Abstract:
:Recent reports from single institutions have confirmed the efficacy of carotid endarterectomy (CEA) performed in the urgent or emergent setting, although with higher perioperative mortality and morbidity. We determined the results of urgently performed CEA in academic and community hospitals and whether patient or hospital factors affected outcome. The records of patients undergoing CEA in all nonfederal hospitals in the state of Connecticut between 1992 and 2002 were reviewed, and symptomatic patients who presented in an urgent or emergent fashion were compared to patients treated electively. Multivariable logistic regression was used to determine the effect of patient risk factors on perioperative mortality, stroke, and cardiac complications. Patients undergoing urgent CEA (n = 764, 6.3%) had higher perioperative mortality (2.0% vs. 0.3%, p < 0.0001) and stroke (2.9% vs. 1.1%, p < 0.0001) but not cardiac complications (3.0% vs. 2.2%, p = 0.14) compared to patients undergoing elective CEA (n = 11,312). Patients undergoing urgent CEA and with high rates of associated comorbidity had a higher risk of perioperative mortality (7.8% vs. 0.4, p = 0.001), stroke (10.9% vs. 0.8%, p = 0.0002), and cardiac complications (14.1% vs. 0.8%, p < 0.0001) compared to patients presenting urgently but with little comorbidity. Perioperative mortality was associated with performance of the procedure in hospitals with low bed capacity (odds ratio [OR] = 4.6, p = 0.01). Perioperative stroke was associated with renal insufficiency (OR = 5.3, p = 0.04). Perioperative cardiac complications were associated with diabetes (OR = 2.6, p = 0.03) and performance in hospitals with low bed capacity (OR = 5.0, p < 0.01). Urgent admission was associated with age >/=80 (OR = 1.2, p = 0.04), renal disease (OR = 1.8, p = 0.05), and cardiac disease (OR = 1.3, p < 0.01). Urgently performed CEA has higher perioperative mortality and stroke compared with electively performed cases. However, the subset of patients with low rates of associated comorbid medical conditions but urgently needing CEA is associated with low rates of perioperative complications. Patients with severe associated comorbid medical conditions who present urgently for CEA may form a high-risk group of patients to be considered for referral to large treatment centers or possibly alternative therapy.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Bazan HA,Pradhan S,Westvik TS,Sumpio BE,Gusberg RJ,Dardik Adoi
10.1016/j.avsg.2007.12.019subject
Has Abstractpub_date
2008-07-01 00:00:00pages
505-12issue
4eissn
0890-5096issn
1615-5947pii
S0890-5096(08)00084-8journal_volume
22pub_type
杂志文章abstract:BACKGROUND:A patch made of woven ultrahigh-molecular-weight polyethylene (UHMWPE) fibers is thin, strong, and flexible and may be attractive for use in cardiovascular prostheses. This study assessed the hemocompatibility of this patch in a sheep model. METHODS:The UHMWPE patches were sutured in the right carotid arter...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.04.002
更新日期:2018-10-01 00:00:00
abstract:BACKGROUND:IVCFs are usually placed under fluoroscopic guidance in dedicated angiography suites. Bedside placement of inferior vena cava filters (IVCF) is possible in patients not suitable for transportation, but data regarding their use are limited. The objective of this study is to compare utilization, procedural out...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.013
更新日期:2017-02-01 00:00:00
abstract:BACKGROUND:In this study, we sought to assess knowledge, attitudes, and behaviors regarding venous thromboembolism (VTE) prophylaxis among clinicians at a tertiary hospital of China. METHODS:An electronic questionnaire was sent to clinicians to gather information regarding demographic data (5 items), knowledge about V...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.013
更新日期:2020-09-16 00:00:00
abstract::Resection of carotid body tumors (neck paragangliomas) carries inherent risks of injury to the cranial nerves and other structures as well excessive blood loss. Preoperative embolization has been used to lessen the morbidity in tumors that are larger than 2 cm in diameter. Two female patients presented for treatment w...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010058
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Renal vein aneurysms (RVAs) are uncommon entities, which are usually incidental findings or may cause mild nonspecific symptoms. Modern radiological imaging, mainly multislice computed tomography (CT), has substantially contributed to a prompt and accurate diagnosis. Treatment may range from watchful waiting...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.08.075
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:We seek to present our experience with innovative abdominal wall arteriovenous access grafts for patients who have run out of traditional dialysis access options. METHODS:We retrospectively reviewed our cohort of patients who have undergone creation of abdominal wall grafts. In all patients, an iliac artery...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.087
