Abstract:
BACKGROUND:International guidelines recommend carotid revascularization within 14 days for patients with a symptomatic transient ischemic attack (TIA) or stroke event. However, significant delays in care persist, with only 9% of outpatients and 36% of inpatients in Ontario meeting this target. The study objective was to explore the influence of health system factors on carotid revascularization timelines. METHODS:We conducted a retrospective chart review of all symptomatic TIA/stroke patients undergoing carotid endarterectomy or stenting at The Ottawa Hospital (2015-2016). The primary outcome was time from TIA/stroke to carotid revascularization. Health system variables of interest included location and timing of patient presentation, timelines to vascular imaging, and same-day collaboration between key services such as emergency, neurology, and surgery. Descriptive statistics and univariate analysis were used to determine statistically significant differences between groups. RESULTS:A total of 228 records met the inclusion criteria. The median time from TIA/stroke to carotid revascularization was 10 days, with 58% of patients meeting the 14-day guideline. Prompt patient presentation to emergency demonstrated significantly shorter timelines to surgery (7 days; P < .001). Early vascular imaging was strongly correlated with early revascularization (4-5 days; P < .001). In addition, collaboration from two or more care services enhanced timelines to surgery ranging from 2.0 to 6.5 days (P < .001-.008). CONCLUSIONS:Early/emergency response to stroke symptoms was pivotal in achieving best practice recommendations for rapid carotid revascularization, emphasizing the need for ongoing public awareness. Emergency and ambulatory strategies to facilitate urgent vascular imaging, as well as mechanisms for same-day communication between teams require optimization to promote early revascularization.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Gocan S,Bourgoin A,Shamloul R,Sivakumar B,Dowlatshahi D,Stotts Gdoi
10.1016/j.jvs.2020.02.024subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1728-1734issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(20)30296-2journal_volume
72pub_type
杂志文章abstract:OBJECTIVE:We investigated the intraobserver and interobserver variability of using semiautomatic finite element analysis to calculate the von Mises stress and peak wall rupture risk (PWRR) in patients with an abdominal aortic aneurysm (AAA) in longitudinal studies. METHODS:Four independent observers made 3-dimensional...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.012
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Successful thoracic endovascular aneurysm repair (TEVAR) requires adequate proximal and distal fixation and seal. We report our experience of planned celiac artery coverage during endovascular repair of complex thoracic aortic aneurysms (TAA). METHODS:Since 2004, 228 patients underwent TEVAR under elective (...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.105
更新日期:2010-11-01 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
abstract::The Society for Vascular Surgery considers the placement and maintenance of arteriovenous hemodialysis access to be an important component of any vascular surgery practice. Therefore, the Society has long been involved in setting the standards for the management of arteriovenous access. Formulating clinical recommenda...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2008.08.045
更新日期:2008-11-01 00:00:00
abstract::In this report, we present a patient who developed an infected femoral artery after repuncture cannulation for carotid angioplasty and intraluminal stenting. The case was complicated by persistent bacteremia and a delay in diagnosis before it was managed successfully with an autogenous replacement graft and appropriat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119398
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to assess the effect of obesity on procedural metrics, radiation exposure, quality of life (QOL), and clinical outcomes of fenestrated-branched endovascular aortic repair (FB-EVAR) of pararenal and thoracoabdominal aortic aneurysms. METHODS:We reviewed the clinical data from...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.07.088
更新日期:2020-08-25 00:00:00
abstract:OBJECTIVE:The gold standard for the treatment of abdominal aortic infections remains controversial. Cryopreserved arterial homografts and silver-coated Dacron grafts have both been advocated as reasonable grafts. Direct clinical or experimental comparisons between these two treatment options have not been published bef...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.11.052
更新日期:2011-05-01 00:00:00
abstract::Scalp arteriovenous malformations are treated by surgical excision in many patients. We report a patient with a scalp arteriovenous malformation who was successfully treated by a combination of ultrasound-guided thrombin injection (UGTI) and transarterial coil embolization. This patient was a 52-year-old man with a su...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.013
更新日期:2012-03-01 00:00:00
abstract::Vascular smooth muscle cells exhibit varied responses after vessel injury and surgical interventions, including phenotypic switching, migration, proliferation, protein synthesis, and apoptosis. Although the source of the smooth muscle cells that accumulate in the vascular wall is controversial, possibly reflecting mig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.02.061
更新日期:2007-06-01 00:00:00
abstract::Contrast angiography with carbon dioxide (CO2) is frequently used in patients with renal dysfunction or iodinated contrast allergies, as CO2 is nonallergenic, nontoxic, and rapidly absorbed in the blood. However, when delivered intra-arterially, there is a possibility that CO2 may create a vapor lock with resultant tr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.06.075
更新日期:2012-12-01 00:00:00
abstract::A growing body of evidence suggests that the occurrence of cardiovascular events is not evenly distributed over time, but shows peculiar temporal patterns that vary with time of day, day of the week, and month (season) of the year. These patterns coincide with the temporal variation in the pathophysiologic mechanisms ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2004.04.019
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complicatio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.059
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate early and late results of the Anaconda aortic endograft (Vascutek, Terumo, Inchinnan, Scotland) in a single-center experience. METHODS:From September 2005 to March 2012, patients underwent endovascular aortic repair for abdominal aortic aneurysm (AAA) with Anaconda...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.04.073
更新日期:2014-11-01 00:00:00
abstract::The interaction between pharmaceutical and device companies and hospitals and physicians has undergone significant transformation in the past few years due to the public's perception that bias may result when such relationships are not disclosed and monitored. Policies need to be written by medical centers and hospita...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.04.067
更新日期:2011-09-01 00:00:00
abstract::Isolated superior mesenteric artery dissection is a relatively rare vascular pathology. However, the number of recent case reports has shown an increasing incidence with the widespread use of computed tomography imaging for abdominal pain. Here we report three cases of isolated superior mesenteric artery dissection. T...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.052
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The present randomized double-blind multicenter study was designed to assess the efficacy of a progressive compressive stocking (new concept with maximal pressure at calf), compared to a degressive compressive stocking graded 30 mm Hg, evaluating the improvement of lower leg symptoms of chronic venous insuff...
