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Article ; Online: The Effect of Chronic and End-Stage Renal Disease on Long-Term Outcomes after Infrainguinal Bypass.

Cheng, Thomas W / Farber, Alik / Kalish, Jeffrey A / King, Elizabeth G / Rybin, Denis / Siracuse, Jeffrey J

2023 Volume 94, Page(s) 129–135

Abstract: Background: Patients undergoing infrainguinal bypass for chronic limb threatening ischemia (CLTI) with renal dysfunction are at an increased risk for perioperative and long-term morbidity and mortality. Our goal was to examine perioperative and 3-year ... ...

Abstract	Background: Patients undergoing infrainguinal bypass for chronic limb threatening ischemia (CLTI) with renal dysfunction are at an increased risk for perioperative and long-term morbidity and mortality. Our goal was to examine perioperative and 3-year outcomes after lower extremity bypass for CLTI stratified by kidney function. Methods: A retrospective, single-center analysis of lower extremity bypass for CLTI was performed between 2008 and 2019. Kidney function was categorized as normal (estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m Results: There were 221 infrainguinal bypasses performed for CLTI. Patients were classified by renal function as normal (59.7%), CKD (24.4%), and ESRD (15.8%). Average age was 66 years and 65% were male. Overall, 77% had tissue loss with 9%, 45%, 24%, and 22% being Wound, Ischemia, and foot Infection stages 1-4, respectively. The majority (58%) of bypass targets was infrapopliteal and 58% used ipsilateral greater saphenous vein. The 90-day mortality and readmission rates were 2.7% and 49.8%, respectively. ESRD, compared to CKD and normal renal function, respectively, had the highest 90-day mortality (11.4% vs. 1.9% vs. 0.8%, P = 0.002) and 90-day readmission (69% vs. 55% vs. 43%, P = 0.017). On multivariable analysis, ESRD, but not CKD, was associated with higher 90-day mortality (odds ratio (OR) 16.9, 95% confidence interval (CI) 1.83-156.6, P = 0.013) and 90-day readmission (OR 3.02, 95% CI 1.2-7.58, P = 0.019). Kaplan-Meier 3-year analysis showed no difference between groups for primary patency or major amputation; however, ESRD, compared to CKD and normal renal function, respectively, had worse primary-assisted patency (60% vs. 76% vs. 84%, P = 0.03) and survival (72% vs. 96% vs. 94%, P = 0.001). On multivariable analysis, ESRD and CKD were not associated with 3-year primary patency loss/death, but ESRD was associated with higher primary-assisted patency loss (hazard ratio (HR) 2.61, 95% CI 1.23-5.53, P = 0.012). ESRD and CKD were not associated with 3-year major amputation/death. ESRD was associated with higher 3-year mortality (HR 4.95, 95% CI 1.52-16.2, P = 0.008) while CKD was not. Conclusions: ESRD, but not CKD, was associated with higher perioperative and long-term mortality after lower extremity bypass for CLTI. Although ESRD was associated with lower long-term primary-assisted patency, there were no differences in loss of primary patency or major amputation.
MeSH term(s)	Humans ; Male ; Aged ; Female ; Risk Factors ; Retrospective Studies ; Peripheral Arterial Disease/diagnostic imaging ; Peripheral Arterial Disease/surgery ; Treatment Outcome ; Limb Salvage ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/diagnosis ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Endovascular Procedures/adverse effects ; Chronic Limb-Threatening Ischemia ; Ischemia/diagnostic imaging ; Ischemia/surgery ; Lower Extremity/blood supply
Language	English
Publishing date	2023-05-05
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2023.04.020
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Article ; Online: Selective use of endovascular techniques in the management of vascular trauma.

Kalish, Jeffrey

Seminars in vascular surgery

2010 Volume 23, Issue 4, Page(s) 243–248

Abstract: Endovascular techniques have become crucial to the success of many elective and emergent vascular surgical cases. Although diagnostic angiography has always played a central role in the evaluation and management of vascular trauma, interventions such as ... ...

