Abstract:
OBJECTIVE:A 24-hour venous duplex ultrasound (VDU) for suspected deep vein thrombosis (DVT) imposes significant resource burdens on a hospital. We hypothesize that termination of after-hours services increases empiric therapy without affecting clinical outcomes. METHODS:A retrospective review of patients evaluated by the emergency department (ED) for suspected DVT in 2005 and 2007. Demographics, empiric treatment, and complications were compared using propensity scores and multivariate regression models. RESULTS:In 2005 and 2007, 318 and 365 patients, respectively, had VDU after referral by the ED. In all, 49 (16%) tests during 2005 were after-hours, with 31 and 25 acute DVTs in 2005 and 2007, respectively. More patients received empiric treatment in 2007: 51 (14%) vs 26 ([8%]; P = .019) and tended to be more likely to have acute DVT: 7 (28%) vs 3 ([10%]; P = .08). We detected no complications from empiric anticoagulation and no difference in outcome. Estimated annual savings were $11 864. CONCLUSIONS:Elimination of around-the-clock VDU can render substantial savings to hospitals without adverse consequence in the management of acute DVT.
journal_name
Vasc Endovascular Surgjournal_title
Vascular and endovascular surgeryauthors
Arnaoutakis GJ,Pirrucello J,Brooke BS,Reifsnyder Tdoi
10.1177/1538574410365731subject
Has Abstractpub_date
2010-07-01 00:00:00pages
329-33issue
5eissn
1538-5744issn
1938-9116pii
1538574410365731journal_volume
44pub_type
杂志文章abstract:PURPOSE:Catheter-directed thrombolysis (CDT) is a relatively new therapy for pulmonary embolism that achieves the superior clot resolution compared to systemic thrombolysis while avoiding the high bleeding risk intrinsically associated with that therapy. In order to examine the efficacy and safety of CDT, we conducted ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574418757400
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abstract::Reperfusion injury is the paradoxical and complex phenomenon of exacerbation of cellular dysfunction and increase in cell death after the restoration of blood flow to previously ischemic tissues. It involves biochemical and cellular changes causing oxidant production and complement activation, which culminates in an i...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574407304510
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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
pub_type: 杂志文章,评审
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abstract:OBJECTIVE:The optimal antithrombotic regimen in peripheral arterial disease (PAD) is not known, leading to significant variations in antithrombotic treatment protocols in randomized trials and clinical practice. In device trials, antithrombotic regimens in patients receiving peripheral vascular interventions have not b...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574419836316
更新日期:2019-05-01 00:00:00
abstract::The prevalence of upper extremity deep vein thrombosis (UEDVT) has shown a dramatic increase with the use of central venous catheters (CVCs) for patient care. The objective of this study was to identify risk factors and clinical outcomes in patients diagnosed with UEDVT at an academic medical center over a 1-year peri...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411432145
更新日期:2012-02-01 00:00:00
abstract::Mycotic aneurysms of the internal carotid artery (ICA) are rare and often difficult to diagnose. They can have nonspecific signs and symptoms, an unclear etiology, and can lead to severe morbidity and mortality if left untreated. We present a case of a 47-year-old woman with an apparent mycotic aneurysm of the extracr...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574409340590
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Recently, angioplasty and stenting of carotid arteries (CAS) have taken the place of surgery. The aim of our study is to assess the role of transcranial Doppler (TCD) monitoring during CAS to address the embolic complications during the stages of the procedure, with or without embolic cerebral protection dev...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574410375313
更新日期:2010-10-01 00:00:00
abstract::Since the outbreak of the COVID-19 pandemic, increasing evidence suggests that infected patients present a high incidence of thrombotic complications. We report a 67-year-old-woman admitted for severe acute respiratory syndrome coronavirus 2 infection. Chest CT images showed bilateral ground glass opacities, bilateral...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574420966106
更新日期:2020-10-09 00:00:00
abstract:PURPOSE:To describe the use of custom fenestrated endografts to preserve left subclavian artery (SCA) flow when requiring coverage during endovascular repair of blunt aortic injury (BAI). CASE REPORT:A 39-year-old male involved in a motor vehicle accident sustained injuries including intracranial hemorrhage, BAI, and ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574411413939
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abstract:OBJECTIVES:Cilostazol improves walking in patients with peripheral arterial disease (PAD). We hypothesized that cilostazol reduces diabetic complications in PAD patients. METHODS:Diabetic PAD patients were prospectively recruited to a randomized double-blinded, placebo-controlled trial, using cilostazol 100mg twice a ...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2009-04-01 00:00:00
