Abstract:
BACKGROUND:This report examines the effects of regional versus general anesthesia for infrainguinal bypass procedures performed in the treatment of critical limb ischemia (CLI). METHODS:Nonemergent infrainguinal bypass procedures for CLI (defined as rest pain or tissue loss) were identified using the 2005 to 2008 American College of Surgeons National Surgical Quality Improvement Program database using International Classification of Disease, ninth edition, and Current Procedure Terminology codes. Patients were classified according to National Surgical Quality Improvement Program data as receiving either general anesthesia or regional anesthesia. The regional anesthesia group included those specified as having regional, spinal, or epidural anesthesia. Demographic, medical, risk factor, operative, and outcomes data were abstracted for the study sample. Individual outcomes were evaluated according to the following morbidity categories: wound, pulmonary, venous thromboembolic, genitourinary, cardiovascular, and operative. Length of stay, total morbidity, and mortality were also evaluated. Associations between anesthesia types and outcomes were evaluated using linear or logistic regression. RESULTS:A total of 5,462 inpatient hospital visits involving infrainguinal bypasses for CLI were identified. Mean patient age was 69 ± 12 years; 69% were Caucasian; and 39% were female. In all, 4,768 procedures were performed using general anesthesia and 694 with regional anesthesia. Patients receiving general anesthesia were younger and significantly more likely to have a history of smoking, previous lower-extremity bypass, previous amputation, previous stroke, and a history of a bleeding diathesis including the use of warfarin. Patients receiving regional anesthesia had a higher prevalence of chronic obstructive pulmonary disease. Tibial-level bypasses were performed in 51% of procedures, whereas 49% of procedures were popliteal-level bypasses. Cases performed using general anesthesia demonstrated a higher rate of resident involvement, need for blood transfusion, and operative time. There was no difference in the rate of popliteal-level and infrapopliteal-level bypasses between groups. Infrapopliteal bypass procedures performed using general anesthesia were more likely to involve prosthetic grafts and composite vein. Mortality occurred in 157 patients (3%). The overall morbidity rate was 37%. Mean and median lengths of stay were 7.5 days (± 8.1) and 6.0 days (Q1: 4.0, Q3: 8.0), respectively. Multivariate analyses demonstrated no significant differences by anesthesia type in the incidence of morbidity, mortality, or length of stay. CONCLUSION:These results provide no evidence to support the systematic avoidance of general anesthesia for lower-extremity bypass procedures. These data suggest that anesthetic choice should be governed by local expertise and practice patterns.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Ghanami RJ,Hurie J,Andrews JS,Harrington RN,Corriere MA,Goodney PP,Hansen KJ,Edwards MSdoi
10.1016/j.avsg.2012.04.006subject
Has Abstractpub_date
2013-02-01 00:00:00pages
199-207issue
2eissn
0890-5096issn
1615-5947pii
S0890-5096(12)00262-2journal_volume
27pub_type
杂志文章abstract:BACKGROUND:Renal artery aneurysms (RAAs) represent a rare vascular pathology with an estimated incidence of <1%. Although an endovascular approach is being increasingly used to treat RAAs, we hypothesized that open surgical repair of RAA, specifically via aneurysmectomy with arterial reconstruction (AAR), is a safe, ef...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.07.030
更新日期:2010-05-01 00:00:00
abstract:BACKGROUND:Transcarotid artery revascularization (TCAR) has been shown to have half the rates of transient ischemic attack (TIA), stroke, and death compared with transfemoral carotid artery stenting (TFCAS). Successful outcomes of TFCAS require careful patient selection. The aim of this study was to determine the outco...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.016
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Phleboliths are a common finding, especially in the pelvic veins. There are generally multiple thrombi associated with vascular malformations, trauma, or iatrogenic or noniatrogenic intravenous foreign bodies. METHODS:Herein, we report a unique case of a single moving phlebolith in the cephalic vein of a 65...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.10.055
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Doppler ultrasound (DUS) and computed tomography angiography (CTA) are the most commonly used imaging modalities for carotid disease. The aim of this study was to test the accuracy and reproducibility of CTA-derived measurements of carotid stenosis and compare them with those obtained by DUS. METHODS:Images...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.01.102