更新日期:2016-01-01 00:00:00
abstract::Tuberculous aneurysms of the aorta are rare and give rise to various issues related to their diagnosis and treatment. In this article, we report on an exceptional case concerning a patient who presented with a false tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aort...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.034
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to better define the clinical relevance of aneurysms affecting collateral vessels in patients with celiac artery (CA) occlusive disease. METHODS:True pancreaticoduodenal artery (PDA) and gastroduodenal artery (GDA) aneurysms associated with CA stenoses or occlusions reported fro...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.09.018
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Thoracic endovascular aortic repair (TEVAR) is the treatment of choice for thoracic blunt aortic injury (TBAI). A 20 mm proximal seal zone is recommended based on aneurysmal disease literature which often results in coverage of the left subclavian artery (LSA). The aim of this study was to analyze our experi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.12.007
更新日期:2020-12-31 00:00:00
abstract::Between January 1980 and December 1992, 75 prophylactic carotid endarterectomies (CE) were performed on 72 asymptomatic patients presenting high-grade stenosis of the internal carotid artery (ICA). In all patients preoperative assessment consisted of continuous Doppler or duplex scanning. There were 33 women and 39 me...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900108
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Concern exists about durability of stent grafts used to bridge aortic grafts to visceral and renal arteries during fenestrated and branched endovascular aneurysm repair (F/B-EVAR). There are no guidelines regarding the ideal technique for joining target vessels (TVs). METHODS:We systematically reviewed data...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2020.10.052
更新日期:2021-01-05 00:00:00
abstract::Advanced complicated atherosclerotic lesions have been related to many factors, including inflammation, infectious agents, and growth factors. Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP), inflammation, and growth factors have been associated with severe atherosclerotic lesions in necropsy material in rece...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9076-1
更新日期:2006-09-01 00:00:00
abstract::With the development of endovascular aneurysm repair, abdominal aortic aneurysms with short infrarenal necks (< or =10 mm, AAASN) are considered juxtarenal aneurysms. Minimally invasive treatment consists of hybrid procedures or fenestrated endografts. We present our experience with direct aortic repair for AAASN perf...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.09.005
更新日期:2009-01-01 00:00:00
abstract::A 42-year-old black man, a physician, presented with a three week history of intermittent right arm and leg numbness and weakness, lasting about five minutes. This was not associated with headache, visual changes, seizures, aphasia or loss of consciousness. There was no history of head trauma, migraines, or previous a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015304
更新日期:1991-07-01 00:00:00
abstract::A 66-year-old man with multiple comorbidities presented with a juxtarenal perianastomotic aortic aneurysm 10 years after open abdominal aortic aneurysm repair. The aneurysmal disease also involved both iliac bifurcations, the right internal iliac artery, the left common femoral artery (CFA) up to its bifurcation, and ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.044
更新日期:2011-10-01 00:00:00
abstract::During the last 20 years, we encountered 14 arterioportal fistulas in 12 patients. Gastrointestinal hemorrhage or mesenteric artery insufficiency were the most frequent conditions found after the diagnosis. Arterioportal arterial fistulas were congenital in two cases and acquired in 10; seven of these 10 were iatrogen...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60834-0
更新日期:1990-11-01 00:00:00
abstract::We describe a case of high-dose regional intraoperative thrombolysis subsequent to mechanical thrombectomy for the treatment of postoperative distal extremity embolization of the right lower limb owing to open repair of a ruptured abdominal aortic aneurysm. Mechanical thrombectomy was performed from the popliteal arte...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.03.010
更新日期:2011-10-01 00:00:00
abstract::Since December 1985, we have operated upon seven bicycle racers for endofibrosis of the external iliac artery. In all instances, the athletes had started cycling early in life and were engaged in top level competition by the age of 17. The principal complaint was intermittent claudication of one lower limb at "near-ma...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60123-4
