Relationship of Adhesive Drapes on Groin Surgical Site Infection Prevention in Vascular Surgery.

Introduction: Iodine impregnated adhesive drapes have been shown to reduce incidence of surgical site infection (SSI) in cardiothoracic surgery. A Cochrane review of its use in multiple specialties found significantly more SSIs in the adhesive group versus control. No studies have evaluated their use in vascular surgery and infrainguinal SSIs which this study sought to evaluate.

Thinking outside the box: Axillary to superior mesenteric artery bypass for chronic mesenteric ischemia.

Endovascular and open approaches are available for patients with chronic mesenteric ischemia. Axillary to superior mesenteric artery bypass has been described sparsely in the vascular literature. We describe a successful axillary to superior mesenteric artery bypass in an 84-year-old female patient with extensive aortoiliac disease precluding traditional approaches and performed in a community vascular surgery setting.

Autologous Arteriovenous Loop Graft Creation for Head and Neck Microsurgical Reconstruction: A Pictorial Essay.

Background: The arteriovenous (AV) loop is a versatile and reliable technique for establishing vascular access in head and neck free tissue reconstruction. This method is particularly advantageous in complex cases where conventional vascular access may be challenging.

Methods And Results: In this pictorial essay, we present the pre-operative planning and patient selection factors for creating AV loops, and artist-illustrated drawings detailing our intraoperative technique.

In-Hospital Risk Factors for Reintervention and Amputation in Femoral Arterial Trauma.

Introduction: Known risk factors for surgical reintervention of traumatic femoral artery injuries include thrombosis of vascular reconstruction, kinking of anastomosis, and iatrogenic injury. The literature regarding possible in-hospital risk factors is sparse. We sought to identify risk factors associated with increased reintervention and amputation in this civilian population.

Endoscopic vein harvest and its effect on lower extremity arterial bypass patency.

Objective: The use of endoscopic vein harvest (EVH) vs open vein harvest (OVH) for lower extremity arterial bypass has been an area of continued interest. Previous studies have suggested wound complication rates are improved with EVH, but there has been concern for decreased patency of these grafts long term from possible damage with EVH techniques. This study aims to evaluate the effect of EVH and patency rates.

Risk factors for non-compliance of patient reported outcome measures following achilles tendon repair surgery.

Background: Patient-Reported Outcome Measures (PROMs) are increasingly utilized in orthopaedic research and assess the patient's response to care, allow for assessment of the patient's overall health, and provide tools to promote the shared decision-making process. Our hypothesis is that risk factors for non-compliance is increasing age and increasing time after surgery.

Methods: PROMs compliance was conducted from survey data of 90 individuals from May 2017 to July 2023 who had Achilles tendon surgery.

Standardization of Narcotic Prescriptions in Minimally Invasive General Surgery Procedures.

Introduction: The opioid crisis is a major public health issue, and postoperative opioids play a unique role. Many institutions have implemented standardized protocols to decrease excess opioids available. The objective of this study was to establish a standardized pain protocol for common surgical procedures and assess postoperative pain control.

Transcarotid Artery Revascularization for Symptomatic Retropharyngeal Internal Carotid Artery Stenosis.

Retropharyngeal internal carotid artery (ICA) is a rare, yet well-described anatomical variant that poses significant challenges to the management of carotid artery stenosis. In this case report, we discuss the treatment of symptomatic ICA stenosis with a retropharyngeal ICA using the transcarotid artery revascularization (TCAR) technique. A 70-year-old female with comorbidities presented with neurological symptoms and severe ICA stenosis.

Patient selection for arterial procedures in office-based laboratories: A systematic review.

A dramatic increase in the number of vascular procedures performed in the office-based laboratory setting has been observed since 2008, when the Centers for Medicare and Medicaid Services increased reimbursement for procedures performed in the ambulatory setting. We sought to evaluate the appropriateness of arterial intervention in the office-based laboratory and patient selection. This systematic review was conducted with a search of Google Scholar and PubMed using the following search terms: office-based lab, outpatient, angioplasty, patient selection, arterial, and appropriateness.

Expansion of WallStents® after Initial Deployment in Nonthrombotic Iliac Vein Lesions.

Background: To determine the structural changes of Wallstents (Boston Scientific, Natick, MA) in vivo following deployment in iliac veins.

Methods: This retrospective single-center study was performed from September 2012 to April 2013 and included 100 office-based patients who underwent initial stent placement for nonthrombotic iliac vein lesions with Wallstent as well as a second procedure for stenting of the contralateral iliac vein. Measurements were obtained with marker balloons and the diameters of the stents were compared at the time of the index procedure to the secondary procedure.

In-Hospital Risk Factors for Reintervention and Amputation in Brachial Arterial Trauma.

