A multicenter clinical trial on the five-year outcomes following treatment of acute, complicated type B aortic dissection with a conformable stent graft.

Objective: Thoracic endovascular repair (TEVAR) has become the treatment of choice for acute, complicated type B aortic dissections. The purpose of this study was to evaluate the 5-year outcomes of the GORE TAG 08-01 study on TEVAR for acute, complicated type B aortic dissections using the Conformable GORE® TAG® Thoracic Endoprosthesis (CTAG), and to establish if late aortic complications are avoided and remodeling is sustained.

Methods: From January 2010 to February 2017, 50 patients with acute, complicated type B aortic dissections were enrolled from 26 sites in the U.

The Impact of Follow-Up on Mortality in Chronic Limb Threatening Ischemia.

Objectives: Chronic Limb Threatening Ischemia (CLTI) is associated with high morbidity and mortality. As such, close follow-up is recommended to ensure patency of revascularization, limb viability, and optimization of cardiovascular risk factors. This study aimed to test the association between follow-up adherence and mortality, and to identify risk factors for non-adherence with recommended vascular follow-up.

Approaches to management of HIT in complex scenarios, including cardiac surgery.

Although heparin-induced thrombocytopenia (HIT) presents management challenges for any population, it adds complexity to the management of certain patient populations, including those undergoing cardiac surgery and those with refractory HIT and/or acute bleeding. For each of these scenarios, we review alternative management strategies when standard therapies-heparin cessation and the initiation of a nonheparin anticoagulant-are either insufficient or not practicable. In patients with HIT undergoing cardiac surgery, we review the clinical experience for heparin reexposure using therapeutic plasma exchange (TPE) or antiplatelet therapy.

Outcomes of concurrent and delayed leadless pacemaker implantation following extraction of infected cardiovascular implantable electronic device.

Introduction: The optimal reimplantation strategies following the removal of infected cardiovascular implantable electronic devices (CIEDs) remain inadequately understood. Given the limitations and risks associated with traditional approaches, the investigation of alternative devices, such as leadless pacemakers (LPs), has gained attention due to their potentially lower infection risk.

Methods: We reviewed literature sources including PubMed, Scopus, and Embase, utilizing a combination of search terms.

Short-term effects of opioids during therapeutic hypothermia for neonatal encephalopathy.

Objective: To examine the effects of opioids during therapeutic hypothermia (TH) on short-term outcomes in neonates with neonatal encephalopathy (NE).

Methods: Multicenter retrospective study of neonates with moderate/severe NE from Jan. 2013-Feb 2021.

Dura Opening in Cases with Acute Traumatic Subdural Hemorrhage.

The most common pathophysiological etiology of traumatic subdural hematoma is the rupture of bridging veins that drain the venous blood from the brain parenchyma into the superior sagittal sinus. Treatment of choice for such a hematoma would be craniotomy and evacuation. Opening dura in a stellate fashion during in acute traumatic subdural hematoma surgery might decrease the risk of added injury to bridging veins and decrease possible morbidity due to brain edema.

Decoding the evidence: A synopsis of indications and evidence for catheter ablation in atrial fibrillation (Review).

The present study reviews the role of catheter ablation (CA) in the management of atrial fibrillation (AF), a widespread arrhythmia associated with increased morbidity and mortality. The present review explores current indications and recent evidence supporting CA, assessing patient outcomes and identifying common complications associated with the procedure. Emphasis is placed on optimizing risk factors prior to ablation, including weight control and hypertension management, as these measures can significantly enhance post-procedural outcomes.

Endovascular abdominal aortic aneurysm repair (EVAR) outcomes of unibody and single/double docking limb endografts in Medicare beneficiaries between 2012 and 2018.

Objective: The evaluation of perioperative and long term outcomes for endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAA) using anatomic (unibody) and proximal neck fixated (docking limbs) endografts across consecutive time cohorts.

Design: This study compares the outcomes of EVAR in Medicare patients stratified by mode of fixation.

Methods: All patients who underwent EVAR between 2012 and 2018 were identified in the Medicare database.

Rapid Pleurodesis in Patients With Chronic Noninfectious Pleural Effusion: Twenty Years of Real-world Performance Data.

Background: Small cohort studies have shown rapid pleurodesis protocol's (RPP) effectiveness and capacity to expedite pleurodesis for malignant pleural effusion (MPE). This study intends to evaluate the effectiveness of the RPP in inducing pleurodesis in patients with pleural effusions from either malignant or benign etiologies.

Methods: In this single-center, retrospective cohort study spanning 2 decades, we assessed patients with recurrent symptomatic chronic noninfectious pleural effusion, both benign and malignant.

Groin Complications Among Obese Patients Undergoing Vascular Procedures.