Abstract	Endovascular techniques have become crucial to the success of many elective and emergent vascular surgical cases. Although diagnostic angiography has always played a central role in the evaluation and management of vascular trauma, interventions such as stent grafting and coil embolization are increasingly being used as treatment modalities. Research exists to support the selective use of endovascular techniques in the management of blunt and penetrating vascular trauma, and specific scenarios and indications will be reviewed here. To ensure the most favorable outcomes, vascular interventionalists must always be aware of the limitations of these techniques as well as the limitations facing them in their hospital practice environments.
MeSH term(s)	Blood Vessels/injuries ; Endoscopy/methods ; Humans ; Vascular Surgical Procedures/methods ; Wounds and Injuries/surgery
Language	English
Publishing date	2010-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645131-7
ISSN	1558-4518 ; 0895-7967
ISSN (online)	1558-4518
ISSN	0895-7967
DOI	10.1053/j.semvascsurg.2010.10.004
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Zs.A 2503: Show issues

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Article ; Online: High Mortality and Venous Thromboembolism Risk Following Major Penetrating Abdominal Venous Injuries.

Haqqani, Maha H / Levin, Scott R / Kalish, Jeffrey A / Brahmbhatt, Tejal S / Richman, Aaron P / Siracuse, Jeffrey J / Farber, Alik / Jones, Douglas W

Annals of vascular surgery

2021 Volume 76, Page(s) 193–201

Abstract: Background: Penetrating injuries to the inferior vena cava and/or iliac veins are a source of hemorrhage but may also predispose patients to venous thromboembolism (VTE). We sought to determine the relationship between iliocaval injury, VTE and ... ...

Abstract	Background: Penetrating injuries to the inferior vena cava and/or iliac veins are a source of hemorrhage but may also predispose patients to venous thromboembolism (VTE). We sought to determine the relationship between iliocaval injury, VTE and mortality. Methods: The National Trauma Data Bank was queried for penetrating abdominal trauma from 2015-2017. Univariate analyses compared baseline characteristics and outcomes based on presence of iliocaval injury. Multivariable analyses determined the effect of iliocaval injury on VTE and mortality. Results: Of 9,974 patients with penetrating abdominal trauma, 329 had iliocaval injury (3.3%). Iliocaval injury patients were more likely to have a firearm mechanism (83% vs. 43%, P < 0.001), concurrent head (P = 0.036), spinal cord (P < 0.001), and pelvic injuries (P < 0.001), and higher total injury severity score (median 20 vs. 8.0, P < 0.001). They were more likely to undergo 24-hr hemorrhage control surgery (69% vs. 17%, P < 0.001), but less likely to receive VTE chemoprophylaxis during admission (64% vs. 68%, P = 0.04). Of patients undergoing iliocaval surgery, 64% underwent repair, 26% ligation, and 10% unknown. Iliocaval injury patients had higher rates of VTE (12% vs. 2%), 24-hr mortality (23% vs. 2.0%) and in-hospital mortality (33% vs. 3.4%) (P < 0.001 for all). VTE rates were similar following repair (14%) and ligation (17%). Iliocaval injury patients also had higher rates of cardiac complications (10.3% vs. 1.4%), acute kidney injury (8.2% vs. 1.3%), extremity compartment syndrome (4.0 vs. 0.2%), and unplanned return to OR (7.9% vs. 2.5%) (P < 0.001 for all). In multivariable analyses, iliocaval injury was independently associated with risk of VTE (OR 2.12; 95% CI, 1.29-3.48; P = 0.003), and in-hospital mortality (OR = 9.61; 95% CI, 4.96-18.64; P < 0.001). Conclusion: Iliocaval injuries occur in <5% of penetrating abdominal trauma but are associated with more severe injury patterns and high mortality rates. Regardless of repair type, survivors should be considered high risk for developing VTE.
MeSH term(s)	Abdominal Injuries/diagnosis ; Abdominal Injuries/epidemiology ; Abdominal Injuries/mortality ; Abdominal Injuries/surgery ; Adult ; Databases, Factual ; Female ; Humans ; Iliac Vein/injuries ; Iliac Vein/surgery ; Ligation ; Male ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; United States/epidemiology ; Vascular Surgical Procedures ; Vascular System Injuries/diagnosis ; Vascular System Injuries/epidemiology ; Vascular System Injuries/mortality ; Vascular System Injuries/surgery ; Vena Cava, Inferior/injuries ; Vena Cava, Inferior/surgery ; Venous Thromboembolism/diagnosis ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/mortality ; Wounds, Penetrating/diagnosis ; Wounds, Penetrating/epidemiology ; Wounds, Penetrating/mortality ; Wounds, Penetrating/surgery ; Young Adult
Language	English
Publishing date	2021-06-19
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2021.06.002
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Article ; Online: Vascular surgery-related violations of the Emergency Medical Treatment and Labor Act.

