Two-Stage Mayo Clinic Class IIIb Celiac Axis Resection for Pancreatic Adenocarcinoma: Stepwise Management.

Background: The National Comprehensive Cancer Network guidelines consider pancreatic cancer with celiac axis (CA), proper hepatic artery (PHA), and superior mesenteric artery (SMA) involvement unresectable. Thus, technical reports and video illustrations of these operations are rare. We report the stepwise management of multivascular reconstruction for Mayo Clinic class IIIb CA resections at New York University Langone Health, a dedicated center of excellence in pancreatic surgery.

Mechanical thrombectomy for the management of iliofemoral deep venous thrombosis in the second trimester of pregnancy secondary to May-Thurner syndrome.

Treatment of pregnancy-related venous thromboembolism is limited by considerations of the health risks to both the patient and fetus. Anticoagulation is the cornerstone treatment for pregnancy-related venous thromboembolism; however, early thrombus removal may be preferred for prompt symptom resolution and to decrease the risk of post-thrombotic syndrome. We report the successful treatment of a patient in the second trimester of pregnancy with symptomatic iliofemoral deep venous thrombosis and May-Thurner syndrome using percutaneous mechanical thrombectomy.

A rare case of early onset lewy body dementia with parkinsonism associated with chronic exposure to copper contaminated drinking water.

There is a well-recognized relationship between a person's body burden of essential trace elements such as copper and their neurological function in which both deficiencies and exposures to excessive concentrations are associated with adverse clinical outcomes. Preclinical studies indicate chronic excess copper exposure is associated with altered motor function, dopaminergic neuronal loss, astrocytosis, and microgliosis. Copper also promotes oligomerization and fibrilization of α-synuclein suggesting it may hasten the course of an α-synucleinopathy.

Supra-Inguinal Inflow for Distal Bypasses Have Acceptable Patency and Limb Salvage Rates.

Background: There is a paucity of data evaluating outcomes of lower extremity bypass (LEB) using supra-inguinal inflow for revascularization of infra-inguinal vessels. The purpose of this study is to report outcomes after LEB originating from aortoiliac arteries to infra-femoral targets.

Methods: The Vascular Quality Initiative database (2003-2020) was queried for patients undergoing LEB from the aortoiliac arteries to the popliteal and tibial arteries.

Preoperative COVID-19 Vaccination is Associated with Decreased Perioperative Mortality after Major Vascular Surgery.

Objective: The objective of this study was to examine the effect of corona virus 2019 (COVID-19) vaccination on perioperative outcomes after major vascular surgery.

Background Data: COVID-19 vaccination is associated with decreased mortality in patients undergoing various surgical procedures. However, the effect of vaccination on perioperative mortality after major vascular surgery is unknown.

The substantial burden of iatrogenic vascular injury on the vascular surgery workforce at an academic medical center.

Objective: Vascular surgeons are often called upon to provide emergent surgical assistance to other specialties for iatrogenic complications, both intraoperatively and in the inpatient setting. The management of iatrogenic vascular injury remains a critical role of the vascular surgeon, especially in the context of the increasing adoption of percutaneous procedures by other specialties. This study aims to characterize consultation timing, management, and outcomes for iatrogenic vascular injuries.

Short-term outcomes of endovascular management of acute limb ischemia using aspiration mechanical thrombectomy.

Objective: Management of acute limb ischemia (ALI) has seen greater utilization of catheter-based interventions over the last two decades. Data on their efficacy is largely based on comparisons of catheter-directed thrombolysis (CDT) and open thrombectomy. During this time, many adjuncts to CDT have emerged with different mechanisms of action, including pharmacomechanical thrombolysis (PMT) and aspiration mechanical thrombectomy (AMT).

Protecting Human and Animal Health: The Road from Animal Models to New Approach Methods.

Animals and animal models have been invaluable for our current understanding of human and animal biology, including physiology, pharmacology, biochemistry, and disease pathology. However, there are increasing concerns with continued use of animals in basic biomedical, pharmacological, and regulatory research to provide safety assessments for drugs and chemicals. There are concerns that animals do not provide sufficient information on toxicity and/or efficacy to protect the target population, so scientists are utilizing the principles of replacement, reduction, and refinement (the 3Rs) and increasing the development and application of new approach methods (NAMs).

Outcomes and predictors of amputation-free survival in patients undergoing below-knee popliteal-distal bypass.

Objective: The infrageniculate popliteal artery is a potential source for inflow in lower extremity bypass surgery in patients with isolated tibial artery disease. The objective of our study was to assess the short- and long-term outcomes of popliteal-distal bypasses using data from the Vascular Quality Initiative (VQI).

Methods: The VQI registry was queried between 2003 and 2021 for patients undergoing surgical revascularizations with the below-knee popliteal artery serving as inflow.