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Hyperbaric oxygen (HBO) is used as an adjunctive therapy for a variety of indications. However, there is a lack of high-quality research evaluating HBO treatment outcomes for different indications available in the current literature. METHODS:We retrospectively reviewed all patients who underwent HBO therapy...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.07.034
更新日期:2015-02-01 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:BACKGROUND:To determine whether direct open repair of thoracoabdominal aortic aneurysms after previous abdominal aortic surgery is a safe option. METHODS:Ten patients were operated between January 2006 and January 2012. Mean age was 70 years (62-78 years). Four aneurysms (Crawford type III) were treated by firstly per...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.04.002
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Carotid endarterectomy (CEA) is the gold standard for treatment of carotid artery stenosis. CEA can be challenging, even technically impossible. Prosthetic carotid bypass grafting is a proven and safe alternative when CEA is hazardous. An alternative technique that is prosthetic carotid bifurcation resection...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.05.025
更新日期:2015-11-01 00:00:00
abstract::Aortic wall tension was determined in 40 patients to assess its predictive value in abdominal aortic aneurysm (AAA) rupture. A 3-year retrospective analysis of 243 patients with ruptured AAAs and 45 patients with intact AAAs was conducted. The 288 patient sample was limited to the 40 patients with an abdominal CT scan...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910027
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND:Carotid revascularization for asymptomatic carotid artery stenosis (ACAS) has become increasingly controversial in the past few decades as the best medical therapy has improved. The aim of this study was to assess and define contemporary trends in the rate of carotid revascularization procedures for ACAS in ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.08.118
更新日期:2020-09-03 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:The possibility of predicting severe compartment syndrome using simple biochemical parameters was evaluated in a single-center study of 55 patients who presented with acute femoral embolism and who were treated with open surgical embolectomy. METHODS:Parameters related to tissue damage and oxidative metabol...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.12.006
更新日期:2014-01-01 00:00:00
abstract::Cervical aortic arch (CAA) is a rare vascular malformation which sometimes accompanies other cardiovascular malformations. Surgical approaches such as a lateral thoracotomy and a median sternotomy are selected depending on the position and type of aneurysm and other associated malformations. We herein report the case ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2007.07.028
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Our goal was to analyze the incidence and risk factors for 30-day postdischarge mortality in patients with vascular disease undergoing major lower extremity amputation. METHODS:We queried the American College of Surgeons National Surgery Quality Improvement Program data set from the years 2005 to 2009 for a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.05.012
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to ascertain the technical difficulties and complications of video-assisted thoracic sympathectomy (VTAS) in the treatment of hyperhidrosis in a large group of patients. METHODS:Between October 1995 and February 2008, 1731 patients with palmar, axillary, or craniofacial hyperhidros...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.026
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Recently, the new Cordis INCRAFT abdominal aortic aneurysm (AAA) Stent-Graft System ultra low-profile device has been introduced in the clinical practice of endovascular aortic repair (EVAR) for the treatment of infrarenal AAAs (iAAAs). In our operative unit, it has been used since November 2014. We report o...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.06.096
更新日期:2016-01-01 00:00:00
abstract::Pseudoaneurysm of the internal mammary artery is an unusual complication of wounds to the chest. We report a case of a 41-year-old man who sustained a stab chest wound and posttraumatic pseudoaneurysm of the internal mammary artery, resulting in hemomediastinum and hemothorax. The patient was successfully treated usin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.06.034
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the predictive factors of reduction in diameter ≥10 mm of the aneurysm sac after endovascular treatment and analyze evolution in these patients. METHODS:Between December 1997 and December 2008, all patients electively treated at our center for an infrarenal abdominal a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.12.016
更新日期:2015-01-01 00:00:00
