Abstract:
PURPOSE:The purpose of this study was to determine factors that may influence patient selection for surgery in recurrent carotid stenosis (RCS) and to contrast the results of primary and secondary carotid endarterectomy (CENDX) with regard to operative morbidity and stroke prevention. METHODS:Forty-eight patients who underwent CENDX for RCS (RCS-OP group) were compared with a contemporaneous group of 40 patients who on at least one post-CENDX duplex ultrasonography study had a greater than 50% stenosis but did not undergo operation (RCS-NO-OP group). This latter group was drawn from 1053 follow-up duplex studies in 348 patients who underwent primary CENDX between the years 1983 and 1993. Each of these two groups was compared with a metanalysis of six key series derived from the literature. RESULTS:No significant differences were seen in the demographics or the incidence of risk factors between the two groups except for a higher incidence of coronary artery disease (p < 0.03) and peripheral vascular disease (p < 0.001) in the RCS-OP group. The operation-specific stroke rate was 2.1%, and the 30-day mortality was also 2.1%. Symptomatic RCS was the indication in 56% of cases. Important anatomic differences were found between groups. The duplex/arteriographic degree of stenosis was greater than 90% in 75% of the patients in the RCS-OP group, whereas only 10% of the patients in the RCS-NO-OP group had greater than 80% stenosis, most being in the 50% to 80% range. An unexpected finding was the sudden progression to occlusion in 10 (25%) of 40 in the RCS-NO-OP group, with 2 (5%) of 10 of the occlusions presenting as unheralded strokes. Overall, a stroke without an antecedent transient ischemic attack occurred in 3 (7.5%) of 40 of patients in the RCS-NO-OP group, all in patients with greater than 75% stenosis on their last documented scan preceding the stroke. CONCLUSION:Given the relatively low stroke rate with surgery in the RCS-OP group (2.1%) and the higher incidence of unheralded strokes (7.5%) in the RCS-NO-OP group, a more aggressive approach may be warranted in patients with asymptomatic high-grade (> 75%) RCS, a strategy not unlike that adopted for primary CENDX.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
O'Donnell TF Jr,Rodriguez AA,Fortunato JE,Welch HJ,Mackey WCdoi
10.1016/s0741-5214(96)70095-2subject
Has Abstractpub_date
1996-08-01 00:00:00pages
207-12issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(96)70095-2journal_volume
24pub_type
杂志文章abstract:PURPOSE:We evaluated the day-to-day variability of transcutaneous oxygen tension (tcPO2) in patients with diabetes mellitus and peripheral arterial occlusive disease who were at risk for chronic foot ulceration. METHODS:The tcPO2 was measured in the morning once daily for 3 consecutive days in 10 male patients with di...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115799
更新日期:2001-08-01 00:00:00
abstract:PURPOSE:Aortoenteric fistula (AEF) is an uncommon but catastrophic complication that can occur either primarily or after aortic reconstruction. Untreated, it is uniformly fatal. Conventional surgical management is associated with a perioperative mortality rate of 25% to 90% and frequent major complications. We reviewed...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.119752
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:Firearm injuries have traditionally been associated with worse outcomes compared with other types of penetrating trauma. Lower extremity trauma with vascular injury is a common presentation at many centers. Our goal was to compare firearm and non-firearm lower extremity penetrating injuries requiring vascular...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.12.036
更新日期:2020-10-01 00:00:00
abstract::During your preoperative visit, a very wealthy patient, Gill Bates, who donated a wing to the large teaching hospital in which you practice, has an unusual request: He does not want any residents involved with his care. He is scheduled for an open infrarenal aneurysmectomy. He explains that his decision is based on th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.099
更新日期:2013-10-01 00:00:00
abstract::Dialysis access-associated steal syndrome (DASS) is an uncommon complication after the creation of an arteriovenous fistula and can cause irreversible ischemic damage in severe cases. Dialysis access-associated steal syndrome has been managed with the surgical reduction of the volume flow in the fistula, but this is a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70192-8
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVES:During the last decade, endovascular repair (EV) has replaced open surgical repair (OSR) as the preferred method of treatment of blunt traumatic thoracic aortic injuries (BTAIs) at many trauma centers. This has resulted in reductions in mortality, length of stay, and major complications, including paraplegia...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.01.087
