Abstract:
BACKGROUND:Increasing evidence supports that urgent carotid endarterectomy (CEA), defined as CEA during the index hospitalization, may be undertaken in select patients with acute carotid-related neurologic symptoms to prevent recurrent ischemic events. We aimed to determine the effect of a stroke/vascular neurology service on the volume of urgent CEAs performed and assess perioperative outcomes. METHODS:A retrospective review from a single tertiary referral center between June 2005 through December 2011 revealed 393 patients who underwent CEA. We identified the number of urgent CEAs before (June 2005-August 2008) and after (September 2008-December 2011) a stroke/vascular neurology service was implemented, as well as asymptomatic CEAs and symptomatic but electively performed CEAs. Demographic data as well as 30-day adverse outcomes (transient ischemic attack [TIA], stroke, myocardial infarction, and mortality) were analyzed for each group. In patients undergoing urgent CEA, TIA and stroke severity were assessed by a stroke neurologist using the ABCD2 TIA score and National Institutes of Health Stroke Scale (NIHSS), respectively. The χ2 test was used to compare differences between the urgent CEA volume before and after a stroke/vascular neurology service. Fisher's exact test was used to analyze perioperative outcomes. RESULTS:Demographics and comorbidities were similar between the 2 groups. The proportion of urgent CEAs performed increased significantly after initiation of a vascular neurology service (4.1% [7 of 172] vs. 22.2% [49 of 221], P<0.0001). Per annum, urgent CEAs increased from 5.3% (4/75) in 2005 to 39.6% (25/63) in 2011. A vascular neurology service did not increase the number of nonurgent referrals. Urgent CEA indications were ocular ischemic events 4% (2/49), cerebral ischemic/infarction events 35% (17/49), crescendo TIAs 6% (3/49), acute stroke 45% (22/49), and stroke-in-evolution 10% (5/49). Mean NIHSS was 3.5 (range 0-24); mean TIA score was 5 (range 1-8). Although there were no statistical differences in 30-day outcomes, there was a trend toward a higher combined complication rate (stroke, death, myocardial infarction) in the urgent compared with the symptomatic but electively performed CEA group (7.1 % [3/49] vs. 2% [1/49]; P=.36). However, patients undergoing urgent CEA with an NIHSS<10 had no perioperative complications. CONCLUSIONS:Collaboration with a vascular neurology team increased the volume of urgent CEAs over a 3-year period. In patients with mild-to-moderate strokes (NIHSS<10), urgent CEA perioperative outcomes approximate those for electively performed CEAs, suggesting improved care through a multidisciplinary approach.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Bazan HA,Caton G,Talebinejad S,Hoffman R,Smith TA,Vidal G,Gaines K,Sternbergh WC 3rddoi
10.1016/j.avsg.2013.10.002subject
Has Abstractpub_date
2014-07-01 00:00:00pages
1172-7issue
5eissn
0890-5096issn
1615-5947pii
S0890-5096(13)00584-0journal_volume
28pub_type
杂志文章abstract:BACKGROUND:Strategies available to facilitate decision making for patients with peripheral arterial disease (PAD) include a Markov-based decision analysis (DA) model and the Lower Extremity Grading System (LEGS) score. Both have suggested inferior outcomes when the actual treatment received (ATX) differs from that pred...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.08.006
更新日期:2015-02-01 00:00:00
abstract::We describe a single case of Kawasaki's disease (mucocutaneous lymph node syndrome) with the rare complication of a hepatic artery aneurysm which was surgically repaired. Unusual features include arterial aneurysmal formation in the hepatic arteries rather than in coronary arteries, the unusual morphology of the hepat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015278
更新日期:1991-11-01 00:00:00
abstract::Literature has been published stating that thrombosis is occurring at higher rates in patients who are positive for COVID-19. This experience is more with limb ischemia. Reports of mesenteric ischemia are coming in from different parts of the globe. We share our early experience of managing two patients with acute mes...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2021.01.064
更新日期:2021-01-25 00:00:00
abstract:BACKGROUND:Ehlers-Danlos syndrome (EDS) is a hereditary connective tissue disorder caused by mutations in genes involved with collagen matrix formation that results in weakened blood vessels. Endovascular therapy on patients with EDS is fraught with concerns of vessel dissection and access site complications. We descri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.05.028
更新日期:2012-01-01 00:00:00
abstract::The prevalence of combined severe aortic stenosis and abdominal aortic aneurysm is increasing with the aging of the population. Both conditions are associated with adverse outcome if not adequately managed. The choice of the optimal treatment of these patients is challenging and no clear recommendations are available....
