Faculty Bibliography

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Annals of vascular surgery. 2015(25th).DOI: 10.1016/j.avsg.2015.04.051

Gender differences in aortic neck morphology in patients with abdominal aortic aneurysms undergoing evar [Meeting Abstract]

Ayo, D; Blumberg, S N; Gaing, B; Baxter, A; Rockman, C; Mussa, F; Maldonado, T
Introduction and Objectives: Prior studies have alluded to gender differences in aortic neck morphology resulting in anatomic exclusion of some women from EVAR. The objective of this study is to correlate gender differences in aortic neck morphology and changes in the neck and aneurysm sac after EVAR. Methods: A retrospective review of consecutive EVARs performed for infrarenal AAA was conducted from 2004 to 2013 at a single institution. Pre- and post-operative imaging studies were utilized to measure aortic neck length and diameter, shape, and angulation, aneurysm sac diameter. Volumetric analysis of neck thrombus burden was performed using TeraRecon. Results: 146 patients met inclusion criteria 21% were women with a mean age of 75.5 (p=0.724) with comparable baseline comorbidities to men. Neck angulation was greater in women 23.9degreevs 13.5degree (P<0.028). The percent thrombus of the aortic neck was greater in female patients at 35.7% vs 30%(P=0.02). Preoperative AAA diameter was 5.8 in female and 5.5 in males (p=0.348). Abdominal aneurysm sacs were smaller in women at 1 year follow up (4.2cm vs. 5.1cm, P<0.002). In addition, although not statistically significant, reintervention rates post-EVAR for type 1 leaks were higher in men (3.5% vs. 0% P=0.27). Neck shape, changes in neck diameter, neck length, percent oversizing of graft where not significantly different between gender (table 1). Conclusions: Although female patients have more hostile aortic neck morphology compared to males, AAAs post-EVAR have acceptable sac regression and reintervention rates. Long term follow up is necessary to further validate findings
EMBASE:615207328
ISSN: 1615-5947
CID: 2534382
Annals of vascular surgery. 2015:29(8):1656.e1-6.DOI: 10.1016/j.avsg.2015.07.006

Iliac artery-uretero-colonic fistula presenting as severe gastrointestinal hemorrhage and hematuria: a case report and review of the literature

Policha, Aleksandra; Baldwin, Melissa; Mussa, Firas; Rockman, Caron
Arterioenteric fistulas represent an infrequent but potentially fatal cause of gastrointestinal hemorrhage. Patients often present in extremis from shock and sepsis. This mandates a rapid diagnosis so that prompt, potentially life-saving interventions can be performed. We report the case of a 35 year-old male who presented with hematuria and hematochezia secondary to an iliac artery-uretero-colonic fistula that developed years following open common iliac artery aneurysm repair. His condition rapidly progressed to hemorrhagic shock and he underwent successful endovascular treatment with a covered stent graft as a bridge to definitive open surgery. Subsequently, graft explantation, extra-anatomic arterial bypass, bowel resection and ureter ligation was undertaken. A summary of the literature on iliac artery-enteric fistulas follows.
PMID: 26303272
ISSN: 1615-5947
CID: 1742052
Atherosclerosis. 2015:241(2):687-91.DOI: 10.1016/j.atherosclerosis.2015.06.029

Co-existence of vascular disease in different arterial beds: Peripheral artery disease and carotid artery stenosis - Data from Life Line Screening

Razzouk, Louai; Rockman, Caron B; Patel, Manesh R; Guo, Yu; Adelman, Mark A; Riles, Thomas S; Berger, Jeffrey S
BACKGROUND: Atherosclerosis is a systemic vascular disorder, involving multiple arterial territories. This project sought to investigate the relationship between lower extremity peripheral artery disease (PAD) and carotid artery stenosis (CAS) in a large self-referred population. METHODS: Data from the ankle brachial index (ABI) and carotid duplex ultrasound were analyzed from 3.67 million US subjects in the Life Line Screening program between 2004 and 2008. PAD was defined by ABI<0.9 and CAS was defined by greater than 50% stenosis. Multivariate logistic regression analysis was used to estimate odds of CAS by PAD status and severity. RESULTS: Mean age of the population was 63.7 +/- 10.6 years and 64% were women. The prevalence of PAD and CAS was 4.1% and 3.9%, respectively. Subjects with PAD had a higher prevalence of CAS than those without PAD (18.8% vs. 3.3%, P < 0.0001). In multivariate analysis, PAD was associated with greater odds of CAS (OR 3.28, 95% CI 3.22-3.34). Both symptomatic (OR 3.66, 95% CI 3.58-3.75) and asymptomatic PAD (OR 2.91, 95% CI 2.84-2.98) was associated with CAS. Increasing severity of PAD was associated with greater odds of CAS (OR 2.32, 3.61, 4.19, 5.14, and 7.59 for ABI categories 0.81-0.90, 0.71-0.80, 0.61-0.70, 0.41-0.60,
PMCID:5514366
PMID: 26122189
ISSN: 1879-1484
CID: 1649802
Journal of the American College of Cardiology. 2015:65(11):1150-1.DOI: 10.1016/j.jacc.2014.12.052

Particulate Air Pollution and Carotid Artery Stenosis [Letter]

