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  1. Article ; Online: The New Virus Tells the Old Story.

    Goldschmidt, Eric / Lurie, Fedor

    European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery

    2021  Volume 61, Issue 4, Page(s) 635

    MeSH term(s) COVID-19 ; Critical Illness ; Embolism ; Humans ; SARS-CoV-2
    Language English
    Publishing date 2021-01-09
    Publishing country England
    Document type Journal Article ; Comment
    ZDB-ID 1225869-6
    ISSN 1532-2165 ; 1078-5884
    ISSN (online) 1532-2165
    ISSN 1078-5884
    DOI 10.1016/j.ejvs.2020.12.014
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Surgical removal of a foreshortened right innominate vein Wallstent causing venous outflow obstruction.

    Schafer, Kristin / Goldschmidt, Eric / Seiwert, Andrew

    Vascular

    2022  Volume 31, Issue 3, Page(s) 594–597

    Abstract: Objectives: Stenting of central venous stenosis to preserve upper extremity hemodialysis access is well-described, though upper extremity complications secondary to these stents are less frequently discussed.: Methods: We present the case of a 43- ... ...

    Abstract Objectives: Stenting of central venous stenosis to preserve upper extremity hemodialysis access is well-described, though upper extremity complications secondary to these stents are less frequently discussed.
    Methods: We present the case of a 43-year-old male with a right brachiocephalic fistula who developed symptoms of venous hypertension following placement of a Wallstent for central venous stenosis. Workup demonstrated venous outflow obstruction secondary to stent foreshortening into the right subclavian vein.
    Results: The Wallstent was removed in a piecemeal fashion using an open surgical technique and a HeRO graft was placed for dedicated fistula outflow with complete relief of the patient's symptoms.
    Conclusion: In situations where a stent has migrated and endovascular removal is not possible, individual Wallstent fibers can be removed through a limited venotomy.
    MeSH term(s) Male ; Humans ; Adult ; Brachiocephalic Veins/diagnostic imaging ; Brachiocephalic Veins/surgery ; Constriction, Pathologic ; Vascular Patency ; Subclavian Vein/diagnostic imaging ; Subclavian Vein/surgery ; Stents ; Renal Dialysis ; Arteriovenous Shunt, Surgical/adverse effects ; Hypertension ; Treatment Outcome
    Language English
    Publishing date 2022-01-03
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2137151-9
    ISSN 1708-539X ; 1708-5381
    ISSN (online) 1708-539X
    ISSN 1708-5381
    DOI 10.1177/17085381211068996
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: A systematic review on the treatment of nonhealing venous ulcers following successful elimination of superficial venous reflux.

    Goldschmidt, Eric / Schafer, Kristin / Lurie, Fedor

    Journal of vascular surgery. Venous and lymphatic disorders

    2021  Volume 9, Issue 4, Page(s) 1071–1076.e1

    Abstract: Objective: Nonhealing leg ulcers are frequently associated with the saphenous vein reflux. Despite the success of endovascular ablations, there are patients who either fail to heal or develop recurrent ulcers. This systematic review aims to summarize ... ...