The natural history and long-term follow-up of splenic artery aneurysms.

Objective: Although splenic artery aneurysms (SAAs) are the most common visceral aneurysm, there is a paucity of literature on the behavior of these entities. The objective of this study was to review the natural history of patients with SAA.

Methods: This single-institution, retrospective analysis studied patients with SAA diagnosed by computed tomography imaging between 2015 and 2019, identified by our institutional radiology database.

Risk of Preterm Birth among Secundiparas with a Previous Cesarean due to a Failed Vacuum Delivery.

Background: Studies have found an association between second-stage cesarean sections (SSCSs) and subsequent preterm birth (PTB). We aimed to evaluate if secundiparas with previous second-stage cesarean sections due to a failed vacuum delivery (SSCS-F-VD) are associated with PTB in the subsequent delivery compared with secundiparas with previous spontaneous vaginal birth (SVB) at term. A secondary aim was to compare this association with secundiparas with a previous SSCS at term.

The Effect of Ipsilateral Carotid Revascularization on Contralateral Carotid Duplex Parameters in Patients with Bilateral Carotid Stenosis.

Background: Duplex-derived velocity measurements are often used to determine the need for carotid revascularization. There is evidence that severe ipsilateral carotid stenosis can cause artificially elevated velocities in the contralateral carotid artery, which may decrease following ipsilateral revascularization. The objective of this study was to determine if contralateral carotid artery duplex velocities decrease following ipsilateral carotid endarterectomy or stenting procedures.

Insulin Dependence is Associated with Poor Long-Term Outcomes Following AAA Repair.

Background: While prior studies have confirmed the protective effect of diabetes on abdominal aortic aneurysm (AAA) development, much less is known about the effect of diabetes, and in particular insulin dependence, on outcomes following AAA repair. In this study, we aim to evaluate the role of insulin-dependent diabetes on short-term and long-term outcomes following open and endovascular AAA repair.

Methods: The Vascular Implant Surveillance and Interventional Outcomes Network (VISION), a registry linking the Vascular Quality Initiative (VQI) data with Medicare claims, was queried for patients who underwent open or endovascular AAA repair from 2011 to the present.

Intravascular lithotripsy for the treatment of inferior mesenteric artery in-stent restenosis.

Endovascular revascularization with intraluminal stenting is the recommended first-line therapy for chronic mesenteric ischemia. However, early recurrence and in-stent thrombosis remain significant challenges. We present the case of a patient with recurrent chronic mesenteric ischemia secondary to in-stent restenosis that was successfully treated with intravascular lithotripsy, a novel, safe approach to stent salvage.

Does lower extremity fracture fixation technique influence neurologic outcomes in patients with traumatic brain injury? The EAST Brain vs. Bone multicenter trial.

Objective: This study aimed to determine whether lower extremity fracture fixation technique and timing (≤24 vs. >24 hours) impact neurologic outcomes in TBI patients.

Methods: A prospective observational study was conducted across 30 trauma centers.

Depressed Ejection Fraction Does Not Affect Perioperative Mortality After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection.

Background: Despite the expanded application of thoracic endovascular aortic repair (TEVAR) in patients with significant cardiac comorbidities, the effect of decreased left ventricular ejection fraction (EF) on outcomes remains unknown. The aim of this study was to compare outcomes in patients with normal and abnormal EFs undergoing TEVAR for type-B aortic dissection (TBAD).

Methods: The Vascular Quality Initiative database was reviewed from 2012 to 2020.

An Analysis of the Nutritional Adequacy of Mass-Marketed Vegan Recipes.

The popularity of plant-based and vegan diets has grown in recent years. While following a vegan diet has been associated with various health benefits, the intake of certain vitamins and minerals including vitamins B12 and D, calcium, and iron, are likely to be inadequate in an exclusively plant-based diet. Low nutrient intake over time can lead to nutritional deficiencies and potentially increased risk of adverse health outcomes.

Urgent endarterectomy for symptomatic carotid occlusion is associated with a high mortality.

Objective: Interventions for carotid occlusions undertaken are undertaken and the outcomes are poorly defined. We sought to study patients undergoing urgent carotid revascularization for symptomatic occlusions.

Methods: The Society for Vascular Surgery Vascular Quality Initiative database was queried from 2003 to 2020 to identify patients with carotid occlusions undergoing carotid endarterectomy.

Young patients undergoing carotid endarterectomy have increased rates of recurrent disease and late neurological events.

Objectives: There are few data regarding outcomes of patients with premature cerebrovascular disease (age ≤55 years) who undergo carotid endarterectomy (CEA). The objective of this study was to analyze the demographics, presentation, perioperative and later outcomes of younger patients undergoing CEA.

Methods: The Society for Vascular Surgery Vascular Quality Initiative was queried for CEA cases between 2012 and 2022.