Abstract:
:Since carotid endarterectomy was revitalized following the North American Symptomatic Carotid Endarterectomy Trial and Asymptomatic Carotid Atherosclerosis Study, results have improved. However, types of carotid endarterectomy, indications, risk factors, surgical factors, techniques, and other treatment modalities may be associated with outcomes of carotid endarterectomy. The purpose of this study was to identify those factors in a broad-based carotid endarterectomy patient. This study involved review of the data from 3,644 patients undergoing carotid endarterectomy in New York State hospitals. A multivariate statistical model was used to identify significant patient risk factors to examine the association of the process of care and surgical factors, including surgical specialty for outcome of carotid endarterectomy. In-hospital death and stroke rate overall was 1.84%. After adjustment for patient risk factors, specific processes of care, such as eversion endarterectomy, protamine, heparin, or shunt, were associated with lower adverse outcomes relative to patients undergoing carotid endarterectomy without these processes. Similarly, patients undergoing carotid endarterectomy by vascular surgeons had lower adverse outcomes compared to neurosurgeons and general surgeons. This retrospective review showed that processes of care and surgical specialty were significant factors that contributed to outcomes following carotid endarterectomy.
journal_name
Semin Vasc Surgjournal_title
Seminars in vascular surgeryauthors
Shah DM,Darling RC 3rd,Chang BB,Paty PS,Kreienberg PB,Roddy SP,Ozsvath KJ,Mehta Mdoi
10.1016/s0895-7967(04)00052-3subject
Has Abstractpub_date
2004-09-01 00:00:00pages
257-9issue
3eissn
0895-7967issn
1558-4518pii
S0895796704000523journal_volume
17pub_type
杂志文章,多中心研究abstract::The development of carotid duplex scanning revolutionized the diagnosis of carotid artery disease. Continued advances in the technology as well as widespread experience with cartoid ultrasound have redefined the role this technology plays in the care of patients with carotid atherosclerosis. Recent clinical trials hav...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-03-01 00:00:00
abstract::Increased intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) are important clinical problems after repair of ruptured abdominal aortic aneurysms and are reviewed here. IAP >20 mm Hg occurs in approximately 50% of patients treated with open abdominal aortic aneurysm repair after rupture, and approx...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2012.03.002
更新日期:2012-03-01 00:00:00
abstract::Tobacco abuse is a highly prevalent modifiable risk factor in vascular surgery patient populations. Despite the known benefits of smoking cessation, quitting smoking is difficult for most patients. Physician advice to stop smoking can help, though more intensive or multifactorial interventions have greater impact. Smo...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2015.10.001
更新日期:2015-06-01 00:00:00
abstract::Ischemia-reperfusion injury is a continuing challenge to vascular surgeons. Microvascular factors and mechanisms underlying edema and compartment syndrome provide a useful end point for analysis and planning of therapy. We review the pivotal role of endothelium-leukocyte interactions and of cytokines in the genesis of...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-09-01 00:00:00
abstract::Patients with end-stage liver disease (ESLD) who develop hepatorenal syndrome (HRS) have very high mortality rates. For patients with HRS type I, median survival without specific therapy is only 2 weeks. Due to worsening clinical condition in such patients secondary to uremia and hepatic disease, some form of renal re...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.semvascsurg.2017.04.001
更新日期:2016-12-01 00:00:00
abstract::Renal artery stenting remains an important adjuvant treatment for true-resistant hypertension, although recent disappointing randomized trials highlight the importance of careful patient selection. Safe and successful renal interventions begin with critical core knowledge regarding renal artery anatomy and understandi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.06.002
更新日期:2013-12-01 00:00:00
abstract::It is estimated that 20% to 40% of the patients who survive the acute phase of aortic dissection will develop significant aneurysmal dilatation of the descending thoracic or thoracoabdominal aorta. Aortic dissection has long been considered a risk factor for mortality and neurologic deficit following surgical repair o...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2002.33088
更新日期:2002-06-01 00:00:00
abstract::Venous invasion is a common characteristic of renal cell carcinoma, manifesting as tumor thrombus with possible extension into the renal vein and, in extensive cases, the thrombus can reach from the renal vein to the right atrium. Currently, cytoreductive nephrectomy and tumor thrombectomy are the foundations for impr...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.06.015
更新日期:2013-12-01 00:00:00
abstract::Given both the high-risk nature of the critical limb ischemia (CLI) patient population, as well as the variety of available treatment options, the ability to use preprocedure variables to predict a given outcome has become increasingly important. The three main advantages associated with accurate risk stratification i...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2009.10.002
更新日期:2009-12-01 00:00:00
abstract::The obturator bypass is a useful method for revascularizing the lower extremity in the presence of a hazardous groin dissection. The most common indication for employing this method of reestablishing arterial continuity is in circumventing infected vascular prostheses. One- and 5-year patency rates of 72.7% and 56.9% ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract::Management of venous ulceration has evolved tremendously during the last 2 decades. There has been considerable progress in our understanding of the pathophysiology, hemodynamics, venous imaging, and therapeutic options for venous ulcers, including endovenous ablation, iliac vein stenting, and vein-valve repair techni...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2015.07.002
更新日期:2015-03-01 00:00:00
abstract::Inflammatory abdominal aortic aneurysms (IAAA) are being treated more frequently by endovascular aneurysm repair (EVAR). Some authors caution against treating IAAA by EVAR because retroperitoneal inflammation may not subside post-operatively. A recent experience of 69 IAAA treated by open and endovascular methods is p...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2012.09.008
更新日期:2012-12-01 00:00:00
abstract::Acute limb ischemia is one of the most potentially devastating but treatable diseases faced by the vascular surgeon. It is crucial to identify the ischemic process early, as the outcomes of early intervention can lead to limb salvage, whereas late recognition places the patient at risk for limb loss and potential mort...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.12.004
