Abstract:
BACKGROUND:In this study, we sought to analyze emerging national trends in the treatment of lower extremity peripheral arterial disease and associated outcomes. METHODS:The Nationwide Inpatient Sample was queried between 2001 and 2007. Patients diagnosed with lower extremity atherosclerosis were selected by using the International Classification of Diseases, 9th Revision codes 440.20-440.24, resulting in an average of 307,000 annual hospitalizations. Within this group, we determined the annual number of lower extremity bypasses, endovascular interventions, and major and/or minor amputations (below-the- and/or above-the-knee amputation versus toe and/or foot amputation). Chi-square analysis was performed on discharge-weighted data to compare two periods (2001-2003 and 2004-2007) to determine changes in management and differences in outcome. Multivariate logistic regression was used to identify predictors of amputation. RESULTS:Comparing the two periods, it was found that the average annual number of endovascular interventions increased by 78% (37,692 vs. 67,248, p < 0.001), and open lower extremity bypasses decreased by 20% (68,326 vs. 54,348, p < 0.001). Annually, the total number of interventions increased by 15% (106,018 vs. 121,596, p < 0.001), whereas the number of total amputations (59,693 vs. 50,254, p < 0.001), major amputations (39,543 vs. 31,043, p < 0.001), and minor amputations (20,150 vs. 19,211, p < 0.001) performed all significantly decreased. Diabetes was the leading predictor of amputation, especially those involving the toe and forefoot. After adjusting for age and comorbidities, African Americans were found to have a 2.4 times odds of amputation as compared with Caucasians, whereas those with Medicare or Medicaid had a 1.5 times odds as compared with those having private insurance or Health Maintenance Organization. CONCLUSIONS:Between the periods examined, we observed that the treatment of lower extremity peripheral arterial disease has evolved with increased use of lesser invasive endovascular techniques and fewer open lower extremity bypasses. These trends are associated with fewer major lower extremity amputations. Significant socioeconomic disparities persist in amputation rates, with racial minorities and those with Medicare or Medicaid having higher odds of amputation.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Hong MS,Beck AW,Nelson PRdoi
10.1016/j.avsg.2010.08.006subject
Has Abstractpub_date
2011-01-01 00:00:00pages
44-54issue
1eissn
0890-5096issn
1615-5947pii
S0890-5096(10)00437-1journal_volume
25pub_type
杂志文章abstract::Ischemia occurring during hyperextension of the upper limb in a 25-year-old woman led to the discovery of a supracondylar spur responsible for compression of the brachial artery with anomalous insertion of the pronator teres muscle. Resection of all abnormal structures provided immediate relief of symptoms. When atypi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60736-X
更新日期:1987-05-01 00:00:00
abstract::Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury (BTAI). A 29-year-old pedestrian ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.12.007
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Elective repair of large abdominal aortic aneurysms (AAAs) is associated with the risk of significant perioperative mortality. When abdominal aneurysm repair is delayed, patients with asymptomatic large AAAs face the risk of death from rupture. In addition to the risk of rupture, the advancing age of the pat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.03.041
更新日期:2015-08-01 00:00:00
abstract::Between 1985 and 1988 45 patients with descending thoracic or thoracoabdominal aortic aneurysms underwent selective arteriography of the intercostal and lumbar arteries to delineate preoperatively the artery of Adamkiewicz and the thoracic radicular artery. Identification of these vessels failed in five patients (11%)...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)62382-0
更新日期:1989-01-01 00:00:00
abstract:BACKGROUND:Almost 80% of patients with end-stage renal disease (ESRD) initiate dialysis via a central venous catheter (CVC). CVCs are associated with multiple complications and a high cost of care. The purpose of our project is to determine the impact of early cannulation arteriovenous grafts (ECAVGs) on quality of car...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.007
更新日期:2019-08-01 00:00:00
abstract::The etiology of varicose veins remains elusive. We hypothesized that abnormal cell cycle events in the vein wall may contribute to changes in its structural integrity predisposing to varicosity development. Since cell cycle checkpoint controls are linked to the signaling and execution of apoptotic cascades, possibly a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910005
更新日期:2000-01-01 00:00:00