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.03.028
更新日期:2019-10-01 00:00:00
abstract::Steal syndrome is an uncommon complication following hemodialysis access. Options for management include fistula ligation, banding, and distal revascularization with interval ligation (DRIL). Plication is another technique that is simple yet infrequently reported. We have adopted plication as the procedure of choice f...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.08.009
更新日期:2009-01-01 00:00:00
abstract::With the development of endovascular aneurysm repair, abdominal aortic aneurysms with short infrarenal necks (< or =10 mm, AAASN) are considered juxtarenal aneurysms. Minimally invasive treatment consists of hybrid procedures or fenestrated endografts. We present our experience with direct aortic repair for AAASN perf...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.09.005
更新日期:2009-01-01 00:00:00
abstract::Lipoprotein (a) [Lp(a)] is a serum protein that has been reported to be predictive of complications from coronary and cerebrovascular atherosclerotic disease. This study was designed to compare plasma levels of Lp(a) in 100 white male patients with and without peripheral vascular disease (PVD) and to determine the rol...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02002128
更新日期:1993-09-01 00:00:00
abstract::Routine intraoperative imaging of the carotid artery following carotid endarterectomy can detect defects at the site of endarterectomy that may lead to neurologic morbidity. A number of methods have been used to evaluate the completed endarterectomy. In this prospective study we compared subjective methods of assessme...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02135281
更新日期:1995-05-01 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::Aortic aneurysm rupture into the retroaortic left renal vein (RALRV) is an uncommon phenomenon. We herein present the case of a 66-year-old man with left flank pain, hematuria, fever, and symptoms of acute right-sided heart failure. Computed tomography angiography (CTA) demonstrated an 83-mm infrarenal aortic aneurysm...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.11.003
更新日期:2021-01-15 00:00:00
abstract::Although the histologic effects of balloon catheter thromboembolectomy in arteries are well described, little is known about its effects on arterialized vein grafts. A chronic canine model was used to compare the intimal hyperplasia that develops following balloon catheter thrombectomy versus thrombolytic therapy when...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900091
更新日期:1997-11-01 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::We present a case of extra-anatomic axillo-mesenteric reconstruction for chronic mesenteric ischemia. Endovascular access and retrograde bypass options were prohibited by severe aortoiliac occlusive disease. Standard antegrade bypass was impossible because of the presence of a thoracoabdominal aortic aneurysm. This un...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.08.005
更新日期:2016-02-01 00:00:00
abstract::The purpose of this study is to describe the advantages and value of an endovascular suite in the operating room from a vascular surgeon's perspective. All endovascular procedures were performed in a specially equipped operating room by vascular surgeons using digital fluoroscopic imaging equipment. Between January 1,...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900157
更新日期:1998-05-01 00:00:00
abstract::Acute spontaneous isolated common and external iliac dissection with aneurysm is a very rare entity involving high morbidity and mortality, with only few reports in literature. If not treated promptly, they have high morbidity or mortality in case they rupture. We report a case of similar dissection with aneurysmal fo...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.09.009
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:We propose a novel technique for endovenous treatment of varicose veins (VVs) using combined coil embolization and foam sclerotherapy of the great saphenous vein (GSV). METHODS:A retrospective case-series analysis on patients undergoing fluoroscopically guided coil embolization of the GSV and foam sclerothe...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.05.101
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Loss of critical endothelial cell function and subsequent vascular smooth muscle cell (VSMC) migration is central to the pathology of injury-induced neointimal hyperplasia and recurrent stenosis. Thrombomodulin (TM), well known for its function as an endothelial surface anticoagulant, may have an unknown dir...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.10.002
