Abstract:
BACKGROUND:Because of improved medical therapy in contemporary practice, some have advocated that, most if not, all patients with asymptomatic carotid disease should be managed medically without intervention. Disease progression in this patient population is not well established, and data describing risk factors for disease progression in patients with moderate asymptomatic carotid artery stenosis (ASCAS) are lacking. The aim of our study was to determine the incidence of and risk factors for disease progression in this patient population. METHODS:All patients presenting to a tertiary center between January 2005 and May 2012 with moderate (50-69%) ASCAS as determined by carotid artery duplex were included. Outcomes including disease progression to severe stenosis (≥70%), incidence of symptoms, need for operative intervention, and all-cause mortality were recorded. Cox proportional hazard regression models were used to identify risk factors for disease progression. RESULTS:A total of 282 carotid arteries in 258 patients with moderate ASCAS were identified from 1555 carotid duplex scans over the 7.5-year study period (mean age: 70.6 ± 0.55 years, 52% male). Mean follow-up time was 2.6 ± 0.10 years. Overall, disease progression to severe stenosis occurred in 25.2% (n = 71) and followed a linear trend. The incidence of symptoms including ipsilateral stroke (2.13%, n = 6) and transient ischemic attack (0.71%; n = 2) was low. Carotid endarterectomy was performed in 15.3% (n = 43) of patients, all with severe disease. Carotid stenting was performed in 3.90% (n = 11) patients. Risk of progression was higher in patients receiving dual antiplatelet therapy (Hazard Ratio [HR] 1.85, 95% confidence interval [CI] 1.09-3.15; P = 0.02) and smokers (HR 1.85, 95% CI 0.96-3.55; P = 0.05). Age, gender (women), hypertension, statin use, and aspirin use were not significant predictors of progression to severe stenosis. There was a nonsignificant trend toward increased mortality in patients who progressed compared with those who did not (HR 3.39, 95% CI 0.91-12.6; P = 0.07). CONCLUSIONS:In our study, one-quarter of patients with moderate ASCAS progressed to severe disease, although the majority remained asymptomatic. Smoking and dual antiplatelet therapy are independent risk factors for disease progression. Patients with identifiable risk factors may warrant more careful follow-up.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Hicks CW,Talbott K,Canner JK,Qazi U,Arhuidese I,Glebova NO,Freischlag JA,Perler BA,Malas MBdoi
10.1016/j.avsg.2014.02.007subject
Has Abstractpub_date
2015-01-01 00:00:00pages
1-8issue
1eissn
0890-5096issn
1615-5947pii
S0890-5096(14)00102-2journal_volume
29pub_type
杂志文章abstract::The need for enhanced surgical exposure for the high extracranial (Zone III) internal carotid artery is not uncommon. In certain circumstances, the posterior border and angle of the mandible may interfere with access to the distal internal carotid artery (ICA). The use of modified mandibular osteotomies has provided v...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02007006
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:To propose a protocol for the routine clinical use of duplex ultrasound (DUS) assessment after transcarotid artery revascularization (TCAR) procedures, with its specific point of vascular access, based on DUS data from routine clinical practice. METHODS:DUS data were retrospectively collected at 2 centers f...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.065
更新日期:2020-11-24 00:00:00
abstract::The treatment of recurrent aortoenteric fistula (AEF) previously repaired by surgery is challenging, with a high mortality rate. Open repair is often limited by "hostile abdomen," while endovascular treatment is difficult when the distance between the aortic stump and the origin of the renal arteries is short, with hi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.12.104
更新日期:2019-08-01 00:00:00
abstract::Primary subclavian vein stents are not recommended for venous thoracic outlet syndrome before surgical decompression by first rib resection due to a high risk of fracture because they are compressed between the clavicle and first rib. After rib removal, however, stent insertion has been advocated for venous restenosis...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.064
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Unintentional renal artery occlusion after endovascular aortic aneurysm repair (EVAR) is an uncommon phenomenon. The sequelae from this specific complication are severe; consequently, the topic of renal artery coverage is a pertinent issue. We present a case series of patients undergoing EVAR with unintentio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.02.018
更新日期:2012-11-01 00:00:00
