Abstract:
PURPOSE:To validate the accuracy of previously established duplex ultrasound criteria for > or =50% superior mesenteric artery (SMA) and celiac artery (CA) stenosis by comparison with arteriography. METHODS:Duplex criteria established retrospectively in our laboratory in 1991 identified an end-diastolic velocity (EDV) > or =45 cm/sec, or no flow signal, as highly sensitive (100%) and specific (92%) indicators for SMA stenosis > or =50% or occlusion. EDV was more accurate (95%) than peak systolic velocity (PSV), which had a maximal accuracy of 86% at a PSV > or =300 cm/sec, with low sensitivity (62%), but high specificity (100%). For CA, accurate velocity thresholds were not identified, but we subsequently noted that retrograde common hepatic artery flow direction from SMA collateral was highly predictive of severe CA stenosis or occlusion. Since publication of those findings, 243 mesenteric duplex scans were performed for clinical evaluation of suspected chronic mesenteric ischemia. Angiographic confirmation was available for a subset of 46. SMA and CA diameters were measured on lateral aortograms by observers blinded to the duplex results, and the original duplex diagnostic criteria were tested for accuracy. In addition, receiver operator characteristic curve analysis was performed on the velocity data to identify the most accurate velocity thresholds in the new data. RESULTS:Duplex was technically adequate in 98% of SMA, 96% of CA, and 89% of hepatic arteries, and arteriograms were adequate in 100% of SMA and 98% of CA. For the SMA, EDV > or =45 cm/sec again provided the best sensitivity (90%), specificity (91%), positive predictive value (90%), negative predictive value (91%), and overall accuracy (91%). As in the retrospective study, PSV > or =300 cm/sec provided low overall accuracy (81%), low sensitivity (60%), but high specificity (100%). Lowering the PSV threshold improved sensitivity but reduced accuracy. For CA, retrograde common hepatic artery flow direction was 100% predictive of severe CA stenosis or occlusion. Velocity data in CA provided accuracy not found in the original study. EDV > or =55 cm/sec or no flow signal had best overall accuracy (95%) with high sensitivity (93%) and specificity (100%). PSV > or =200 cm/sec or no signal also had excellent accuracy (93%), sensitivity (93%), and specificity (94%). In addition, three of four anatomic anomalies were correctly identified by duplex. These included one right hepatic and one common hepatic artery originating from the SMA, and one common celiacomesenteric trunk. CONCLUSION:This validation analysis confirms that duplex velocity criteria are accurate in the identification of mesenteric occlusive disease. Retrograde common hepatic artery flow direction correctly predicts severe CA stenosis or occlusion. Duplex ultrasound may also identify mesenteric anatomic variants that can influence study interpretation.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Zwolak RM,Fillinger MF,Walsh DB,LaBombard FE,Musson A,Darling CE,Cronenwett JLdoi
10.1016/s0741-5214(98)60010-0subject
Has Abstractpub_date
1998-06-01 00:00:00pages
1078-87; discussion 1088issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(98)60010-0journal_volume
27pub_type
杂志文章abstract::Antithrombin (AT III), a major circulating anticoagulant, may be influenced by ischemia-induced changes in microvascular integrity and contribute to localized hypercoagulability. In a nonheparinized intact canine hindlimb model we determined AT III activity by chromogenic substrate assay (S-2238); coagulation changes ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.vs0090740
更新日期:1989-05-01 00:00:00
abstract:BACKGROUND:Endovascular treatment of ruptured abdominal aortic aneurysms (r-AAAs) has the potential to offer improved outcomes. As our experience with endovascular repair of r-AAA evolved, we recognized that the development of abdominal compartment syndrome (ACS) led to an increase in morbidity and mortality. We theref...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.033
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVES:Creating a diverse workforce is paramount to the success of the surgical field. A diverse workforce allows us to meet the health needs of an increasingly diverse population and to bring new ideas to spur technical innovation. The purpose of this study was to assess trends in workforce diversity within vascul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.12.063
更新日期:2020-12-18 00:00:00
abstract::Epithelioid hemangioendothelioma (EHE) is a rare neoplasm originating from various organs. The clinical outcome mostly depends on surgical resectability. The authors report an EHE of the extracranial internal carotid artery developed in a 59-year-old male patient 14 years after the intravascular coil embolization for ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.06.108