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.2012.02.060
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Buerger disease is a rare inflammatory vasculopathy presenting with severe claudication or critical limb ischemia. In this study, we sought to evaluate the feasibility and clinical outcomes of endovascular therapy for Buerger disease involving arteries in the lower extremities. METHODS:Between January 2006 a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.020
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:This study was performed for the determination of the expansion rates and outcomes and for recommendations for the surveillance of the 3.0-cm to 3.9-cm abdominal aortic aneurysm (AAA). DESIGN:The study was observational with data from patients screened with ultrasound scanning for AAA at five Veterans Affair...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1067/mva.2002.121572
更新日期:2002-04-01 00:00:00
abstract:PURPOSE:A recent overview indicated that although routine patching is safer than routine primary closure after carotid endarterectomy (CEA), there is no systematic evidence that patch type influences outcome. However, most surgeons still believe that prosthetic patches are probably more thrombogenic than vein patches. ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.2001.115005
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:Radial-cephalic fistulas (RCFs) perianastomotic stenoses (PASs) are on and around the fistula anastomosis. This group of lesions encompasses juxta-anastomotic stenosis (stenosis located on the venous side within 3 cm away from the anastomosis), anastomotic, and arterial stenosis. The purpose of our study was ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2010.08.007
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:Because vein graft neointimal hyperplasia engenders vein graft failure, and because most vein graft neointimal cells derive from outside the vein graft, we sought to determine whether vein graft neointimal hyperplasia is affected by activity of the CXC chemokine receptor-4 (CXCR4), which is important for bone...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.254
更新日期:2012-11-01 00:00:00
abstract::We report an unusual case of type IV Thoracoabdominal Aneurysm (TAA) with Superior Mesenteric Artery (SMA), celiac artery, and bilateral renal artery aneurysms in a patient who underwent an earlier repair of two infrarenal Abdominal Aortic Aneurysm (AAA) ruptures. Because of the presence of the visceral artery aneurys...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70084-4
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVE:The use of cross-sectional area (CSA) measurements obtained from computed tomographic angiography (CTA) for the calculation of carotid artery stenosis has been suggested but not yet validated in a large population. The objective of this study was to determine whether CTA-derived CSA measurements were able to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.031
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVE:Peripheral artery disease is a common comorbidity in patients with end-stage renal disease (ESRD), but there is a paucity of data comparing outcomes of different interventions in this group of patients. In this study, we examined perioperative outcomes of lower extremity endovascular revascularization (ER) an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.12.054
更新日期:2019-10-01 00:00:00
abstract:INTRODUCTION:Racial disparities in open thoracic aortic aneurysm repair have been well documented, with black patients reported to suffer from poor outcomes compared with their white counterparts. It is unclear whether these disparities extend to the less invasive thoracic endovascular aortic repair (TEVAR). This study...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.10.087
更新日期:2020-12-02 00:00:00
abstract:BACKGROUND:Objective scoring systems have been developed for risk stratification of open infrarenal aneurysm repair. To date, none have been applied for the selection of patients who would most benefit from either an open or an endovascular approach. This study assessed the utility of comorbidity-based objective scorin...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.02.036
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:The efficacy of carotid endarterectomy in the prevention of strokes mandates low perioperative morbidity, as well as a low incidence of late ipsilateral stroke. This prospective study involving 430 patients (461 carotid endarterectomies) correlated the results of intraoperative assessment with end points of str...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.44844
更新日期:1993-05-01 00:00:00
abstract:PURPOSE:We tested the hypothesis that the course of primary chronic venous insufficiency can be changed by correction of the incompetent valve in the superficial femoral vein. METHODS:This was a prospective, randomized, controlled study. A total of 125 extremities with reflux in greater saphenous and superficial femor...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.2001.110511
更新日期:2001-02-01 00:00:00
abstract::Arterial-ureteral fistulas are rare complications of iliac artery reconstruction or ureteral manipulation. The diagnosis should be considered in patients with intermittent hematuria who have had ureteral catheterization, arterial bypass, or nephrectomy. The following case demonstrates the difficulty in making the diag...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:BACKGROUND:The ankle-brachial index (ABI) may underestimate the severity of peripheral arterial disease (PAD) in patients with noncompressible vessels. This study analyzed limitations of the ABI and toe-brachial index (TBI), if done alone, in patients with symptomatic PAD, diagnosed by duplex ultrasound (DUS) examinati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.050
更新日期:2020-03-01 00:00:00