Journal of Vascular Surgery – October 2020 Audiovisual Summary

Abstract

Hello! My name is Peter Lawrence and I am pleased to introduce the October issue of the Journal of Vascular Surgery and highlight three outstanding papers that are freely available for the next month. The CME article and Editors' Choice for this issue is “Retrograde open mesenteric stenting should be considered as the initial approach to acute mesenteric ischemia,” by Andraska et al.1Andraska E. Haga L. Li X. Avgerinos E. Singh M. Chaer R. et al.Retrograde open mesenteric stenting should be considered as the initial approach to acute mesenteric ischemia.J Vasc Surg. 2020; 72: 1260-1268Abstract Full Text Full Text PDF Scopus (10) Google Scholar These investigators compared open mesenteric stenting as an alternative to traditional bypass in patients who present with acute mesenteric ischemia. All patients at the University of Pittsburgh Medical Center who presented with acute mesenteric ischemia from 2008 to 2019 were included. Thirty-four patients either underwent mesenteric bypass or retrograde stenting in approximately equal numbers. The procedural time in the operating room was significantly longer with a bypass. Within 1 year, 1 stent thrombosed, requiring later mesenteric bypass; 1 initial bypass thrombosed, resulting in perioperative death; and 1 bypass anastomosis stenosed, requiring angioplasty. Complication, reintervention, and mortality rates were otherwise similar between groups, so the authors concluded that retrograde stenting should be the first option patients with acute mesenteric ischemia. The next article by Sher et al, “Safety and feasibility of transradial infrainguinal peripheral arterial disease interventions,”2Sher A. Posham R. Vouyouka A. Patel R. Lookstein R. Faries P. et al.Safety and feasibility of transradial infrainguinal peripheral arterial disease interventions.J Vasc Surg. 2020; 72: 1237-1246Abstract Full Text Full Text PDF Scopus (4) Google Scholar analyzes the use of newer length wires and catheters to treat infrainguinal peripheral arterial disease. Thirty-two patients with peripheral arterial disease who had a left radial artery that measured more than 2 mm underwent peripheral intervention. Treated vessels included the common femoral, superficial femoral, deep femoral, popliteal, tibioperoneal trunk, tibial, and plantar arteries. Interventions included angioplasty, atherectomy, and stenting. Procedural success was 100%, with a later failure rate of 11%. The clinical success rate was 89%. At a median follow-up of 286 days, adverse events included a radial artery pseudoaneurysm, access site hematoma/bleeding, radial artery occlusion, groin hematoma, popliteal artery dissection, and a superficial femoral artery perforation. No patients had a cerebrovascular event or distal embolism. The authors concluded that transradial interventions are a useful option for treating patients with peripheral arterial disease. The final article highlighted this month is “Arterial reconstruction with human bioengineered acellular blood vessels in patients with peripheral arterial disease,” by Gutowski et al.3Gutowski P. Gage S.M. Guziewicz M. Ilzecki M. Kazimierczak A. Kirkton P.D. et al.Arterial reconstruction with human bioengineered acellular blood vessels in patients with peripheral arterial disease.J Vasc Surg. 2020; 72 (discussion: 1258): 1247-1257Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar These investigators have developed a tissue-engineered human acellular vessel (HAV) that can be manufactured, stored on site at hospitals, and be immediately available for arterial vascular reconstruction. HAVs were manufactured using human vascular smooth muscle cells grown on a biodegradable scaffold. After adequate cell growth and extracellular matrix deposition, the vessels were decellularized to remove human cellular antigens. The manufactured vessels were implanted in 20 patients with peripheral arterial disease as above-knee, femoral-to-popliteal arterial bypass conduits. All HAVs had no structural failure or rejection by the recipient. One vessel developed a pseudoaneurysm during a balloon thrombectomy. No amputations occurred over the 2-year period. Early clinical experience with these vessels in the arterial position suggests that they are safe, have acceptable patency, have a low incidence of infection, and do not require the harvest of autologous vein. Histologic examination of tissue biopsies revealed vascular remodeling and repopulation by host cells. Thank you for watching! For more information, please follow us on social media and remember to like, comment, and share! We hope you enjoy these three highlighted papers and the other excellent papers in this month's Journal of Vascular Surgery. Remember that these articles are free to read until the end of October! The video accompanying this article may be found online at www.jvascsurg.org. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiIzMzM1Mzk1YWI3OTJjMTEzOTc1NThkNDdkMWU1MDBkMiIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjQ4MTE5Nzc5fQ.edaIRV5rfl1Xt_qFGgITuC20kBnRuW-A3pcS_kM-qhyxj7m8YrUt4xfYfr0_gh4w-cmD5DudAq1Jwhqo77ioEgNSqtOiSjww7ka2q7C87VlBxH9zwk8otCnVPew9FHBT8CN_Ko0z614N3DS_zpsMyuy44aywm-tAMxOIAlhaITamGqeO6-OczLZ5Ebl3-Gv0DEPx3XqTRavck4cyIm9B1C0u71WqnM7rgPoAG_H0eTZvdm18ZObdXOYHhSZu1YF8bEK2ZgcX_Ud-fzI1DuRAkmu9yQpTbGneEEqvXXsuSKDByzNK518aMmx2M3i3fA0hXqXMZyDiQyy7YNVPgezHCw Download .mp4 (24.58 MB) Help with .mp4 files Video