Endovascular procedures are frequently performed in patients for peripheral arterial disease (PAD) with good results and at minimal risk to most pa- tients. However, there is a paucity of data exam- ining the safety and efficacy of lower extremity (LE) angiograms for limb ischemia in the elder- ly.1e5 Frailty indices have been employed with increasing frequency in an attempt to assist physi- cians with risk stratification and to predict out- comes for patients prior to surgical procedures. Although more prevalent in the general surgery literature, several frailty indices have been studied in patients undergoing vascular procedures. The 11-factor modified frailty index (MFI-11) has been validated as a tool to evaluate frailty and stratify a vascular patient’s risk; however, nonage- narian patients are largely excluded from these studies and some of the studies are broad in their application to patients beyond limb ischemia.6e8 This is increasingly relevant for the treatment of PAD as the population of the United States ages, particularly in geographic areas in which the elderly population has a more robust functional status than the national average..  Read More>>

TCAR is a patient-friendly, endovascular procedure that incorporates the neuroprotection principles of CEA. It utilizes the ENROUTE® Transcarotid Neuroprotection System to temporarily reverse blood flow away from the brain, collecting any potential debris in the device filter, before returning the blood to a vessel in the leg. With reverse flow neuroprotection established, the ENROUTE® Transcarotid Stent is then implanted in the lesion for long-term plaque stabilization and stroke prevention.  Read More>>

The Central Coast Medical Association stands firmly in support of our public health servants and their recommendations throughout the coronavirus pandemic. Based solely on science, these policies are in place to protect the health and safety of our communities as we hasten a return to “normal life.” As health professionals, they are driven by the science of protecting human life through good, sound public health measures. It is that simple. Read More>>

The happiest place on earth. You may think I'm talking about the Central Coast, but I recently attended the California Medical Association's House of Delegates (HOD) in Anaheim at the Disneyland Hotel. I, along with over 400 other physicians from around the state, discussed and debated many of the most salient issues affeting our state, our patients, and the medical community.  Read More>>

The Central Coast Medical Association has named Dr. Kevin Casey as president of its 2020 Board of Directors. Dr. Casey has been a member of the Central Coast Medical Association since 2016. He has been active with CCMA's state affiliate, the California Medical Association, where he has worked on policies and legislation that affects physicians and patients. Read More>>

Thoracic outlet syndrome (TOS) is a complex medi-cal condition. Rather than one entity, it is instead three different processes each causing external compression on either the subclavian artery, subclavian vein, and/or the brachial plexus. Neuro- genic (nTOS) is the most common (80%), followed by venous (vTOS; 20%) and arterial (aTOS; <1%). While surgery is frequently not the initial treatment for nTOS, first rib resection (FRR) is the standard therapy for arterial and venous TOS. Read More>>

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Clinical Research Article Links:

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The Society for Clinical Vascular Surgery

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Annals of Vascular Survery

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US National Library of Medicine National Institutes of Health - PubMed

Recent global health initiatives have been focused on the need for universal access to surgical and anesthesia care, provided safely through a collaborative approach between surgeons, anesthesiologists, and host nation (HN) partners. The United States Naval Ship (USNS) Mercy (T-AH-19) has been partici-pating in humanitarian assistance missions (HAMs) for over a decade. Pacific Partnership is the largest annual multilateral humanitarian assistance and disaster relief preparedness mis-sion conducted in the Indo-Pacific region. Read More>>

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Case Report Article Links:

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Sage Journals

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Augusta University

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US National Library of Medicine National Institutes of Health - PubMed

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Society for Clinical Vascular Surgery​

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Research Gate

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ePosters Online

The Global War on Terror (GWOT) remains the longest sustained conflict in our nation’s history. The mor-tality during Operation Iraqi Freedom and Operation From the Division of Vascular Surgery, Department of General Surgery, Enduring Freedom is significantly lower than in previous conflicts. Despite this improvement, service members have endured significant injuries during the past 12 years. Improvised explosive devices and other explosions have been the cause of a significant number of injuries in Iraq and Afghanistan.  Read More>>

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Article in Press Links:

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Journal of Vascular Surgery​

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Science Direct - Elsevier

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US National Library of Medicine National Institute of Health - PubMed

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Research Gate

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Academia

Pseudoaneurysms (PSAs) of the tibial vessels are rare but have been reported following both blunt and penetrating trauma. Iatrogenic causes have also been described follow-ing orthopedic procedures. Treatment modalities include ultrasound guided thrombin injection, endovascular stenting, external compression, coil embolization, and operative liga-tion or repair.  Various clinical and anatomic factors influence the best approach for each individual patient. We present a case of a patient treated for a large, traumatic PSA in the proximal aspect of the anterior tibial artery (ATA) in Papua New Guinea during the Pacific Partner-ship 2015 (PP15) onboard the United States Naval Ship (USNS) Mercy (T-AH-19).  Read More>>

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Military Medicine Links:

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Oxford Academic

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US National Library of Medicine National Institutes of Health - PubMed

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Research Gate

Iliac artery aneurysms are frequently found in conjunc-tion with aortic aneurysms and isolated iliac aneurysms are uncommon. The incidence of hypogastric artery aneurysms (HAAs) is exceedingly low, occurring in <0.0001% of the population.1,2 Mycotic HAAs have rarely been described in the literature.3-5 The best treat-ment of this rare entity may be different from and more challenging than that of a mycotic aortoiliac aneu-rysm. We present the case of a patient with an infected HAA and discuss a unique approach to treatment of this unusual entity. The patient consented to publication of this case.  Read More>>

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Case Report Links:

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Journal of Vascular Surgery

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US National Library of Medicine National Institutes of Health - PubMed

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Research Gate

The conflicts in Iraq and Afghanistan have extended over a decade, making the Global War on Terror the longest war in which the United States has been directly involved. One of the signature injury patterns is a major single injury or multiple extremity injuries secondary to blast-related trauma. Improvised explosive devices are the most common cause of such extremity injuries. Blast-related injuries exhibit a complex injury pattern, with both high- and low-velocity penetrating and blunt mechanisms of injury that often result in extensive soft-tissue and bony destruction.3 These patients suffer from high rates of concomitant vascular and neurologic injuries and severe orthopedic and soft-tissue extremity patterns of injury.  Read More>>

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Links:

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Plastic and Reconstructive Surgery - PRS Journal

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Annals of Vascular Surgery

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US National Library of Medicine National Institutes of Health - PubMed

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Europe PMC

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Academia

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Ovid Article

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Research Gate​

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Watch YouTube Video

Extremity injuries continue to predominate in the current war in Afghanistan and recently comp-leted war in Iraq. Compared with prior conflicts, troops wounded during the Global War on Terror (GWOT) sustained a significant number of injuries to the extremities, often with a higher Injury Severity Score (ISS) and more significant soft tissue, osseous, and neurologic damage. The rate of vascular injury during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) is 5 times that of previous conflicts.  Read More>>

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Links:

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Journal of Vascular Surgery

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Annals of Vascular Surgery

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US National Library of Medicine National Institutes of Health - PubMed

Research Gate​