Pub Date : 2025-12-19DOI: 10.1016/j.jvs.2025.12.156
Thomas W Cheng, Alik Farber, Maha Haqqani, Elizabeth G King, Stephanie D Talutis, Andrea Alonso, Khu Aten Maaneb de Macedo, Caitlin W Hicks, Mahmoud B Malas, Denis Rybin, Jeffrey J Siracuse
Background: Intermittent claudication (IC) interventions are predicated on safety, durability, and long-term expected benefit. Patients with end-stage renal disease (ESRD) have a higher risk of complications after many surgical procedures and have lower overall survival. Our goal was to assess perioperative and 1-year outcomes of IC interventions in patients with ESRD.
Methods: The Vascular Quality Initiative was queried from 2010 to 2020 for peripheral vascular interventions (PVI) and infrainguinal bypasses (IIBs) for IC. Demographics, comorbidities, procedural details, and outcomes were analyzed in patients with and without ESRD.
Results: There were 83,698 PVIs (2% ESRD and 98% non-ESRD) and 10,935 IIBs (1.2% ESRD and 98.8% non-ESRD) performed for IC. For PVI, ESRD patients more often underwent femoropopliteal (65.1% vs 59.5%) and infrapopliteal (26.5% vs 10.1%), and less often iliac interventions (32.1% vs 46.4%) (all P < .001). There were no differences in access site complications; however, ESRD patients had higher 30-day mortality (2.2% vs 0.4%; P < .001). At 1 year, ESRD patients less often ambulated independently (74.3% vs 90.4%; P < .001). On Kaplan-Meier analysis, patient with ESRD had lower 1-year freedom from reintervention/major amputation/death (62.8% vs 86.7%), major amputation/death (67.8% vs 93.9%), and survival (81.7% vs 96.6%) (all P < .001). On multivariable analysis, ESRD was associated with reintervention/major amputation/death (hazard ratio [HR], 2.46; 95% confidence interval [CI], 2.1-2.8; P < .001), major amputation/death (HR, 3.72; 95% CI, 3.1-4.4; P < .001), and death (HR, 3.8; 95% CI, 3.2-4.58; P < .001). For IIB, ESRD patients more often had an infrapopliteal target (33.3% vs 20%; P < .001) and similar great saphenous vein use (43.9% vs 50.3%; P = .33). ESRD patients had more cardiac complications (8.7% vs 3.2%; P = .001) with a similar risk of 30-day mortality (1.6 % vs 0.5%; P = .11). At 1 year, ESRD patients less often ambulated independently (66.7% vs 88.5%; P = .006). On Kaplan-Meier analysis, ESRD patients had lower 1-year freedom from reintervention/major amputation/death (66.7% vs 81.3%), major amputation/death (70.3% vs 93.7%), and survival (81.6% vs 96.3%) (all P < .001). On multivariable analysis, ESRD was associated with reintervention/major amputation/death (HR, 1.72; 95% CI, 1.04-2.87; P = .034), major amputation/death (HR, 2.87,95% CI 1.59-5.15; P = .001), and death (HR, 3.58; 95% CI, 1.86-6.9; P < .001).
Conclusions: Patients with ESRD have higher perioperative morbidity and long-term ambulatory impairment, limb loss, and mortality. The risks/benefit profile should be carefully assessed, and noninvasive interventions should be maximized in this population.
{"title":"Outcomes after infrainguinal interventions for intermittent claudication in patients with end-stage renal disease are poor.","authors":"Thomas W Cheng, Alik Farber, Maha Haqqani, Elizabeth G King, Stephanie D Talutis, Andrea Alonso, Khu Aten Maaneb de Macedo, Caitlin W Hicks, Mahmoud B Malas, Denis Rybin, Jeffrey J Siracuse","doi":"10.1016/j.jvs.2025.12.156","DOIUrl":"10.1016/j.jvs.2025.12.156","url":null,"abstract":"<p><strong>Background: </strong>Intermittent claudication (IC) interventions are predicated on safety, durability, and long-term expected benefit. Patients with end-stage renal disease (ESRD) have a higher risk of complications after many surgical procedures and have lower overall survival. Our goal was to assess perioperative and 1-year outcomes of IC interventions in patients with ESRD.</p><p><strong>Methods: </strong>The Vascular Quality Initiative was queried from 2010 to 2020 for peripheral vascular interventions (PVI) and infrainguinal bypasses (IIBs) for IC. Demographics, comorbidities, procedural details, and outcomes were analyzed in patients with and without ESRD.