Cheng, Thomas W / Farber, Alik / Forsyth, Alexandra M / Levin, Scott R / Haqqani, Maha / Kalish, Jeffrey A / Siracuse, Jeffrey J

Journal of vascular surgery

2021 Volume 74, Issue 2, Page(s) 599–604.e1

Abstract: Objective: The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law established in 1986 to ensure that patients who present to an emergency department receive medical care regardless of means. Violations are reported to the Centers for ... ...

Abstract	Objective: The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law established in 1986 to ensure that patients who present to an emergency department receive medical care regardless of means. Violations are reported to the Centers for Medicare and Medicaid Services and can result in significant financial penalties. Our objective was to assess all available EMTALA violations for vascular-related issues. Methods: EMTALA violations in the Centers for Medicare and Medicaid Services publicly available hospital violations database from 2011 to 2018 were evaluated for vascular-related issues. Details recorded were case type, hospital type, hospital region, reasons for violation, disposition, and mortality. Results: There were 7001 patients identified with any EMTALA violation and 98 (1.4%) were deemed vascular related. The majority (82.7%) of EMTALA violations occurred at urban/suburban hospitals. Based on the Association of American Medical Colleges United States region, vascular-related EMTALA violations occurred in the Northeast (7.1%), Southern (56.1%), Central (18.4%), and Western (18.4%) United States. Case types included cerebrovascular (28.6%), aortic related (22.4%; which consisted of ruptured aortic aneurysms [8.2%], aortic dissection [11.2%], and other aortic [3.1%]), vascular trauma (15.3%), venous-thromboembolic (15.3%), peripheral arterial disease (9.2%), dialysis access (5.1%), bowel ischemia (3.1%), and other (1%) cases. Patients were transferred to another facility in 41.8% of cases. The most common reasons for violation were specialty refusal or unavailability (30.6%), inappropriate documentation (29.6%), misdiagnosis (18.4%), poor communication (17.3%), inappropriate triage (13.3%), failure to obtain diagnostic laboratory tests or imaging (12.2%), and ancillary or nursing staff issues (7.1%). The overall mortality was 19.4% and 31.6% died during the index emergency department visit. Vascular conditions associated with death were venous thromboembolism (31.6%), ruptured aortic aneurysm (21.1%), aortic dissection (21.1%), other aortic causes (10.5%), vascular trauma (10.5%), and bowel ischemia (5.3%). Conclusions: Although the frequency of vascular-related EMTALA violations was low, improvements in communication, awareness of vascular disease among staff, specialty staffing, and the development of referral networks and processes are needed to ensure that patients receive adequate care and that institutions are not placed at undue risk.
MeSH term(s)	Centers for Medicare and Medicaid Services, U.S./legislation & jurisprudence ; Databases, Factual ; Delivery of Health Care/legislation & jurisprudence ; Emergency Service, Hospital/legislation & jurisprudence ; Government Regulation ; Health Policy/legislation & jurisprudence ; Hospital Mortality ; Humans ; Liability, Legal ; Malpractice/legislation & jurisprudence ; Medical Errors/legislation & jurisprudence ; Patient Safety/legislation & jurisprudence ; Patient Transfer/legislation & jurisprudence ; Practice Patterns, Physicians'/legislation & jurisprudence ; Refusal to Treat/legislation & jurisprudence ; Retrospective Studies ; Surgeons/legislation & jurisprudence ; United States ; Vascular Surgical Procedures/adverse effects ; Vascular Surgical Procedures/legislation & jurisprudence ; Vascular Surgical Procedures/mortality
Language	English
Publishing date	2021-02-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2020.12.110
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Article ; Online: Inadequate Adherence to Imaging Surveillance and Medical Management in Patients with Duplex Ultrasound-Detected Carotid Artery Stenosis.

Boelitz, Kris / Jirka, Caroline / Eberhardt, Robert T / Kalish, Jeffrey A / Siracuse, Jeffrey J / Farber, Alik / Jones, Douglas W

Annals of vascular surgery

2021 Volume 74, Page(s) 63–72

Abstract: Background: It is recommended that patients with ≥50% carotid artery stenosis undergo surveillance imaging and atherosclerotic risk reduction medical therapies, regardless of whether revascularization is performed. The objective of this study was to ... ...

