the diffuse nature of this disease. There were no peri-procedural complications. Two of 3 patients with complex wounds required major amputations for gangrene, including one above-knee and one below-knee amputation at 128 months and 66 months after the index procedure respectively. Conclusions AVMs in PWS can be successfully treated by a transcatheter approach. Multiple interventions are usually required. Patients with extensive wounds remain at risk for loss of limb.Background As many as 30% of autogenous cephalic vein arteriovenous fistulae are too deep for reliable cannulation. Several techniques to superficialize these AVFs have been described, including direct elevation, retunneling or transposition under a flap, lipectomy, minimal incision superficialization technique (MIST), V-Wing placement, and liposuction. This report describes a new surgical technique for arteriovenous fistula superficialization and provides a brief review of each alternative above. Methods The path of the fistula is marked using ultrasound, and three to four transverse incisions are made along this path. The subcutaneous tissue and superficial fascia are separated from the dermis over this entire area. Unlike MIST, the fistula is then accessed through the transverse incisions by dividing the adipose tissue rather than removing it. The mobilized vein is then elevated and "trapped" directly under the dermis by closing the superficial fascia and adipose tissue beneath it. No anastomotic revisionsr writing this manuscript and one thrombosed. Excluding the two patients lost to follow-up, the one newly superficialized AVF and the two not yet on dialysis, our cannulation rate was thus 16 of 18, or 89%. Excluding the two patients lost to follow-up and two deceased patients, 18 of 19 (94.7%) of the fistulas remained patent at last visit, with only one thrombosed 8-10 weeks after superficialization. Conclusions This technique appears to be both safe and effective, and results in a vein that is immediately subdermal without major contour deformity or a lengthy scar. Early outcomes are comparable to those alternative methods described in the literature.Background Vertebral artery injury (VAI) is often grouped with carotid artery injury into a broader classification of blunt cerebrovascular injury, despite fundamental differences in mechanism of injury and outcome. This study seeks to evaluate the efficacy of medical therapy in preventing strokes for isolated VAI. Methods Patients with isolated blunt VAI (2011-2018) were identified from the trauma registry of a level I trauma center. A retrospective chart review was conducted excluding patients with concomitant carotid artery injury. Factors examined included demographics, injury characteristics, anatomic classification and management strategy. Patients were stratified by whether they received pharmacological (antiplatelet or anticoagulation) therapy. The primary outcome was new posterior circulation stroke within 30 days of injury as confirmed by imaging studies. Results A total of 206 patients with blunt VAI were included. Median injury severity score was 17 and 33 (16.0%) patients presented with Glasgow C a very low risk of stroke and treatment with medical therapies including antiplatelet or anticoagulation does not improve risk of stroke.Background Patients requiring vascular surgery have turned in older subjects with several comorbidities with frailty problems and increased vulnerability. Treating this kind of patients has become an important challenge both for vascular surgeons and for dedicated nurses, as these patients are more susceptible to postoperative complications and during discharge. The aim of this review is to analyze the role of vascular nurse in vascular surgery activities. Methods For this study, Medline, ScienceDirect, and Scopus databases were searched. The following keywords were used nursing and vascular surgery, nursing and vascular disease, nursing and vascular procedure, and care and vascular patient. Results From the search strategy, the following areas were identified as relevant and analyzed in detail vascular disease related to vascular surgery, the definition of vascular nursing, the role of vascular nursing in implementing clinical pathways in vascular surgery procedures, nursing postoperative care in vascular surgery, frailty assessment in vascular patient, nursing in phlebology and wound care, and the management of vascular access. Conclusions Vascular nursing is a discipline that is able to provide comprehensive and optimal care, better postoperative outcomes, and coordinated, standardized, and cost-effective clinical pathways for patients managed in the area of vascular surgery.Stable coil placement is an imperative when treating arterial pathology at branch points. Coil kick and escape threaten distal organs, particularly as the pack tightens. Before the development of the VBX balloon-expandable stent graft (W.L. Gore, Flagstaff, AZ), vessel caliber change often precluded straightforward stent graft coverage with a single device to secure coils in place.  https://www.selleckchem.com/products/Erlotinib-Hydrochloride.html  We describe 3 cases using this unique feature of the Gore VBX device to accommodate challenging anatomy. All 3 patients recovered well.Background Inferior perioperative outcomes for women receiving major vascular surgery are well established in the literature in multiple arterial distributions. Therefore, this study was completed to determine the perioperative and durability results associated with women undergoing complex aortic reconstruction using the Zenith Fenestrated platform (ZFEN; Cook Medical, Bloomington, IN). Methods A retrospective review of a fenestrated endovascular aortic repair (FEVAR) database capturing all ZFENs performed at our institution between October 2012 and March 2019 was completed. Preoperative, intraoperative, perioperative, and follow-up outcomes were tabulated for females and compared with their male counterparts. Results Within our study period, 136 total ZFEN procedures were performed; of which, 20 devices (14.7%) were implanted in women. Intraoperatively, we observed a higher rate of estimated blood loss (660.0 mL vs. 311.6 mL, P 0.99) and femoral artery cutdowns (55.0% vs. 49.1%, P = 0.81). Operative (295.7 min vs.