High-risk carotid plaque features may be more accurate predictors of ipsilateral ischemic stroke risk than the degree of carotid artery stenosis.

Introduction: The optimal management of patients with asymptomatic carotid stenosis (AsxCS) is enduringly controversial. The current stratification of AsxCS patients based on the degree of stenosis alone does not always reflect ipsilateral ischemic stroke risk. We hypothesized that the presence of ≥1 "high-risk" carotid plaque feature may more accurately identify AsxCS patients at high risk for a future ipsilateral ischemic cerebrovascular event.

Clinical Outcomes Following Carotid Intervention in Patients with Radiation-Induced Carotid Artery Stenosis: A Propensity Score-matched Cohort Study.

Background: Radiation therapy, often combined with surgical excision is widely used in treating head and neck neoplasms. A long-term consequence of this therapy is radiation-induced carotid artery stenosis (RICS), with incidence rates reaching 27%. This study aimed to compare clinical outcomes in patients who underwent transfemoral carotid artery stenting (TFCAS) with and without RICS.

Higher All-Cause but Not Aortic-Related Mortality for Women After Abdominal Aortic Aneurysm Repair.

Introduction: Sex-based disparities have been consistently reported after abdominal aortic aneurysm (AAA) repair. This single-center study aimed to identify whether this is a reproducible finding within our institution's cohort following AAA repair.

Methods: This is a single-center retrospective cohort study of patients with AAA who underwent surgical repair (open or endovascular) between 2014 and 2024.

Aortoenteric Fistulas Following Endovascular Aortic Aneurysm Repair: A Review.

BackgroundSecondary aortoenteric fistulas (SAEF) following endovascular aortic repair (EVAR) is an extremely rare event but life threatening. Our review offers comprehensive knowledge on pathophysiology, clinical presentation, diagnosis, and treatment options.AimTo summarize the current literature regarding pathophysiology, clinical, diagnostic and therapeutic approach of aortoenteric fistulas secondary to EVAR.

Urgent Carotid Artery Revascularization Fraught with Higher Rates of Neurovascular Events in Symptomatic Carotid Artery Stenosis.

Background: Symptomatic carotid artery stenosis requires timely intervention to reduce risk of recurrent stroke. However, the optimal timing of revascularization remains debated. This study evaluates outcomes in patients undergoing urgent (<48 hr), early (3-14 days), or delayed (>14 days) carotid artery revascularization.

Height Index and Diameter as Predictors of Outcomes in Males With Abdominal Aortic Aneurysms.

Introduction: Abdominal aortic aneurysms (AAAs) affect over 1 million adults in the United States, with current guidelines recommending elective repair for males at diameters greater than 5.5 cm. While aneurysm diameter (AD) remains the primary predictor of rupture in men, indexed measurements such as the aortic size index (ASI) and aortic height index (AHI) may improve risk stratification.

Impact of estimated plasma volume status on postoperative outcomes in patients undergoing open abdominal aortic aneurysm repair.

Background: Major surgeries often lead to significant insensible fluid losses, posing challenges in achieving optimal fluid balance. Estimated plasma volume status (ePVS), calculated using the Kaplan-Hakim formula from hemoglobin and hematocrit values, serves as a marker for volume status and has been associated with adverse outcomes in various medical conditions. This study aims to explore the correlation of preoperative ePVS with postoperative outcomes in patients undergoing open abdominal aortic aneurysm (AAA) repair.

Chronic Kidney Disease is a Stronger Predictor for Mortality than Charlson Comorbidity Index after Abdominal Aortic Aneurysm Repair.

Background: Patients undergoing abdominal aortic aneurysm (AAA) repair face elevated mortality risk associated with advanced age and comorbidities, including chronic kidney disease (CKD). CKD alone demonstrates an increased risk for mortality in patients. Our cohort study aimed to identify whether CKD and/or comorbid burden using the Charlson Comorbidity Index (CCI) are potential contributors toward negative outcomes in patients who underwent AAA repair.

Delayed malignant appendiceal fistula with ileal conduit following radical cystectomy: A case report.

Fistula formation after radical cystectomy is rare, often presenting early and involving the small bowel. Herein we describe a case of an appendiceal fistula in a patient who underwent chemoradiotherapy and pelvic exenteration over a decade prior to the presentation of their fistula. Initially suspected to be radiation-induced, final pathology revealed a mucinous neoplasm of the appendix, which had fistulized with the ileal conduit.

The future in the management of patients with asymptomatic carotid artery stenosis.

Introduction: The optimal management of patients with asymptomatic (AsxCS) and symptomatic carotid stenosis (SxCS) is still debatable. The present article will discuss emerging technological advances for the diagnosis and management of patients with AsxCS.

Evidence Acquisition: PubMed/MedLine was searched until December 31, 2024 for studies in English discussing emerging technological advances in the diagnosis and management of patients with AsxCS.

Comparison of restenosis and reintervention rates in closed cell stents compared to open cell stents after carotid artery stenting.

Objective: The aim of this study was to compare short- and mid-term outcomes after carotid artery stenting (CAS) related to stent configuration.

Methods: This is a retrospective study of all CAS including transcarotid and transfemoral approaches, performed at our institution from 2015 to 2024. Groups were identified according to the stent used at the index procedure by open-cell stents (OCS) and closed-cell stents (CCS).

