Pre-induction and post-discharge venous thromboembolism chemoprophylaxis should be considered in patients after major vascular open abdominal procedures.

Background: Venous thromboembolism (VTE) is a significant morbidity following major open abdominal surgery. While there are clear recommendations for perioperative and post-discharge VTE chemoprophylaxis in general surgery, guidance for vascular patients is unclear. We compared the incidence of VTE in vascular versus general surgery cases and then investigated the timing of VTE in vascular patients.

Consumer-grade wearable devices in arrhythmia diagnostics for clinicians: where we are and where we are going.

Atrial arrhythmias, including atrial fibrillation (AF), are a major contributor to cardiovascular morbidity and mortality. Early detection and effective management are critical to mitigating adverse outcomes such as stroke, heart failure, and overall mortality. Wearable devices have emerged as promising tools for monitoring, detecting, and managing atrial arrhythmias near-continuously.

Thirty-day stroke/mortality of carotid revascularization in asymptomatic patients with newly diagnosed and/or decompensated heart failure exceeds the Society for Vascular Society guideline risks.

Background: According to the latest Society for Vascular Surgery (SVS) guidelines, carotid revascularization for asymptomatic individuals should be offered if the perioperative stroke/death rate does not exceed 3%. Heart failure (HF) has been associated with reduced survival rates following carotid revascularization, which may significantly impact the risk-benefit decision of treating asymptomatic patients with HF. This study aimed to evaluate the 30-day postoperative risks in asymptomatic patients with newly diagnosed and/or decompensated HF undergoing carotid endarterectomy (CEA) and carotid artery stenting (CAS).

Infrainguinal bypass for limb salvage has comparable mortality and affords a better chance of home discharge than amputation among octogenarians.

Background: Infrainguinal bypass for chronic limb-threatening ischemia (CTLI) in octogenarians is considered a high-risk procedure due to the presumed associated frailty of the patient population. However, the alternative which is major amputation may not be a better option. This study retrospectively compares the outcomes of bypass versus major amputation for functionally independent and partially dependent patients.

Brachial thromboembolectomy and retrograde innominate artery stenting in acute limb ischemia.

Acute limb ischemia is a critical vascular emergency often resulting from embolic sources, requiring prompt intervention to prevent significant morbidity and mortality. This paper presents a case of a 74-year-old female with acute limb ischemia due to a thromboembolus in the distal brachial artery and a nonocclusive mobile thrombus in the innominate artery. The patient underwent urgent brachial artery thromboembolectomy and subsequent retrograde innominate artery stenting via right open transcarotid approach.

Favorable 30-day outcomes of initial open inguinal hernia repair with local anesthesia among frail patients.

Background: Open inguinal hernia repair (OIHR) can be conducted under either general anesthesia (GA) or local anesthesia (LA). Despite a lack of evidence supporting improved perioperative outcomes, GA is the predominant anesthesia type used in OIHR. Frailty is defined as a clinically recognizable state of age-related increased vulnerability.

Retooling the Massive Transfusion Protocol at a Veterans Affairs Medical Center.

Introduction: Massive transfusion protocols (MTPs) ensure the timely and life-saving delivery of blood products to patients who are rapidly exsanguinating. Although essential, MTPs are also highly resource-intensive. Effective MTP implementation must balance the resources of the hospital with the needs of the patient population that they serve, as well as avoid instances of unjustified activations.

Iliofemoral Venous Thrombectomy and Angioplasty in a Patient Following Simultaneous Pancreas-Kidney Transplant: A Case Report.

Simultaneous pancreas-kidney (SPK) transplantation is a recognized treatment for patients with insulin-dependent diabetes and advanced chronic kidney disease or end-stage renal disease (ESRD), offering significant survival benefits. However, it is associated with a higher risk of venous thrombosis, which can jeopardize the survival of the pancreaticoduodenal graft. This case report describes a patient with type 2 diabetes, hypertension, and ESRD who developed acute, occlusive deep vein thrombosis (DVT) involving the right common femoral, profunda femoral, and greater saphenous veins on postoperative day 1 (POD1) following a deceased donor SPK transplant, despite systemic prophylactic anticoagulation.

Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis.

Adenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities have been used to improve pregnancy rates and live birth outcomes; however, because of a lack of high-quality evidence, there is no clear consensus on the best pretreatment option.

Same-day discharge after intracranial shunt revision: a retrospective propensity-matched safety analysis.

Objective: Patients are often observed overnight after ventricular shunt revision for hydrocephalus. We believe that a same-day discharge after a shunt revision is safe in the appropriate population. The purpose of this study was to determine the appropriate patient population and the safety profile for a same-day discharge following a ventricular shunt revision.

Arachnoid granulations: Dynamic nature and review.

Arachnoid granulations have been known for centuries yet remain incompletely understood. While traditionally associated with cerebrospinal fluid transport, the precise mechanism remains uncertain. This manuscript reviews the literature on the anatomy, histology, and imaging findings of arachnoid granulations and their mimickers and anomalous variations.

Comparing antihypertensive strategies in hypertensive emergencies with heart failure.

Background: 6.2 million Americans live with heart failure (HF) and are at risk for hospitalization due to hypertensive emergencies. Optimal treatment strategy for acute hypertensive heart failure remains unclear.

Representation Matters: A Higher Percentage of Women Orthopaedic Surgery Faculty Is Associated With an Increased Number of Women Residents.

Introduction: Orthopaedic surgery has been recognized as one of the least diverse surgical specialties. Previous studies have demonstrated that women are heavily underrepresented within orthopaedic surgery. The purpose of this study was to determine whether orthopaedic surgery residency programs with a higher presence of women faculty had a higher proportion of women residents.

Triple inhaled therapy in asthma: Beliefs, behaviours and doubts.

Long-acting muscarinic antagonists (LAMA) in association with inhaled corticosteroids (ICS) plus long-acting beta-2 agonists (LABA) are recommended by the GINA report as further option in step 4 and first choice in step 5 treatment. Despite consistent evidence of its efficacy and safety, inhaled triple therapy (ITT) is still not largely used in patients with asthma. With the aim to explore belief and behaviours of asthma specialists, an ad hoc survey has been developed by a panel of Interasma Scientific Network (INESnet) experts and subsequently defined by two Delphi rounds among an international group of physicians.

Deoxycholic Acid for Submental Convexity: A MAUDE Database Analysis.

Study Design: The study was a retrospective cross-sectional database analysis.

Objective: Deoxycholic acid (DOC) injections are a novel, in-office procedural alternative to submental liposuction or submentoplasty to address excess submental fat. Post-market safety data regarding this treatment is currently limited.

Anesthesia choice for frail patients undergoing endovascular repair of nonruptured infrarenal abdominal aortic aneurysms.

Background: Althugh general anesthesia is the predominant choice in endovascular aneurysm repair (EVAR), recent studies have suggested that locoregional anesthesia could be a viable alternative for suitable patients. Frailty has been identified as an independent predictor of increased mortality and morbidity in EVAR. However, the choice of anesthesia in frail patients undergoing EVAR has not been explored.

Psoas Muscle Volume as an Indicator of Sarcopenia and Disposition in Traumatic Hip Fracture Patients.

Introduction: Sarcopenia, or the loss of lean muscle mass, is associated with increased morbidity and mortality as well as poor surgical outcomes. The aim of our study was to utilize computed tomography imaging to obtain the total psoas volume (TPV) as a potential marker of sarcopenia. We then investigated the relationship between TPV and outcomes in surgically managed hip fracture patients, particularly their discharge disposition.

Thirty-day outcomes of endovascular repair of Stanford type B aortic dissection in patients with chronic obstructive pulmonary disease.

Background: Thoracic Endovascular Aortic Repair (TEVAR) has revolutionized the surgical treatment for Stanford type B aortic dissection (TBAD). While chronic obstructive pulmonary disease (COPD) is associated with worse outcomes in major surgeries, the specific outcomes of TEVAR in patients with COPD have not been extensively explored. This study aimed to evaluate the 30-day postoperative outcomes of COPD patients undergoing TEVAR for TBAD utilizing data from a multi-institutional national registry.