abstract::Most physicians are aware of the important role that platelets play in thrombus formation. The mechanisms that regulate platelet function are now understood at the molecular level. The same biologic processes that control platelet participation in the hemostatic process also allow platelets to interact with the vessel...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02001017
更新日期:1993-03-01 00:00:00
abstract::Despite major advances in pharmacologic and endovascular therapies, acute limb ischemia (ALI) continues to result in significant morbidity and mortality. The incidence of ALI may be as high as 13-17 cases per 100,000 people per year, with mortality rates approaching 18% in some series. This review will address the con...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2011.05.017
更新日期:2012-01-01 00:00:00
abstract::Spontaneous dissection of the superior mesenteric artery represents a rare cause of abdominal angina. Conservative or more aggressive treatments such as surgery or endovascular therapy depend on the symptoms. We present a case report of acute mesenteric ischemia due to spontaneous dissection of the superior mesenteric...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2008.12.004
更新日期:2009-07-01 00:00:00
abstract::Behcet disease (BD) is a chronic systemic inflammatory disorder characterized by recurrent oral and genital ulcerations, üveitis, and skin lesions. Vascular system involvement is common in BD. Aneurysm formation appears to be more common than arterial occlusion. Extracranial carotid aneurysms in BD are extremely rare....
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.10.033
更新日期:2015-01-01 00:00:00
abstract::A Mucorales infection of an external iliac artery stent in a renal transplant patient is described. Following a kidney transplantation operation and an acute rejection of the transplant, an aneurysm developed at the site of the arterial ligation and three stents were inserted. Two months following insertion of the ste...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9007-1
更新日期:2006-03-01 00:00:00
abstract::Sixty-two first episodes of aortofemoral (eight patients) or aortobifemoral (42 patients) bypass thrombosis were operated upon in 50 patients between 1980 and 1985. There were 47 men and three women whose mean age was 58 years. Retrograde thrombectomy through the distal anastomosis was achieved in all cases by using e...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02021771
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to evaluate 2 patients who underwent endovascular repair directly after acute life-threatening vascular injury complicating lumbar disc surgery, and to update an overview of the literature from 2002 to gain insights into characteristics, diagnosis, treatment, and outcomes of this...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.07.019
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine early and mid-term outcomes after open repair of thoracoabdominal aortic aneurysm, with moderate to deep hypothermia as part of proximal aortic management. METHODS:Between April 2009 and March 2015, 44 patients underwent thoracoabdominal aortic repair by total cardiopu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.08.021
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Redo area region operation is associated with a significant morbidity such as neurovascular injury, infection, and lymphorrhea. The traditional management of occluded femoropopliteal grafts often includes redissection of a scarred groin to obtain adequate inflow via the common femoral artery. These procedure...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.04.013
更新日期:2018-10-01 00:00:00
abstract::The purpose of this study was to evaluate whether duplex ultrasound arterial mapping (DAM) can reliably replace standard arteriography (SA) in the preoperative assessment of candidates for popliteal and infrapopliteal bypasses. This is the report of a two-phase study undertaken at our institution from July 1997 to May...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900213
更新日期:1999-01-01 00:00:00
abstract::This study was designed to compare outcomes following infrainguinal bypass between patients with end-stage renal disease (ESRD) and patients with normal renal function (NRF). Sixty-three patients with ESRD undergoing 78 infrainguinal bypasses from 1990 to 1999 were compared with a concurrent group of 132 age-, race-, ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010067
更新日期:2001-05-01 00:00:00
abstract::This study reports our experience of using thoracoscopic cervicodorsal sympathectomy with diathermy. From December 1994 to September 1998, we performed 53 thoracoscopic sympathectomies in 35 patients. There were 15 men and 20 women, ages 18 to 61 years. Ten surgeries were performed on the right side, 7 were the left, ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900302
更新日期:1999-11-01 00:00:00