更新日期:2016-01-01 00:00:00
abstract::Balloon angioplasty produces a mechanically induced injury to the blood vessel wall. Heat shock protein 70 (HSP70) is a molecular chaperone whose expression can be induced by chemical or thermal stress. Thus, we hypothesized that the mechanical injury associated with balloon angioplasty would lead to increases in the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900286
更新日期:1999-09-01 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:BACKGROUND:This study aims to assess primary bare stenting for iliac chronic total occlusions (CTOs) with midterm follow-up. METHODS:From April 2013 to May 2016, all patients presenting with symptomatic iliac CTO were treated endovascularly and included in a prospective single-center cohort. Common iliac CTOs were tre...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.05.046
更新日期:2020-06-02 00:00:00
abstract::Pancreaticoduodenal artery aneurysms (PDAAs) are rare, but rupture can occur at any time regardless of the size. We describe here the case of 53-year-old woman who presented with a ruptured PDAA associated with compression of the celiac trunk by the median arcuate ligament. We first performed revascularization of the ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.05.007
更新日期:2017-08-01 00:00:00
abstract::True and false aneurysms of veins are very rare conditions and only few cases have been described in the literature. We present a case of a 56-year-old female with personal history of primary arterial hypertension and connective tissue disease. Ultrasound of the neck showed a saccular, compressible, hypoechoic structu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.09.017
更新日期:2017-05-01 00:00:00
abstract::We present a unique case of listeria-infected pseudoaneurysm of the superficial femoral artery. Listeria monocytogenes, a gram positive, intracellular bacterium, is widespread in the environment. The manifestation of infection in humans ranges from mild gastroenteritis to life-threatening listeriosis. The incidence in...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.09.013
更新日期:2016-02-01 00:00:00
abstract::The immediate inflammatory response following aortic reconstruction with two types of sealed Dacron grafts was studied in a prospective, randomized manner. C-reactive protein (CRP) levels were measured before surgery and on days 2 and 8 postoperatively. In the collagen-sealed group (n = 10) CRP levels were 10 +/- 9.6,...
journal_title:Annals of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02139657
更新日期:1995-03-01 00:00:00
abstract::Pseudoaneurysm (PA) formation after carotid endarterectomy (CEA) is a very uncommon but dangerous complication, potentially responsible for cerebral embolism or rupture. Therefore, the PA treatment is imperative. Until few years ago, the treatment of choice was represented by open surgical repair, with a higher mortal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.051
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The research aims to study the effect of circumferential compliance of synthetic vascular prostheses on their healing during implantation in the infrarenal abdominal aorta of pigs. METHODS:In an experiment, 12 pigs were implanted with blood vessel prostheses in the infrarenal abdominal aorta. The prostheses...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.08.117
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:To evaluate the use of retrograde endovascular internal iliac artery preservation (REIIAP) technique for treating aortoiliac aneurysms. METHODS:We reviewed our database for all patients with aortoiliac aneurysms who underwent REIIAP technique between April 2004 and April 2014. Patients underwent implantatio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.01.034
更新日期:2016-08-01 00:00:00
abstract::Injury to the axillary artery after anterior shoulder dislocation is a very rare occurrence; although infrequently seen as an iatrogenic complication, very few cases have been reported. We describe a case of delayed axillary artery pseudoaneurysm, presenting as single complication after anterior shoulder dislocation r...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.05.039
更新日期:2012-02-01 00:00:00
abstract::We report the case of a patient with internal carotid artery (ICA) mycotic pseudoaneurysm secondary to Lemierre's syndrome, urgently treated. A 75-year-old man presented to E.R. with a left swelling lesion of the neck and complaining left visions lost since that morning, fever, hypotension, and dyspnea. Since 15 days ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.05.026
更新日期:2017-10-01 00:00:00