Technique and outcomes of robotic median arcuate ligament release in 52 patients: a multidisciplinary experience.

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.

Brachial Artery Entrapment in a Professional Athlete.

Background: Pathologic compression of the median nerve at the elbow by the bicipital aponeurosis, or lacertus fibrosus, in athletes has been described well; however arterial compression at this level has been rarely described. We describe the evaluation and surgical treatment of a case of distal brachial artery and proximal radial artery compression by the lacertus fibrosus in a professional baseball pitcher.

Methods: We received verbal consent from the patient involved to prepare a published report of this case.

Proteomics of arterial thrombi in acute limb ischemia.

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.

Outcomes of Acute Limb Ischemia at a Large Public Hospital in Brazil: Insights before, during and after the COVID-19 Pandemic.

Background: This study compared outcomes of patients with acute limb ischemia (ALI) before, during, and after the COVID-19 pandemic, hypothesizing that poor outcomes observed during the pandemic have not yet been resolved.

Methods: This retrospective, observational, single-center study analyzed ALI patients from 2019 to 2023.

Results: Over 5 years, 298 patients underwent surgery for ALI at our hospital: 35 had COVID-19 (COVID group), 132 tested negative (non-COVID group), 71 were treated before the pandemic (pre-COVID group), and 60 after (post-COVID group).

Vascular Surgeon Involvement in Pulmonary Embolism Response Teams: Barriers, Challenges, Concerns and the Imperative for Integration.

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.

Impact of COVID-19 on patients undergoing scheduled procedures for chronic venous disease.

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.

Carotid Artery Operation Delay During the Covid-19 Pandemic: Results of a Multicenter International Study.

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.

Recent advances and the future of abdominopelvic and lower extremity vascular injury management.

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.

A review of disparities in peripheral artery disease and diabetes-related amputations during the COVID-19 pandemic.

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.

Rivaroxaban in patients with symptomatic peripheral artery disease after lower extremity bypass surgery with venous and prosthetic conduits.

Background: Patients with peripheral artery disease (PAD) requiring lower extremity revascularization (LER) have a high risk of adverse limb and cardiovascular events. The results from the VOYAGER PAD (efficacy and safety of rivaroxaban in reducing the risk of major thrombotic vascular events in subjects with symptomatic peripheral artery disease undergoing peripheral revascularization procedures of the lower extremities) trial have demonstrated that rivaroxaban significantly reduced this risk with an overall favorable net benefit for patients undergoing surgical revascularization. However, the efficacy and safety for those treated by surgical bypass, including stratification by bypass conduit (venous or prosthetic), has not yet been described.

A primer on cohort studies in vascular surgery research.

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.

A Pilot Study Examining the Effects of Ischemic Conditioning on Walking Capacity and Lower Extremity Muscle Performance in Patients with Claudication.

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.

The mental health impact of aortic dissection.

Although the topics of surgical techniques and medical therapies have been widely studied in aortic dissection (AD), studies examining the short- and long-term impact of this event on mental health are largely lacking. Many of the studies have used the 36-Item Short Form Survey at variable time points after the event. However, AD as medical trauma has a complex impact on a person's identity.

Inferior Mesenteric Artery Revascularization with ChEVAR in High Risk Patient with Bilateral Occlusion of Internal Iliac Arteries, Case Report and Review of Literature.

Background: This article describes a chimney technique (ChEVAR) to preserve the patency of the inferior mesenteric artery (IMA) in a patient with abdominal aortic aneurysm (AAA) and bilateral internal iliac artery obstruction. In addition, a review of the literature is performed.

Case Report: This article describes a male in his 70s with multiple comorbidities and a 5.

Distal arteriovenous fistula to preserve patency in COVID-19-associated acute limb ischemia.

The purpose of this study was to report our institutional experience with patients with COVID-19 who developed acute limb ischemia during hospitalization and to determine the characteristics and clinical outcomes. Between March 2020 and January 2021, we treated 3 patients who were COVID-19-positive and developed acute limb ischemia after they received thromboprophylaxis. We performed an embolectomy by exposing the popliteal artery below the knee to treat an occlusion of the popliteal and tibial arteries.

Coming face to face with implicit bias, microagressions, and macroaggressions: Understanding the influence of structural racism and misogyny on physician wellness.

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.

The impact of COVID-19 pandemic on vascular registries and clinical trials.

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.

Aortic Neck IFU Violations During EVAR for Ruptured Infrarenal Aortic Aneurysms are Associated with Increased In-Hospital Mortality.

Objective: Vascular surgeons treating patients with ruptured abdominal aortic aneurysm must make rapid treatment decisions and sometimes lack immediate access to endovascular devices meeting the anatomic specifications of the patient at hand. We hypothesized that endovascular treatment of ruptured abdominal aortic aneurysm (rEVAR) outside manufacturer instructions-for-use (IFU) guidelines would have similar in-hospital mortality compared to patients treated on-IFU or with an infrarenal clamp during open repair (ruptured open aortic aneurysm repair [rOAR]).

Methods: Vascular Quality Initiative datasets for endovascular and open aortic repair were queried for patients presenting with ruptured infrarenal AAA between 2013-2018.

Modifiable risk factors for burnout in vascular surgery trainees.

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.

Sharp Recanalization with the Upstream GoBack Catheter for Chronic Occlusive Ilio-Caval Thrombosis.

Recanalization of chronic iliofemoral deep vein thrombosis is indicated to reduce symptoms and improve quality of life. However, recanalization is dependent on the ability to cross chronic obstructions. We present a case of chronically thrombosed inferior vena cava and common iliac veins that failed conventional crossing techniques but were successfully recanalized using the recently approved Upstream GoBack Crossing Catheter.