Perioperative care in open aortic vascular surgery: A consensus statement by the Enhanced Recovery After Surgery (ERAS) Society and Society for Vascular Surgery.

The Society for Vascular Surgery and the Enhanced Recovery After Surgery Society formally collaborated and elected an international, multidisciplinary panel of experts to review the literature and provide evidence-based recommendations related to all the health care received in the perioperative period for patients undergoing open abdominal aortic operations (both transabdominal and retroperitoneal approaches, including supraceliac, suprarenal, and infrarenal clamp sites) for aortic aneurysm and aortoiliac occlusive disease. Structured around the Enhanced Recovery After Surgery core elements, 36 recommendations were made and organized into preadmission, preoperative, intraoperative, and postoperative recommendations.

Diagnosis and management of external iliac endofibrosis: A case report.

External iliac artery endofibrosis is an uncommon, nonatherosclerotic disease seen in endurance cyclists. It is poorly identified by providers. These otherwise healthy patients usually present with symptoms of arterial insufficiency, such as thigh or buttock pain, loss of power, or weakness occurring during strenuous exercises. These symptoms subside rapidly with rest. As these patients lack traditional risk factors of peripheral artery disease, their symptoms are often overlooked or are attributed to other etiologies, resulting in mismanagement and delayed treatment. In this case study, we report our experience with the successful management of a 48-year-old male who is a longstanding, avid cyclist. He self-referred to our institution after extensive research of providers familiar with his problem and at the recommendation of other cyclists with similar experiences. The patient underwent a successful left external iliac to common femoral artery endarterectomy and patch angioplasty. Three months after operation, he returned to cycling and, for the most part, has remained without symptoms.

Exercise therapy for claudication: Should home-based exercise therapy be prescribed in clinical practice?

Peripheral artery disease is a cause of morbidity and mortality in the United States. The literature suggests evidence that an exercise program can be beneficial in the treatment of patients with claudication. Supervised exercise therapy is well documented in the literature, and national guidelines recommend it as an initial conservative management. When a supervised exercise program is unavailable or not covered by insurance, an alternative to supervised exercise is vital. The purpose of this review is to examine the evidence regarding the efficacy of a home-based exercise program. Four studies were included in this review, and although the evidence supporting a home-based exercise program is limited in the literature, the findings indicate that a home-based exercise program increases claudication onset time, resulting in greater mobility and improvement in the patient's quality of life.