Commentaries: Pharmacomechanical Thrombolysis for Deep-Vein Thrombosis – NEJM Resident 360 (free) AND Pharmacomechanical Thrombolysis for DVT – American College of Cardiology, Latest in Cardiology (free)
Pharmacomechanical thrombolysis did not result in lower risk of post-thrombotic syndrome and was associated with higher risk of major bleeding.
Readmissions After Revascularization Procedures for Peripheral Arterial Disease: A Nationwide Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Burden of Readmission High in PAD Patients Following Revascularization – TCTMD (free) AND 1 in 6 Patients Undergoing Peripheral Arterial Revascularization Readmitted Within 30 Days – Physician’s First Watch (free) AND 1 in 6 Readmitted After Peripheral Revascularization – MedPage Today (free registration required)
“Low dose aspirin does not increase time to healing of venous leg ulcers, percentage healed, estimated change in venous leg ulcer area, or change in health related quality of life”.
Diabetic foot – The BMJ (free for 2 weeks)
Infographic: A visual overview of the primary care assessment and monitoring of a diabetic foot (free PDF)
Comparative clinical effectiveness and cost effectiveness of endovascular strategy versus open repair for ruptured abdominal aortic aneurysm: three year results of the IMPROVE randomised trial – The BMJ (free)
Editorial: Endovascular or open repair for ruptured abdominal aortic aneurysm? (free)
Commentaries: Perioperative aspirin may improve short-term outcomes after noncardiac surgery in patients with prior PCI – ACP Internist (free) AND Aspirin can prevent heart attacks after noncardiac surgery in patients with prior PCI – University of Alberta Faculty of Medicine & Dentistry, via ScienceDaily (free) AND Aspirin Protective Against Early Death/MI in Prior PCI Patients Undergoing Noncardiac Surgery – TCTMD (free)
European guidelines on perioperative venous thromboembolism prophylaxis (free PDF articles):
Original article: Interventions for the prevention of recurrent erysipelas and cellulitis – Cochrane Library (link to abstract – $ for full-text)
Original guideline: The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine (free)
Related meta-analysis: A meta-analysis of resuscitative endovascular balloon occlusion of the aorta (REBOA) or open aortic cross-clamping by resuscitative thoracotomy in non-compressible torso hemorrhage patients – World Journal of Emergency Surgery (free)
Commentary with highlights from the document: European Society for Vascular Surgery Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease (free)
Population screening and intervention for vascular disease in Danish men (VIVA): a randomised controlled trial – The Lancet (link to abstract – $ for full-text)
Commentaries: Screening for vascular disease saves one life for every 169 patients assessed (VIVA) – ESC Press Releases (free) AND VIVA: Could Population-Wide Screening Trial for AAA, PAD, and Hypertension Save Lives at Low Cost? – TCTMD (free) AND VIVA: Overall Mortality Significantly Reduced Among Older Men Receiving Triple Vascular Screening – American College of Cardiology, Latest in Cardiology (free)
2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries (free) (RT @rafavidalperez see Tweet)
See also: #ESCCongress Slides (free PPT file)
Risk of Arterial Thromboembolism in Patients With Cancer – Journal of The American College of Cardiology (link to abstract – $ for full-text)
Commentaries: Cancer Patients at Heightened Risk for Arterial Thromboembolism – American College of Cardiology, Latest in Cardiology (free) AND Thromboembolism Risk Doubled in Cancer Patients – Medscape (free registration required) AND Cancer patients carry double the short-term risk of arterial thromboembolism – Cardiovascular Business (free) AND Short-Term Risk of Arterial Thromboembolism in Newly Diagnosed Patients With Cancer – ASCO Post (free)
Interventions for the prevention of recurrent erysipelas and cellulitis – Cochrane Library (link to summary – $ for full-text)
Commentary: Ongoing Antibiotic Prophylaxis Helps Prevent Cellulitis Recurrence – Medscape (free registration required)
Randomized clinical trial of comprehensive geriatric assessment and optimization in vascular surgery – British Journal of Surgery (link to abstract – $ for full-text)
Source: ACP Journal Club ($ resource to find articles of interest)
In this RCT, a comprehensive preoperative geriatric assessment and optimization before vascular surgery was associated with shorter length of hospital stay, lower incidence of complications, and patients were less likely to be discharged to a higher level of dependency.
