Abstract：
PURPOSE:This study was performed to determine whether comprehensive cost-cutting strategies adversely affect the outcome in patients undergoing carotid endarterectomy. METHODS:From December 1994 to December 1995, 237 consecutive patients undergoing 260 carotid endarterectomies were prospectively studied. The following variables were assessed: carotid arteriography, preoperative laboratory tests, electrocardiograms and chest x-ray films, use of carotid shunts during operation, use of pathology department, intensive care, oxygen therapy, telemetry, and hospital stay. In addition, complications were tabulated. RESULTS:Previously, all variables evaluated were routinely ordered. Subsequent to initiating the cost-containment strategies, the following results were achieved: arteriography in 52 (22%) of 237 patients, preoperative complete blood cell count and SMA-7 in 161 (62%) of 260 cases, preoperative electrocardiograms in 185 (71%) of 260 cases, preoperative chest x-ray films in 190 (73%) of 260 cases, carotid shunts in 83 (32%) of 260 cases, disease in no cases (0%), intensive care in 29 (11%) of 260 cases, oxygen therapy in 34 (13%) of 260 cases, telemetry in 17 (7%) of 260 cases, and hospital stay was decreased from an average of 2.6 to 1.3 days. Total savings based on average hospital and physician charges was $2.3 million. Complications included four strokes, one myocardial infarction, and no deaths. No patient required readmission. No recurrent or new neurologic or cardiac findings were identified clinically in follow-up at 1 and 4 weeks after surgery. CONCLUSIONS:The results clearly demonstrate that comprehensive cost-cutting strategies can reduce charges significantly while maintaining patient safety.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ammar ADdoi
10.1016/s0741-5214(96)70052-6subject
Has Abstractpub_date
1996-12-01 00:00:00pages
1050-6issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(96)70052-6journal_volume
24pub_type
杂志文章,多中心研究abstract：OBJECTIVE:Although current treatments for restenosis attempt to prevent the development of intimal hyperplasia, an alternative strategy is to induce intimal atrophy after restenosis has developed. Because platelet-derived growth factor (PDGF) is a smooth muscle cell growth and survival factor, we tested the hypothesis ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2003.07.010
更新日期：2004-02-01 00:00:00
abstract：OBJECTIVE:This study assessed the risk of left subclavian artery (LSA) coverage and the role of revascularization in a large population of patients undergoing thoracic endovascular aortic aneurysm repair. METHODS:A retrospective multicenter review of 1189 patient records from 2000 to 2010 was performed. Major adverse ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jvs.2012.06.101
更新日期：2013-01-01 00:00:00
abstract：:This review considers the roles of endovascular and open surgery for critical lower limb ischemia. The TransAtlantic Inter-Society Consensus document offers sensible guidelines for the treatment of both suprainguinal and infrainguinal disease. For bilateral/diffuse suprainguinal disease, aortobifemoral bypass remains ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jvs.2008.08.036
更新日期：2008-12-01 00:00:00
abstract：:We report a patient with a transient ischemic attack presumably caused by an entrapment of the internal carotid artery by the hyoid bone and without a significant carotid artery stenosis. The patient was operated on, with a release of the right internal and external carotid artery and resection of the right greater co...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2008.04.062
更新日期：2008-10-01 00:00:00
abstract：PURPOSE:Open revascularization in patients with chronic mesenteric ischemia (CMI) is considered the gold standard. Percutaneous transluminal angioplasty and stenting (PTAS) is often reserved for patients not suitable for open revascularization. In our institute, endovascular revascularization is the first-choice treatm...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2009.08.055
更新日期：2010-02-01 00:00:00
abstract：OBJECTIVE:Lower extremity arterial injury may result in limb loss after blunt or penetrating trauma. This study examined outcomes of civilian lower extremity arterial trauma and predictors of delayed amputation. METHODS:The records of patients presenting to a major level I trauma center from 2004 to 2014 with infraing...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2016.04.052
更新日期：2016-09-01 00:00:00
abstract：OBJECTIVE:To examine the outcome of a comprehensive follow-up program for autogenous arteriovenous hemodialysis access (AVF) when performed by the hemodialysis access surgeon. METHODS:Patients with first time AVFs between 2000 and 2005 underwent history and physical examination between the third and sixth postoperativ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2007.01.013
