Abstract:
:As increasing experience and comfort with endovascular interventions performed in an outpatient setting has occurred, the safety and cost effectiveness of performing these procedures without an overnight stay were analyzed, especially when endovascular procedures were combined with open vascular operations requiring an arteriotomy and surgical closure. Ninety patients underwent endovascular procedures alone or concomitantly with open, minor vascular operations to salvage a failing graft between February 1994 and June 1999. Patients undergoing endovascular interventions during primary lower extremity bypass or other major surgical procedures were not included in this review because they were not candidates for outpatient procedures. Balloon angioplasty alone (79) or angioplasty with stent placement (11) was performed to treat stenoses in 50 failing grafts, 16 iliac, 14 femoral, 5 tibial, and 5 axilla/subclavian arteries. A significant increase in outpatient procedures was accomplished as more experience was garnered with these techniques: 19% (8/42) between 1994 and 1996 vs 57% (28/48) between 1997 and 1999 (p = 0.001). Age and comorbidity did not play a role in determining the need for admission because there were no significant differences in patients with diabetes mellitus, hypertension, smoking, or hyperlipidemia and those admitted or discharged the same day (p > 0.05). Patients admitted for overnight observation tended to have longer mean operative times and more complex revascularizations than outpatients (110 vs 69 min, respectively; p < 0.0001). Twenty-seven patients underwent surgical exposure of the access vessel: 63% (17) were admitted and 37% (10) were discharged the same day. Sixty-three patients underwent a percutaneous procedure: 42% (27) were admitted and 58% (37) were discharged the same day. Outpatients were more likely to receive only local anesthesia (83%; 30/35) compared to patients admitted overnight (67%; 36/53); the remaining patients received spinal or epidural anesthesia. Complications included graft thrombosis within 30 days in 6% (5/90) of patients and arterial graft infection in 2% (2). No patient required surgery for bleeding. The average charges for outpatient interventions were $1980 compared to $10,026 for patients who stayed overnight (p < 0.0001). As vascular surgeons become more experienced and comfortable with outpatient endovascular procedures, especially when performed in combination with open minor vascular surgery, significant cost savings can be realized without sacrificing patient safety. Even when open surgical exposure is planned, patients should be instructed preoperatively to anticipate discharge the day of their procedure to minimize resistance to this strategy.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Lombardi JV,Calligaro KD,Dougherty MJdoi
10.1177/153857440203600312keywords:
subject
Has Abstractpub_date
2002-05-01 00:00:00pages
231-5issue
3eissn
1538-5744issn
1938-9116journal_volume
36pub_type
杂志文章abstract:BACKGROUND AND IMPORTANCE:High-flow spontaneous vertebral arteriovenous shunts in patients with fibromuscular disease (FMD) are rare. Onyx embolization of the recipient veins with shunt disconnection and preservation of the affected vertebral artery in a patient with FMD has not been reported. CLINICAL PRESENTATION:A ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412452156
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVES:After surgical or endovascular revascularization, some ischemic lesions will not heal, while some others will heal at a variable period of time from the intervention, indicating a multifactorial interaction between local and systematic "wound healing-promoting" factors. Our objective was to identify predicto...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574419868863
更新日期:2019-11-01 00:00:00
abstract::The objective of this study was to explore the protective effect and possible mechanism of Ginkgo biloba extract (Ginaton) on human vascular endothelial cells (VECs) injured by angiotensin II (Ang-II) and hypoxia. The human aortic VECs were divided into different groups to observe the changes in endothelin (ET), intra...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574413486361
更新日期:2013-07-01 00:00:00
abstract:PURPOSE:To evaluate the effectiveness of endovascular management of steno-oclusive disease in liver transplants. METHODS:Retrospective review of liver transplant recipients with hepatic artery stenosis (HAS) or thrombosis (HAT) was performed. The HAS group was treated with balloon angioplasty with selective stent plac...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411407088
更新日期:2011-07-01 00:00:00
abstract::Moyamoya disease is a rare cerebrovascular disorder that is characterized by progressive stenosis of the distal portion of the internal carotid artery and its main branches. Here the authors present the first case of spontaneous recanalization of an occluded middle cerebral artery in a woman with moyamoya who had not ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574413495463
更新日期:2013-08-01 00:00:00