abstract::Open surgical repair of complex abdominal aortic aneurysms requires more extensive dissection and aortic clamping above the renal or mesenteric arteries. Although results of open surgical series have shown variation, morbidity and mortality is higher compared with infrarenal aortic aneurysm repair. Potential complicat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2010.10.005
更新日期:2011-01-01 00:00:00
abstract::Although transperitoneal surgical repair has been the gold standard for patients with a suspected ruptured abdominal aortic aneurysm (rAAA), the retroperitoneal approach and endovascular aortic repair (EVAR) are increasingly being recommended as preferred approaches due to lower morbidity and mortality. To highlight t...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2006.10.019
更新日期:2007-03-01 00:00:00
abstract::Surgical reconstruction for patients with symptomatic lower extremity arterial occlusive disease is successful when a suitable distal target vessel is present. In patients with unreconstructable disease, practical surgical options are at a minimum. We report our initial experience with dorsal venous arch arterializati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0148-y
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Arterial revascularizations can present significant challenges when vessels are disadvantaged and advances in technology present the surgeon with innovative opportunities. A number of studies have used the GORE® Hybrid Vascular Graft (GHVG), and we have been using this device in arterial revascularizations s...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2019.12.002
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to retrospectively evaluate the safety, efficacy, and retrievability of the Aegisy vena cava filter (LifeTech Scientific Co. Ltd, Shenzhen, China). METHODS:Data from all patients who underwent Aegisy vena cava filter placement for pulmonary embolism (PE) prophylaxis during catheter...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.02.025
更新日期:2016-10-01 00:00:00
abstract::Infection of an aortic endoprosthesis is a potentially lethal complication of an endovascular abdominal aortic aneurysm repair (EVAR). Surgical treatment usually involves excision of the infected endograft and vascular reconstruction, either in-line or extraanatomic. We present a case of severe infection of an endogra...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.09.007
更新日期:2013-07-01 00:00:00
abstract::Aortic stent graft infection is uncommon. Most cases have been described anecdotaly in single-case reports. After observing one case in our experience, we decided to review the literature and contact centers performing endovascular aortic repair to determine the frequency, risk factors, and current treatment of stent ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0075-9
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:To compare aortic sac changes after endovascular aneurysm repair (EVAR) assessed by three-dimensional ultrasound (3D-US), two-dimensional ultrasound (2D-US), and traditional computed tomographic angiography (CTA). METHODS:Using volume assessment with three-dimensional CTA (3D-CTA-volume) as the gold standar...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.061
更新日期:2020-11-04 00:00:00
abstract:BACKGROUND:Endovascular therapy (EVT) is being adopted by many surgeons as a suitable first choice in the treatment of most femoropopliteal disease when clinically indicated. However, there are multiple factors affecting the outcome of EVT including the anatomy of lesions and distal runoff status. The evidence of runof...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.11.024
更新日期:2020-12-24 00:00:00
abstract::Rarely, internal carotid artery (ICA) patency is maintained above a common carotid artery occlusion (CCAO) through collateral flow of the ipsilateral external carotid artery or an aberrant ICA branch. Several small series report excellent results of ICA revascularization in relieving cerebral ischemic symptoms in thes...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900223
更新日期:1999-01-01 00:00:00
abstract::We report one case of posterior nutcracker syndrome treated by left ovarian vein (LOV) transposition. A 36-year-old woman was suffering from nutcracker syndrome associated with pelvic congestion syndrome. Color duplex scan, computed tomographic scan, and angiography demonstrated a stenosis of a retroaortic left renal ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.08.026
更新日期:2009-05-01 00:00:00
abstract::Surgical treatment for popliteal artery cystic adventitial disease (PACAD) is still controversial. PACAD often occurs in young or middle-aged adults. Therefore, the maintenance of graft patency for very long periods is a concern if a prosthesis is used. Because the intima is intact in PACAD patients with popliteal art...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.01.016