更新日期:2009-03-01 00:00:00
abstract::Various endovascular techniques, including the placement of embolization coils, intravascular stents, and the use of stented grafts, have been used in the setting of traumatic upper extremity injuries. Coil embolization and stent placement are effective in a limited number of cases. Endovascular grafts have greatly ex...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-06-01 00:00:00
abstract::The first commercially available stent grafts were unable to withstand the hemodynamic forces of the vascular environment. The past 15 years have seen a gradual improvement in long-term stent graft performance as designs evolved through the elimination of features associated with late failure and the replication of fe...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2009.04.008
更新日期:2009-06-01 00:00:00
abstract::The clinical application of serum biomarkers (d-dimer, C-reactive protein) to predict the natural history of descending thoracic aortic dissection remains elusive. In this review, our current understanding of biomarkers in descending thoracic aortic dissection detection, predicting complications, and aiding in patient...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2015.01.001
更新日期:2014-12-01 00:00:00
abstract::Arterial and venous trauma of the cervicothoracic region continues to present challenging problems for the surgeon, despite advances in vascular diagnostics and surgical technique. Whether due to penetrating or blunt mechanisms, overall incidence of these injuries is low, whereas morbidity and mortality remain high. D...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Nutcracker syndrome is one of the abdominal venous entrapments, caused by compression of the left renal vein between the superior mesenteric artery and the abdominal aorta. Occasionally a retro-aortic left renal vein is compressed between the aorta and the vertebral body (posterior nutcracker syndrome). The renal vein...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2013.04.006
更新日期:2013-03-01 00:00:00
abstract::Aortoiliac occlusive disease is a significant cause of lower extremity ischemic symptoms. Over the past two decades, most patients have been treated with a variety of surgical procedures, including aortofemoral and extra-anatomic bypasses. Most recently, percutaneous balloon angioplasty and stents have been successful...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1997-12-01 00:00:00
abstract::In vascular surgery, the gold standard for evaluation of the lower-extremity arterial tree has long been contrast arteriography (CA). Associated risks of CA are well-documented and include severe allergic reactions, arterial injury and/or hemorrhage, and contrast-induced nephropathy. Increasingly, less-invasive techni...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.02.005
更新日期:2007-03-01 00:00:00
abstract::For generations, the use of techniques to defer skin pressure and protect the lower-extremity wound has been a cardinal goal to achieve therapeutic success and healing. Choosing the appropriate postoperative offloading device or shoe is often difficult, as it is challenging to merge optimal mechanical protection with ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2014.10.002
更新日期:2014-03-01 00:00:00
abstract::The continuing evolution of endovascular approaches to the repair of descending thoracic and thoracoabdominal aortic aneurysms necessitates careful evaluation of the safety and efficacy of these alternative therapies as they compare to the "gold standard" of open surgical repair. The purpose of this report is to prese...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2007.11.009
更新日期:2008-03-01 00:00:00
abstract::The increasing availability of and vascular surgeons' familiarity with digital cine-fluoroscopy in the operating room has been facilitated by the advent and growing popularity of endovascular aortoiliac aneurysm repair and other endovascular techniques that are being incorporated into vascular surgical practice. Digit...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2003.08.006
更新日期:2003-12-01 00:00:00
abstract::Thrombembolic complications frequently occur during and after endovascular procedures because of associated arterial injury and thrombotic characteristics of implanted devices such as stents. New strategies in platelet aggregation inhibition are now available blocking the final and common pathway of platelet aggregati...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.23171
更新日期:2001-06-01 00:00:00
abstract::Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2010.05.001
更新日期:2010-09-01 00:00:00
abstract::Early detection of abdominal aortic aneurysms potentially can save many lives by preventing aneurysm rupture. Screening programs, however, have yet to be proven as an efficient means of accomplishing this goal and improving overall life expectancy. Until more information is available, selective high-risk screening may...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/svas.2001.25491
更新日期:2001-09-01 00:00:00
abstract::Restenosis following lower-extremity revascularization remains a significant and costly public health burden. Technical advances in endovascular therapy afford us the choice of treating longer and more distal lesions, which were heretofore reserved for vein bypass surgery. While contemporary vascular surgeons are well...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2008.05.007
更新日期:2008-09-01 00:00:00
abstract::Aortic infection is an uncommon but life-threatening condition. Conservative medical treatment is insufficient in many cases because of the high risk of persistent infection, aortic rupture, and death. Conventional open surgical treatment consists of extensive tissue debridement, complete removal of the infected prost...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章,评审
doi:10.1053/j.semvascsurg.2011.10.009
更新日期:2011-12-01 00:00:00
abstract::Elimination of the embolic potential of existing thrombus, restoration of unobstructed flow, prevention of further thrombosis, and preservation of venous valve function are the ideal goals of therapy for acute deep vein thrombosis (DVT). Meeting these goals will not only prevent pulmonary embolus, but will also minimi...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/j.semvascsurg.2010.10.002
更新日期:2010-12-01 00:00:00
abstract::The purpose of this article is to describe the development and utilization of a unique paperless medical record system in a large multispeciality group practice setting. The Scott and White integrated health care delivery system provides care over a 34-county area in Central Texas. Since 1988, clinicians at Scott and ...
journal_title:Seminars in vascular surgery
pub_type: 杂志文章
doi:10.1053/svas.2001.21253
更新日期:2001-03-01 00:00:00