abstract::Bilateral internal carotid artery agenesis is a very rare congenital anomaly, which may be accompanied by various types of associated vascular abnormalities, included intracranial aneurysms or dolichoectatic change of posterior circulation. In this article, we present unique, and to the best of our knowledge, the firs...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574409347393
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:To determine previous experience and results of autologous splenic vein graft repairs in traumatic superior mesenteric vein (SMV) avulsions. DESIGN OF STUDY:Systemic review was conducted for SMV trauma and methods of repair between 1897 and 2010. Articles were further analyzed for use of the splenic vein as ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574410390712
更新日期:2011-02-01 00:00:00
abstract::Renal vein compression syndromes are rare causes of hematuria and can be divided into anterior and posterior nutcracker syndrome. When the left renal vein is compressed between the aorta and the superior mesenteric artery it causes anterior nutcracker syndrome. The posterior nutcracker syndrome is very rare and is con...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411419376
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:The systemic nature of atherosclerosis compromises medium-term survival following major vascular surgery. Neutrophil-lymphocyte ratio (NLR) is a simple index of systemic inflammatory burden which correlates with survival following percutaneous coronary intervention. METHODS:Patients undergoing elective majo...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1177/1538574410396590
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the safety and efficacy of preoperative percutaneous n-butyl cyanoacrylate (nBCA) embolization of venous malformations in children. MATERIAL AND METHODS:Clinical data were retrospectively reviewed in children who underwent embolization using nBCA followed by resection ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574418762192
更新日期:2018-05-01 00:00:00
abstract:BACKGROUND/PURPOSE:This study analyzes the safety and efficacy of carotid angioplasty/stenting (CAS) with embolic protection devices in high surgical risk (HSR) patients. PATIENT POPULATION/METHODS: This study includes 100 consecutive HSR patients, who were followed prospectively, and had carotid duplex ultrasounds at ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574408318477
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:Most common tumor extending into the inferior vena cava (IVC) are renal carcinomas, such extension have been noted in nearly one-fifth of tumors. Tumor thrombectomy improves the prognosis of patients including those with extension of tumor as far as supra hepatic vena cava. In contrast, if radical nephrect...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574419831834
更新日期:2019-05-01 00:00:00
abstract::Although uncommon, hoarseness can be a presenting symptom of a thoracic aneurysm. We present a case of a 67-year-old man with hoarseness, subsequently found to have left vocal paralysis. On workup, a computed tomography scan demonstrated a saccular thoracic aneurysm compressing the recurrent laryngeal nerve at the aor...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574408324616
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:Our goal was to assess the outcomes of females compared to males treated with endovascular lower extremity interventions in order to determine optimal therapy based on gender. METHODS:We performed a retrospective review evaluating the outcomes of primary transluminal angioplasty (PTA) and PTA + stenting (PTA...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411418008
更新日期:2011-11-01 00:00:00
abstract::Cystic adventitial disease (CAD) is a rare vascular pathology which predominantly affects peripheral vessels of young otherwise healthy males. Much debate exists regarding its exact etiology. It is characterized by a collection of mucinous material within the adventitial wall layer of the affected vessel, resulting in...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574417722921
更新日期:2017-10-01 00:00:00
abstract::Although the radial artery has proven to be a reliable conduit for arterial bypass procedures in cardiac surgery, its use in lower extremity revascularization has been limited due to its length. In patients who have undergone multiple cardiovascular procedures, venous conduit options can be limited, and infrapopliteal...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574407299807
更新日期:2007-08-01 00:00:00
abstract::Postoperative carotid artery pseudoaneurysms are rare. The traditional treatment of choice has been operative repair, which can present a significant technical challenge owing to the reoperative neck inflammation and potential cranial nerve injuries. The authors report 3 cases of postoperative carotid pseudoaneurysms ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440303700308
更新日期:2003-05-01 00:00:00
abstract::Recent reports have established the feasibility and safety of percutaneous transluminal angioplasty and stent placement in the treatment of innominate artery occlusive disease. Although the long-term durability of these endovascular approaches has not been clearly established, they are particularly attractive in patie...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440303700407
