Multi-center experience with an off-the-shelf single retrograde thoracic branch endoprosthesis for acute aortic pathology.

Objective: The thoracic branch endoprosthesis (TBE) (W.L. Gore) offers an off-the-shelf single option for thoracic endovascular aortic repair (TEVAR) of aortic arch pathology with sealing in zones 0 to 2.

Endovascular management of central venous catheter induced superior vena cava syndrome.

This case series describes the endovascular management of three patients with catheter-associated superior vena cava (SVC) syndrome. SVC syndrome can result from malignant (60%) or benign (40%) etiologies. The most common causes of benign SVC syndrome are indwelling central venous catheters (CVCs) with 1%-3% and 0.

A Multicenter Evaluation of Clopidogrel Resistance and Its Role in Predicting Stent Thrombosis in Transcarotid Artery Revascularization.

Background: Clopidogrel resistance testing is not routine prior to transcarotid artery revascularization (TCAR) and resistance rates are not well described in this setting despite frequent use of periprocedural clopidogrel. We compared 2 resistance testing modalities to determine the relationship between resistance and stent outcomes.

Methods: Consecutive patients undergoing TCAR at 3 institutions were retrospectively identified.

Symptomatic carotid stenosis in Eagle syndrome managed with traditional endarterectomy and styloidectomy.

Eagle syndrome represents an anatomic variant present in 4% of the population. It is characterized by an elongated styloid process or ossified stylohyoid ligament with resultant irritation of cervical neurovascular structures. Common manifestations include craniofacial or cervical pain related to compression of the glossopharyngeal nerve.

Use of a prosthetic conduit for stent delivery in transcarotid artery revascularization for patients with unfavorable anatomy.

Transcarotid artery revascularization (TCAR) provides a safe alternative to carotid endarterectomy. The anatomic requirements include a 5-cm minimum clavicle to carotid bifurcation distance for sheath access proximal to the lesion. In the present report, we describe our experience with conduit use for patients not meeting that requirement.

Radial arterial access is a safe alternative to brachial artery and femoral artery access for endovascular lower extremity peripheral arterial disease.

Objective: Radial artery access is a well-described technique that has proven to be safe and efficacious in percutaneous cardiac intervention. This technique has been used with increased frequency in the treatment of lower extremity peripheral arterial disease (LE-PAD); however, the overall safety has not yet been well described in the vascular surgery literature. We sought to evaluate the safety of this technique compared with retrograde femoral artery access and brachial artery access (BA) in the treatment of PAD.

Chinook salmon diversity contributes to fishery stability and trade-offs with mixed-stock harvest.

Variation among populations in life history and intrinsic population characteristics (i.e., population diversity) helps maintain resilience to environmental change and dampen interannual variability in ecosystem services.

Medical Student Perspectives on Choosing a Career in Vascular Surgery.

Background: Vascular surgery is facing an impending workforce shortage as the population ages and the demand for vascular surgical services increases. The integrated vascular surgery residency (0+5) paradigm is well-established and provides a mechanism to increase the number of board-certified vascular surgeons. Recruitment of medical students to these programs has proven challenging with unfilled positions in each of the past 2 years.

Virtual medical student education and recruitment during the COVID-19 pandemic.

Due to the immediate need for social distancing, as well as widespread disruption in clinical practices, brought on by the novel severe acute respiratory syndrome coronavirus 2 (COVID-19) pandemic, medical student education rapidly shifted to a virtual format, which resulted in a variety of innovative and remotely accessible practices to address new restrictions on face-to-face education. Educators approached curriculum design seeking to replicate as much of the in-person experience as possible, and were faced with overcoming the challenges of replacing the innately hands-on nature of surgery with virtual operative and skills experiences. Restrictions on in-person visiting electives expedited the role of virtual education as a notable opportunity for medical student education and recruitment, with a variety of approaches to engaging undergraduate medical learners, including the use of live-streaming operative cases, virtual didactic curricula, and a rise in podcasts; web-based conferences; and virtual journal clubs.

How We Do It: A Multicenter National Experience of Virtual Vascular Surgery Rotations.

Objective: To describe the development and implementation of virtual vascular surgery rotations among 6 integrated vascular surgery programs.

Design: A collaborative teleconference retrospectively discussing 6 independently developed virtual vascular surgery rotations to make a framework for future use.

Setting: University of California Davis initiated a joint teleconference among the various integrated vascular surgery programs.

Challenges of treating mixed arterial-venous disease of lower extremities.

Introduction: Mixed arterial-venous lower extremity disease (AVLED) poses a unique challenge for clinicians. This review will outline the impact mixed AVLED has on patients and the healthcare system, by reviewing its epidemiology, diagnosis, current treatment, and the challenges encountered implementing therapies.

Evidence Acquisition: An extensive search of current literature from online sources, journals and book chapters identified the current challenges facing the treatment of mixed arterial venous ulcers of the lower extremities and potential solutions to these challenges.

Endovascular repair of an innominate artery pseudoaneurysm using the Valiant Mona LSA branched graft device.

A 60-year-old woman involved in a motor vehicle collision presented with a traumatic pseudoaneurysm of the innominate artery origin in addition to multiple concomitant injuries. She was classified as a high-risk candidate for open repair. An experimental thoracic branched graft device was used for coverage of the injury with the addition of a right carotid-to-left carotid-to-left subclavian artery bypass.

Location is everything: evaluating the effects of terrestrial and marine resource subsidies on an estuarine bivalve.

Estuaries are amongst the world's most productive ecosystems, lying at the intersection between terrestrial and marine environments. They receive substantial inputs from adjacent landscapes but the importance of resource subsidies is not well understood. Here, we test hypotheses for the effects of both terrestrial- and salmon-derived resource subsidies on the diet (inferred from stable isotopes of muscle tissue), size and percent nitrogen of the soft-shell clam (Mya arenaria), a sedentary estuarine consumer.

Ecosystemic effects of salmon farming increase mercury contamination in wild fish.

Net-pen salmon aquaculture has well-known effects on coastal ecosystems: farm waste increases sediment organic content and the incidence of sediment anoxia, supports increased production of deposit-feeding invertebrates, and attracts higher densities of demersal fish and other mobile carnivores. These impacts are widely considered to be localized and transitory, and are commonly managed by imposing a period of fallowing between cycles of production. The implications of these ecosystemic effects for contaminant cycling, however, have not previously been considered.