Proteomic analysis of carotid artery plaques with and without vulnerable features on magnetic resonance angiography with vessel wall imaging: a pilot study.

Objective: Extracranial carotid artery pathology accounts for 15% to 20% of ischemic strokes. Advancements in magnetic resonance angiography (MRA) with vessel wall imaging (VWI) have enabled the identification of vulnerable plaques, aiding in risk stratification for neurovascular events. This pilot study aimed to identify proteins in plaques with and without vulnerable features on MRA with VWI.

Mortality After Ruptured Abdominal Aortic Aneurysm Repair in Women (Open and Endovascular Approaches): A Literature Review and Meta-Analysis.

Introduction: Ruptured abdominal aortic aneurysm (rAAA) repair outcomes in women have not been extensively studied. The current work examines the outcomes after repair of rAAA in women compared to men. We further analyzed the specific outcomes depending on the type of repair including open surgical repair (OSR) and endovascular repair (EVAR).

Higher Rate of Reinterventions after Transfemoral Carotid Artery Stenting in Symptomatic Patients: A Retrospective Stroke Center's Cohort Study Between 2015-2024.

Background: Carotid artery stenosis is a significant contributor to ischemic strokes, and its surgical management includes carotid artery endarterectomy (CEA), transfemoral carotid artery stenting (TF-CAS), and transcarotid artery revascularization (TCAR). CEA has traditionally been preferred, but TF-CAS and TCAR are also excellent alternative options if the anatomy of the vessels allows them. This study reports our short- and mid-term outcomes after carotid artery revascularization in symptomatic patients at a stroke center.

Lipidomic Expression Analysis in Carotid Atherosclerotic Disease: A Systematic Review.

Background: Lipids are key molecules for atherosclerosis, with tight regulation mechanisms, making them potential biomarkers for disease-specific diagnostics and therapeutics. Therefore, we aim to perform a systematic literature review on lipidomic analysis in serum/plasma and plaque samples of patients with carotid atherosclerosis.

Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on the lipidomic profile in serum/plasma and carotid artery plaques from patients with significant carotid disease by degree of stenosis in preoperative imaging and clinical presentation (symptomatic, asymptomatic, and radiation-induced carotid disease).

Presentation, treatment, and outcomes of brachial artery aneurysms.

Objective: Brachial artery aneurysms are rare entities that have typically been associated with trauma, infection, arteriovenous fistula creation, or connective tissue disorders. These aneurysms are often asymptomatic, but they can also cause local tenderness or thrombo-embolic events. Due to the very low incidence of true brachial artery aneurysms, there are no standardized guidelines on their optimal management.

New Trends of Personalized Medicine in the Management of Abdominal Aortic Aneurysm: A Review.

Abdominal aortic aneurysm (AAA) is a significant vascular condition characterized by the dilation of the abdominal aorta, presenting a substantial risk of rupture and associated high mortality rates. Current management strategies primarily rely on aneurysm diameter and growth rates to predict rupture risk and determine the timing of surgical intervention. However, this approach has limitations, as ruptures can occur in smaller AAAs below surgical thresholds, and many large AAAs remain stable without intervention.

Intraplaque Hemorrhage and Plaque Ulceration Are More Likely in Patients with Symptomatic Mild-to-Moderate Carotid Artery Stenosis than in Symptomatic and Asymptomatic High-Grade Stenosis: A Retrospective Cohort Study.

Background: To compare a cohort of symptomatic patients with mild-to-moderate (<70%) carotid artery stenosis (CAS) with those patients with high-grade (≥70%) CAS (symptomatic and asymptomatic) to assess for markers that places them at a higher risk for stroke.

Methods: A propensity score-matched cohort study design for all patients who underwent carotid revascularization between 2015 and 2024 was utilized to compare the high-grade (≥70%) symptomatic and asymptomatic carotid stenosis groups against the mild to moderate (<70%) symptomatic carotid stenosis group. Matched variables included age, sex, and atrial fibrillation.

Gender Parity Among Vascular Surgeons: Progress and Attrition.

Introduction: Improving representation of women in medicine and surgery has been tempered by higher rates of attrition from residencies and from academic medicine among women compared to men. The attrition of women from the practicing vascular surgery workforce has not been studied.

Methods: We utilized the Center for Medicare and Medicaid Services' Doctors and Clinicians database to study vascular surgery employment patterns from 2015 to 2022.

Nutcracker syndrome (a Delphi consensus).

Background: Nutcracker syndrome (NCS) describes the symptomatic compression of the left renal vein between the aorta and superior mesenteric artery. Whereas asymptomatic compression is a common radiological finding, patients with NCS can report a range of symptoms. There are no specific diagnostic criteria and interventions include a range of open surgical and endovascular procedures.

Recent advances in proteomic analysis to study carotid artery plaques.

Objective: We sought to identify differentially expressed proteins in serum, plasma, and plaque samples of patients with carotid atherosclerotic lesions.

Methods: We performed a systematic review of the proteomic profile of serum, plasma, and plaque samples of patients with carotid artery disease. We included full-length peer-reviewed studies of adult humans and reported them using PRISMA guidelines.