Review
Cardiac & Cardiovascular Systems
He Jiao, Jinghui Li, Yunpeng Bai, Zhigang Guo
Summary: This study compared the outcomes of sequential and individual saphenous vein grafts in coronary artery bypass grafting. The results showed that sequential grafts had higher rates of graft failure and long-term mortality, but also an increased risk of perioperative repeat revascularization. Based on the study, the selection of surgical techniques should be based on patients and surgeons.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2022)
Article
Surgery
Nathan Belkin, Jordan B. Stoecker, Benjamin M. Jackson, Scott M. Damrauer, Julia Glaser, Venkat Kalapatapu, Michael A. Golden, Grace J. Wang
Summary: This study found an increasing proportion of patients receiving DAPT after lower extremity bypass surgery, with DAPT showing better patency outcomes in the prosthetic bypass conduit group. However, overall bypass graft patency and major adverse limb events did not differ significantly between the DAPT and aspirin treatment groups. Further research is needed to determine the optimal duration of DAPT therapy and possible bleeding complications in patients with prosthetic bypass conduits.
JOURNAL OF VASCULAR SURGERY
(2021)
Review
Cardiac & Cardiovascular Systems
Fabiana Baganha, Alwin de Jong, J. Wouter Jukema, Paul H. A. Quax, Margreet R. de Vries
Summary: Obstructive arterial disease is a major cause of morbidity and mortality in the developed world. Venous bypass graft surgery is commonly used despite its failure rate. Vein grafts can fail due to factors like vessel wall remodeling, inflammation, and accelerated atherosclerosis. New insights into the role of immunity in vein graft failure may lead to potential therapeutic options for improving patency.
JOURNAL OF CARDIOVASCULAR TRANSLATIONAL RESEARCH
(2021)
Article
Surgery
Shinsuke Mii, Atsushi Guntani, Sho Yamashita, Masaru Ishida
Summary: This study investigated the association between intra-operative flow waveform and flow volume and graft prognosis in infra-inguinal vein bypass surgery. The results showed that the flow waveform and flow volume are closely correlated with graft patency, and could be used to predict the postoperative graft function.
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Chunyuan Wang, Zhan Hu, Zhihui Hou, Yang Wang, Lei Song, Bo Xu, Changdong Guan, Yu Ning, Wei Feng, Yan Zhang
Summary: This study investigated the impact of preoperative quantitative flow ratio (QFR) on internal mammary artery graft failure rate and patient outcomes. The results showed that grafts on functionally nonsignificant left anterior descending (LAD) arteries had a higher failure rate, and QFR outperformed the degree of stenosis in predicting graft failure. A preoperative QFR of >0.80 was associated with higher graft failure rate at 1 year and worse patient outcomes at the 3.6-year follow-up.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Cardiac & Cardiovascular Systems
Masafumi Ono, Shigetaka Kageyama, Neil O'Leary, Mohammed S. El-Kurdi, Jochen Reinoehl, Eric Solien, Richard W. Bianco, Mirko Doss, Bart Meuris, Renu Virmani, Martijn Cox, Yoshinobu Onuma, Patrick W. Serruys
Summary: This study demonstrates the feasibility and effectiveness of a novel biorestorative graft in an ovine coronary artery bypass graft model, suggesting its potential as an alternative to saphenous vein grafts. These findings could pave the way for the first-in-man trial of using this new material for coronary artery bypass graft patients who struggle with harvesting SVGs.
JACC-BASIC TO TRANSLATIONAL SCIENCE
(2023)
Review
Cardiac & Cardiovascular Systems
Mario Gaudino, Irbaz Hameed, N. Bryce Robinson, Yongle Ruan, Mohamed Rahouma, Ajita Naik, Viola Weidenmann, Michelle Demetres, Derrick Y. Tam, David L. Hare, Leonard N. Girardi, Giuseppe Biondi-Zoccai, Stephen E. Fremes
Summary: This study conducted a network meta-analysis to compare the angiographic patency rates of various conduits used in coronary bypass surgery. The results showed that radial artery and no-touch saphenous vein grafts were associated with significantly lower graft occlusion rates compared to conventionally harvested saphenous vein, with radial artery ranking as the best conduit.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Article
Engineering, Biomedical
Alexander Stahl, Dake Hao, Janos Barrera, Dominic Henn, Sien Lin, Seyedsina Moeinzadeh, Sungwoo Kim, William Maloney, Geoffrey Gurtner, Aijun Wang, Yunzhi Peter Yang
Summary: Conventional synthetic vascular grafts have high failure rates due to mismatched mechanical properties with native vessels and poor regenerative potential. In this study, we developed a new bioactive synthetic vascular graft with tailored pore sizes to promote pro-regenerative macrophage populations and improve vascular regeneration. The grafts showed similar mechanical properties to native blood vessels and maintained patency and vascular regeneration in animal models.