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To summarize the association of simple renal cyst (SRC) with abdominal aortic aneurysm (AAA), we reviewed currently available clinical studies with a systematic literature search and meta-analytic evaluation. METHODS:To identify all case-control studies evaluating the association of SRC with AAA, databases i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2015.08.095
更新日期:2016-01-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the stenosis-free patency of open repair (vein-patch angioplasty, interposition, jump grafting) and percutaneous transluminal balloon angioplasty (PTA) of 144 vein graft stenoses that were detected during duplex scan surveillance after infrainguinal vein bypass grafting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70361-7
更新日期:1999-01-01 00:00:00
abstract::Aortobifemoral bypass (ABF) is the preferred operation for patients with bilateral aortoiliac occlusive disease, but for those with unilateral occlusion without significant stenosis of the contralateral iliac artery, alternative reconstructions, such as femorofemoral (FF) or iliofemoral (IF) bypass have been advocated...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0080211
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVES:Complications after abdominal aortic aneurysm (AAA) repair resulting in reintervention increase mortality risk, but have not been well studied. Mortality after reintervention is termed failure to rescue and may reflect differences related to quality management of the complication. This study describes the re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.01.030
更新日期:2011-08-01 00:00:00
abstract:PURPOSE:The endovascular approach to external iliac artery (EIA) disease extending into the common femoral artery (CFA) has been avoided because of problems with stent placement across the inguinal ligament. Surgical treatment for this disease distribution includes extensive endarterectomy or bypass procedures or both....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.124374
更新日期:2002-06-01 00:00:00
abstract::Endovascular techniques with coil embolization have been used in certain visceral aneurysm cases, often resulting in sacrifice of the involved visceral vessel and end-organ thrombosis. We describe two cases in which stent grafts were used to treat these aneurysms, allowing preservation of visceral artery and end-organ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.129645
更新日期:2002-12-01 00:00:00
abstract::Ibuprofen reduces early occlusion and surface thrombogenicity of small-diameter polytetrafluoroethylene (PTFE) grafts in sheep. The following experiments were designed to determine the effects of cyclooxygenase inhibition by ibuprofen on long-term patency and arterial wall and graft neointima prostaglandin synthesis. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::Polytetrafluoroethylene interposition grafts were used for carotid reconstruction in 26 operations performed in 23 patients during a 7-year period. There were 10 men and 13 women with a mean age of 66 years. The indication for interposition graft placement was recurrent stenosis with inability to perform endarterectom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.39750
更新日期:1992-10-01 00:00:00
abstract::We report the case of a 67-year-old woman who was admitted for surgical removal of a Greenfield filter that had been inserted 7 years before because of recurrent deep vein thrombosis associated with pulmonary embolism. This complication appeared on a plain abdominal radiogram that showed a 7 cm distal migration of the...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(95)70115-x
更新日期:1995-08-01 00:00:00
abstract::Type B dissections complicated by pain, malperfusion, or aneurysm expansion mandate surgical intervention. Success of this therapy is predicated on exclusion and thrombosis of the false lumen of the aneurysm. We report a case where cessation of flow was achieved using covered stent grafts in conjunction with coil embo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.012
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVES:A protective inferior vena cava (IVC) filter may later be incorporated into a chronic postthrombotic ilio-caval obstruction (occlusive, requiring recanalization, or nonocclusive). This study aims to assess the safety and stent-related outcome following stenting across an obstructed filter. METHODS:From 1997...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.11.117
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:The outcome of leg bypass in women is unknown. To date, most series of lower extremity bypass have included few women, and the results in women compared with those in men have not been reported. The experience with infrainguinal arterial reconstruction in women treated at the Oregon Health Sciences University h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.48556
