METHODS: Between July 1, 2005 and June 30, 2013, we placed 142 stent grafts in 73 patients (1.9 stent grafts/stenotic artery) for lower extremity occlusive disease who also underwent at least one DU surveillance study documenting a patent stent graft. Stent grafts were placed in 27 iliac and 36 femoro-popliteal arteries and 11 failing infrainguinal bypass grafts. Devices used were Viabahn [116 (82%)], Wallgraft [23 (16%)], Fluency [2 (1%)], and iCast [1 (1%)]. Mean follow-up was 16 months (1 week-86 months). Postoperative DU surveillance was performed in our ICAVL accredited non-invasive vascular lab at 1 week, then every three months the first year and every 6 months thereafter. DU measured peak systolic velocities (PSVs) and ratio of adjacent PSVs (Vr) every 5 cms within the stent graft and adjacent arteries. RESULTS: We retrospectively classified the following factors as abnormal DU findings: focal PSV > 300 cms/s, uniform PSVs < 50 cms/s throughout the graft, and Vr > 3.0. Fifteen of 20 patients with one or more of these abnormal DU findings underwent prophylactic intervention (8) or occluded without intervention (7) while only 1 of 53 with normal DU findings occluded (p=0.001). Excluding the 8 patients who underwent prophylactic intervention, 7 of 12 patients with abnormal DU findings went on to occlude without intervention vs. 1 of 53 with normal DU findings (p=0.001). CONCLUSIONS: These findings suggest that follow-up DU surveillance can predict failure of stent grafts placed for lower extremity occlusive disease. Focal PSV > 300 cm/s, uniform PSVs <50 cm/s throughout the stent graft, or Vr > 3.0 were statistically reliable markers for predicting stent graft thrombosis. AUTHOR DISCLOSURES: K.D. Calligaro: Nothing to disclose; M.J. Dougherty: Nothing to disclose; N.J. Madden: Nothing to disclose; D.A. Troutman: Nothing to disclose. L1: Late-Breaking Clinical Trial Session
2:10 – 3:05 p.m. uBallroom A/B, Level 3
At the end of this session, participants should be able to: 1. Discuss the methodology, results and conclusions of the research presented in vascular health. 2. Identify new technology for diagnosis and treatment of vascular disease. Moderators: Benjamin W. Starnes, MD, University of Washington, Seattle, Wash. Jason T. Lee, MD, Stanford University Medical Center, Stanford, Calif.
L1:
symptomatic Carotid Stenosis Impairs Cognitive A Function: Preliminary Results of the ACCOF Study
2:10 p.m.
Brajesh K. Lal,1,2,3 Moira C. Dux,4 Siddhartha Sikdar,3 Limin Zhao,1 Khalid AlMuhanna,3 Gregory Kowalewski,2 Murad Hossian.3 1 Vascular Surgery, University of Maryland School of Medicine, Baltimore, Md.; 2 Vascular Surgery, VA Medical Center, Baltimore, Md.; 3 Bioengineering, George Mason University, Fairfax, Va.; 4 Neuropsychology, VA Medical Center, Baltimore, Md.
OBJECTIVES: Vascular comorbidities (diabetes, hypertension, coronary disease and hyperlipidemia) cause vascular cognitive impairment (VCI). The Asymptomatic Carotid Stenosis and Cognitive Function (ACCOF) study is the first attempt to identify the isolated impact of asymptomatic carotid stenosis (ACS) on cognitive function; stenosis patients were Vascular Annual Meeting 2014 • June 5 – 7, 2014 • Boston, Massachusetts
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