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:In patients with thoracoabdominal aortic aneurysms (TAAAs), the blood supply to the spinal cord is highly variable and unpredictable because of obstructed intercostal and lumbar arteries. This study was performed for the prospective documentation of patent segmental arteries during TAAA repair and the assessm...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mva.2002.120041
更新日期:2002-01-01 00:00:00
abstract::We report seven cases of dissection of the abdominal aorta. Three patients had acute back pain, whereas four patients had more chronic courses. In six cases, as a result of the palpation of a pulsatile abdominal mass, clinical diagnosis was an atheromatous aneurysm. Angiography and CT scanning demonstrated a dissected...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:Vasculogenesis relies on the recruitment of bone marrow-derived endothelial progenitor cells (BMD EPCs) and is stimulated by tissue-level ischemia. We hypothesized that the BMD EPC response is impaired in ischemic wounds and studied the relationship between BMD EPCs and wound healing. METHODS:We used transge...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.038
更新日期:2006-01-01 00:00:00
abstract::We report a case of successful surgical management of a potentially life-threatening complication of aortoiliac stent placement. A 59-year-old man who had Leriche syndrome underwent bilateral iliac artery and infrarenal aortic stent placement at another institution. His history was significant for retroperitoneal lymp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70007-7
更新日期:1997-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess the short-term and mid-term results of endovascular aneurysm repair with the Zenith stent graft in a single-center prospective study. METHOD:Between October 1998 and July 2001, we used the Zenith stent graft for elective endovascular aneurysm repair in 116 patients, six ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.125032
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:There is significant controversy in the management of critical limb ischemia (CLI) arising from infrainguinal peripheral arterial disease. We sought to compare practice patterns and perioperative and long-term outcomes for patients undergoing lower extremity bypass (LEB) and percutaneous vascular intervention...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.09.063
更新日期:2016-04-01 00:00:00
abstract::The long-term patency of the internal mammary artery graft is better than that of the saphenous vein graft in coronary bypass surgery because of a low incidence of atherosclerosis in the internal mammary artery. In search of a possible biochemical explanation of the low degree of atherosclerosis in the internal mammar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.17248
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVES:We investigated the utility of color duplex ultrasound (CDU)-derived common femoral artery (CFA) hemodynamics for detecting significant aortoiliac occlusive disease and predicting its severity. METHODS:From January 1997 to June 2001, 132 consecutive patients with lower extremity arterial insufficiency under...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.282
更新日期:2003-05-01 00:00:00
abstract:BACKGROUND:Simultaneous treatment of multilevel aortic disease is controversial due to the theoretic increase in morbidity. This study was conducted to define the outcomes in patients treated electively with simultaneous thoracic endovascular aortic aneurysm repair (TEVAR) and abdominal aortic endovascular endografting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.272
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Early failure (within 6 weeks of construction) of prosthetic arteriovenous access (AVA) is traditionally treated by surgical revision rather than endovascular intervention because it is assumed to be related to technical factors related to the surgery. This premise is not evidence based and our results for s...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jvs.2007.10.047
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:Data regarding the cardiac abnormalities associated with Stanford type B aortic dissection (TBAD) and whether these abnormalities are related to outcomes are limited. We describe the prevalence of cardiac abnormalities in patients with TBAD as detected by echocardiography. METHODS:This retrospective review i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.09.050
更新日期:2019-06-01 00:00:00
abstract:PURPOSE:The North American and the European Symptomatic Carotid Endarterectomy Trial investigators reported a conclusive benefit of carotid endarterectomy for patients with symptomatic 70% to 99% internal carotid artery (ICA) stenosis. However, it has been suggested that plaque structure may be an even more important f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90014-0
更新日期:1994-08-01 00:00:00
abstract:PURPOSE:The incidence rate of disease progression and stroke after the diagnosis of a moderate (50% to 79%) carotid stenosis was determined by means of color-flow duplex scanning. METHODS:During a 4-year period, 344 male veterans with moderate internal carotid artery stenoses, on one or both sides, were examined at re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70375-7
