Publications by authors named "Max V Wohlauer"

Despite previous reports of robotic-assisted release for median arcuate ligament syndrome (MALS), the safety and efficacy of this approach have been difficult to establish due to the rarity of the disease. We aimed to present our experience at a tertiary surgery referral center. We performed a retrospective analysis of all robotic-assisted median arcuate ligament release (rMALR) performed at our institution from 7/2019 to 5/2025.

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Acute limb ischemia (ALI) is characterized by a sudden decrease in limb perfusion due to arterial occlusion. Without urgent revascularization, patients are at risk of ischemic damage and amputation. This study uses novel proteomic techniques to investigate the molecular architecture of ALI thrombi, identifying key proteins that may influence coagulation dynamics and fibrinolysis resistance.

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Background: The effective management of pulmonary embolism (PE) necessitates coordinated care among physicians from diverse specialties within a time-sensitive framework. Pulmonary Embolism Response Teams (PERTs) have been developed as a strategic approach to optimize and expedite treatment by integrating and coordinating different specialties. The current survey audit aimed to understand the level of interest among vascular surgeons and the logistical considerations surrounding their participation within the PERT.

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Article Synopsis
  • REBOA is a medical procedure used in emergencies to help control bleeding in seriously injured people, especially in trauma cases.
  • This study looked at 17 cases where REBOA was used in military settings between 2017 and 2019.
  • Most of the injured patients survived after getting treatment, with many having serious injuries mostly in the abdomen and limbs.
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ObjectiveThe COVID-19 pandemic has drastically altered the medical landscape. Various strategies have been employed to preserve hospital beds, personal protective equipment, and other resources to accommodate the surges of COVID-19 positive patients, hospital overcapacities, and staffing shortages. This has had a dramatic effect on vascular surgical practice.

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Background: To measure the impact of the COVID-19 pandemic on the management of patients with carotid artery stenosis.

Methods: We prospectively collected data from 25 centers (19 centers in the United States and 6 centers internationally) on postponed carotid artery operations between March 2020 and January 2022. We describe the characteristics of these patients and their planned operations, along with outcomes including mortality and neurological deterioration during the period of operative delay due to the COVID-19 pandemic.

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Despite advances in open and endovascular management of trauma, vascular injuries remain a source of devastating outcomes. This narrative review of the literature between 2018 and 2023 explored recent advances in abdominopelvic and lower extremity vascular injury management. New conduit choices, use of temporary intravascular shunts, and advances in endovascular management of vascular trauma were reviewed.

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The COVID-19 pandemic has profoundly affected health care delivery. In addition to the significant morbidity and mortality associated with acute illness from COVID-19, the indirect impact has been far-reaching, including substantial disruptions in chronic disease care. As a result of pandemic disruptions in health care, vulnerable and minority populations have faced health inequalities.

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Vascular research questions can be answered using various study designs. Observational studies are used frequently to address a wide range of clinical questions when randomized clinical trials are not feasible or practical. One of the powerful vascular research tools is the cohort study.

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Introduction: This study investigated whether a novel therapy called ischemic conditioning (IC) improves walking capacity and lower extremity muscle performance in patients with peripheral vascular disease who experience intermittent claudication.

Methods: Forty-three patients with claudication were enrolled and received either IC or IC Sham for 2 weeks in this randomized, controlled, double-blinded, prospective study. IC sessions involved five cycles of alternating 5-min inflations of a blood pressure cuff to 225 mm Hg (25 mm Hg for IC Sham) and 5-min deflations, around the thigh of the affected lower extremity.

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Article Synopsis
  • The study aimed to compare the effects of using instructions for use (IFU) versus nonIFU when treating common iliac artery aneurysms (CIAA) with the Gore Excluder iliac branch endoprosthesis (IBE).
  • A retrospective analysis looked at data from 51 CIAA cases across two medical centers, analyzing both perioperative and intermediate outcomes over a period from September 2016 to May 2020.
  • Results indicated no significant differences in major adverse events or effectiveness at one year between the IFU and nonIFU groups, although the nonIFU group had longer procedure times and more patients with previous aortic repairs.
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Article Synopsis
  • This systematic review focused on the outcomes of acute limb ischemia (ALI) in COVID-19 patients, analyzing data from 36 articles and 194 patients.
  • The majority of the patients were male (80%) with an average age of 60, and the most common treatment was thromboembolectomy (31% of interventions).
  • The findings revealed a low technical success rate (68%) and a high mortality rate (35%), indicating a serious risk of ALI in COVID-19 patients and highlighting the need for further research to understand the underlying mechanisms and treatment approaches.
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Implicit bias, microaggressions, and macroaggressions have a negative impact on physician and trainee wellness. In this article, we describe how structural racism, misogyny, and other social constructs have shaped the medical landscape. Increasing awareness in medical education, patient care, and research can help to dismantle the effects.