abstract::The fate of popliteal artery aneurysms after ligation and bypass is believed to be relatively innocuous. The patient presented in this report, however, experienced spontaneous rupture of a popliteal aneurysm 11 years after ligation and bypass. Magnetic resonance angiography was used to establish the diagnosis of ruptu...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440403800613
更新日期:2004-11-01 00:00:00
abstract::This study was conducted to evaluate the potential for percutaneous catheter based limb salvage angioplasty in patients who have no surgical bypass option. Twenty patients, 12 males and 8 females, with end-stage limb ischemia (Rutherford category 4 and 5) were treated with balloon angioplasty. Antegrade femoral access...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440303700203
更新日期:2003-03-01 00:00:00
abstract::Replacement of the abdominal aorta, whether by autogenous or prosthetic conduit, has been an a priori requisite in the vascular surgeon's armamentarium since its technical feasibility was described in the early 1950s. The Achilles' heel of this operation, in spite of the progress made over the last half century, is st...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/153857440604000101
更新日期:2006-01-01 00:00:00
abstract::Patients with chronic occlusion of iliac veins may present with symptoms ranging from mild discomfort to severe disability, including limb swelling, venous claudication, and ulceration. Endovascular treatment has emerged as first line of interventional therapy. Surgical venous-venous bypasses for the management of the...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412454584
更新日期:2012-10-01 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...
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doi:10.1177/1538574416675675
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doi:10.1177/153857440203600312
更新日期:2002-05-01 00:00:00
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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::Iliac artery tortuosity can be a limiting factor in treating abdominal aortic aneurysms by endovascular means. In this case, a 6F catheter guiding sheath was used to allow tracking of the superstiff wire to straighten the iliac artery on the left. This allowed for tracking of the larger sheath so that a bifurcated dev...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574410369569
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journal_title:Vascular and endovascular surgery
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doi:10.1177/1538574418763208
更新日期:2018-07-01 00:00:00
abstract::Thoracic endografting offers many advantages over open repair. However, delivery of the device can be difficult and may necessitate adjunctive procedures. We describe our techniques for preserving perfusion to the left subclavian artery despite endograft coverage to obtain a proximal seal zone. We reviewed our experie...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574406293735
更新日期:2006-10-01 00:00:00
abstract:PURPOSE:This study tests an existing Vascular Biochemistry and Haematology Outcome Model (VBHOM) on independent data and presents further refinements to the model. METHODS:Data from 306 patients who underwent lower limb amputation over a 4-year period were collated. Urea, creatinine, sodium, potassium, hemoglobin, whi...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/1538574412445600
更新日期:2012-07-01 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::Nail-patella syndrome (NPS) is a rare disorder characterized by abnormal development of ectodermal and mesodermal tissues. Classically, NPS presents as a triad of nail dysplasia, dysplastic patellae, and bony exostoses of the ilia known as "iliac horns." Apart from dermatological and skeletal abnormalities, patients m...
journal_title:Vascular and endovascular surgery
pub_type:
doi:10.1177/1538574419888345
更新日期:2020-02-01 00:00:00
abstract::Intraoperative infrainguinal autologous vein graft stenoses are common, and some authors advise revision of these stenoses. But the natural history of these lesions is not clear. This study was undertaken to determine the natural history of duplex-detected intraoperative stenoses with a nonrevision policy. Intraoperat...
journal_title:Vascular and endovascular surgery
pub_type: 杂志文章
doi:10.1177/153857440503900403
更新日期:2005-07-01 00:00:00
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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::This study evaluated the learning curve for a second-year general surgery resident and compared 2 totally laparoscopic aortic surgery techniques in 10 pigs: the transretroperitoneal apron approach and the transperitoneal retrocolic approach. Five end points were compared: success rate, percentage of conversion, time r...
journal_title:Vascular and endovascular surgery
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更新日期:2007-06-01 00:00:00
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journal_title:Vascular and endovascular surgery
pub_type: 杂志文章,评审
doi:10.1177/1538574417744085
更新日期:2018-02-01 00:00:00