Upper Extremity Arteriovenous Grafts are Less likely to be Abandoned Compared to Autogenous Fistulas Despite a Higher Reintervention Rate.

Objective: Upper-extremity arteriovenous (AV) access often requires re-intervention. However, the frequency of re-interventions and subsequent access failure is not well-characterized. Our goal was to evaluate the frequency and type of re-interventions, risk-factors, and outcomes after AV access creation.

Evaluating the Emergency Management of Arteriovenous Fistula and Graft Bleeds.

Background: Arteriovenous (AV) access bleeding requires prompt management, but little is known about short- and long-term outcomes after these events. Our goal was to evaluate emergency management of AV access bleeds and their outcomes.

Methods: This is a retrospective analysis of emergency department (ED) visits for AV access bleeding at a tertiary care center between 2014 and 2022.

Expert Consensus on Single-Inhaler Triple Therapy for the Treatment of Asthma in Adult Patients.

Introduction: Despite existing guidelines, many patients with asthma do not achieve adequate control of their disease. This is largely due to low adherence to inhaled therapy. Single-inhaler administration may improve this and other aspects of asthma therapy, such as cost-effectiveness.

Factors associated with cancellation of arteriovenous access creations.

Objective: Cancellation of arteriovenous (AV) access creation delays establishing permanent hemodialysis (HD) access, potentially affecting patient outcomes and health care efficiency. Our goal was to assess the rate of AV access cancellations and identify contributing factors in a safety net hospital.

Methods: All AV access creations at a single academic medical center (2018-2024) were retrospectively reviewed.

Regional and Specialty-Based Medicare Reimbursement Trends in Arterial Endovascular Procedures.

Objective: Medicare Part B reimbursements have been overall declining at the national level. Our goal was to characterize Medicare reimbursement trends for endovascular lower extremity interventions stratified based on geographic region and physician specialty.

Methods: The 2018-2022 Medicare Physician and Other Practitioners by Provider and Service dataset was queried for eight lower extremity CPT codes.

Circulating Tumor DNA in the Surgical Management of Cancer: A Review of Clinical Trials to Understand Future Impact on Multidisciplinary Practice.

BackgroundCirculating tumor DNA (ctDNA) has been proposed as a surrogate for solid tumor tissue biopsies. Our study evaluated trends of clinical trials that assess the role of ctDNA in surgical oncology.MethodsThe ClinicalTrials.

Endovascular Management of Acute and Chronic Mesenteric Ischemia.

Background: Mesenteric ischemia demands prompt and effective revascularization. Endovascular therapy (EVT) has become a well-established treatment modality with several benefits. This review examines current EVT options for managing acute and chronic mesenteric ischemia (CMI) in contemporary practice.

Anticoagulation does not improve limb outcomes after lower extremity cryopreserved vein bypass.

Objective: Cryopreserved vein grafts serve as alternative conduits for infrainguinal bypass when autogenous vein is unavailable or inadequate. Anticoagulation has been advocated to improve outcomes, but published studies demonstrate conflicting results. We assessed the association of anticoagulation on outcomes after infrainguinal bypass with cryopreserved vein in patients with chronic limb-threatening ischemia.

Disability and associated outcomes among patients suffering periprocedural strokes after carotid artery stenting.

Objective: Perioperative stroke after carotid artery stenting (CAS) is rare. However, the degree of disability and long-term effects from a postoperative stroke remain unclear. Our goal was to assess the degree of disability from a stroke after transcarotid artery revascularization (TCAR) and transfemoral CAS (TFCAS) for asymptomatic carotid artery disease, and the associated 1-year impact on subsequent neurological events and mortality.

Evaluating the management of intermittent claudication before and after publication of the Society of Vascular Surgery's Appropriate Use Criteria.

Objective: In April 2022, the Society for Vascular Surgery (SVS) published the Appropriate Use Criteria (AUC) for the management of intermittent claudication (IC). Our goal was to compare practice patterns before and after publication of the AUC to identify changes.

Methods: The Vascular Quality Initiative (VQI) peripheral vascular intervention (PVI) and suprainguinal and infrainguinal bypass registries were analyzed for interventions for IC.

Peripheral vascular emboli in patients with infective endocarditis are common.

Objective: Infective endocarditis (IE) is associated with significant morbidity and mortality and places patients at risk for subsequent peripheral vascular emboli. Our goals were to analyze the incidence of peripheral emboli and their associated complications and outcomes.

Methods: A retrospective single-center review of all patients with IE from 2013 through 2021 was performed.