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Prospective validation of prognostic scoring systems for ruptured abdominal aortic aneurysm (AAA) is lacking. This study assesses the validity of three established risk scores and a new prognostic index. METHOD:Patients admitted with ruptured AAA during a 26-month period (August 2002-December 2004) were rec...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2007.10.031
更新日期：2008-02-01 00:00:00
abstract：:Treating flush iliac artery occlusion by endovascular means can be very challenging and is a cause of technical failure requiring open surgical intervention. We describe a simple endovascular technique that can be valuable in increasing technical success and avoiding the use of a re-entry device. The technique involve...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2011.10.029
更新日期：2012-03-01 00:00:00
abstract：OBJECTIVE:The application of thoracic endovascular aortic repair (TEVAR) has changed treatment paradigms for thoracic aortic disease. We sought to better define specific treatment patterns and outcomes for type B aortic dissection treated with TEVAR or open surgical repair (OSR). METHODS:Medicare patients undergoing t...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2013.12.047
更新日期：2014-07-01 00:00:00
abstract：OBJECTIVE:End-stage renal disease (ESRD) imparts a significant survival disadvantage to individuals undergoing lower extremity revascularization; however, the influence of lesser degrees of renal impairment remains unclear. This study examined the prognostic significance of the chronic kidney disease (CKD) classificati...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2007.01.025
更新日期：2007-05-01 00:00:00
abstract：:We report two patients with a carotid body paraganglioma that extended to the skull base, a position that is surgically inaccessible by means of a traditional lateral cervical approach. In both patients we were able to remove the lesion by performing a double mandibular osteotomy. Both patients underwent preoperative ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2012.11.086
更新日期：2013-08-01 00:00:00
abstract：PURPOSE:We evaluated the effects of wearing 20 to 30 mm Hg gradient thigh-length stockings during daily activity on the lower leg venous system. METHODS:Twenty-one healthy women volunteers, aged 39 +/- 12 years, were examined. One subject was clinical class 4, one was class 2, two were class 1, and the remainder were ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(99)70007-8
更新日期：1999-11-01 00:00:00
abstract：OBJECTIVE:Foot complications in patients with diabetes or peripheral artery disease (PAD) are serious events in the life of these patients that often lead to amputations and mortality. No evidence synthesis has been reported on the mortality rates after minor lower extremity amputation; thus, a quantitative evidence sy...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jvs.2020.07.086
更新日期：2020-12-01 00:00:00
abstract：PURPOSE:The major cause of vascular prosthesis failure is anastomotic intimal hyperplasia caused by the proliferation and migration of smooth muscle cells. Hepatocyte growth factor (HGF) is an endothelium-specific growth factor that exerts a mitogenic action on endothelial cells. This study was designed to examine the ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2002.119747
更新日期：2002-04-01 00:00:00
abstract：OBJECTIVE:The use of sirolimus eluting stent (SES) has strongly limited the incidence of in-stent restenosis that still remains a problem at the stent edge. The aim of this study was to analyze the neointimal thickening after implantation of SES and to assess the influence of the stent implantation procedure on the neo...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2007.04.063
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVE:To achieve an optimal sealing zone during endovascular aneurysm repair, the intended positioning of the proximal end of the endograft fabric should be as close as possible to the most caudal edge of the renal arteries. Some endografts exhibit a small offset between the radiopaque markers and the proximal fabr...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2017.05.092
更新日期：2018-05-01 00:00:00
abstract：PURPOSE:Foot venous pressure measurement is considered to be useful for assessing lower limb venous insufficiency, because venous hypertension is the main factor predisposing to venous insufficiency. In this study, we investigated the utility of foot venous pressure measurement in the evaluation of venous insufficiency...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(98)70232-0
更新日期：1998-04-01 00:00:00
