Publications by authors named "Joe L Pantoja"

Background: Low wall shear stress (WSS) is predictive of aortic aneurysm growth and rupture. Yet, estimating WSS in a clinical setting is impractical, whereas measuring aneurysm geometry is feasible. This study investigates the association between saccular aneurysm geometry of the infrarenal aorta and WSS.

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In recent years, artificial intelligence (AI) has permeated different aspects of vascular surgery to solve challenges in clinical practice. Although AI in vascular surgery is still in its early stages, there have been promising developments in its applications to vascular diagnosis, risk stratification, and outcome prediction. By establishing a baseline knowledge of AI, vascular surgeons are better equipped to use and interpret the data from these types of projects.

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Objective: Tools that quantify tissue perfusion of the foot are deficient, contributing to the uncertainty in predicting ulcer healing potential. This pilot study aims to quantify peri-wound foot perfusion at various tissue depths using a novel application of pseudo-continuous arterial spin labeling magnetic resonance imaging.

Methods: Ten diabetic patients with neuropathic wounds and 20 healthy volunteers without wounds were recruited.

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Objectives: Congenital abnormalities of the first rib (ABNFR) are a rare cause of thoracic outlet syndrome (TOS). The range of abnormalities have not been clearly documented in the literature. Surgical decompression in these patients presents with increased complexity secondary to anomalous anatomy.

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Article Synopsis
  • Vascular surgeons have increasingly used endovascular techniques for treating arterial thoracic outlet syndrome (ATOS) over the last two decades, with significant shifts observed in treatment methods.
  • A study reviewed 51 ATOS cases, comparing outcomes from two time periods: before and after the adoption of endovascular methods, highlighting the rise in catheter-based interventions performed by vascular surgeons in the later period.
  • Results showed that while endovascular repairs had shorter operation times and hospital stays compared to open repairs, the long-term success rates (patency rates) were lower, indicating a trade-off between immediate benefits and long-term outcomes.
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Background: Long standing, recalcitrant venous ulcers fail to heal despite standard compression therapy and wound care. Stenting of central veins has been reported to assist in venous ulcer healing. This study reports outcomes of deep venous stenting for central venous obstruction in patients with recalcitrant venous ulcers at a single comprehensive wound care center.

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Objective: Patients with functioning renal allografts may need ligation of pre-existing hemodialysis conduits. Chronic immunosuppression for renal allografts may adversely affect wound healing and perioperative complications following these procedures. We sought to analyze outcomes following elective ligation and resection of symptomatic arteriovenous (AV) access in immunosuppressed patients with renal allografts no longer requiring dialysis at a high-volume renal transplant hospital.

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Background: Simulation continues to be an important adjunct to vascular surgery training, yet the optimal implementation of simulation to complement conventional surgical training continues to evolve. This study aims to find areas for improvement in current simulation-based training of open vascular skills by characterizing the experience of vascular trainees attending a national simulation-based course.

Method: This was a survey study conducted at the simulation course of the Annual UCLA/SVS Symposium: A Comprehensive Review and Update of What's New in Vascular and Endovascular Surgery, a national vascular surgery meeting.

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Patients with acute coronavirus disease 2019 (COVID-19) respiratory infection are associated with concomitant thromboembolic complications and a hypercoagulable state. Although these mechanisms are not completely understood, unique alterations in the serum markers for hemostasis and thrombosis have been detected. A high index of suspicion is required by vascular surgeons for patients presenting with this novel virus.

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Background: The en bloc resection of inferior vena cava (IVC) leiomyosarcoma often necessitates IVC reconstruction. The objective of this study is to examine outcomes after IVC reconstruction and determine optimal graft sizing.

Methods: A retrospective review was conducted of all IVC reconstructions after IVC leiomyosarcoma resection at a single institution.

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Background: Venous resection during pancreaticoduodenectomy for the excision of pancreatic cancer allows for a more complete resection with negative margins, which increases survival. When the resected vein is greater than 3 cm, reconstruction with an interposition graft is recommended. However, consensus regarding the optimal venous conduit has not been reached.

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Background: Recurrent mitral regurgitation after mitral valve repair is common, occurring in nearly 50% of patients within 10 years of surgery. Durability of repair is partly related to stress distribution over the mitral leaflets. We hypothesized that repair with neochords (NCs) results in lower stress than leaflet resection (LR).

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Article Synopsis
  • * Researchers used finite element modeling of the LV to analyze the effects of a 24-mm annuloplasty ring on wall strain during heart cycles in sheep with ischemic MR.
  • * Results showed that undersized MA increased longitudinal strain significantly in the LV wall, potentially contributing to continued LV dilation and a higher risk of MR recurrence.
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Article Synopsis
  • The mitral valve manages blood flow between the left atrium and left ventricle, but various diseases can lead to severe mitral regurgitation, which is best treated by repairing the valve.
  • The mitral valve is a complex and dynamic structure with many interacting components that can be affected by different health issues.
  • Computational modeling using finite element analysis is a useful method to study the biomechanical characteristics of the mitral valve and to inform surgical repair techniques.
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Background: Surgical ventricular restoration (Dor procedure) is generally thought to reduce left ventricular (LV) myofiber stress (FS) but to adversely affect pump function. However, the underlying mechanism is unclear. The goal of this study was to determine the effect of residual stress (RS) on LV FS and pump function after the Dor procedure.

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Article Synopsis
  • The study examines the effects of posterior papillary muscle anchoring (PPMA) on left ventricular stress and pump function in cases of chronic ischemic mitral regurgitation (CIMR) following myocardial infarction in sheep.
  • Different anchoring techniques and relocation displacements were tested, revealing that PPMA consistently reduced myofiber stress in the heart, especially in the affected areas, without significantly compromising overall pump function.
  • Results suggest that using PPMA to manage stress in the myocardium may help improve heart remodeling without negatively impacting left ventricular performance, regardless of the anchoring point chosen.
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Chemotherapy for intracranial gliomas is hampered by limited delivery of therapeutic agents through the blood brain barrier (BBB). An optimal therapeutic agent for brain tumors would selectively cross the BBB, accumulates in the tumor tissue and be activated from an innocuous prodrug within the tumor. Here we show brain tumor-targeted delivery and therapeutic efficacy of a nanometer-sized prodrug (nanoprodrug) of camptothecin (CPT) to treat experimental glioblastoma multiforme (GBM).

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We demonstrated that hydrophobic derivatives of the nonsteroidal anti-inflammatory drug (NSAID)flufenamic acid (FA), can be formed into stable nanometer-sized prodrugs (nanoprodrugs) that inhibit the growth of glioma cells, suggesting their potential application as anticancer agent. We synthesized highly hydrophobic monomeric and dimeric prodrugs of FA via esterification and prepared nanoprodrugs using spontaneous emulsification mechanism. The nanoprodrugs were in the size range of 120 to 140 nm and physicochemically stable upon long-term storage as aqueous suspension, which is attributed to the strong hydrophobic interaction between prodrug molecules.

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