Biomechanical dysregulation of SGK-1 dependent aortic pathologic markers in hypertension.

Introduction: In hypertension (HTN), biomechanical stress may drive matrix remodeling through dysfunctional VSMC activity. Prior evidence has indicated VSMC tension-induced signaling through the serum and glucocorticoid inducible kinase-1 (SGK-1) can impact cytokine abundance. Here, we hypothesize that SGK-1 impacts production of additional aortic pathologic markers (APMs) representing VSMC dysfunction in HTN.

Hostile neck anatomy contributes to higher rates of reintervention following endovascular aortic repair for ruptured infrarenal abdominal aortic aneurysm.

Introduction: Ruptured abdominal aortic aneurysms (AAA) presenting with hostile neck anatomy can represent a challenge in surgical decision-making. We hypothesized that, patients who require reinterventions have higher rates of compromised neck anatomy at initial presentation and may indicate a need for altered surveillance paradigm.

Methods: Patients presenting with ruptured AAA to a single tertiary care institution from 2014 to 2021 were retrospectively reviewed.

Pioneer re-entry into covered stent graft to recanalize occluded, jailed external iliac artery.

Aortoiliac occlusive disease in patients who are poor surgical candidates requires innovative strategies in endovascular surgery. We present a case of a 59-year-old gentleman with significant medical comorbidities and chronic limb-threatening ischemia secondary to a chronically occluded left-to-right cross-femoral bypass, as well as an occluded right iliac system owing to a jailed right external iliac artery from a prior common-to-internal iliac covered stent, originally done for buttock claudication. He was treated successfully from an endovascular approach with kissing stents in the right internal and external iliac arteries after gaining access to the old right common iliac stent via an ipsilateral access and use of a Pioneer intravascular ultrasound-guided re-entry catheter.

Thoracic Aortic Aneurysms and Arch Disease.

Aortic arch and descending thoracic pathology have historically remained in the realm of open surgical repair. Technology is quickly pushing to bring these under the endovascular umbrella, with lower morbidity repairs proving safe in their early experience. Much work remains particularly for acute aortic syndromes, however, to understand who is best treated medically, surgically, endovascularly, or with hybrid approaches.

Successful endovascular salvage of a maldeployed iliac limb extension during complex aortic reconstruction.

Purpose: The worst complication during cannulation of the contralateral gate during complex endovascular aortic repair is deployment of the limb extension behind the main graft body.

Case Report: A patient with a 5.7 cm juxtarenal abdominal aortic aneurysm was taken to the operating room for fenestrated endovascular aortic repair and iliac branch device.

Integrating Ultrasound-Derived Carotid Artery Stiffness in the Assessment of Cardiovascular Risk.

Historically, pulse wave velocity (PWV) has been used to measure vascular stiffness, but is limited in its utility when certain vascular disease states are present, such as aneurysm or iliac stenosis. PWV can therefore only provide reliable assessment of global vascular stiffness in limited vascular pathology. Speckle tracking is a method of post-hoc ultrasound image analysis that can measure vascular stiffness in a more comprehensive manner.

Percutaneous, Antegrade Access of the Superficial Femoral Artery can be Safely Used in Procedures for the Treatment of Lower Extremity Limb Ischemia.

Background: Recent studies have shown that antegrade access for treatment of infrainguinal peripheral vascular disease is associated with decreased radiation exposure and contrast use without a significant increase in access complication, although data are limited on antegrade superficial femoral artery (SFA) access for larger sheath sizes. We aim to describe a single institution's contemporary experience with percutaneous antegrade SFA access.

Methods: A retrospective review of percutaneous, infrainguinal endovascular interventions for arterial occlusive disease at a major academic institution was conducted between 2018 and 2020.

Plaque contact surface area and lumen volume predict stroke risk in extracranial carotid artery stenosis.

Background: The standard indication for intervention in asymptomatic disease is currently percent stenosis in the internal carotid artery as measured by the North American Symptomatic Carotid Endarterectomy Trial (NASCET) method, which remains limited in discriminating power. Computed tomography angiography (CTA) is widely used to calculate NASCET stenosis, but also offers the opportunity to analyze carotid artery plaques from a morphological perspective that has not been widely used. We aim to improve stroke risk stratification of patients with carotid artery stenosis using plaque three-dimensional (3D) modeling and image analysis.

Does etiology of gastroparesis determine clinical outcomes in gastric electrical stimulation treatment of gastroparesis?

Background: Gastroparesis is a condition characterized by impaired gastric motility that may result in weight loss and malnutrition. There have been promising studies demonstrating improvement in symptoms after gastric electrical stimulation (GES) implantation for medically refractory gastroparetics [1-10]. With the heterogeneous population of gastroparetics, the aim of this study was to assess if etiology correlated with response to GES.

Occlusion of the Celiac Artery during Endovascular Thoracoabdominal Aortic Aneurysm Repair Is associated with Increased Perioperative Morbidity and Mortality.

Background: Some studies suggest that celiac artery coverage during elective endovascular thoracoabdominal aortic aneurysm (TAAA) repair is safe given sufficient collateralization of visceral organ perfusion from the superior mesenteric artery. However, there is concern that celiac artery coverage may lead to increased risk of foregut or spinal cord ischemia with an attendant increased risk of mortality. We sought to investigate rates of bowel ischemia, spinal cord ischemia, and 30-day mortality associated with celiac artery coverage during TEVAR and complex EVAR.

Identification of Priority Areas for Increased Testing Using Geospatial Mapping of Incident HIV Cases Near Charleston, South Carolina.

Analysis of disease incidence using geospatial mapping techniques can enhance targeted public health efforts in resource-limited settings. While data for HIV incidence are readily available for some metropolitan regions, there is no existing resource that maps HIV incidence geospatially for Charleston, South Carolina and surrounding counties. To facilitate the public health approach to address the HIV epidemic in this region, we used data collected by the South Carolina Department of Health and Environmental Control (SC-DHEC) from 2014 to 2015 to generate local geospatial maps of disease incidence and identify specific areas that may benefit from increased testing and educational efforts.