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Quality improvement programs and clinical trial research experienced disruption due to the coronavirus disease 2019 (COVID-19) pandemic. Vascular registries showed an immediate impact with significant declines in second-quarter vascular procedure volumes witnessed across Europe and the United States. To better understand the magnitude and impact of the pandemic, organizations and study groups sent grass roots surveys to vascular specialists for needs assessment.

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Objective: Burnout is prevalent among vascular surgery trainees. Here we aim to identify modifiable risk factors for burnout in vascular surgery training, to facilitate the development of programs to enhance and sustain trainee well-being.

Methods: The Association of Program Directors in Vascular Surgery issued the Annual Training survey in the fall of 2018 to all trainees.

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Background: The impact of the coronavirus disease 19 (COVID-19) pandemic on health care workers has been substantial. However, the impact on vascular surgery (VS) trainees has not yet been determined. The goals of our study were to gauge the impact of COVID-19 on VS trainees' personal and professional life and to assess stressors, coping, and support structures involved in these trainees' response to the COVID-19 pandemic.

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Background: The COVID-19 pandemic has made a significant impact on all spheres of society. The objective of this study was to examine the impact of COVID-19 on the practices, finances, and social aspects of Brazilian vascular surgeons' lives.

Methods: This is a descriptive analysis of the responses from Brazilian vascular surgeons to the cross-sectional anonymous Society for Vascular Surgery Wellness Task Force Pandemic Practice, Anxiety, Coping, and Support Survey for Vascular Surgeons disseminated 14-24 April 2020.

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Background: The coronavirus disease 2019 (COVID-19) pandemic has led to widespread postponement and cancelation of elective surgeries in the United States. We designed and administered a global survey to examine the impact of COVID-19 on vascular surgeons. We describe the impact of the pandemic on the practices of vascular surgeons in the United States.

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Background: The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented challenges for health care systems globally. We designed and administered a global survey to examine the effects of COVID-19 on vascular surgeons and explore the COVID-19-related stressors faced, coping strategies used, and support structures available.

Methods: The Pandemic Practice, Anxiety, Coping, and Support Survey for Vascular Surgeons was an anonymous cross-sectional survey sponsored by the Society for Vascular Surgery Wellness Task Force.

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Background: COVID-19 predisposes patients to a prothrombotic state with demonstrated microvascular involvement. The degree of hypercoagulability appears to correlate with outcomes; however, optimal criteria to assess for the highest-risk patients for thrombotic events remain unclear; we hypothesized that deranged thromboelastography measurements of coagulation would correlate with thromboembolic events.

Study Design: Patients admitted to an ICU with COVID-19 diagnoses who had thromboelastography analyses performed were studied.

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Background: Symptomatic peripheral artery disease of the lower extremity rarely affects young adults and, when present, typically has a nonatherosclerotic etiology. Anatomical variants have manifested as symptomatic foot ischemia in four cases in the literature. We describe the case of a 17-year-old girl presenting with foot pain upon plantar flexion due to dynamic dorsalis pedis (DP) artery entrapment by fibrous bands and the extensor hallucis brevis (EHB) tendon.

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Background: Surgical training is constantly adapting to better prepare trainees for an evolving landscape of surgical practice. Training in vascular surgery additionally underwent a paradigm shift with the introduction of the integrated training pathway now more than a decade ago. With this study, we sought to characterize the needs and goals of our current vascular surgery trainee population.

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Although management paradigms for certain arterial trauma, such as aortic injuries, have moved towards an endovascular approach, the application of endovascular techniques for the treatment of peripheral arterial injuries continues to be debated. In the realm of peripheral vascular trauma, popliteal arterial injuries remain a devastating condition with significant rates of limb loss. Expedient management is essential and surgical revascularization has been the gold standard.

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Background: Massive transfusion protocols (MTPs) have become standard of care in the management of bleeding injured patients, yet strategies to guide them vary widely. We conducted a pragmatic, randomized clinical trial (RCT) to test the hypothesis that an MTP goal directed by the viscoelastic assay thrombelastography (TEG) improves survival compared with an MTP guided by conventional coagulation assays (CCA).

Methods: This RCT enrolled injured patients from an academic level-1 trauma center meeting criteria for MTP activation.

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