    Abstract Objective: Nonhealing leg ulcers are frequently associated with the saphenous vein reflux. Despite the success of endovascular ablations, there are patients who either fail to heal or develop recurrent ulcers. This systematic review aims to summarize the available evidence on how to treat these patients after successful elimination of superficial reflux.
    Methods: A systematic review was performed following the PRISMA guidelines. The MEDLINE and Embase databases were searched for full text articles in English from 1946 to July 31, 2020. All articles that did not specifically mention the treatment of persistent venous ulcers or superficial venous reflux associated with healed or active venous ulcers were eliminated. The remaining abstracts were read for mention of either recurrent or persistent venous ulcers and, if mentioned, the full article was reviewed. All study designs were included. Study selection, data extraction and risk of bias assessment were performed by two independent reviewers.
    Results: Four eligible studies including a total of 161 patients (177 limbs) with C6 disease were included in the review after the screening of 546 identified articles. A total of 62 patients were treated for persistent or recurrent venous ulcers after treatment of superficial reflux. Treatments included four-layer compression dressings, repeat ablations of superficial veins, and endovenous ablation of incompetent perforator veins. Overall, successful healing was noted in 50% of patients undergoing repeat ablative procedures, 100% of patients treated solely with four-layer compression dressings, and 90% of patients treated with compression and successful ablation of incompetent perforator veins. Across all studies the presence of deep vein reflux was 31% (50 of 164 limbs), post-thrombotic (secondary) ulcers 13.7% (16 of 117), and proximal obstruction was present in a single patient. Superficial venous reflux was treated using endovenous ablation (either radiofrequency ablation or laser), foam sclerotherapy, and endovenous radiofrequency ablation with or without microphlebectomy procedures. The frequency of persistent ulcers after elimination of superficial reflux ranged from 2.3% at 2 years after the intervention to 21.1% at 1 year with follow-up ranging from 6 to 52 months.
    Conclusions: Although further studies are warranted to improve the quality of evidence, it seems that additional ablative procedures to address incompetent perforating veins and persistent superficial reflux in combination with ongoing compression therapy is effective in healing persistent or recurrent venous ulcers after the elimination of superficial venous reflux.
    MeSH term(s) Compression Bandages ; Endovascular Procedures ; Humans ; Laser Therapy ; Radiofrequency Ablation ; Recurrence ; Sclerotherapy ; Varicose Ulcer/physiopathology ; Varicose Ulcer/surgery ; Varicose Ulcer/therapy ; Wound Healing
    Language English
    Publishing date 2021-02-26
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Systematic Review
    ISSN 2213-3348
    ISSN (online) 2213-3348
    DOI 10.1016/j.jvsv.2020.12.085
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Salvage of a megafistula causing high-output cardiac failure in a young adult with aneurysmorrhaphy and banding.

    Goldschmidt, Eric / Schafer, Kristin / Hariri, Nizar / Seiwert, Andrew / Lurie, Fedor

    The journal of vascular access

    2021  Volume 24, Issue 4, Page(s) 832–835

    Abstract: We present the case of a 21-year-old male with significant lengthening and aneurysmal degeneration of his brachiocephalic arteriovenous fistula resulting in a megafistula and high-output cardiac failure. A computed tomography angiogram showed narrowing ... ...

    Abstract We present the case of a 21-year-old male with significant lengthening and aneurysmal degeneration of his brachiocephalic arteriovenous fistula resulting in a megafistula and high-output cardiac failure. A computed tomography angiogram showed narrowing at the cephalic arch. Further evaluation during the operation revealed kinking and elongation of the fistula in addition to compression of the cephalic arch in the deltopectoral groove leading to outflow obstruction. The aneurysmal fistula was treated successfully with aneurysmorrhaphy of the remaining conduit and banding of the inflow. This case demonstrates a unique etiology of venous outflow obstruction for a fistula and describes the surgical approach to its treatment in a young patient suffering from cardiac failure.
    MeSH term(s) Male ; Humans ; Young Adult ; Adult ; Arteriovenous Shunt, Surgical/adverse effects ; Arteriovenous Shunt, Surgical/methods ; Renal Dialysis ; Treatment Outcome ; Heart Failure/diagnostic imaging ; Heart Failure/etiology ; Heart Failure/surgery ; Fistula
    Language English
    Publishing date 2021-11-11
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2252820-9
    ISSN 1724-6032 ; 1129-7298
    ISSN (online) 1724-6032
    ISSN 1129-7298
    DOI 10.1177/11297298211055615
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Norepinephrine-Induced Peripheral Ischemia Leading to Gangrene: A Case Series.

    Wilson, Michael / Schafer, Kristin / Goldschmidt, Eric / Wu, Benita / Simman, Richard

    Advances in skin & wound care

    2021  Volume 34, Issue 5, Page(s) 273–277

    Abstract: Abstract: Norepinephrine is used in the acute care setting to establish and maintain hemodynamic stability in patients with hypotension. Although it is often a lifesaving medication, norepinephrine may lead to profound vascular insufficiency in the ... ...

