Harmondiaz3040

001), total operating time (325 ± 116 minutes in Q1 to 248 ± 92 minutes in Q4; P  less then .001), total fluoroscopy time (121 ± 59 minutes in Q1 to 85 ± 39 minutes in Q4; P  less then .001), contrast volume (201 ± 92 mL in Q1 to 160 ± 61 mL in Q4; P = .002), and radiation dose (4141 ± 2570 mGy in Q2 to 2543 ± 1895 mGy in Q4; P  less then .001). Independent predictors of MAEs were total operating time (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.3-1.8; P  less then .001), Society for Vascular Surgery total score (OR, 1.1; 95% CI, 1.02-1.2; P = .009), and quartile 1 (OR, 3.0; 95% CI, 1.7-5.2; P  less then .001). CONCLUSIONS This study demonstrates significant improvement in perioperative mortality, MAEs, procedural variables, and secondary interventions in patients treated by F-BEVAR, despite the increase in complexity of aneurysm pathology during the study period. Also, better patient selection contributed to improve outcomes. OBJECTIVE Seat belt aorta is rare and difficult to manage. The lack of data and follow-up increases the complexity of treating such patients. We aimed to create a decision algorithm by reviewing our current experience and analyzing the presentation and management of our patients. METHODS We performed a descriptive case series based on retrospective analysis of all consecutive patients admitted with the diagnosis of seat belt aorta from 2008 to 2018. Seat belt aorta was defined as any blunt abdominal aortic lesion resulting from a seat belt compression mechanism after a car accident. RESULTS Nine consecutive patients were admitted with the diagnosis of seat belt aorta, all of whom developed lesions in the infrarenal aorta. Eight patients were assessed in the acute phase and one patient presented with late-onset symptoms. Associated injuries were present in all acute patients, and seat belt sign and small bowel injury were present in 88%. One patient presented with a small intimal tear and was treated conservatively. All other patients diagnosed with large intimal flaps (seven patients) and pseudoaneurysm (one patient) underwent open repair in five cases and endovascular repair in three cases. In-hospital mortality for the acute cases was 38%, with no mortality seen during follow-up. Two patients submitted to endovascular repair required reinterventions. CONCLUSIONS Seat belt aorta is a deadly condition, frequently associated with blunt thoracoabdominal trauma with concomitant injuries; the presence of a seat belt sign or lower limb ischemia must lead to a high diagnostic suspicion. Management must take into account the other concomitant injuries. Follow-up is crucial as most patients are young; they may develop complications and subsequently require further intervention. OBJECTIVE The objective of this study was to determine whether calf muscle hemoglobin oxygen saturation (Sto2) obtained during a standardized treadmill test is associated with ambulatory function and health-related quality of life (HRQoL) in patients with symptomatic peripheral artery disease (PAD). We hypothesized that a rapid decline in calf muscle Sto2 during walking is associated with impaired ambulatory function and HRQoL and that these associations are independent of ankle-brachial index (ABI). METHODS Calf muscle Sto2, peak walking time, and claudication onset time were obtained during a treadmill test in 151 symptomatic men and women with PAD. Patients were further characterized by demographic variables, comorbid conditions, cardiovascular risk factors, ABI, 6-minute walk distance, daily ambulatory activity, Walking Impairment Questionnaire (WIQ) score, and Medical Outcomes Study 36-Item Short Form Health Survey physical function score to assess HRQoL. RESULTS The median calf muscle Sto2 value at restne in oxygen saturation of the calf musculature during walking, indicative of impaired microcirculation, is predictive of impaired ambulatory function and HRQoL in patients with symptomatic PAD. Of particular importance, these associations are independent of ABI and other common health burdens, highlighting the clinical relevance that the microcirculation has on ambulatory function and HRQoL in patients with symptomatic PAD. BACKGROUND The aim of this study was to report midterm outcomes (up to 72 months) of patients who received femoropopliteal helical interwoven nitinol stents (Supera Peripheral Stent System, Abbott Laboratories, Inc, Webster, Tex). METHODS Prospectively collected data on patients treated with femoropopliteal non-drug-eluting angioplasty and helical interwoven nitinol stents were retrospectively analyzed. Patients were followed up with 6, 12, 18, 24, 36, 48, 60, and 72 months clinical, duplex, and radiographic assessments. Restenosis is defined as 50% or greater restenosis of the target lesion on duplex ultrasound imaging. RESULTS From October 2011 to September 2018, 315 patients (198 males) with 360 legs and a median age of 78 years (range, 46-100 years) were included. Symptoms of claudication, rest pain, and tissue loss were found in 212 (58.9%), 53 (14.7%), and 150 (41.7%) legs, respectively. In 176 (48.9%) legs, stents were placed in the popliteal segments. The mean stented lesion length was 119.0 mm (range, 40-450 mm). The overall primary patency rates at 6, 12, 24, 36, 48, 60, and 72 months were 90.6%, 80.5%, 73.8%, 68.9%, 65.3%, 63.1%, and 63.1%, respectively. The ankle-brachial pressure index increased from 0.58 ± 0.18 preoperatively to 0.87 ± 0.16 postoperatively. learn more There were no stent fractures on follow-up. Patency rate was not statistically affected by indication of treatment, lesion calcification, or diabetes, but the length of stents and involvement of popliteal arteries were statistically significantly worse (log-rank test, P = .011 and P = .005). Stents with inner diameters of 4-mm had an initial lower patency compared with 5-mm stents, but the patency rates merged and crossed over at 46 months (log-rank test, P = .131). There was no procedural- or device-related morbidity or mortality, and there were nine major amputations after revascularization. CONCLUSIONS This study provides long-term clinical data demonstrating that Supera stents are effective and durable.