Patients Experience Significant Long-Term Social and Health Challenges After Major Lower Extremity Amputation.

Background: Major lower extremity amputation is a significant life-changing event that can have long-term implications. The goal of this study was to assess long-term medical outcomes and social determinants of health (SDH) challenges in this population.

Methods: A retrospective review of major lower extremity (previously mentioned ankle) amputations (2018-2022) was performed at a safety-net tertiary care center.

Early Kidney Transplantation or Conversion to Peritoneal Dialysis after First-Time Arteriovenous Access Creation.

Background: After autogenous arteriovenous (AV) access creation for end-stage renal disease, a majority of patients will continue on hemodialysis (HD), a minority will receive definitive treatment with kidney transplantation, and a subset of patients will convert to peritoneal dialysis (PD). Our goal was to identify patient factors associated with early transition from HD to either kidney transplantation or PD.

Methods: This is a case-control study of all patients with first-time AV access creation in the Vascular Quality Initiative (2011-2022) who had long-term follow-up.

Medicare billing and utilization trends in vascular surgery.

Objective: Within the past decade, Medicare Part B reimbursements for various surgical procedures have been declining, whereas health care expenses continue to increase. As a result, hospitals may increase service charges to offset losses in revenue, which may disproportionately affect underinsured patients. Our analysis aimed to characterize Medicare billing and utilization trends across common vascular surgical procedures.

Assessing Time to Removal of Tunneled Dialysis Catheters after Arteriovenous Access Creation.

Background: Tunneled dialysis catheters (TDCs) are a temporary bridge until definitive arteriovenous (AV) access is established. Our objective was to evaluate the time to TDC removal in patients who underwent AV access creations with TDCs already in place.

Methods: A single-center analysis of all AV access creations in patients with TDCs was performed (2014-2020).

The ethics of nursing care for transgender people.

Objectives: to discuss ethical aspects in nursing care for transgender people.

Methods: reflective study based on the dilemmas that emerges in nursing care for transgender people. The report was structured around the four bioethical principles.

Long-term functional outcomes of upper extremity civilian vascular trauma.

Objective: Civilian analyses of long-term outcomes of upper extremity vascular trauma (UEVT) are limited. Our goal was to evaluate the management of UEVT in the civilian trauma population and explore the long-term functional consequences.

Methods: A retrospective review and analysis was performed of patients with UEVT at an urban Level 1 trauma center (2001-2022).

Protecting patient safety and privacy in the era of artificial intelligence.

The promise of artificial intelligence (AI) in health care has propelled a significant uptrend in the number of clinical trials in AI and global market spending in this novel technology. In vascular surgery, this technology has the ability to diagnose disease, predict disease outcomes, and assist with image-guided surgery. As we enter an era of rapid change, it is critical to evaluate the ethical concerns of AI, particularly as it may impact patient safety and privacy.

Outcomes of lower extremity revascularization in octogenarians and nonagenarians for intermittent claudication.

Objective: Revascularization for intermittent claudication (IC) due to infrainguinal peripheral arterial disease (PAD) is dependent on durability and expected benefit. We aimed to assess outcomes for IC interventions in octogenarians and nonagenarians (age ≥80 years) and those younger than 80 years (age <80 years).

Methods: The Vascular Quality Initiative was queried (2010-2020) for peripheral vascular interventions (PVIs) and infrainguinal bypasses (IIBs) performed to treat IC.

Impact of disturbed flow and arterial stiffening on mechanotransduction in endothelial cells.

Disturbed flow promotes progression of atherosclerosis at particular regions of arteries where the recent studies show the arterial wall becomes stiffer. Objective of this study is to show how mechanotransduction in subcellular organelles of endothelial cells (ECs) will alter with changes in blood flow profiles applied on ECs surface and mechanical properties of arterial wall where ECs are attached to. We will examine the exposure of ECs to atherogenic flow profiles (disturbed flow) and non-atherogenic flow profiles (purely forward flow), while stiffness and viscoelasticity of arterial wall will change.

Alternative access for peripheral vascular interventions.

Percutaneous endovascular interventions for advanced lower extremity peripheral arterial disease are becoming increasingly used, often as first-line treatment of chronic limb threatening ischemia. Advancements in endovascular techniques have provided safe and effective alternative revascularization options, especially for high-risk surgical patients. Although the classic transfemoral approach results in high technical success and patency rates, an estimated 20% of lesions remain challenging to access via an antegrade approach.