Vascular Surgery

Meta-analysis: ATK femoropopliteal prosthetic bypass shows declining patency but high limb salvage

This meta-analysis of 16 records (2,083 patients; 2,118 limbs) reports pooled primary patency of 0.80 at 12 months and 0.61 at 36 months. Secondary patency remained higher, 0.86 at 12 months and 0.68 at 36 months, while limb salvage stayed near 0.97–0.98 through 24 months. Pooled mortality rose over time (approximate pooled rates 0.09 at 12 months and 0.24 at 36 months). Subgroup analyses found comparable outcomes between PTFE and Dacron prostheses, but definitions and study designs varied. 1

Target-trial emulation: hysterectomy (no oophorectomy) modestly raises 5‑year ASCVD risk

In Optum data (11,106 myomectomy; 23,089 hysterectomy; 27,657 no surgery), hysterectomy without oophorectomy increased 5‑year atherosclerotic CVD risk by 1.24 percentage points versus no surgery. Myomectomy showed no meaningful difference in 5‑year ASCVD risk compared with no surgery. Hysterectomy-associated increases were concentrated in coronary disease and myocardial infarction and larger with open/abdominal approach. Findings were adjusted using inverse probability weighting but remain observational and susceptible to residual confounding. 2

Portal messaging rose ~400%; surgical patients message more and disparities persist

In 23,643 shoulder and elbow patients, 21% sent ≥1 medical-advice message, totaling 41,542 such messages. Medical-advice messaging increased nearly 400% over the study period and surgical patients had much higher odds (aOR 5.93) and counts (aIRR 23.3). Black patients and Spanish-speaking patients had substantially lower odds and message counts, suggesting unequal portal access. The volume rise signals growing uncompensated provider workload and a need to address equity in portal design. 3