</p><p><strong>Results: </strong>There were 83,698 PVIs (2% ESRD and 98% non-ESRD) and 10,935 IIBs (1.2% ESRD and 98.8% non-ESRD) performed for IC. For PVI, ESRD patients more often underwent femoropopliteal (65.1% vs 59.5%) and infrapopliteal (26.5% vs 10.1%), and less often iliac interventions (32.1% vs 46.4%) (all P < .001). There were no differences in access site complications; however, ESRD patients had higher 30-day mortality (2.2% vs 0.4%; P < .001). At 1 year, ESRD patients less often ambulated independently (74.3% vs 90.4%; P < .001). On Kaplan-Meier analysis, patient with ESRD had lower 1-year freedom from reintervention/major amputation/death (62.8% vs 86.7%), major amputation/death (67.8% vs 93.9%), and survival (81.7% vs 96.6%) (all P < .001). On multivariable analysis, ESRD was associated with reintervention/major amputation/death (hazard ratio [HR], 2.46; 95% confidence interval [CI], 2.1-2.8; P < .001), major amputation/death (HR, 3.72; 95% CI, 3.1-4.4; P < .001), and death (HR, 3.8; 95% CI, 3.2-4.58; P < .001). For IIB, ESRD patients more often had an infrapopliteal target (33.3% vs 20%; P < .001) and similar great saphenous vein use (43.9% vs 50.3%; P = .33). ESRD patients had more cardiac complications (8.7% vs 3.2%; P = .001) with a similar risk of 30-day mortality (1.6 % vs 0.5%; P = .11). At 1 year, ESRD patients less often ambulated independently (66.7% vs 88.5%; P = .006). On Kaplan-Meier analysis, ESRD patients had lower 1-year freedom from reintervention/major amputation/death (66.7% vs 81.3%), major amputation/death (70.3% vs 93.7%), and survival (81.6% vs 96.3%) (all P < .001). On multivariable analysis, ESRD was associated with reintervention/major amputation/death (HR, 1.72; 95% CI, 1.04-2.87; P = .034), major amputation/death (HR, 2.87,95% CI 1.59-5.15; P = .001), and death (HR, 3.58; 95% CI, 1.86-6.9; P < .001).</p><p><strong>Conclusions: </strong>Patients with ESRD have higher perioperative morbidity and long-term ambulatory impairment, limb loss, and mortality. The risks/benefit profile should be carefully assessed, and noninvasive interventions should be maximized in this population.</p>","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jvs.2025.10.017
S.M. Carr, O. Scrivner, K.E. Hekman
{"title":"Narrative review of endothelial cell metabolism and aberrations in atherosclerosis and peripheral artery disease","authors":"S.M. Carr, O. Scrivner, K.E. Hekman","doi":"10.1016/j.jvs.2025.10.017","DOIUrl":"10.1016/j.jvs.2025.10.017","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 1","pages":"Pages A19-A20"},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/S0741-5214(25)01915-9
{"title":"Table of contents (4-color)","authors":"","doi":"10.1016/S0741-5214(25)01915-9","DOIUrl":"10.1016/S0741-5214(25)01915-9","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 1","pages":"Pages A3-A10"},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jvs.2025.08.018
Malachi G. Sheahan MD, Claudie Sheahan MD
{"title":"A call to arms","authors":"Malachi G. Sheahan MD, Claudie Sheahan MD","doi":"10.1016/j.jvs.2025.08.018","DOIUrl":"10.1016/j.jvs.2025.08.018","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 1","pages":"Page 317"},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jvs.2025.10.061
A. Besch, J. Heckenkamp, F. Adili, M. Steinbauer, L. Cotta, C.-A. Behrendt
{"title":"Editor's Choice – Endovascular Treatment of Abdominal Aortic Aneurysm and Impact of Annual Caseload in the Quality Registry of the German Society for Vascular Surgery and Vascular Medicine (DGG)","authors":"A. Besch, J. Heckenkamp, F. Adili, M. Steinbauer, L. Cotta, C.-A. Behrendt","doi":"10.1016/j.jvs.2025.10.061","DOIUrl":"10.1016/j.jvs.2025.10.061","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 1","pages":"Page 318"},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jvs.2025.10.064
E. Bako, P. Pengermä, E. Palm, P. Saari, S. Venesmaa, J. Halonen, J. Karjalainen, J.M. Kärkkäinen
{"title":"Editor's Choice – Incidence Rates of Arterial Occlusive Acute and Atherosclerotic Chronic Mesenteric Ischaemia: A Population Based Study Over a 15 Year Period","authors":"E. Bako, P. Pengermä, E. Palm, P. Saari, S. Venesmaa, J. Halonen, J. Karjalainen, J.M. Kärkkäinen","doi":"10.1016/j.jvs.2025.10.064","DOIUrl":"10.1016/j.jvs.2025.10.064","url":null,"abstract":"","PeriodicalId":17475,"journal":{"name":"Journal of Vascular Surgery","volume":"83 1","pages":"Pages 318-319"},"PeriodicalIF":3.6,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145765951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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