BIOACTIVE MATERIALS
(2023)
Review
Biochemistry & Molecular Biology
Eleonora Mezzetti, Aniello Maiese, Federica Spina, Fabio Del Duca, Alessandra De Matteis, Marco Di Paolo, Raffaele La Russa, Emanuela Turillazzi, Vittorio Fineschi
Summary: Saphenous vein graft (SVG) is a cardiac surgical practice that creates a cardiac bypass in cases of coronary artery obstruction. This paper presents a rare case of SVG aneurysmal rupture that occurred 24 h after surgery. A systematic review of the literature was also conducted to provide a general overview.
Article
Biochemistry & Molecular Biology
Maura Brioschi, Erica Gianazza, Daniele Andreini, Saima Mushtaq, Laura Cavallotti, Fabrizio Veglia, Calogero C. Tedesco, Gualtiero Colombo, Mauro Pepi, Gianluca Polvani, Elena Tremoli, Alessandro Parolari, Cristina Banfi
Summary: Coronary artery bypass graft (CABG) surgery is the preferred treatment for patients with complex multivessel coronary artery disease, but graft occlusion still occurs in a significant proportion. This study found that the preoperative level of mercaptoalbumin (HSA-SH) is independently associated with graft occlusion within 5 years after CABG.
Article
Multidisciplinary Sciences
Gaetan Ploton, Nicolas Brebion, Beatrice Guyomarch, Marc-Antoine Pistorius, Jerome Connault, Jeanne Hersant, Alizee Raimbeau, Guillaume Bergere, Mathieu Artifoni, Cecile Durant, Giovanni Gautier, Romain Dumont, Jean-Manuel Kubina, Claire Toquet, Olivier Espitia
Summary: Upper extremity venous thrombosis (UEVT) accounts for about 10% of venous thrombo-embolic disease, mainly due to central venous line usage. Factors associated with venous recanalization after UEVT include thrombosis associated with central venous catheter, UEVT limited to a venous segment, occlusive thrombosis, presence of a PICC Line, deep and distal thrombosis, and superficial thrombosis of the forearm. Occlusive thrombosis is associated with lack of UEVT recanalization.
Article
Medicine, General & Internal
Louise Y. Sun, Anna Chu, Derrick Y. Tam, Xuesong Wang, Jiming Fang, Peter C. Austin, Christopher M. Feindel, Garth H. Oakes, Vicki Alexopoulos, Natasa Tusevljak, Maral Ouzounian, Douglas S. Lee
Summary: This study developed clinical models to accurately predict the 30-day mortality rates for coronary artery bypass grafting (CABG), surgical aortic valve replacement (AVR), and combined CABG + AVR procedures, utilizing a wide range of data sources. The models showed excellent discrimination and predictive accuracy, offering valuable insights for quality improvement initiatives in institutions performing these cardiac surgeries.
CANADIAN MEDICAL ASSOCIATION JOURNAL
(2021)
Article
Critical Care Medicine
Shamsh P. Shaikh, Maha H. Haqqani, Daniel B. Alfson, Alexandra Forsyth, Fernando Brea, Aaron Richman, Jeffrey J. Siracuse, Denis Rybin, Robert Eberhardt, Alik Farber, Tejal S. Brahmbhatt
Summary: This study retrospectively analyzed the records of patients who underwent autogenous great saphenous vein (GSV) bypass surgery for lower extremity arterial injuries at an ACS verified Level I urban trauma center between 2001 and 2019. The results showed that there were no significant differences in terms of graft patency, ambulatory status, and other factors between patients who underwent ipsilateral GSV bypass and those who underwent contralateral GSV bypass. Therefore, ipsilateral GSV can be used as a durable conduit for bypass in cases of lower extremity arterial trauma, offering comparable long-term graft patency rates and ambulatory status.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2023)
Article
Chemistry, Multidisciplinary
Hyunsu Ha, Ju Young Park, Chan Hee Lee, Deok-Hyeon Son, Soon Won Chung, Sewoom Baek, Kyubae Lee, Kang Suk Lee, Se Won Yi, Mi-Lan Kang, Dae-Hyun Kim, Hak-Joon Sung
Summary: The structural stability of medical devices is achieved by managing stress distribution during organ movement. The use of a vascular cast with a bridge connection effectively suppresses vein dilation, induces healthy flow, promotes healthy functions of vein grafting, and reduces stenosis. This bridge connection acts as a critical element to prevent stress concentrations and improve elastic fixity. Validation of the advantages of the bridge addition is done through computational modeling and experimental studies.