更新日期:1999-02-01 00:00:00
abstract::A prospective, randomized study was conducted to compare the retroperitoneal versus transperitoneal approach for elective aortic reconstruction. One hundred thirteen patients (transperitoneal = 59, retroperitoneal = 54) were randomized between March 1987 and October 1988. In addition, to assess the changing course of ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.1990.17353
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate and report our treatment policies in the management of nonpulmonary arterial aneurysms in Behçet disease and to assess the prognosis in a cohort of 25 patients diagnosed between 1996 and 2007 by formally reassessing their outcome at the present time. METHODS:We ident...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.07.049
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to select branched endograft designs that could fit most aortic arch anatomies. Such off-the-shelf endografts, once available, would be an endovascular therapeutic option to consider in the acute setting and would shorten the design and manufacturing process. METHODS:We retrospecti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.11.046
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to investigate variations between states and changes in state-specific carotid endarterectomy (CEA) and 30-day mortality rates. Cross-sectional variations and changes over time in such measures may be indicative of improvement in the quality of care. METHODS:We performed re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00616-5
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:This study examined the outcomes of our novel concept of expanded provisional extension to induce complete attachment strategy (Petticoat) for safety, durability, and remodeling of chronic type B dissections. METHODS:Twenty patients with chronic type B aortic dissection with aneurysmal degeneration qualified...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.073
更新日期:2019-12-01 00:00:00
abstract::Fifty-five patients with 72 aneurysms of the iliac vessels were evaluated retrospectively during a 12-year period (1972 to 1985). Atherosclerotic vascular disease was found in all aneurysms. Marked male predominance (5:1) and advanced age (mean 74.6 years) characterized this population group. Two thirds of them harbor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze the early and late outcomes of patients who require a suprarenal aortic cross-clamp during elective open repair of an abdominal aortic aneurysm (AAA). METHODS:Patients from 1998 to 2012 who required a suprarenal aortic cross-clamp during elective open AAA repair wer...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.04.034
更新日期:2014-10-01 00:00:00
abstract:OBJECTIVE:The tumor suppressor protein p53 regulates angiogenesis and is a key regulatory mediator of cellular apoptosis, proliferation, and growth. p53 expression is induced in response to ischemia; however, its role in regulating ischemia-induced angiogenesis and arteriogenesis remains undefined. The objective of thi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.055
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the fate of aneurysmal iliac arteries managed during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). METHODS:We analyzed data from the Cook Zenith trial. Follow-up was at 1 month, 6 months, 12 months, and then annually for 5 years. Patients w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.062
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Aortic arch aneurysmal disease remains a therapeutic challenge. For patients unsuitable for standard open surgery, hybrid repair with debranching of the supra-aortic arteries followed by thoracic endovascular grafting has been shown to be an effective solution. The aim of this study was to report the clinical...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.11.033
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared wit...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.03.420
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:The use of radiation for medical purposes falls under the purview of the Food and Drug Administration (FDA) and individual states. Enhanced regulations are in place to promote the right exam for the right reason at the right time for every patient exposed to medical x-rays. METHODS:The February 2010 FDA ini...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.177
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease poses a significant burden in the hemodialysis (HD)-dependent population. Race is a known modifier of outcomes after surgical treatment of peripheral arterial disease. A comprehensive evaluation of the effect of race on infrainguinal bypass surgery (IBS) outcomes in HD patients is...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.04.044
更新日期:2017-10-01 00:00:00