Newman, Jonathan D; Thurston, George D; Cromar, Kevin; Guo, Yu; Rockman, Caron B; Fisher, Edward A; Berger, Jeffrey S
PMCID:4465218
PMID: 25748098
ISSN: 0735-1097
CID: 1494462
Vascular. 2015:23(2):217-9.DOI: 10.1177/1708538114568417

The recent randomized trials of EVAR versus open repair for ruptured abdominal aortic aneurysms are misleading

Veith, Frank J; Rockman, Caron B
PMID: 25623027
ISSN: 1708-5381
CID: 1447592
Preventive medicine. 2015:72:15-8.DOI: 10.1016/j.ypmed.2014.12.014

Greater Frequency of Nut Consumption is Associated with Lower Prevalence of Peripheral Arterial Disease

Heffron, Sean P; Rockman, Caron B; Gianos, Eugenia; Guo, Yu; Berger, Jeffrey S
Nut consumption has been associated with lower risk of coronary heart disease and all-cause mortality. The association between nut intake and peripheral arterial disease (PAD) is uncertain. OBJECTIVE: We sought to investigate the association between nut consumption and presence of prevalent PAD in a large cross-sectional sample. METHODS: Self-referred participants at >20,000 US sites who completed a medical and lifestyle questionnaire were evaluated by screening ankle brachial indices for PAD. Multivariable logistic regression analysis was used to estimate odds of PAD in different nut consumption categories. RESULTS: Among 3,312,403 individuals, mean age was 63.6+/-10.6years and 62.8% were female. There were 219,527 cases of PAD. After multivariable adjustment there was an inverse association of nut intake with PAD. Compared to subjects with consumption of nuts
PMCID:4518851
PMID: 25532677
ISSN: 0091-7435
CID: 1416232
Arteriosclerosis, thrombosis, & vascular biology. 2015:35(1):206-12.DOI: 10.1161/ATVBAHA.114.304161

Association Between Physical Activity and Peripheral Artery Disease and Carotid Artery Stenosis in a Self-Referred Population of 3 Million Adults

Stein, Richard A; Rockman, Caron B; Guo, Yu; Adelman, Mark A; Riles, Thomas; Hiatt, William R; Berger, Jeffrey S
OBJECTIVE: Although the relationship between physical activity and coronary heart disease is well characterized, a paucity of data exists on physical activity and vascular disease in other arterial territories. This study examined the prevalence of peripheral artery disease (PAD) and carotid artery stenosis (CAS) in association with physical activity. APPROACH AND RESULTS: The association between physical activity and vascular disease was examined in >3 million self-referred US participants in the United States from 2003 to 2008 who completed a medical and lifestyle questionnaire in the Life Line screening program. All subjects were evaluated by screening ankle brachial indices <0.90 for PAD and ultrasound imaging for CAS >50%. Multivariable logistic regression modeling was used to estimate odds of disease. Among 3 250 350 subjects, 63% of the population engaged in some leisure time vigorous physical activity. After adjustment for age, sex, race/ethnicity, hypertension, hypercholesterolemia, smoking status, diabetes mellitus, body mass index, and family history of cardiovascular disease, subjects who reported any physical activity had a significantly lower odds of PAD (odds ratio, 0.64; 95% confidence interval, 0.63-0.65) and CAS (odds ratio, 0.80; 95% confidence interval, 0.79-0.81). The association between physical activity with PAD and CAS was robust when stratified by sex, race, and age categories. Physical activity intensity frequency was associated with lower PAD and CAS in a graded manner (P trend <0.0001 for both). Findings seemed unaffected by confounding by comorbidity or indication. CONCLUSIONS: In a large population-based study, higher levels of physical activity were independently associated with lower odds of vascular disease in the lower extremities and carotid arteries.
PMCID:4518860
PMID: 25359858
ISSN: 1079-5642
CID: 1323072
Journal of the American College of Cardiology. 2014:63:A1328-A1328.DOI:

ASSOCIATION OF MARITAL STATUS WITH VASCULAR DISEASE IN DIFFERENT ARTERIAL TERRITORIES: A POPULATION BASED STUDY OF OVER 3.5 MILLION SUBJECTS [Meeting Abstract]

Alviar, Carlos L.; Rockman, Caron; Guo, Yu; Adelman, Mark; Berger, Jeffrey
ISI:000359579102086
ISSN: 0735-1097
CID: 3574122
Journal of vascular surgery. 2014:59(6):9S-9S.DOI:

Natural History of Renal Artery Aneurysms: An 18-Year Single-Institution Experience [Meeting Abstract]

Wang, Ziqing; Pak, Peter; Rockman, Caron B; Megibow, Alec; Cayne, Neal S
ISI:000337258400017
ISSN: 0741-5214
CID: 2726032
Journal of vascular surgery. 2014:60(3):816-816.DOI:

Differential Effect of Atherosclerotic Risk Factors on Vascular Disease Phenotypes Between the Sexes [Meeting Abstract]

Rockman, Caron B; Guo, Yu; Jacobowitz, Glenn R; Maldonado, Thomas; Cayne, Neal; Mussa, Firas; Adelman, Mark; Berger, Jeffrey
ISI:000341629700065
ISSN: 0741-5214
CID: 2726042