Introduction: Brachial artery trauma is a rare but potentially devastating injury. There is little data regarding risk factors for reintervention and amputation prevention in this population, as well as anticoagulant (AC) and antiplatelet (AP) regimens and outcomes after discharge in trauma patients with vascular injuries requiring repair. This study aims to identify in-hospital risk factors for reintervention and amputation and stratify outcomes of follow-up by discharge AC or AP regimen.

Thoracic Ultrasound for Detection of Pneumothorax Following Thoracostomy Tube Removal in Trauma Patients.

Introduction: Screening for pneumothorax (PTX) is standard practice after thoracostomy tube removal, with postpull CXR being the gold standard. However, studies have shown that point-of-care thoracic ultrasound (POCTUS) is effective at detecting PTX and may represent a viable alternative. This study aims to evaluate the safety and efficacy of POCTUS for evaluation of clinically significant postpull PTX compared with chest x-ray (CXR).

Liver Transplantation in a Woman with Mahvash Disease.

Mahvash disease is an exceedingly rare genetic disorder of glucagon signaling characterized by hyperglucagonemia, hyperaminoacidemia, and pancreatic α-cell hyperplasia. Although there is no known definitive treatment, octreotide has been used to decrease systemic glucagon levels. We describe a woman who presented to our medical center after three episodes of small-volume hematemesis.

Traumatic Endograft Fracture With Subsequent Type IIIb Endoleak.

Abdominal aortic aneurysm (AAA) repair is commonly treated via endovascular aneurysm repair (EVAR). A known complication of EVAR is an endoleak: types I to IV. Type III endoleaks have been shown to have a relative risk of 8.

Body mass index does not decline during winter for the sedentary marine gastropod .

Seasonal extremes in environmental conditions can substantially limit the growth and reproduction of animals. Sedentary marine animals are particularly susceptible to winter food limitation since they cannot relocate to more favourable conditions. In several temperate-zone bivalve species, substantial winter tissue mass declines have been documented; however, no comparable studies have been conducted on intertidal gastropods.

Alcoholic vs. Nonalcoholic Steatohepatitis: Vascular Branching Heterogeneity on Magnetic Resonance Imaging as a Diagnostic Marker.

Background And Aims: Distinguishing alcoholic steatohepatitis (ASH) and nonalcoholic steatohepatitis (NASH) with biopsy alone is often difficult without a reliable clinical context. A novel finding on liver imaging, perivascular branching heterogeneity, has shown promise in distinguishing between these chronic liver diseases. Our study investigated the role of this finding on imaging to differentiate between ASH and NASH.

Systematic review of groin incision surgical site infection preventative measures in vascular surgery.

Objective: Groin surgical site infections (SSIs) after open revascularization can lead to devastating consequences in patients. As a result, prevention has been crucial in minimizing the rate of SSIs. This review aims to evaluate the current body of literature regarding prevention ,techniques including prophylactic flaps, incision technique, topical antibiotic use, closed-incision negative pressure wound therapy, and adhesive drapes.

Outcomes Following Modified Broström for Chronic Lateral Ankle Instability With and Without Peroneal Tendon Exploration.

Background: It is not known how peroneal tendon exploration influences results after modified Broström for lateral ankle instability. We propose peroneal exploration at the time of modified Broström will have similar outcomes as no peroneal exploration.

Methods: A retrospective analysis was performed of patients undergoing modified Broström with and without peroneal exploration.

Maximizing success in single-session EUS-directed transgastric ERCP: a retrospective cohort study to identify predictive factors of stent migration.

Background And Aims: EUS-directed transgastric ERCP (the EDGE procedure) is a simplified method of performing ERCP in Roux-en-Y gastric bypass patients. The EDGE procedure involves placement of a lumen-apposing metal stent (LAMS) into the excluded stomach to serve as a conduit for passage of the duodenoscope for pancreatobiliary intervention. Originally a multistep process, urgent indications for ERCP have led to the development of single-session EDGE (SS-EDGE) with LAMS placement and ERCP performed in the same session.

Effect of Post-splenectomy Booster Vaccine Program on Vaccination Compliance in Trauma Patients.

Objective: In 2012, the Centers for Disease Control and Prevention (CDC) Advisory Council on Immunization Practice recommended an additional post-splenectomy booster vaccine at 8 weeks following the initial vaccine. The objective of this study was to evaluate our vaccination compliance rate and what sociodemographic factors were associated with noncompliance following this recommendation.

Materials And Methods: A retrospective review of a performance improvement database of trauma patients eligible for post-splenectomy vaccination (PSV) at a level I trauma center was carried out between 2009 and 2018.

Closed Distal Dislocation of the Intermediate Cuneiform in a Complex Lisfranc Fracture-Dislocation: A Case Report.

Case: A 21-year-old, active duty male sustained an irreducible, complex Lisfranc fracture-dislocation with distal extrusion of his intermediate cuneiform. He was treated in a staged manner with external fixator placement, followed by an extended midfoot fusion with autograft bone. At 19 months, he could perform all activities of daily living independently with minimal pain using an Intrepid Dynamic Exoskeletal Orthosis.