Abstract:
OBJECTIVE:The aim of this study was to evaluate outcomes of fenestrated-branched endovascular aortic repair (F-BEVAR) of pararenal abdominal aortic aneurysms or thoracoabdominal aortic aneurysms (TAAAs) in patients with a solitary functional kidney (SFK). METHODS:We analyzed the outcomes of 287 consecutive patients (206 male; mean age, 74 ± 8 years old) enrolled in a prospective nonrandomized study to investigate use of F-BEVAR for treatment of patients with pararenal abdominal aortic aneurysms or TAAAs between 2013 and 2018. Outcomes were analyzed in patients with solitary kidney (functional or congenital) and compared with control patients who had two functioning kidneys. Acute kidney injury (AKI) was defined using Risk, Injury, Failure, Loss of kidney function, and End-stage renal disease criteria, and renal function deterioration (RFD) was defined by a decline in estimated glomerular filtration the estimated glomerular filtration rate of more than 30% from baseline. End points included 30-day mortality and major adverse events, AKI, freedom from RFD, and patient survival. RESULTS:There where 30 patients (10%) with a SFK and 257 patients with two functioning kidneys. Patients with a SFK were younger and had significantly (P < .05) higher baseline creatinine (+0.3 mg/dL), lower estimated glomerular filtration rate (-16 mL/minute/1.73 m2) and more often had stage III to V chronic kidney disease (73% vs 43%). There were no differences in cardiovascular risk factors and aneurysm extent. Technical success was achieved in 98.9% of patients with SFK and in 99.8% of controls (P = .10). At 30 days, there was no significant differences in mortality (0% vs 1%) and major adverse events (40% vs 24%; P = .08), including rates of AKI (20% vs 12%) and new-onset dialysis (3% vs 1%) between patients with a SFK and the control group, respectively. Mean follow-up was 18 ± 15 months. At 2 years, there was no difference (P = .36) in patient survival (92 ± 5% vs 84 ± 3%) and freedom from RFD (100 ± 0% vs 84 ± 3%) for patients with SFK and controls, respectively. Presence of a SFK was not a predictor for AKI or RFD. By multivariable analysis, estimated blood loss of more than 1 L (odds ratio [OR], 2.9; P = .04) and total fluoroscopy time (OR, 1.8; P = .05) were predictors for AKI, and postoperative AKI (OR, 4.9; P < .001), renal branch occlusion/stenosis (OR, 3.1; P = .001), and Crawford extent II TAAA (OR, 2.4; P = .007) were predictors for RFD. CONCLUSIONS:Despite the worse baseline renal function, F-BEVAR is safe and effective with nearly identical outcomes in patients with a SFK as compared with patients with two functioning kidneys. Development of postoperative AKI is the most important predictor for RFD.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Pather K,Tenorio ER,Kärkkäinen JM,Mendes BC,DeMartino RR,Macedo TA,Gloviczki P,Oderich GSdoi
10.1016/j.jvs.2019.10.062subject
Has Abstractpub_date
2020-08-01 00:00:00pages
457-469.e2issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(19)32554-6journal_volume
72pub_type
杂志文章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:Epidemiologic studies of vascular injuries are usually limited to those caused by trauma. The purpose of this study was to review the management and clinical outcome in patients with operative injuries to abdominal and pelvic veins. METHODS:Clinical data and outcome in all patients with iatrogenic venous injur...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2003.11.040
更新日期:2004-05-01 00:00:00
abstract:OBJECTIVE:We assessed the incidence and outcomes of graft-related secondary interventions (ie, open conversion or proximal or distal extensions) after elective thoracic endovascular aortic repair (TEVAR) for aneurysmal disease. METHODS:An institutional review of TEVAR for descending thoracic aortic aneurysms (DTAAs), ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.124
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Prosthetic graft infection is a major complication of peripheral vascular surgery. We investigated the experience of a single institution over 10 years with bypass grafts involving the femoral artery to determine the incidence and risk factors for prosthetic graft infection. METHODS:A retrospective cohort s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.09.049
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:To evaluate patterns of use and outcomes of arteriovenous fistulas and prosthetic grafts within racial categories in a large population based cohort of hemodialysis (HD) patients in the United States. METHODS:A retrospective analysis of white, black, and Hispanic patients in the prospectively maintained Unit...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.07.092
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Computed tomographic angiography (CTA) is currently the most commonly used technique for postoperative surveillance to detect endoleaks after endovascular stent graft repair of abdominal aortic aneurysms. We have evaluated the efficacy of duplex ultrasound scan with the addition of an ultrasound scan contrast...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.17
更新日期:2003-02-01 00:00:00
abstract::A case is reported of a woman with an ischemic arm as a result of damage to the subclavian artery by the clavicular anomaly associated with cleidocranial dysostasis. Only one similar case has been reported previously. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70105-8
