Periadventitial delivery of mesenchymal stem cells improves vascular remodeling and maturation in arteriovenous fistulas.

Worldwide, more than 4 million patients with end-stage kidney disease require hemodialysis through an arteriovenous fistula (AVF). AVFs fail because of venous neointimal hyperplasia (VNH) resulting in venous stenosis formation. A phase 1 randomized trial in patients undergoing upper extremity AVF placement was performed to evaluate the safety and efficacy of autologous adipose-derived mesenchymal stem cells (MSCs) in improving AVF function.

Partial Diaphragm Division is Associated with Decreased Ventilator Support after Open Thoracoabdominal Aortic Repair.

Objective: The most frequent complications of open thoracoabdominal aortic repair are respiratory in nature. The aim of this study was to analyze the impact of intraoperative diaphragm management on prolonged postoperative ventilation, pulmonary complications, and overall outcomes in patients undergoing open thoracoabdominal aortic repair.

Methods: Retrospective single-institutional review of patients who underwent extent I-V open thoracoabdominal aortic repair between 2013 and 2024.

Prognostic significance of intraoperative graft flow on long-term patency of below knee popliteal and tibial bypasses with autologous vein in patients with chronic limb-threatening ischemia.

Objective: Intraoperative graft flow (GF) is a quick, composite measure of bypass graft status, encompassing adequacy of conduit, technique as well as inflow/outflow. The aim of this study was to evaluate the prognostic significance of GF on long-term patency of below-knee (BKPB) popliteal and tibial (TB) bypasses performed with autogenous vein conduit in patients with chronic limb-threatening ischemia (CLTI).

Methods: Data from consecutive patients who underwent BKPB or TB for CLTI using autologous vein between July 2003 and July 2023 and had intraoperative GF measurement (Optima Flow-QC transit-time ultrasound) were retrospectively reviewed.

Outcomes of Surgical Decompression for Functional Popliteal Artery Entrapment Syndrome.

Background: Functional popliteal artery entrapment syndrome (FPAES) is a rare cause of claudication, predominantly affecting young females. The optimal workup, approach and outcomes remains poorly defined. We aim to evaluate our institutional experience in surgical decompression of FPAES.

Ten-year experience using cryopreserved arterial allografts for vascular reconstruction during major oncologic surgery.

Objective: Resection of vessel-encasing tumors has been historically associated with high morbidity and mortality. However, advances in surgical techniques and cancer treatments have improved outcomes for patients undergoing resection with vascular reconstruction. In specialized centers, cryopreserved arterial allografts (CAAs) are increasingly used when autologous conduits are unavailable, offering superior anatomical compliance and resistance to infection compared with prosthetic conduits.

Long-term comparison of physician-modified endografts with and without low-profile fabric designs for repair of complex abdominal and thoracoabdominal aortic aneurysms.

Objective: After commercial approval, our institution began using the Cook Zenith Alpha low-profile stent graft (LPSG) for physician-modified endograft (PMEG) repair of complex abdominal aortic aneurysms (CAAAs) and thoracoabdominal aortic aneurysms (TAAA) owing to its smaller sheath size and wider apex-to-apex stent distances, allowing for better accommodation of modifications. We aimed to compare outcomes of PMEGs using LPSGs and the standard-profile stent graft (SPSG), Zenith TX2.

Methods: We reviewed clinical data and outcomes of patients treated using PMEGs for CAAAs (short-neck infrarenal, juxtarenal, and pararenal AAAs) and TAAAs between 2007 and 2024.

Perioperative Events Following Open Versus Endovascular Revascularization for Chronic Limb-Threatening Ischemia: An NSQIP Analysis.

Background: The Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia (BEST-CLI) trial reported the superiority of surgical bypass compared with endovascular intervention for the treatment of chronic limb-threatening ischemia (CLTI) in patients deemed suitable for either; however, the generalizability of these findings to the broader CLTI population is in question. Herein, we analyzed perioperative (30-day) outcomes from the National Surgical Quality Improvement Project (NSQIP) for CLTI interventions.

Methods: The NSQIP-Vascular targeted database was queried from 2014 to 2019, contemporaneous with BEST-CLI, for patients undergoing CLTI intervention.

ACR Appropriateness Criteria® Thoracic Aortic Aneurysm or Dissection-Treatment Planning and Follow-Up: 2024 Update.

