Caron B. Rockman

Patients with peripheral artery disease undergoing lower extremity revascularization remain at high risk for cardiovascular events despite intervention. This retrospective analysis of 289 participants examined the relationship between pre-procedural bleeding history and post-procedural outcomes using a modified International Society on Thrombosis and Haemostasis bleeding assessment tool. After median 18-month follow-up, participants with significant bleeding history experienced lower risk of major adverse cardiovascular events (18.4% versus 30.6%, p = 0.034) and mortality (13.6% versus 24.2%, p = 0.047). An inverse exposure-outcome relationship was observed between bleeding severity and outcomes. Bleeding history may identify patients at lower risk for thrombotic complications.

Objective: The objective of this study was to examine the effect of COVID-19 vaccination on perioperative outcomes after major vascular surgery. Background: COVID-19 vaccination is associated with decreased mortality in patients undergoing various surgical procedures. However, the effect of vaccination on perioperative mortality after major vascular surgery is unknown. Methods: This is a multicenter retrospective study of patients who underwent major vascular surgery between December 2021 and August 2023. The primary outcome was all-cause mortality within 30 days of index operation or before hospital discharge. Multivariable models were used to examine the association between vaccination status and the primary outcomes. Results: Of the total 85,424 patients included, 19,161 (22.4%) were unvaccinated. Unvaccinated patients were younger compared with vaccinated patients (mean age 68.44 +/− 10.37 y vs 72.11 +/− 9.20 y, PPP=0.03), endovascular aneurysm repair (OR 0.6, 95% CI: 0.43–0.83, P=0.002), carotid artery stenting (OR 0.7, 95% CI: 0.51–0.88, P=0.004) and infrainguinal lower extremity bypass (OR 0.7, 95% CI: 0.48–0.96, P=0.03). Conclusions: COVID-19 vaccination is associated with reduced perioperative mortality in patients undergoing vascular surgery. This association is most pronounced in patients undergoing aortic aneurysm repair, carotid stenting, and infrainguinal bypass.

Background The objective of this study was to examine the effect of COVID-19 vaccination on perioperative outcomes after major vascular surgery. Methods This is a multicenter retrospective study of patients who underwent major vascular surgery between December 2021 through August 2023. The primary outcome was all-cause mortality within 30 days of index operation or prior to hospital discharge. Multivariable models were used to examine the association between vaccination status and the primary outcome. Results Of the total 85,424 patients included, 19161 (22.4%) were unvaccinated. Unvaccinated patients were younger compared to vaccinated patients (mean age 68.44 +/− 10.37 years vs 72.11 +/− 9.20 years, p <.001) and less likely to have comorbid conditions, including hypertension (87.2% vs 89.7%, p <.001), congestive heart failure (14.5% vs 15.9%, p <.001), chronic obstructive pulmonary disease (35.7% vs 36.3, p <.001) and renal failure requiring hemodialysis (1.4% vs 1.7%, p = .005). After risk factor adjustment, vaccination was associated with decreased mortality (OR 0.7, 95% CI 0.62 - 0.81, p <.0001). Stratification by procedure type demonstrated that vaccinated patients had decreased odds of mortality after open AAA (OR 0.6, 95% CI 0.42-0.97, p = 0.03), EVAR (OR 0.6, 95% CI 0.43-0.83, p 0.002), CAS (OR 0.7, 95% CI 0.51-0.88, p = 0.004) and infra-inguinal lower extremity interventions (OR 0.7, 95% CI 0.48-0.96, p = 0.03). Conclusions COVID-19 vaccination is associated with reduced perioperative mortality in patients undergoing vascular surgery. This association is most pronounced for patients undergoing aortic aneurysm repair, carotid stenting and infrainguinal bypass.