    Abstract Abstract: Norepinephrine is used in the acute care setting to establish and maintain hemodynamic stability in patients with hypotension. Although it is often a lifesaving medication, norepinephrine may lead to profound vascular insufficiency in the extremities, resulting in dry gangrene and skin necrosis. The purpose of this article is to present a case series of skin complications related to treatment with norepinephrine and review the pathophysiology behind these complications. The authors also explore risk stratification as it relates to history and clinical presentation with subsequent focus on contingencies to mitigate the adverse effects of vasoconstriction on peripheral tissues.
    MeSH term(s) Aged ; Case-Control Studies ; Female ; Gangrene/etiology ; Gangrene/physiopathology ; Humans ; Ischemia/complications ; Ischemia/etiology ; Ischemia/physiopathology ; Male ; Middle Aged ; Norepinephrine/adverse effects ; Norepinephrine/pharmacology ; Peripheral Vascular Diseases/etiology ; Vasoconstrictor Agents/adverse effects ; Vasoconstrictor Agents/pharmacology
    Chemical Substances Vasoconstrictor Agents ; Norepinephrine (X4W3ENH1CV)
    Language English
    Publishing date 2021-04-14
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2012792-3
    ISSN 1538-8654 ; 1527-7941
    ISSN (online) 1538-8654
    ISSN 1527-7941
    DOI 10.1097/01.ASW.0000741528.49437.2c
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Defining the role of risk stratification and duplex ultrasound in the diagnosis of acute lower extremity deep vein thrombosis.

    Schafer, Kristin / Goldschmidt, Eric / Oostra, Drew / Kaminski, Brian / Mattin, Mike / Lurie, Fedor

    Journal of vascular surgery. Venous and lymphatic disorders

    2022  Volume 10, Issue 5, Page(s) 1021–1027

    Abstract: Objective: Risk stratification using the plasma D-dimer level and Wells score has been proposed as a safe strategy to rule out acute lower extremity deep vein thrombosis (DVT) and limit the use of duplex ultrasound (DUS) for low-risk patients. A widely ... ...

    Abstract Objective: Risk stratification using the plasma D-dimer level and Wells score has been proposed as a safe strategy to rule out acute lower extremity deep vein thrombosis (DVT) and limit the use of duplex ultrasound (DUS) for low-risk patients. A widely used diagnostic protocol defining the role of pretest probability and D-dimer testing in lieu of DUS has not been reported. Our aim was to define the risk of DVT in a standard population of emergency department patients who had presented with acute lower extremity symptoms and determine the role of DUS for these patients.
    Methods: Outpatients presenting to the emergency department with symptoms concerning for lower extremity DVT were prospectively enrolled. All the patients underwent whole leg DUS and clinical and laboratory assessments for DVT using the Wells criteria and plasma D-dimer testing. The patients were stratified into three groups according to the combination of their Wells score and plasma D-dimer level. The prevalence of DVT and the statistical performance of the combined Wells score and plasma D-dimer were compared.
    Results: A total of 3087 patients were enrolled. Most of the patients had had a negative plasma D-dimer level and Wells score (n = 2290 patients). A total of 222 patients had had a positive plasma D-dimer level and Wells score. The overall prevalence of acute DVT in the present study was 7.3%. Of the 2290 patients with a negative Wells score and negative plasma D-dimer level, 4 had had a diagnosis of DVT (negative predictive value, 99.8%). In contrast, DVT was present in 181 of 222 patients (81.5%) with a positive Wells score and plasma D-dimer level (positive predictive value, 81.5%). The plasma D-dimer level also correlated with the DVT location, and the D-dimer levels were highest for the patients with proximal DVT.
    Conclusions: The combination of a negative Wells score and negative plasma D-dimer level can safely exclude the presence of DVT. Patients with a negative Wells score and negative plasma D-dimer level are unlikely to benefit from DUS. In contrast, patients with a positive D-dimer level and positive Wells score will benefit from whole leg DUS to rule out the presence of high-risk DVT.
    MeSH term(s) Humans ; Lower Extremity ; Predictive Value of Tests ; Risk Assessment ; Ultrasonography, Doppler, Duplex ; Venous Thrombosis/diagnosis
    Language English
    Publishing date 2022-03-17
    Publishing country United States
    Document type Journal Article
    ISSN 2213-3348
    ISSN (online) 2213-3348
    DOI 10.1016/j.jvsv.2022.02.017
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The clinical significance of ultra-high D-dimer levels.