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:Several trials have reported early superior patency of stenting over isolated angioplasty (plain old balloon angioplasty [POBA]) for infra-inguinal occlusive disease, yet long-term data are sparse. The purpose of this study was to contrast long-term clinical outcomes and costs of angioplasty alone vs angiopla...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.03.283
更新日期:2011-10-01 00:00:00
abstract:PURPOSE:Aortoiliac occlusive disease may preclude retrograde thoracic endovascular aortic repair. This study evaluated the physiologic and anatomic feasibility of introducing an aortic endograft in an antegrade manner into the descending thoracic aorta of a pig through the left ventricular apex. METHODS:Twelve adult p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.06.043
更新日期:2008-11-01 00:00:00
abstract::A nonrandomized prospective clinical study was undertaken to evaluate the technique and efficacy of in vitro endothelial cell lining of synthetic grafts. Twenty-six patients (10 men and 16 women with a mean age of 68.4 years; range, 49 to 80 years) with end stage chronic peripheral vascular disease requiring reoperati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:Little is known about the etiologic factors that lead to the occurrence of intraluminal thrombus (ILT) during abdominal aortic aneurysm (AAA) development. Recent work has suggested that macrophages may play an important role in progression of a number of other vascular diseases, including atherosclerosis; how...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.11.086
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Identifying biomarkers for abdominal aortic aneurysms (AAA) could prove beneficial in prognosis of AAA and thus the selection for treatment. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein that is highly expressed in aorta. MFAP4 is involved in several tissue remodeling-related ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2019.08.253
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Postplacement cost of surveillance and secondary procedures over 5 years increases the global cost of endovascular aortic aneurysm repair (EVAR) by nearly 50%. This study identified and assessed the reimbursement received for long-term postplacement costs after EVAR. METHODS:Between December 1995 and June 20...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.07.064
更新日期:2008-12-01 00:00:00
abstract::High-grade (80% to 99% diameter reduction) asymptomatic internal carotid artery stenoses are associated with an increased neurologic event rate (transient ischemic attack, stroke, asymptomatic internal carotid artery occlusion) compared to less severe asymptomatic lesions. However, many do remain free of associated ev...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.15589
更新日期:1989-11-01 00:00:00
abstract::Transcatheter embolization has emerged as the treatment of choice for pelvic arteriovenous malformations (AVMs), because surgical resection may be difficult and is associated with a high recurrence rate. We report a patient with a large recurrent pelvic AVM in whom transcatheter embolization was not feasible. This pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.02.004
更新日期:2004-06-01 00:00:00
abstract::A case of popliteal entrapment syndrome is reported, in which the patient experienced symptoms of tibial nerve entrapment. Exploratory surgery revealed an abnormal fibrous band between the heads of the gastrocnemius muscle that was compressing both the tibial nerve and popliteal artery. Division of this band provided ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract::We report the case of a 13-year-old boy who, at 3 years of age, was a rear seat-restrained passenger in a high-speed motor vehicle crash necessitating segmental small-bowel resection. The patient remained well for 10 years; then he began to have exercise-induced fatigue in his lower extremities. Routine physical exami...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.06.040
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:Synthetic vascular grafts have never achieved long-term patency comparable to autologous saphenous vein. Changes in graft wall porosity and carbon coating of the luminal surface have both been suggested to improve patency. METHODS:Forty-two mongrel dogs, weighing 20 to 30 kg, underwent bilateral aortoiliac gra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.41708
更新日期:1993-07-01 00:00:00
abstract:PURPOSE:To determine which patients require subfascial endoscopic perforator surgery (SEPS) in addition to saphenous surgery to correct pathologic outward flow within incompetent medial calf perforating veins (IPVs). METHODS:Sixty-two limbs of 47 patients undergoing sapheno-femoral ligation, stripping of the long saph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70058-8
更新日期:1998-11-01 00:00:00