Abstract	Background: It is recommended that patients with ≥50% carotid artery stenosis undergo surveillance imaging and atherosclerotic risk reduction medical therapies, regardless of whether revascularization is performed. The objective of this study was to determine rates of adherence to these recommended measures and to identify risk factors for nonadherence. Methods: A retrospective analysis was performed of all carotid duplex ultrasound (DUS) from 2016 to 2017 at a single institution. Patients with unilateral or bilateral ≥50% carotid stenosis were included. Primary outcomes were rates and timing of surveillance imaging and medication regimen. Patient and study characteristics were compared using univariate and multivariable analyses. A subgroup analysis of patients with a new finding of carotid stenosis was also performed. Results: Carotid stenosis >50% was detected in 340 patients. Overall, 182 patients (54%) had follow-up imaging (median 261 days [IQR 166-366]) and 158 patients (46%) had no imaging follow-up (NIFU). NIFU patients had similar rates of aspirin use (86% vs. 88%, P = 0.6) and tobacco cessation counseling (71% vs. 71%, P = 0.8) but had less statin use (85% vs. 94%, P = 0.01) compared to those with imaging follow-up. Subsequent carotid revascularization was more common in patients with imaging follow-up (18% vs. 3%, P < 0.001). NIFU patients were less likely to have Medicare or commercial insurance (54% vs. 75%, P < 0.001). The indication for DUS in NIFU patients, compared to those in follow up, was less commonly neurologic symptoms (11% vs. 14%), more commonly other clinical findings (35% vs. 16%), and more commonly as work up before nonvascular surgery (25% vs. 4%, P < 0.001), respectively. NIFU rates decreased with increasing degree of carotid stenosis. Prior carotid intervention, prior DUS, or DUS ordered by a vascular surgeon were characteristics associated with imaging follow-up (P < 0.05 for all). In a subgroup of 160 patients with new carotid stenosis, a majority (64%) had NIFU and statin use was lower in these patients (82% vs. 96%, P = 0.007). On multivariable analysis, preop indication was predictive of NIFU (odds ratio [OR] 8.1 [95% confidence interval, CI 2.5-26.4], P < 0.001) whereas protective factors included: 70-80% stenosis (OR 0.33 [95% CI 0.14-0.76], P = 0.01), study ordered by vascular surgeon (OR 0.40 [95% CI 0.19-0.83], P = 0.01), and Medicare/commercial insurance (OR 0.36 [95% CI 0.2-0.66], P = 0.001). Conclusions: Nearly half of patients found to have ≥50% carotid stenosis on DUS had no imaging follow-up; these patients were less likely to be on recommended statin therapy. The benefits of nonrevascularization-based treatments for carotid disease require adherence to therapy. Forgoing surveillance imaging in patients with hemodynamically significant carotid stenosis should be a shared decision between provider and patient and does not obviate the need for medical therapies.
MeSH term(s)	Aged ; Carotid Stenosis/diagnostic imaging ; Carotid Stenosis/drug therapy ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Male ; Multivariate Analysis ; Patient Acuity ; Patient Compliance/statistics & numerical data ; Retrospective Studies ; Ultrasonography, Doppler, Duplex ; Watchful Waiting
Chemical Substances	Hydroxymethylglutaryl-CoA Reductase Inhibitors
Language	English
Publishing date	2021-01-27
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2020.12.027
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Article ; Online: Bilateral Popliteal Artery Entrapment Syndrome in a Young Female NCAA Division-I Collegiate Basketball Player: A Case Report.

Koehler, Rikki M / Cimbak, Nicole C / Parisien, Robert L / Nicoletta, Robert J / Kalish, Jeffrey A

JBJS case connector

2020 Volume 10, Issue 3, Page(s) e19.00652

Abstract: Case: Popliteal artery entrapment syndrome (PAES) is rarely on the differential for exertional lower extremity pain in the young athlete. This article illustrates a case of a 20-year-old female National Collegiate Athletic Association (NCAA) Division-I ... ...

Abstract	Case: Popliteal artery entrapment syndrome (PAES) is rarely on the differential for exertional lower extremity pain in the young athlete. This article illustrates a case of a 20-year-old female National Collegiate Athletic Association (NCAA) Division-I college basketball player who was diagnosed with PAES after conservative treatment of medial tibial stress syndrome and comprehensive evaluation for chronic exertional compartment syndrome. She received bilateral popliteal artery releases through a posterior approach and made an asymptomatic return to Division-I collegiate basketball. Conclusion: PAES is a rare potentially limb-threatening disease that must be included on the differential of young athletes who present with exertional lower extremity pain.
MeSH term(s)	Angiography ; Basketball/injuries ; Female ; Humans ; Popliteal Artery Entrapment Syndrome/diagnostic imaging ; Popliteal Artery Entrapment Syndrome/rehabilitation ; Popliteal Artery Entrapment Syndrome/surgery ; Vascular Surgical Procedures ; Young Adult
Language	English
Publishing date	2020-10-24
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	2160-3251
ISSN (online)	2160-3251
DOI	10.2106/JBJS.CC.19.00652
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Article ; Online: Nationwide patterns in industry payments to academic vascular surgeons.