Background: Groin incision wound complications (WC) are common among vascular surgery patients. Obesity is a known risk factor, but there is no consensus on the best way to prevent WC in obese patients after vascular procedures. The objective of this study was to identify risk factors for WC and strategies to prevent these complications specifically in obese patients.

Impact of Chronic Kidney Disease on Outcomes following Vascular Procedure in the Vascular Quality Initiative.

Background: Chronic kidney disease (CKD) increases morbidity and mortality in most vascular procedures. However, a binary classification of estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, which is often used in both modeling and clinical trials, may not be optimal for predicting clinical outcomes.

Bridging the gap: Addressing disparities in hepatitis C screening, access to care, and treatment outcomes.

Hepatitis C virus (HCV) is a significant public health challenge globally, with substantial morbidity and mortality due to chronic liver disease. Despite the availability of highly effective and well-tolerated direct-acting antiviral therapies, widespread disparities remain in hepatitis C screening, access to treatment, linkage to care, and therapeutic outcomes. This review article synthesizes evidence from various studies to highlight the multifactorial nature of these disparities, which affects ethnic minorities, people with lower socioeconomic status, individuals with substance use disorders, and those within correctional facilities.

Intramedullary Metastases to Conus Medullaris: A Review of the Literature with a Case Illustration.

Intramedullary metastases to the conus medullaris spinalis (IMCM) pose a rare problem in neurosurgical oncology and are usually encountered as a complicated clinical scenario in the setting of advanced systemic malignancy with poor overall survival. Despite the progress in interdisciplinary oncological care, their management remains complicated. We performed a PRISMA-guided literature search to achieve a pooled analysis of all previously reported IMCM cases that contained detailed clinical data on this problem to investigate the currently employed management options and respective outcomes.

Impact of the type of anesthesia on adverse events during transcarotid artery revascularization.

Objective: The use of local or regional anesthesia (LRA) is encouraged during transcarotid artery revascularization (TCAR) because the procedure is performed through a small incision. LRA permits neurologic evaluation during the procedure and may reduce periprocedural cardiac morbidity compared with general anesthesia (GA). There is limited and conflicting information regarding the preferred anesthesia to use during TCAR.

Clinical Trials in Gastroesophageal Cancers: An Analysis of the Global Landscape of Interventional Trials From ClinicalTrials.gov.

Purpose: To describe the global landscape of clinical research into interventions for gastroesophageal cancers (GECs), with examination of trial characteristics, geographic distribution of trial sites, and factors associated with trial termination.

Methods: We queried ClinicalTrials.gov to identify all completed or terminated phase III interventional studies investigating GECs (esophageal squamous cell carcinoma [ESCC], esophageal adenocarcinoma [EAC], gastroesophageal junctional [GEJ], and gastric adenocarcinoma).

Shifting tides in cardiology fellowship: an analysis of trends and the virtual interview revolution, 2017 to 2021.

Introduction: This investigation aimed to delineate the trends in cardiology fellowship applications and match rates between 2017 and 2021, with a particular focus on the effect of the COVID-19 pandemic.

Methods: Utilizing data from the National Resident Matching Program and the American Board of Internal Medicine covering 6693 applicants, we conducted chi-square tests to assess match rate variations. IBM SPSS version 23 was used for statistical analysis.

Impact of breast cancer on in-hospital mortality and health care utilization in female heart failure patients: a retrospective cohort study.

Background: Heart failure (HF) and breast cancer are major health concerns with overlapping risk factors. This study investigated the impact of breast cancer on in-hospital mortality, length of stay, and health care charges in patients with HF.

Methods: A retrospective cohort study was conducted using data from the National Inpatient Sample, focusing on female patients diagnosed with both breast cancer and HF.

Reviewing Ethical Guidelines for the Care of Patients with Do-Not-Resuscitate Orders after 30 Years: Rethinking Our Approach at a Time of Transition.

The American Society of Anesthesiologists (ASA) opposes automatic reversal of do-not-resuscitate orders during the perioperative period, instead advocating for a goal-directed approach that aligns decision-making with patients' priorities and clinical circumstances. Implementation of ASA guidelines continues to face significant barriers including time constraints, lack of longitudinal relationships with patients, and difficulty translating goal-focused discussion into concrete clinical plans. These challenges mirror those of advance care planning more generally, suggesting a need for novel frameworks for serious illness communication and patient-centered decision-making.

Airway Stents for Excessive Central Airway Collapse: A Randomized Controlled Open-label Trial.

Background: Short-term airway stent placement (stent evaluation) has been employed to evaluate whether patients with excessive central airway collapse (ECAC) will benefit from tracheobronchoplasty. Although retrospective studies have explored the impact of stent placement on ECAC, prospective randomized controlled trials are absent.

Methods: This was a randomized open-label trial comparing patients receiving airway stent placement and standard medical treatment (intervention group) versus standard medical treatment alone (control group) for ECAC.