abstract：:Effective endovascular repair of an infrarenal abdominal aortic aneurysm (AAA) requires adequate proximal and distal landing zones to allow secure endograft attachment. We report a patient with an infrarenal AAA originating 3 mm below the left renal artery with cardiac morbidity that precluded open AAA repair. Left re...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(03)00117-4
更新日期：2003-07-01 00:00:00
abstract：:We report the case of a 78-year-old man with coronary artery disease, chronic obstructive pulmonary disease, and chronic renal insufficiency with an enlarging 6.7-cm infrarenal abdominal aortic aneurysm. He also had a 4-cm right common iliac artery aneurysm, and right external iliac artery occlusion. The patient had a...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2013.05.105
更新日期：2014-06-01 00:00:00
abstract：PURPOSE:Conventional pre-endovascular procedural evaluation uses both noninvasive testing and diagnostic arteriography. Diagnostic and therapeutic procedures often must be performed separately because of concerns about excessive contrast administration or inappropriate location of vascular access for the interventional...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(98)70025-4
更新日期：1998-12-01 00:00:00
abstract：:Von Recklinghausen's Type 1 neurofibromatosis (NF) is a genetic disorder of neuroectodermal tissue. Arterial involvement has also been recognized. Stenotic lesions predominate, but aneurysms have been documented as well. Aortoiliac, visceral, and cervical aneurysms are well represented in the literature. Rarely noted,...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2001.112704
更新日期：2001-05-01 00:00:00
abstract：PURPOSE:Cyclooxygenase, either the cox1 or cox2 isoform, controls synthesis of prostaglandin E2 (PGE2), which regulates expression of matrix metalloprotease-9 (MMP-9). PGE2 and MMP-9 are elevated in aortic aneurysms. The mechanisms and time course of the inhibition of aneurysm expansion with a nonspecific cyclooxygenas...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(99)70216-8
更新日期：1999-05-01 00:00:00
abstract：OBJECTIVE:Vascular graft and endograft infection (VGEI) has high morbidity and mortality rates. Diagnosis is complicated because symptoms vary and can be nonspecific. A meta-analysis identified 18F-fluoro-d-deoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) as the most valuable tool for diag...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jvs.2020.05.065
更新日期：2020-12-01 00:00:00
abstract：BACKGROUND:This study analyzed predictors and the long-term consequence of type II endoleak in a large series of elective endovascular abdominal aneurysm repairs (EVARs). METHODS:Baseline characteristics and operative and follow-up data of consecutive patients undergoing EVAR were prospectively collected. Patients who...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2013.10.092
更新日期：2014-04-01 00:00:00
abstract：OBJECTIVE:Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asy...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2017.04.041
更新日期：2017-11-01 00:00:00
abstract：PURPOSE:Most endografts for an endoluminal AAA repair cannot achieve an adequate hemostatic seal in ectatic common iliac arteries larger than 14 mm. The extension of the endograft into the external iliac artery can alleviate this problem but requires sacrifice of the internal iliac artery. We have used the larger diame...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2001.111659
更新日期：2001-02-01 00:00:00
abstract：OBJECTIVE:Our aim was to evaluate the effect of gender on early and late procedural and functional outcomes of lower extremity bypass (LEB). METHODS:We reviewed the records of 2576 patients (828 women; 32%) who underwent LEB for claudication or critical limb ischemia (CLI) in the Vascular Study Group of New England fr...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jvs.2014.05.008
更新日期：2014-11-01 00:00:00
abstract：:Standard approaches to lower extremity arteries may be rendered difficult or unusable because of scarring or infection, or both. This article describes unusual alternative approaches to facilitate lower extremity bypasses that would normally require approaches to the common femoral, deep femoral, or popliteal arteries...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2016.03.472
更新日期：2016-10-01 00:00:00
abstract：PURPOSE:The purpose of this study was to evaluate the long-term safety and efficacy of the titanium Greenfield filter-modified hook for prevention of pulmonary embolism. METHODS:We conducted a prospective study in 173 patients from four institutions who underwent clinical examination, abdominal radiography, and duplex...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/0741-5214(94)90146-5
更新日期：1994-09-01 00:00:00