Diseases of the thoracic aorta include two broad categories: aneurysmal dilation involving all three layers of the intact aortic wall, and acute aortic syndromes, wherein at least one layer of the aortic wall is disrupted, such as in aortic dissection. These diseases carry a variable risk of subsequent aortic rupture, which is associated with high morbidity and mortality. Imaging is critical in the diagnosis, surveillance, and treatment of this constellation of diseases.

Outcomes associated with type II endoleaks after infrarenal endovascular aneurysm repair in the Vascular Quality Initiative linked to Medicare claims.

Objective: Type II endoleaks (T2ELs) are commonly identified after endovascular aneurysm repair (EVAR) and may occur either at the completion of the procedure or during follow-up. However, the impact of T2EL on reintervention and survival remains poorly described. This study aims to evaluate the outcomes associated with T2EL in a real-world cohort using the Vascular Quality Initiative linked Medicare claims (Vascular Quality Initiative-Medicare) database.

Outcomes of patients treated with double-wide scallop vs fenestrations for celiac artery incorporation during repair of complex abdominal aortic aneurysms.

Objective: Celiac artery (CA) incorporation during fenestrated-branched aortic aneurysm repair (FB-EVAR) for complex abdominal aortic aneurysms (cAAAs) is typically performed with fenestrations. Double-wide scallops (DWS) can be used when appropriate. We aimed to assess outcomes of patients treated with DWSs for the CA during FB-EVAR for cAAAs.

Incidence and predictors of gastrointestinal hemorrhage following mesenteric revascularization.

Objective: Postoperative gastrointestinal hemorrhage (GIH) following mesenteric revascularization when performed either openly (OR) or endovascularly (ER) has been clinically observed but not reported. The aim of the study is to assess the incidence and predictors of GIH in patients undergoing mesenteric revascularization.

Methods: This was a single-center retrospective review of consecutive patients treated with open or endovascular mesenteric revascularization from 2009 to 2019.

Carotid artery replacement with superficial femoral artery in a patient with recurrent radiation-induced carotid artery stenosis.

A 58-year-old man presented with a right hemispheric transient ischemic attack from recurrent common carotid artery (CCA) in-stent restenosis. He had undergone prior neck radiation for carcinoma of the right tonsil and subsequent right carotid endarterectomy (10 years prior) and right CCA stenting (5 years prior), all for symptomatic radiation-induced stenosis. We performed CCA reconstruction using a transposed superficial femoral artery and pectoralis major myocutaneous flap coverage.

Implications and late outcomes of type II endoleaks after endovascular aneurysm repair.

Objective: Type II endoleaks (T2ELs) are the most common cause of reintervention after endovascular aneurysm repair (EVAR). Although most resolve spontaneously, the long-term implications of T2ELs remain elusive. We aim to evaluate the impact of persistent and late T2ELs on clinical outcomes after EVAR.

Fostering Collaborative Teamwork-A Comprehensive Approach to Vascular Graft Infection Following Arterial Reconstructive Surgery.

Vascular graft infection (VGI) is one of the most serious complications following arterial reconstructive surgery. VGI has received increasing attention over the past decade, but many questions remain regarding its diagnosis and management. In this review, we describe our approach to VGI through multidisciplinary collaboration and discuss decision making for challenging presentations.

Executive Summary: State-of-the-Art Review: Fostering Collaborative Teamwork-A Comprehensive Approach to Vascular Graft Infection Following Arterial Reconstructive Surgery.

Vascular graft infection (VGI) is one of the most serious complications following arterial reconstructive surgery. VGI has received increasing attention over the past decade, but many questions remain regarding its diagnosis and management. In this review, we describe our approach to VGI through multidisciplinary collaboration and discuss decision-making for challenging presentations.

National trends in utilization of surgeon-modified grafts for complex and thoracoabdominal aortic aneurysms.

Introduction: Custom-branched/fenestrated grafts are widely available in other countries, but in the United States, they are limited to a handful of centers, with the exception of a 3-vessel juxtarenal device (ZFEN). Consequently, many surgeons have turned to alternative strategies such as physician-modified endografts (PMEGs). We therefore sought to determine how widespread the use of these grafts is.

Cryopreserved arterial allografts vs autologous vein for arterial reconstruction in infected fields.

Objective: Peripheral arterial infections are rare and difficult to treat when an in situ reconstruction is required. Autologous vein (AV) is the conduit of choice in many scenarios. However, cryopreserved arterial allografts (CAAs) are an alternative.