更新日期:2003-07-01 00:00:00
abstract::In this study, the effect of heparin-derived oligosaccharide on bovine vascular smooth muscle cell (VSMC) proliferation and signal transduction mechanism was investigated. Extracellular-signal-regulated kinase (ERK) 1/2 has been implicated in the regulation of various cellular functions including proliferation, and we...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412442595
更新日期:2012-07-01 00:00:00
abstract::Aneurysms of the superior mesenteric artery (SMA) are an uncommon but lethal entity, which must be treated expeditiously to avoid mortality and high incidence of ischemic small bowel complications. In the past 7 years the authors have treated 4 patients with a variety of types of aneurysms involving the SMA and its br...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440303700108
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:Remote endarterectomy is a less invasive technique compared with supragenicular bypass surgery for superficial femoral artery (SFA) occlusive disease. Early restenosis remains one of the drawbacks of this procedure. To prevent restenosis following remote endarterectomy, concomitant cryoplasty of the desobstru...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1177/1538574409347397
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abstract::Complications after open aortic surgery pose a challenge both to the vascular surgeon and the patient because of aging population, widespread use of cardiac revascularization, and improved survival after aortic surgery. The perioperative mortality rate for redo elective aortic surgery ranges from 5% to 29% and increas...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440503900208
更新日期:2005-03-01 00:00:00
abstract::The ruptured hypogastric artery aneurysm (RHAA) is a rare clinical entity with an evolving and dynamic therapeutic armamentarium. The anatomical location and varied clinical presentation can pose a challenge for successful repair. Recently, endovascular and hybrid operative repairs have significantly improved the hist...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574413475887
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Many devices are available for endovascular aneurysm repair (EVAR). Our aim was to analyze morphological effects of the Zenith and Talent systems. METHODS:Patients included underwent EVAR from June 1999 to June 2005 using a Zenith or Talent stent-graft, with computed tomography follow-up. Aortic dimensions ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574407307404
更新日期:2007-12-01 00:00:00
abstract::Pulmonary embolism remains an endemic challenge for public health care. The first line of treatment for venous thromboembolic disorder has been anticoagulation; however, in the absence of appropriate pharmacologic treatment, because of failure or contraindication, caval filter placement has been widely performed in th...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
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更新日期:2009-08-01 00:00:00
abstract::Thoracic endovascular aortic repair has become the preferred modality for the treatment of diverse aortic pathologies of the thoracic aorta. This report is the first to describe the use of 2 different devices for successful exclusion of a dissecting thoracic aneurysm. ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574409336021
更新日期:2010-01-01 00:00:00
abstract::Matrix metalloproteinases (MMPs) are overexpressed in venous leg ulcers, determining a breakdown of the main extracellular matrix (ECM) components owing mainly to collagenase activities, and so playing a crucial role in ulcer pathogenesis. The authors studied the effects of coagulation factor XIII (FXIII), which cross...
journal_title:Vascular and endovascular surgery
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doi:10.1177/153857440403800506
更新日期:2004-09-01 00:00:00
abstract::Inadvertent complications of jugular vein catheterization are not uncommon, however, a persistent symptomatic carotid-jugular fistula has been rarely reported. A 72-year-old male with infected surgical wound after coxofemoral disarticulation for sarcoma presented with symptoms of acute right heart failure. A fistula b...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574416675675
更新日期:2016-11-01 00:00:00
abstract::Aortic dissection represents the most common aortic emergency, affecting 3 to 4 per 100,000 people per year and is still associated with a high mortality. Twenty percent of the patients with aortic dissection die before reaching hospital and 30% die during hospital admission. Aortic dissections may be classified in 3 ...
journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574410362118
更新日期:2010-04-01 00:00:00
abstract::A 57-year-old male presented with intermittent gastrointestinal bleeding (GIB) 1 year after a successful simultaneous pancreas and kidney transplant. No source could be found after 5 tagged red blood cell studies, 3 computed tomographies (CTs), 7 endoscopies, and 4 catheter angiograms. Review of CTs showed pathologica...
journal_title:Vascular and endovascular surgery
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更新日期:2019-07-01 00:00:00