received increasing attention over the past decade, but many questions remain regarding its diagnosis and management. In this review, we describe our approach to VGI through multidisciplinary collaboration and discuss decision-making for challenging presentations.

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Introduction: Custom-branched/fenestrated grafts are widely available in other countries, but in the United States, they are limited to a handful of centers, with the exception of a 3-vessel juxtarenal device (ZFEN). Consequently, many surgeons have turned to alternative strategies such as physician-modified endografts (PMEGs). We therefore sought to determine how widespread the use of these grafts is.

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Background: The aims of this study were: i) to assess fragility indices (FIs) of individual randomized controlled trials (RCTs) that compared paclitaxel-based drug-coated balloons (DCBs) or drug-eluting stents (DESs) versus standard endovascular devices, and ii) to meta-analyze mid-term and long-term safety and efficacy outcomes from available RCT data while also estimating the FI of pooled results.

Methods: This systematic review has been registered in the PROSPERO public database (CRD42022304326 http://www.crd.

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Objective: Peripheral arterial infections are rare and difficult to treat when an in situ reconstruction is required. Autologous vein (AV) is the conduit of choice in many scenarios. However, cryopreserved arterial allografts (CAAs) are an alternative.

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Background: Limited research has focused on bloodstream infection (BSI) in patients with arterial grafts. This study aims to describe the incidence and outcomes of BSI after arterial aneurysm repair in a population-based cohort.

Methods: The expanded Rochester Epidemiology Project (e-REP) was used to analyze aneurysm repairs in adults (aged ≥18 years) residing in 8 counties in southern Minnesota from January 2010 to December 2020.

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Background: Nonhome discharge (NHD) has significant implications for patient counseling and discharge planning and is frequently required following fenestrated-branched endovascular aortic repair (FB-EVAR) of complex abdominal aortic aneurysms (CAAA) and thoracoabdominal aortic aneurysms (TAAA). We aimed to identify preoperative predictors of NHD after elective FB-EVAR for CAAA and TAAA and develop a risk calculator able to predict NHD.

Methods: A retrospective review of prospectively collected data on all patients undergoing FB-EVAR between January 2007 and December 2021 at a single institution was performed.

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Article Synopsis
  • Patients with chronic limb-threatening ischemia (CLTI) face high amputation risks when they lack a usable great saphenous vein for bypass surgery; the study investigates the use of the Human Acellular Vessel (HAV) to address this.* -
  • The HAV is a synthetic vascular conduit made from human cells and a dissolvable scaffold, designed to be nonimmunogenic, and was tested in a clinical study approved by the FDA for patients unable to use their own veins for arterial bypass.* -
  • In a trial involving 29 patients with severe CLTI, the HAV achieved 100% technical success in surgeries, resulting in an 86% limb salvage rate, although there was a 7% mortality
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Purpose: The present scoping review aims to describe and analyze available clinical data on the most commonly reported risk prediction indices in vascular surgery for perioperative mortality, with a particular focus on ruptured abdominal aortic aneurysm (rAAA).

Materials And Methods: A scoping review following the PRISMA Protocols Extension for Scoping Reviews was performed. Available full-text studies published in English in PubMed, Cochrane and EMBASE databases (last queried, 30 March 2023) were systematically reviewed and analyzed.

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Objective: To report outcomes of the human acellular vessel (HAV) implanted for limb salvage through the Food and Drug Administration (FDA) Expanded Access Program for patients with chronic limb-threatening ischemia with no autologous conduit.

Methods: The HAV is a bioengineered vascular conduit designed with human vascular smooth muscle cells. The product is under regulatory study.

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Importance: Endovascular aneurysm repair (EVAR) is the dominant treatment strategy for abdominal aortic aneurysms, encompassing 80% of all repairs in the United States. Endoleaks are ubiquitous and affect 30% of patients treated by EVAR, potentially leading to sac enlargement and increased risk of rupture. The care of EVAR patients requires long-term surveillance by a multidisciplinary team.

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