更新日期:2014-08-01 00:00:00
abstract::Primary venous leiomyosarcoma is rare. We report the case of a primary leiomyosarcoma of the left innominate vein, with neoplastic thrombus extending into the left jugular and subclavian veins. The tumor was curatively resected en bloc with anterior mediastinal and laterocervical lymphatics, through a median sternotom...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2006.05.003
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:High glucose (HG)-induced endothelial dysfunction is a common pathologic process of vascular disease in patients with diabetes. HoxA9EC is a transcriptional regulator of genes involved in the stabilization of endothelial function. We sought to elucidate the effect of HG on HoxA9EC expression in human umbilic...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.011
更新日期:2012-10-01 00:00:00
abstract::In recent decades, the increasing complexity of arterial bypasses in the management of chronic limb-threatening ischemia has spurred the development of alternative techniques, such as revascularization of genicular arteries. Few publications on this technique can be found in the literature, and its use has been restri...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2020.06.008
更新日期:2020-11-01 00:00:00
abstract::We report a massive infected pseudoaneurysm of the right external iliac artery in the setting of Girdlestone pseudoarthroplasty (GSA) for chronic infection. Around the time of her GSA, the patient underwent cardiac catheterization with resultant pseudoaneurysm formation. Infection was likely due to spread from her pre...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.070
更新日期:2017-04-01 00:00:00
abstract::Since December 1985, we have operated upon seven bicycle racers for endofibrosis of the external iliac artery. In all instances, the athletes had started cycling early in life and were engaged in top level competition by the age of 17. The principal complaint was intermittent claudication of one lower limb at "near-ma...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60123-4
更新日期:1986-11-01 00:00:00
abstract::Endoleaks remain a significant challenge after endovascular abdominal aortic aneurysm repair (EVAR). Translumbar thrombin injection of the aneurysm sac has been used to treat endoleaks, with low reported morbidity. We present an unusual case of ischemic colitis following translumbar thrombin injection of an endoleak. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-003-0102-2
更新日期:2004-01-01 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::Cases of malignant fibrous histiocytoma arising from the aorta are rare and have a dismal outlook despite treatment. The longest reported survival period following resection is only 28 months. A patient with malignant fibrous histiocytoma of the descending thoracic aorta was successfully treated with resection and rec...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02001377
更新日期:1990-03-01 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::Lymphedema is a common and progressive disease which causes deterioration of the quality of life of the patients, and still, there is no gold standard therapeutic option. In this article, we discuss about our new approach to deal with management of lymphedema which is lymphatic drainage by a subcutaneous channel which...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.10.026
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The endovascular approach has been widely used for aortoiliac occlusive disease (AIOD), especially for aortic bifurcation and iliac artery Trans-Atlantic Inter-Society Consensus II (TASC-II) A and B lesions. However, the outcomes of self-expanding covered stents (SECSs) for extensive aortoiliac lesion remain...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.04.055
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Aortic thrombus in the absence of atherosclerotic plaque or aneurysm is rare, and its optimal management remains unclear. Although atypical aortic thrombus (AAT) has been historically managed operatively, successful nonoperative strategies have been recently reported. Here, we report our experience in treati...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.03.028
更新日期:2014-10-01 00:00:00
abstract::Infected or mycotic aneurysms (MAs) of the aorta and adjacent arteries are rare and difficult to treat. We report a unique case of a Salmonella serotype enteritidis-induced rapidly expanding aortic and iliac pseudoaneurysm during preoperative workup. Based on the presented case, we postulate that the agressive nature ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2017.05.034
更新日期:2017-10-01 00:00:00