Abstract:
OBJECTIVE:Contemporary data on outcomes in open thoracoabdominal aortic aneurysm (TAAA) repair are limited to reports from major aortic referral centers showing excellent outcomes. This study aimed to characterize the national experience of open TAAA repair using national outcomes data, with a primary focus on the association of hospital volume with mortality and morbidity. METHODS:The Nationwide Inpatient Sample was queried from 1998 to 2011, and all patients with a diagnosis of TAAA who underwent open operative repair were included. These patients were further stratified into tertiles based on the operative volume of the institution that performed the operation: low volume (LV), <3 cases/y; medium volume (MV), 3 to 11 cases/y; and high volume (HV), ≥12 cases/y. Baseline demographics as well as perioperative outcomes were compared between these groups. Multivariable logistic regression was performed to determine predictors of operative mortality and morbidity. Subgroup analyses were performed for patients presenting for elective surgery and for those presenting for urgent and emergent surgery. RESULTS:Overall operative mortality was 21% for the entire cohort. Operative mortality was higher at LV (26%) and MV (21%) centers compared with HV centers (15%; P < .001). This difference was similar in both elective surgery (LV, 18%; MV, 14%; HV, 12%; P < .001) and urgent and emergent surgery (LV, 34%; MV, 30%; HV, 19%; P < .001). Furthermore, rates of blood transfusion and acute renal failure were significantly lower in the HV group. Multivariable analysis revealed that compared with the HV group, patients operated on at LV centers (odds ratio [OR], 1.9, 95% confidence interval [CI], 1.7-2.1; P < .001) and MV centers (OR, 1.5; 95% CI, 1.4-1.7; P < .001) had at least 1.5 times the odds of in-hospital mortality. The HV group also had significantly lower odds of dying in the subgroup analyses of both elective surgery and urgent and emergent surgery. Increasing TAAA volume was associated with increased use of distal aortic perfusion (OR, 1.03; 95% CI, 1.02-1.03; P < .001). CONCLUSIONS:Patients with TAAA in the United States operated on at HV centers have significantly lower mortality and morbidity compared with patients operated on at lower volume centers. Consideration of referral to HV centers may be warranted, but further research is required to justify this conclusion.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Polanco AR,D'Angelo AM,Shea NJ,Allen P,Takayama H,Patel VIdoi
10.1016/j.jvs.2020.05.027subject
Has Abstractpub_date
2021-02-01 00:00:00pages
451-458issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(20)31282-9journal_volume
73pub_type
杂志文章abstract:OBJECTIVE:The objective of this study was to describe characteristics and in-hospital outcomes of patients treated with carotid endarterectomy (CEA) and carotid artery stenting (CAS) for stroke in evolution (SIE) under routine conditions in Germany. METHODS:This secondary data analysis is based on the German statutory...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.085
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:Diabetes mellitus (DM) is associated with reduced progression of abdominal aortic aneurysm (AAA) disease. Mechanisms responsible for this negative association remain unknown. We created AAAs in hyperglycemic mice to examine the influence of serum glucose concentration on experimental aneurysm progression. ME...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.05.086
更新日期:2010-10-01 00:00:00
abstract:PURPOSE:The early and late outcomes of carotid endarterectomy (CEA) following a rigid protocol of patch angioplasty or occasionally interposition bypass grafting, when the arteriotomy required to obtain a complete internal carotid end point extended distal to the bulb segment, and primary closure, when it was limited t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104591
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:The clinical impact of peripheral arterial disease (PAD) is well characterized and is associated with significant morbidity and mortality. Health care-related expenditures among individuals with PAD, particularly for patients, are not well described. METHODS:Health care-related expenditure data from the 2011...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.102
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Three-dimensional ultrasound (3D-US) examination is a relatively new modality that can be used for abdominal aortic aneurysm (AAA) surveillance, and may offer improved reproducibility over conventional two-dimensional ultrasound (2D-US) examination. The aim of this study was to evaluate the interoperator repr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.03.066
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Prior studies have suggested improved wound complication rates but decreased primary patency in lower extremity bypasses performed with endoscopic vein harvest (EVH) vs open vein harvest (OVH). We hypothesize that the inferior patency reflects the initial learning curve for EVH and that improved patency can b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.02.043
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:Deep venous arterialization (DVA) is a technique aimed at providing an option for chronic limb-threatening ischemia patients with no options except amputation. In patients with no outflow distal targets permitting bypass, DVA involves creating a connection between a proximal arterial inflow and a distal venou...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2019.10.085
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Information on outcome of patients with long superficial femoral artery (SFA) obstruction undergoing endovascular treatment is scarce. The present study reports results from a prospective multicenter registry designed to evaluate the safety, effectiveness, and patency of the aSpire self-expanding polytetraflu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2006.08.032
更新日期:2007-01-01 00:00:00
abstract::Congenital vascular malformations (CVMs) of the limb include simple and cavernous hemangiomas, microarteriovenous and macroarteriovenous fistulas, venous angiomas, and mixed CVMs. In differentiating these lesions, Doppler waveform analysis, labeled microsphere studies, arteriography, closed-space phlebography, and con...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080064
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:Several studies have described a higher mortality among patients admitted or operated during the weekend for various diseases. However, pooled data on patients undergoing elective vascular surgery procedures are sparse. METHODS:The PubMed, Embase, Scopus, and Cochrane Library databases were systematically se...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2019.03.020
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:Thoracic endograft collapse after thoracic endovascular aortic repair (TEVAR) is a potentially devastating complication. This study evaluates the management of thoracic stent graft collapse. METHODS:A multicenter review of thoracic stent graft collapse was performed from 2005 to 2009. Diagnosis and preopera...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2010.10.119
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:The primary aim of this study was to assess if self-reported measures of walking limitation correlate better with a community-based assessment of maximum walking distance (MWD) than they do with laboratory-based tests in patients with intermittent claudication. A secondary aim was to examine the effect of pri...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.02.073
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:In the Carotid Revascularization Endarterectomy versus Stent Trial (CREST), carotid artery atherosclerotic lesion length and nature of the lesions were important factors that predicted the observed difference in stroke rates between carotid endarterectomy and carotid artery stenting (CAS). Additional patient...