Cheng, Thomas / Boelitz, Kris / Rybin, Denis / Menard, Matthew T / Kalish, Jeffrey / Siracuse, Jeffrey J / Farber, Alik / Jones, Douglas W

Journal of vascular surgery

2020 Volume 73, Issue 2, Page(s) 675–681

Abstract: Objective: Financial relationships between vascular surgeons and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly ... ...

Abstract	Objective: Financial relationships between vascular surgeons and industry are essential to the development and adoption of innovative technology. However, these relationships may establish competing interests. Our objective was to describe publicly available financial transactions between industry and academic vascular surgeons. Methods: Academic vascular surgeons were identified and characterized on the basis of publicly available data correlated with Accreditation Council for Graduate Medical Education and Association of American Medical Colleges data to identify academic practice settings. Vascular surgeons were linked to Open Payments data for 2017 as reported by the Centers for Medicare & Medicaid Services. Univariate and nonparametric tests were used for analysis. Results: Of 1158 academic vascular surgeons identified, 997 (86%) received industry payments totaling $8,548,034. Overall, the median of total payments received was $814 (interquartile range [IQR], $124-$2863). The top paid decile of vascular surgeons received $29,645 (IQR, $16,128-$61,701). Payments to the top decile accounted for 81% of all payments. Payments did not vary by academic rank but did vary by sex, with male vascular surgeons (n = 954) receiving $889 (IQR, $146-$3217) vs female vascular surgeons (n = 204) receiving $467 (IQR, $87-$1533; P = .002). By leadership role, division chiefs received the highest median payment amount ($1571; IQR, $368-$11,281) compared with department chairs ($424; IQR, $56-$2698) and vascular surgeons without leadership role ($769; IQR, $117-$2592; P = .002). Differences in payments were also seen on the basis of U.S. census region: Northeast, $571 (IQR, $90-2462); Midwest, $590 (IQR, $75-$2364); South, $1085 (IQR, $241-$3405); and West, $1044 (IQR, $161-$4887; P = .001). The most common categories of payments were food and beverage (paid to 85% of all vascular surgeons), travel and lodging (35%), and consulting fees (13%). Among the top decile of vascular surgeons, median payments exceeded $10,000 for three categories: consulting fees, compensation, and honoraria. Payments were made by 178 distinct entities with median total payments of $286 (IQR, $70-$6285). The three top entities paid a total of $5,004,061, which accounted for 59% of all payments. Payments from at least one of the top three entities reached 76% of vascular surgeons. Conclusions: Most academic vascular surgeons receive publicly reported industry payments that are paid by a limited number of entities, typically for food and beverage or travel and lodging. The top 10% of vascular surgeons received higher median payment amounts, totaling 81% of all industry payments. Vascular surgeons should be aware of publicly reported payment information and the potential for conflicts of interest.
MeSH term(s)	Centers for Medicare and Medicaid Services, U.S. ; Conflict of Interest/economics ; Disclosure ; Female ; Financial Support ; Gift Giving ; Health Care Sector/economics ; Health Care Sector/trends ; Humans ; Male ; Retrospective Studies ; Surgeons/economics ; Surgeons/trends ; United States ; Vascular Surgical Procedures/economics ; Vascular Surgical Procedures/trends
Language	English
Publishing date	2020-06-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2020.04.527
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Article ; Online: Recurrent Lower-Extremity Compartment Syndrome after Four-Compartment Fasciotomy Secondary to Acute Limb Ischemia.

Kerkar, Ashwini P / Farber, Alik / Kalish, Jeffrey A / Siracuse, Jeffrey J

Annals of vascular surgery

2016 Volume 30, Page(s) 306.e5–7

Abstract: Lower-extremity compartment syndrome is a limb-threatening event necessitating emergent treatment using fasciotomy. Recurrent compartment syndrome is rare and has only been reported after trauma and in conjunction with underlying connective tissue ... ...