Review
Medicine, General & Internal
Liam Back, Andrew Ladwiniec
Summary: The use of saphenous vein grafts in the surgical management of obstructive coronary artery disease remains high but they have limitations in longevity. The failure rate of saphenous vein grafts can be up to 61% after 10 years of follow-up. Percutaneous coronary intervention has become the favored strategy for revascularization in SVG failure. However, there are challenges such as thrombi formation, friable lesions, and higher rates of myocardial infarction. Studies have shown worse outcomes with SVG PCI compared to native vessel PCI.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Isaac N. Naazie, Isibor Arhuidese, Mohammad S. Abdelgawwad, Jonathan Unkart, Michael S. Conte, Mahmoud B. Malas
Summary: Different patterns of RAASI usage have different associations with outcomes in patients undergoing lower extremity bypass for peripheral arterial disease. Isolated preoperative RAASI use is associated with worse mortality and amputation-free survival, while continuous RAASI use is associated with improved outcomes.
ANNALS OF VASCULAR SURGERY
(2023)
Article
Surgery
Sanuja Bose, Chen Dun, Rebecca Sorber, David P. Stonko, Alex J. Solomon, James H. Black, Ying-Wei Lum, Michael S. Conte, Martin A. Makary, Caitlin W. Hicks
Summary: This study examined the practice patterns of tibial peripheral vascular interventions (PVIs) for the treatment of claudication in the United States. The results showed that tibial PVI was mainly performed by nonvascular surgeons in high-volume practices and high-reimbursement settings. There is a need to reevaluate the indications, education, and reimbursement policies surrounding these procedures.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Surgery
Lewis Meecham, Mathew Popplewell, Gareth Bate, Huw O. B. Davies, Akio Kodama, Michael S. Conte, Andrew W. Bradbury
Summary: The Global Limb Anatomic Staging System (GLASS) is a new method of quantifying the severity of lower limb disease in patients with chronic limb-threatening ischemia. This study found that worsening GLASS stage was associated with reduced immediate technical success and worse outcomes in terms of freedom from reintervention and major adverse limb events. However, further refinement of GLASS may be necessary to fully utilize it as a decision-making tool in clinical practice.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Surgery
Emanuel A. Jaramillo, Eric J. T. Smith, Zachary A. Matthay, Katherine M. Sanders, Jade S. Hiramoto, Warren J. Gasper, Michael S. Conte, James C. Iannuzzi
Summary: Despite controlling for disease severity, racial and ethnic disparities persist in major adverse limb events (MALE) after peripheral vascular intervention (PVI) for chronic limb threatening ischemia (CLTI). This suggests that disease severity does not account for the disparities in outcomes.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Surgery
Eric J. T. Smith, Warren J. Gasper, Peter A. Schneider, Emily Finlayson, Louise C. Walter, Ken E. Covinsky, Michael S. Conte, James C. Iannuzzi
Summary: This study examines cognitive impairment in patients with peripheral arterial disease (PAD) and finds that it is common but often unrecognized. Risk factors for cognitive impairment include age, race, hypertension, prior stroke/TIA, diabetes treated with insulin, and post-traumatic stress disorder (PTSD). The study suggests that cognitive impairment is an underdiagnosed issue in PAD patients and calls for further research on its impact and management.
ANNALS OF VASCULAR SURGERY
(2023)
Article
Surgery
Clara Gomez-Sanchez, Evan Werlin, Thomas Sorrentino, Rym El Khoury, Elizabeth Lancaster, Charles Parks, Brooke Goodman, Monara Dini, James Iannuzzi, Alexander Reyzelman, Michael S. Conte, Warren Gasper
Summary: For CLTI patients requiring TMA, an initial open approach to revascularization is associated with improved healing and higher rates of ambulation compared with endovascular interventions.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Surgery
Katherine M. Sanders, Joyce H. Nacario, Eric J. T. Smith, Emanuel A. Jaramillo, Elizabeth M. Lancaster, Jade S. Hiramoto, Michael S. Conte, James C. Iannuzzi
Summary: This study aimed to evaluate the impact of structured discharge documentation on sex-based disparities. The results showed that there was no significant difference in the proportion of male and female patients prescribed statins after the implementation of structured discharge documentation. Female patients had a higher odds of being prescribed statins at discharge. The study demonstrated the significant role of regional quality improvement projects in eliminating gender disparities among patients.
JOURNAL OF VASCULAR SURGERY
(2023)
Article
Surgery
Iris H. Liu, Rym El Khoury, Bian Wu, Warren J. Gasper, Peter A. Schneider, Jade S. Hiramoto, Shant M. Vartanian, Michael S. Conte
Summary: The SVS WIfI limb staging system is used for risk estimation of major amputation in CLTI and for outcomes comparisons. This retrospective study of 413 CLTI patients who underwent infrainguinal revascularization found that presenting WIfI stage is strongly associated with long-term risks of major amputation and death. Furthermore, effective revascularization is critical in stage 4 disease, and autogenous vein bypass provides durable long-term limb preservation.