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.2018.06.221
更新日期:2019-03-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine whether the combined insults of hemorrhagic shock and aortic clamping simulating ruptured abdominal aortic aneurysm repair had a synergistic effect on the production of pulmonary injury, indicating remote organ injury. METHODS:Animals were randomized to one of three g...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70081-1
更新日期:1995-07-01 00:00:00
abstract:INTRODUCTION:Despite its presumed effectiveness and clinical use, the physiology of selective visceral perfusion combined with distal aortic perfusion during open thoracoabdominal aortic surgery has not been characterized. Thus, the aim of this study was to establish a translatable model of thoracic aortic-clamping to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.126
更新日期:2012-07-01 00:00:00
abstract::Popliteal artery aneurysms represent a common pathology that vascular surgeons are often confronted with. However, several issues remain incompletely understood, including indications for intervention and optimal methods of treatment. In the following article, our discussants debate the appropriate management of small...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.02.001
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:Two of three patients with vertebrobasilar stroke harbor a stenosis of the vertebral or basilar arteries. The best treatment for secondary prophylaxis in vertebrobasilar occlusive disease has not been defined. In patients with high-grade stenoses, and especially those refractory to medication, stenting offers t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2006.02.027
更新日期:2006-06-01 00:00:00
abstract::An 86-year-old man presented with a recurrent groin lymphocele following endovascular abdominal aortic aneurysm repair using an aorto-uni-iliac reconstruction with polytetrafluoroethylene femoral-femoral crossover. Following this procedure, the patient developed a groin lymphocele. This fluid collection was treated wi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.04.049
更新日期:2014-04-01 00:00:00
abstract::With the use of a multifinger photoplethysmography system, finger systolic blood pressures were measured before and after cooling in patients with Raynaud's disease. In 30 patients with arteriographically documented arterial obstructions, significantly low digital pressures were found in 91% of fingers with cold sensi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030456
更新日期:1986-03-01 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
abstract::The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.047
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:Various animal models of critical limb ischemia have been developed in the past. However, there is no animal model that can undergo endovascular treatment, while providing reproducible true critical limb ischemia with arterial ulcers and rest pain. We evaluated the efficacy of a new model of rabbit hindlimb i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.07.140
更新日期:2018-09-01 00:00:00
abstract::The retroperitoneal approach for elective treatment of abdominal aortic aneurysms is an accepted alternative to midline transperitoneal approaches and may provide less physiologic insult and a smoother postoperative course. In recent years we have preferentially used the extended retroperitoneal approach for ruptured ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.17036
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:The risk of patients dying of pulmonary embolism (PE) or bleeding during the treatment of deep vein thrombosis (DVT), and whether these risks are influenced by patient age, has not been thoroughly studied. METHODS:We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to assess...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.05.114
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:Recent studies have suggested that transrenal artery fixation of endovascular stent-grafts is safe and may be a desirable means of reducing the risk of type I endoleaks, particularly those with short infrarenal necks. The close proximity of the superior mesenteric and celiac arteries to the renal arteries may c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119387
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:Successful adaptation of a vein graft to an arterial environment is incompletely understood. We sought to investigate whether early vein graft remodeling is predictive of subsequent patency. METHODS:A prospective longitudinal study was conducted of 67 patients undergoing lower extremity bypass with autogenou...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.06.098
更新日期:2013-01-01 00:00:00
abstract::Many surgeons advocate uniform performance of operative completion arteriography after leg bypass surgery to ensure technical success and to optimize short- and intermediate-term graft patency. To determine the impact of this practice on the outcome of reversed-vein bypass surgery and associated patient charges, we re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)80044-9
更新日期:1996-04-01 00:00:00
abstract::Over a 12-year period, 160 transmetatarsal amputations were performed in patients with peripheral vascular occlusive disease. The following groups were defined: group 1 - nonreconstructable disease (n = 40); group 2 - transmetatarsal amputation in conjunction with distal revascularization (n = 99); group 3 - reconstru...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::Over a 7-year period (1980 to 1987) 24 patients (18 men: mean age 67 years; range, 52 to 78 years, and six women: mean age 67 years; range, 46 to 82 years) undergoing serial carotid artery duplex scans were observed to progress to unilateral carotid artery occlusion. The occlusions were associated with ipsilateral str...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.15723
更新日期:1989-11-01 00:00:00
abstract:PURPOSE:A review of popliteal-crural bypasses via the posterior approach was done to evaluate the results of this technique. METHODS:During a period of 36 months, 21 patients with limb-threatening ischemia underwent 21 popliteal-crural bypasses via the posterior approach in the prone position with reversed lesser saph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00