Abstract	Lower-extremity compartment syndrome is a limb-threatening event necessitating emergent treatment using fasciotomy. Recurrent compartment syndrome is rare and has only been reported after trauma and in conjunction with underlying connective tissue disorders. In this report, we present a case of recurrent lower-extremity compartment syndrome caused by ischemia-reperfusion injury, in a patient previously treated with adequate 4-compartment fasciotomies. As such, this is the first reported case of recurrent compartment syndrome in the setting of ischemia-reperfusion injury that required treatment with 4-compartment fasciotomies on both occasions. This case demonstrates that fasciotomy is not protective against the development of recurrent compartment syndrome due to ischemia-reperfusion injury and that patients at high risk require monitoring.
MeSH term(s)	Acute Disease ; Compartment Syndromes/diagnosis ; Compartment Syndromes/etiology ; Compartment Syndromes/surgery ; Fasciotomy ; Humans ; Lower Extremity/blood supply ; Male ; Middle Aged ; Recurrence ; Reperfusion Injury/complications ; Reperfusion Injury/diagnosis ; Reperfusion Injury/therapy
Language	English
Publishing date	2016-01
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	1027366-9
ISSN	1615-5947 ; 0890-5096
ISSN (online)	1615-5947
ISSN	0890-5096
DOI	10.1016/j.avsg.2015.06.092
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Article ; Online: Femoral vein transposition is a durable hemodialysis access for patients who have exhausted upper extremity options.

Farber, Alik / Cheng, Thomas W / Nimmich, Andrew / Jones, Douglas W / Kalish, Jeffrey A / Eslami, Mohammad H / Hardouin, Scott / Siracuse, Jeffrey J

Journal of vascular surgery

2019 Volume 71, Issue 3, Page(s) 929–936

Abstract: Objective: Access surgeons often encounter patients with end-stage renal disease who have exhausted all upper extremity hemodialysis access options. Although the lower extremity is often the next alternative, prosthetic lower extremity access can be ... ...

Abstract	Objective: Access surgeons often encounter patients with end-stage renal disease who have exhausted all upper extremity hemodialysis access options. Although the lower extremity is often the next alternative, prosthetic lower extremity access can be prone to infectious complications and historically has poor patency. We describe our contemporary experience with an autogenous femoral vein transposition (FVT) arteriovenous fistula. Methods: All FVTs performed at an academic medical center from 2006 to 2018 were analyzed. FVTs were placed after upper extremity access was deemed no longer possible by the treating surgeon. Patient demographics, comorbidities, and access history were described, and perioperative and short-term outcomes, including maturation, were analyzed. Results: Twenty-one patients treated with FVT were identified. The mean age was 55.3 ± 11.1 years; 23.8% were female, and 71.4% were African American. The median body mass index was 27.1 kg/m Conclusions: Although autogenous FVT performed in patients without upper extremity options has a significant wound complication rate, it is associated with an outstanding maturation rate and excellent patency rates at 1 year. This access should be readily considered in hemodialysis patients without upper extremity access options.
MeSH term(s)	Arteriovenous Shunt, Surgical ; Female ; Femoral Vein/surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Renal Dialysis ; Retrospective Studies ; Upper Extremity/blood supply ; Vascular Patency
Language	English
Publishing date	2019-09-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	605700-7
ISSN	1097-6809 ; 0741-5214
ISSN (online)	1097-6809
ISSN	0741-5214
DOI	10.1016/j.jvs.2019.07.062
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Article: Approach to resection of sternoclavicular tumor abutting the common carotid artery in irradiated field.

Muñoz-Largacha, Juan A / Slama, Jaromir / Kalish, Jeffrey / Jalisi, Scharukh / Litle, Virginia R / Suzuki, Kei

Journal of thoracic disease

2018 Volume 10, Issue 1, Page(s) E38–E41

Abstract: Head and neck cancer recurrence at the sternoclavicular junction (SCJ) in irradiated field poses a special challenge in terms of surgical planning. We herein present a case of tonsillar squamous cell cancer recurrence at the SCJ in a patient with history ...

Abstract	Head and neck cancer recurrence at the sternoclavicular junction (SCJ) in irradiated field poses a special challenge in terms of surgical planning. We herein present a case of tonsillar squamous cell cancer recurrence at the SCJ in a patient with history of tracheostomy and head and neck radiation. We describe our preoperative planning for vascular control and possible reconstruction as well as our approach for safe resection.
Language	English
Publishing date	2018-03-26
Publishing country	China
Document type	Case Reports
ZDB-ID	2573571-8
ISSN	2077-6624 ; 2072-1439
ISSN (online)	2077-6624
ISSN	2072-1439
DOI	10.21037/jtd.2017.12.60
Database	MEDical Literature Analysis and Retrieval System OnLINE

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