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:To describe the prevalence and character of complications associated with revascularization procedures as a result of peripheral arterial disease in octogenarians and nonagenarians and to assess their overall survival depending on baseline characteristics, type of treatment modality, and possible procedure-r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.07.016
更新日期:2011-02-01 00:00:00
abstract::The aim of this study was to present a case of iatrogenic thromboembolectomy-related tibialis anterior false aneurysm (FA) treated with endovascular FA exclusion and anterior leg compartment (ALC) operative decompression and to assess the current management options in posttraumatic leg vessel FAs. A 68-year-old man ha...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.09.013
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:The aim of this study was to review the literature on the association between hypothermia and outcomes in open and endovascular abdominal aortic aneurysm (AAA) repair. The secondary aim was to determine whether there is a difference in body temperature in patients undergoing either transperitoneal (TP), retr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.05.121
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Inferior vena cava filters (IVCFs) are indicated for therapeutic and prophylactic treatment of venous thromboembolism in patients when anticoagulation has failed or is contraindicated. Retrievable IVCFs are not always retrieved despite clinical recommendations. The purpose of this review is to compare result...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2018.02.010
更新日期:2018-08-01 00:00:00
abstract::Percutaneous renal artery revascularization for hypertension and renal dysfunction is now common, and there is an increasing realization that renal artery intervention can be associated with parenchymal injury. The frequency, cause, and outcomes of acute functional injury associated with renal intervention are poorly ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.06.006
更新日期:2008-11-01 00:00:00
abstract::Between January 1977 and December 1990, eight patients underwent surgical correction of aneurysms of the extracranial internal carotid artery due to fibromuscular dysplasia. Mean age of patients was 50 years (range 31 to 70 years). Five patients presented with neurologic hemispheric symptoms. Most aneurysms were saccu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000264
更新日期:1992-05-01 00:00:00
abstract::Resistance to activated protein C (RAPC) is a newly recognized hypercoagulable state that was first described in 1993. It has become apparent that RAPC is even more common than deficiencies in protein C, protein S, or antithrombin III (AT-III) and affects an estimated 5% of the general population. The majority of pati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000762
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease (PAD). Patients who are transferred to other hospitals have generally complex medical problems compared to those patients who are directly admitted...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.09.019
更新日期:2017-05-01 00:00:00
abstract::A 12-year-old boy with a family history of hereditary multiple exostosis presented with a 3-week history of progressive knee swelling. The clinical examination revealed drop foot and a loss of extension in his right knee. Evaluation with color duplex ultrasonography, computed tomography angiography, and magnetic reson...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.08.018
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Takayasu arteritis (TA) is a rare, systemic, inflammatory vasculitis of granulomatous nature, and still of unknown etiology. It mainly involves the aorta and its major branches and is more commonly seen in women of childbearing age and Asians. TA leads to stenosis, occlusion, or aneurysmal degeneration of la...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.02.011
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Revascularization of aortic arch vessels was performed with thoracic endovascular aortic repair (TEVAR) to preserve the endoprosthesis landing zone in 19 high-risk patients. METHODS:The operative procedure used was a bypass or transposition involving the common carotid and subclavian arteries. Homemade fene...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.018
更新日期:2011-08-01 00:00:00
abstract::Surgical reconstruction for patients with symptomatic lower extremity arterial occlusive disease is successful when a suitable distal target vessel is present. In patients with unreconstructable disease, practical surgical options are at a minimum. We report our initial experience with dorsal venous arch arterializati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0148-y
更新日期:2002-03-01 00:00:00