Related guideline: 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary : A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines (free) AND Summary: AHA/ACC Guideline on the Management of Lower Extremity Peripheral Artery Disease (free)
Source: EvidenceAlerts (free resource to find articles of interest)
“Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use”
Top Ten Things to Know: Management of Brain Arteriovenous Malformations (free PDF)
Slide Set: Management of Brain Arteriovenous Malformations (free PDF)
Inspired by War Zones, Balloon Device May Save Civilians From Fatal Blood Loss – The New York Times (10 articles per month are free)
Greater Frequency of Fruit and Vegetable Consumption Is Associated With Lower Prevalence of Peripheral Artery Disease – Arteriosclerosis, Thrombosis, and Vascular Biology (link to abstract – $ for full-text)
Growth and Rupture Risk of Small Unruptured Intracranial Aneurysms: A Systematic Review – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Growth, rupture risk appear low for small intracranial aneurysms, review indicates – ACP Internist Weekly (free) AND How Frequently Do Small Brain Aneurysms Rupture? – MedPage Today (free registration required)
“The annualized rupture rate was 0% for aneurysms 3 mm or smaller, below 0.5% for aneurysms 5 mm or smaller, and below 1% for aneurysms 7 mm or smaller”
“CAS and CEA were associated with similar rates of a composite of periprocedural death, stroke, MI, or nonperiprocedural ipsilateral stroke. The risk of long-term overall stroke was significantly higher with CAS, and was mostly attributed to periprocedural minor stroke”.
Original article: Thrombolysis for acute deep vein thrombosis – Cochrane Library (Link to abstract – $ for full-text)
Thrombolysis reduced post-thrombotic syndrome, but lead to more bleeding complications than standard anticoagulation. “Individuals with clots in the pelvis and thigh, which carry higher risk of complications, may be likely to gain most benefit”.
2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines – Journal of the American College of Cardiology (free, and legal, PDF via Unpawall)
Invited commentary: Surgical Site Infection Prevention – What We Know and What We Do Not Know – JAMA Surgery (free)
Commentary: ‘Long-Awaited’ CDC Guidelines on SSI Prevention Released – Medscape (free registration required)
Mortality Trends After a Voluntary Checklist-based Surgical Safety Collaborative – Annals of Surgery (link to abstract – free PDF available)
Sources: Global Health NOW Newsletter (free) AND South Carolina Hospitals Saw Surgery Deaths Drop After Implementing WHO Checklist – AJMC News (free) AND A simple checklist prevents deaths after surgery, a large new study suggests – The Washington Post (a few articles per month are free)
See also: WHO Surgical Safety Checklist – World Health Organization (free) AND A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population – New England Journal of Medicine (free)
The wound/burn guidelines – Japanese Dermatological Association (all guidelines are free)
Wounds in general / Guidelines for the diagnosis and treatment for pressure ulcers / Guidelines for the diagnosis and treatment for diabetic ulcer/gangrene / Guidelines for the management of skin ulcers associated with connective tissue disease/vasculitis / Guidelines for the management of lower leg ulcers/varicose veins / Guidelines for the management of burns
Browse Appropriateness Criteria Topics (free)
This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.
Source: Richard Lehman’s weekly review
HERDOO2 rule stands for Hyperpigmentation, Edema, or Redness in either leg; D-dimer level ≥250 μg/L; Obesity with body mass index ≥30; or Older age, ≥65 years. The authors concluded that women with a first unprovoked VTE event and none or one of the HERDOO2 criteria have a low risk (3.0% per patient year) of recurrent VTE and can safely discontinue anticoagulants after completing short term treatment.
Going Under the Knife, With Eyes and Ears Wide Open – New York Times (free access to 10 articles per month)
“More and more surgeries are being performed with the patient awake and looking on, for financial and medical reasons”.