    Schafer, Kristin / Goldschmidt, Eric / Oostra, Drew / Fish, John / Russell, Todd / Lurie, Fedor

    Journal of vascular surgery. Venous and lymphatic disorders

    2021  Volume 10, Issue 1, Page(s) 8–13

    Abstract: Objective: Plasma D-dimer levels >5000 ng/mL are encountered in a number of conditions other than venous thromboembolism (VTE). Recent studies have used plasma D-dimer levels as a prognostic indicator for coronavirus disease 2019 (COVID-19) infection. ... ...

    Abstract Objective: Plasma D-dimer levels >5000 ng/mL are encountered in a number of conditions other than venous thromboembolism (VTE). Recent studies have used plasma D-dimer levels as a prognostic indicator for coronavirus disease 2019 (COVID-19) infection. The implications of abnormal levels are less clear for patients diagnosed with COVID-19 with a baseline elevation in plasma D-dimer levels. In the present study, we reviewed the occurrence of plasma D-dimer levels >5000 ng/mL and investigated the clinical significance of this finding before the onset of the COVID-19 pandemic.
    Methods: Inpatient records for a 4-year period were screened for laboratory results of plasma D-dimer levels >5000 ng/mL. The patient data were reviewed for the clinical identifiers commonly associated with elevated plasma D-dimer levels, including VTE, cancer, sepsis, pneumonia, other infection, bleeding, and trauma. The patients were then categorized into groups stratified by the plasma D-dimer level to allow for comparisons between the various clinical diagnoses.
    Results: A total of 671 patients were included in the present study. VTE was the most common diagnosis for patients with a plasma D-dimer level >5000 ng/mL, followed by cancer and pneumonia. Multiple clinical diagnoses were present in 61% of the patients. No clear cause for the ultra-high plasma D-dimer level could be identified in 11.3% of the patients. Among the patients lacking a clinical diagnosis at discharge, mortality was 24% in the 5000- to 10,000-ng/mL group, 28.6% in the 10,000- to 15,000-ng/mL group, and 75% in the >15,000-ng/mL group.
    Conclusions: VTE, cancer, and pneumonia were frequently present when ultra-high plasma D-dimer levels were encountered, and mortality was high when the levels were >15,000 ng/mL. The results from our study from a pre-COVID-19 patient population suggest that ultra-high plasma D-dimer levels indicate the presence of severe underlying disease. This should be considered when using the plasma D-dimer level as a screening tool or prognostic indicator for COVID-19 infection.
    MeSH term(s) Aged ; Biomarkers/blood ; COVID-19/blood ; COVID-19/complications ; COVID-19/epidemiology ; Cross-Sectional Studies ; Female ; Fibrin Fibrinogen Degradation Products/metabolism ; Follow-Up Studies ; Humans ; Male ; Ohio/epidemiology ; Pandemics ; Retrospective Studies ; Time Factors ; Venous Thromboembolism/blood ; Venous Thromboembolism/etiology
    Chemical Substances Biomarkers ; Fibrin Fibrinogen Degradation Products ; fibrin fragment D
    Language English
    Publishing date 2021-06-23
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Observational Study
    ISSN 2213-3348
    ISSN (online) 2213-3348
    DOI 10.1016/j.jvsv.2021.06.011
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Rapidly Expanding Renal Artery Aneurysm Open Repair: A Case Report.

    Schafer, Kristin / Al-Balbissi, Laith / Goldschmidt, Eric / Afridi, Sophia / Lurie, Fedor

    Vascular and endovascular surgery

    2020  Volume 55, Issue 3, Page(s) 286–289

    Abstract: Renal artery aneurysms are rare occurrences, representing less than 1% of all aneurysms in the general population. Little is known about the natural history and optimal management of these aneurysms. We report a 58-year-old female patient with bilateral ... ...