abstract::Open surgical repair of complex abdominal aortic aneurysms requires more extensive dissection and aortic clamping above the renal or mesenteric arteries. Although results of open surgical series have shown variation, morbidity and mortality is higher compared with infrarenal aortic aneurysm repair. Potential complicat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2010.10.005
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:In a number of relatively small-size studies, investigators have measured and compared circulating interleukin-6 (IL-6) levels in cases with abdominal aortic aneurysm (AAA) and controls without AAA to assess its possible role in the pathogenesis or progression of AAA. To summarize the present evidence for an...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.avsg.2014.06.058
更新日期:2014-11-01 00:00:00
abstract::Between 1982 and 1991 we performed eight operations on seven patients with carotid artery aneurysms. Their mean age was 52.8 years (range: 20-67 years). Five aneurysms were atherosclerotic, one was associated with Marfan's syndrome, and two were pseudoaneurysms, one occurring after Dacron patch angioplasty and the oth...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015273
更新日期:1991-11-01 00:00:00
abstract::Salmonella aortitis is a known complication of Salmonella infection that usually requires surgical therapy. It is unknown whether endovascular aortic repair (EVAR) is an acceptable alternative to conventional aortic surgery for patients with Salmonella aortitis who are at high risk for perioperative complications. We ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2013.09.015
更新日期:2014-07-01 00:00:00
abstract::Successful treatment by percutaneous catheter drainage of an acute aortic graft infection with an associated pancreatic fistula is reported. Percutaneous catheter drainage can be considered in selected patients when the risk of reoperation is deemed unacceptable or when other reasonable treatment options do not exist....
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02000598
更新日期:1996-09-01 00:00:00
abstract::This report describes a case of defecation syncope secondary to functional inferior vena cava (IVC) obstruction. Preoperative hemodynamic assessment revealed a marked decrease in blood pressure and IVC obstruction when the patient performed a Valsalva maneuver. The intraoperative approach included continuous hemodynam...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02002893
更新日期:1993-07-01 00:00:00
abstract::Behçet's disease is a chronic recurrent inflammatory disorder that affects many organs. A 48-year-old man with known Behçet's disease was admitted to the emergency department with aggravating severe back pain and left lower quadrant pain. A contained rupture of infrarenal abdominal aortic aneurysm (AAA) was discovered...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.05.011
更新日期:2010-02-01 00:00:00
abstract::Venous thrombosis of pancreas transplant allografts often leads to graft loss. It is an worrisome complication and difficult to treat, forming the most common nonimmunological cause of graft loss. Multiple risk factors have been implicated in the development of venous thrombosis of pancreas transplant. Color Doppler u...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.11.021
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Renal transplant recipients often maintain their hemodialysis access in the event of future allograft failure. Patients may develop complications related to the unused dialysis access, and it also limits vein availability for phlebotomy. Accordingly, a change in the current paradigm may be warranted. This st...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.04.020
更新日期:2018-11-01 00:00:00
abstract::Twenty-four patients who underwent surgery for pararenal aortic aneurysms between January 1992 and April 1997 are reviewed. Eighteen patients had primary atherosclerotic aneurysms, three patients had symptomatic infected aneurysms, two patients had an aneurysm proximal to a prior aortic repair, and one patient had a p...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900164
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Antiplatelet treatment prevents cardiovascular events and thrombosis during the endovascular surgery procedure. The aim of this study is to analyze the different antiplatelet treatment used in endovascular procedures in Spain. METHODS:In this investigation we included observational, retrospective, and multi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2011.11.045
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:We tested whether shock wave (SW) offers additional benefits in improving left ventricular (LV) function after acute myocardial infarction (AMI) in rabbits receiving SW-treated autologous bone marrow-derived mononuclear cells (BMDMNCs) transplantation. METHODS AND RESULTS:Saline (750 microL; group 2), BMDMN...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.03.027
更新日期:2010-08-01 00:00:00