JOURNAL OF VASCULAR SURGERY
(2023)
Editorial Material
Surgery
Michael S. Conte
SEMINARS IN VASCULAR SURGERY
(2023)
Article
Multidisciplinary Sciences
Jose L. Lopez, Joel L. Ramirez, Tuan Anh Phu, Phat Duong, Laura Bouchareychas, Christina R. Kuhrau, Pei-Yu Lin, Walter L. Eckalbar, Andrea J. Barczak, Joshua D. Rudolph, Lenka Maliskova, Michael S. Conte, Shant M. Vartanian, Robert L. Raffai, Adam Z. Oskowitz
Summary: This study aimed to identify novel biomarkers for abdominal aortic aneurysms (AAAs) by characterizing the expression profile of microRNAs (miRNA) in circulating exosomes. The study found that miR-122-5p levels were significantly reduced in the exosomes of AAA patients. This suggests that miR-122-5p could potentially be used as a diagnostic biomarker and have implications in AAA pathogenesis.
Article
Peripheral Vascular Disease
Justin Chin-Bong Choi, Jorge Miranda, Erin Greenleaf, Michael S. Conte, Marie D. Gerhard-Herman, Joseph L. Mills, Neal R. Barshes
Summary: This study used the WIfI system to predict limb loss and peripheral artery disease in patients with foot ulcers or gangrene. It found that a toe-brachial index <0.7 and minimum ankle-brachial index <0.9 were effective in identifying patients with severe disease, with high sensitivity rates. The diagnostic accuracy of noninvasive measures varied in identifying different degrees of disease. It also found that the presence of medial artery calcification significantly reduced the sensitivity of other noninvasive parameters.
Article
Surgery
Clara M. Gomez-Sanchez, Michael S. Conte
Summary: Chronic limb-threatening ischemia is difficult to treat due to the complexity of patients, diversity of limb presentations, and complicated arterial pathology. Vascular surgeons require a wide range of skills to tailor interventions to the specific needs of each patient. Inframalleolar bypass is a tool for patients with extensive arterial occlusive disease below the knee, but it requires systematic surgical planning and a high level of technical competence. We describe our approach to inframalleolar bypass for limb preservation in suitable patients with advanced tibial artery disease.
JOURNAL OF VASCULAR SURGERY CASES INNOVATIONS AND TECHNIQUES
(2023)
Review
Endocrinology & Metabolism
Vivienne Chuter, Nicolaas Schaper, Joseph Mills, Robert Hinchliffe, David Russell, Nobuyoshi Azuma, Christian-Alexander Behrendt, Edward J. Boyko, Michael S. Conte, Misty Humphries, Lee Kirksey, Katharine C. McGinigle, Sigrid Nikol, Joakim Nordanstig, Vincent Rowe, Jos C. van den Berg, Maarit Venermo, Robert Fitridge
Summary: Early diagnosis and ongoing monitoring and treatment of peripheral artery disease (PAD) is crucial for reducing the risk of foot ulcer development, non-healing of wounds, infection, amputation, and cardiovascular complications in patients with diabetes. Various non-invasive bedside tests are available for diagnosing PAD, but the most accurate test and its reliability for ongoing monitoring are still uncertain. This systematic review aimed to determine the diagnostic accuracy of non-invasive bedside tests for identifying PAD and their reliability in adults with diabetes. The review included 40 studies on diagnostic accuracy and 7 studies on reliability. Ankle-brachial index (ABI) was the most investigated test. The review found that an ABI <0.9 increases the likelihood of disease, while an ABI within the normal range (≥0.90 and <1.3) does not exclude PAD. Toe-brachial index (TBI) and Doppler waveforms in the pedal arteries were also associated with PAD presence. Several bedside tests showed acceptable reliability, but the margin of error was wide. No single or combination of bedside tests demonstrated superior diagnostic accuracy for PAD in patients with diabetes. However, an ABI of 1.3, TBI <0.70, and absent or monophasic pedal Doppler waveforms can help identify the presence of disease.
DIABETES-METABOLISM RESEARCH AND REVIEWS
(2023)
Article
Surgery
Cindy Huynh, Iris Liu, Rym El Khoury, Bo Zhou, Hillary Braun, Michael S. Conte, Jade Hiramoto
Summary: By incorporating a common iliac artery calcification score into the VQI prediction model, this study improved the accuracy of the 2-year risk calculator. Preoperative assessment of iliac artery calcification may assist with risk stratification and clinical decision-making in patients with chronic limb-threatening ischemia (CLTI) undergoing infrainguinal revascularization.
JOURNAL OF VASCULAR SURGERY
(2023)
Editorial Material
Surgery
Michael S. Conte, Leigh Ann O'Banion
JOURNAL OF VASCULAR SURGERY
(2023)