    Abstract Renal artery aneurysms are rare occurrences, representing less than 1% of all aneurysms in the general population. Little is known about the natural history and optimal management of these aneurysms. We report a 58-year-old female patient with bilateral renal artery aneurysms with significant rapid growth of the right aneurysm on 1-year follow-up. Due to her age and the anatomical complexity of the aneurysm, the patient was not a candidate for endovascular repair. She therefore underwent open repair of the right renal artery aneurysm with resection and primary anastomosis. This case offers an example of surgical management of this rare disease process.
    MeSH term(s) Anastomosis, Surgical ; Aneurysm/diagnostic imaging ; Aneurysm/surgery ; Disease Progression ; Female ; Humans ; Middle Aged ; Renal Artery/diagnostic imaging ; Renal Artery/surgery ; Treatment Outcome ; Vascular Surgical Procedures
    Language English
    Publishing date 2020-10-14
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2076272-0
    ISSN 1938-9116 ; 1538-5744
    ISSN (online) 1938-9116
    ISSN 1538-5744
    DOI 10.1177/1538574420966114
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The Effect of Patient Oral Intake Status on Abdominal Aortic Ultrasound Visualization.

    Goldschmidt, Eric / Al-Embideen, Somya / Abbas, Jihad / Russell, Todd / Paolini, David / Al-Balbissi, Laith / Lurie, Fedor

    Annals of vascular surgery

    2021  Volume 74, Page(s) 204–208

    Abstract: Background: The standard abdominal aortic duplex ultrasound protocol requires fasting for 8-12 hours prior to examination in attempt to reduce bowel gas and improve visualization. Such practice results in frequent testing delays and patient non- ... ...

    Abstract Background: The standard abdominal aortic duplex ultrasound protocol requires fasting for 8-12 hours prior to examination in attempt to reduce bowel gas and improve visualization. Such practice results in frequent testing delays and patient non-compliance. The aim of this study was to determine whether fasting improves visualization of the abdominal aorta in patients undergoing duplex ultrasound or influences diagnostic properties.
    Methods: This was a prospective, randomized, double-blind imaging trail at a single institution. Ninety patients were randomized to one of three dietary groups, including NPO, clear liquids or control (regular diet). Diagnostic ultrasound examinations were performed by accredited Registered Vascular Technologists who remained blinded to the patients' diet. Sonographers commented on the presence of limited visualization in the study based on their ability to accurately measure aortic diameter. Examination results were randomly assigned to interpreting physicians who were also blinded to the patients' diet. Following interpretation, the reading physician was asked to comment whether they had sufficient information for a conclusive diagnostic interpretation.
    Results: All ultrasound studies were deemed diagnostic by the interpreting physician regardless of the patients' dietary status. Limited visualization was reported in 19 of the 90 study patients (21.1%) with no significant difference existing between the dietary groups (P = 0.344). The NPO group contained the most patients with studies deemed to have limited visualization.
    Conclusion: Oral intake status did not affect visualization of the abdominal aorta or the rate of diagnostic studies in patients undergoing DUS at a single center. These results suggest that dietary restrictions prior to DUS evaluation of the abdominal aorta is unnecessary.
    MeSH term(s) Aged ; Aged, 80 and over ; Aortic Aneurysm, Abdominal/diagnostic imaging ; Diet/adverse effects ; Double-Blind Method ; Drinking ; Eating ; Fasting ; Humans ; Middle Aged ; Ohio ; Pilot Projects ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Ultrasonography, Doppler, Duplex
    Language English
    Publishing date 2021-02-05
    Publishing country Netherlands
    Document type Comparative Study ; Journal Article ; Randomized Controlled Trial
    ZDB-ID 1027366-9
    ISSN 1615-5947 ; 0890-5096
    ISSN (online) 1615-5947
    ISSN 0890-5096
    DOI 10.1016/j.avsg.2020.12.035
    Database MEDical Literature Analysis and Retrieval System OnLINE

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