abstract::Previous reports have suggested "short" focal stenoses in peripheral vein grafts (PVGs), namely less than 2 cm long, can be successfully balloon dilated with good long-term patency rates. We questioned if enthusiasm for balloon angioplasty of these lesions in failing PVGs is warranted. Between August 1, 1993 and Decem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900129
更新日期:1998-03-01 00:00:00
abstract::We present a case of a high-risk 76-year-old man who was electively admitted for repair of a large infrarenal abdominal aortic aneurysm. After placement of the main body of the bifurcated graft, the contralateral guidewire became entrapped at the level of suprarenal fixation. Multiple endovascular maneuvers were attem...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.11.007
更新日期:2013-11-01 00:00:00
abstract::Adrenal hemorrhagic necrosis is one of several possible complications of heparin-related thrombocytopenia. We report a case in which adrenal hemorrhagic necrosis developed after aortofemoral bypass. This serious complication remains difficult to diagnose in the absence of a high index of suspicion. A routine search fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02133073
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Gender-related differences in iliofemoral anatomy are critically important for delivery of modern EVAR devices, however remains poorly characterized in the context of other patient-specific factors. The goal of the present study was to provide a detailed quantification of anatomic differences in iliofemoral ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.01.025
更新日期:2017-10-01 00:00:00
abstract::Rest pain, ulceration, and gangrene are often considered together in studies describing outcomes in patients with critical limb ischemia. A retrospective analysis of prospectively collected data of 152 infrainguinal bypass grafts performed on 128 patients with chronic critical limb ischemia over a 6-year period was ca...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0257-7
更新日期:2003-03-01 00:00:00
abstract:BACKGROUND:Angiofollicular lymphoid hyperplasia (Castleman's disease) is a rare inflammatory condition. Its cause is unknown and it can be both localized and general. Eighty-six percent of lesions are found in the mediastinum or hilum, and 91% are of the hyaline vascular type. Although Castleman's disease is primarily ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.015
更新日期:2010-08-01 00:00:00
abstract::The case being presented is a 35-year-old female with a 3-year history of progressive dyspnea and right-sided heart failure following spine surgery. Physical examination identified a continuous bruit in the lower abdomen radiating to her back which prompted further evaluation. Echocardiography showed normal left ventr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.033
更新日期:2017-11-01 00:00:00
abstract::Performance of carotid endarterectomy for asymptomatic carotid stenosis has been restricted during recent years because of concern of reported complications in as high as 10-15% of patients, as well as limited long-term data on stroke protection. During the last 10 years, we have studied immediate and long-term result...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02016741
更新日期:1991-03-01 00:00:00
abstract::This study reports the late results of eight palmar bypass procedures performed between 1983 and 1988 in eight men patients with a mean age of 43 years old, who presented with unilateral digital trophic disorders. The origin of the arterial lesions was post-traumatic in four cases, embolic in three cases, and aneurysm...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02006996
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Carotid endarterectomy (CEA) for asymptomatic patients with limited life expectancy may not be beneficial or cost-effective. The purpose of this study was to examine relationships among survival, outcomes, and costs within 2 years following CEA among asymptomatic patients. METHODS:Prospectively collected da...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.01.024
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Cerebral hyperperfusion syndrome or hemodynamic instability, caused by the hemodynamic changes, often occur within 6 hr after carotid artery stenting (CAS) The postprocedure cerebral hemodynamic change in the early phase, <6 hr after CAS, is largely unknown. In this study, we evaluated the cerebral hemodynam...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.06.124
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:We report a hybrid treatment for a ruptured penetrating aortic ulcer (PAU) of the aortic arch in emergency conditions. METHODS:A 74-year-old man with severe comorbidity was diagnosed with a symptomatic rupture of a PAU of the aortic arch. As he was considered unfit for conventional open repair and it was an...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.03.009
更新日期:2009-09-01 00:00:00