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVE:To determine the clinical and radiological outcomes of patients with symptomatic spontaneous isolated dissection of the superior mesenteric artery (SIDSMA) who were treated with conservative management. METHODS:This retrospective study included 27 consecutive patients who were diagnosed with symptomatic SIDS...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.112
更新日期:2014-02-01 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:The objective of this study was to review our 27-year clinical experience with open proximal abdominal aortic aneurysm repairs, with a focus on long-term survival. METHODS:A retrospective cohort study was undertaken of all patients who underwent proximal abdominal aortic aneurysm repair between 1986 and 2013...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.01.008
更新日期:2014-06-01 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:This study was performed to test whether tenascin, a large oligomeric glycoprotein of the extracellular matrix, is present in AAA disease and whether it could play a pathophysiologic role in the development of this disease. METHODS:Tenascin immunoreactivity was investigated from samples of the aneurysmal walls...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70068-5
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:Evidence to guide management of postdissection abdominal aortic aneurysms (PDAAA) is lacking. This study describes the outcomes of open repair of PDAAA. METHODS:A retrospective cohort study was conducted of all consecutive patients treated with open repair for PDAAA after a Stanford type A or type B thoraci...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.04.483
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the role of endovascular and open surgical reconstructions in patients with superior vena cava (SVC) syndrome caused by nonmalignant disease. METHODS:Clinical data from 32 consecutive patients who underwent endovascular or open surgical reconstruction of central vei...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00331-8
更新日期:2003-08-01 00:00:00
abstract:PURPOSE:This retrospective review describes the surgical management of 51 patients after failed percutaneous renal artery angioplasty (F-PTRA). METHODS:From January 1987 through June 1998, 51 consecutive patients underwent surgical repair of either atherosclerotic (32 patients) or fibromuscular dysplastic (FMD; 19 pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70074-1
更新日期:1999-09-01 00:00:00
abstract::Although the Heimlich maneuver is considered the best intervention for relieving acute upper airway obstruction, several complications have been reported in the literature. These complications can occur as a result of an increase in abdominal pressure leading to a variety of well-documented visceral injuries, includin...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.061
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:G protein-linked receptors are involved in the processes that lead to intimal hyperplasia. This study examined the role of Galphaq signaling pathways in vascular smooth muscle cell (SMC) proliferation in vitro. METHODS:Rat pulmonary artery SMCs were cultured in vitro. Standard assays of cellular DNA synthes...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2003.10.052
更新日期:2004-03-01 00:00:00
abstract::Prostacyclin (PGI2) and thromboxane A2 (TxA2) formation by whole-tissue segments of nine carotid endarterectomy specimens (CES), five normal aortic specimens (NAS), six saphenous vein specimens (SVS), and four platelet samples were determined by incubation with 10 mumol/L 1-14C-radiolabeled prostaglandin endoperoxide ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1988-10-01 00:00:00
abstract::Preferred treatment for thromboembolism when heparin fails or is contraindicated is infrarenal inferior vena cava (IVC) interruption. In the present study suprarenal Greenfield filters were placed in 11 patients in whom routine infrarenal IVC interruption would have been inadequate therapy. As identified by IVC venogr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:INTRODUCTION:Although all areas of the body are susceptible to radiation injury, different tissues have varying tolerances for radiation exposure. The goal of this summary is to introduce basic concepts of radiation biology and discuss the effects of radiation on various tissues. METHODS:Reference texts and literature...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.175
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Blunt abdominal aortic injury (BAAI) is a rare injury with less than 200 cases in the current reported world literature, mostly in case report format. We sought to describe the experience of a high-volume trauma center and to provide a contemporary review of the literature to better understand the natural hi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2011.10.132
更新日期:2012-05-01 00:00:00
abstract::Fibromuscular dysplasia represents one of the more common types of arterial fibrodysplasia, a heterogeneous group of nonatherosclerotic vascular occlusive and aneurysmal diseases. This disorder mainly affects renal and cerebral arteries, and less frequently, arm, leg, and visceral arteries. Exceptionally, it has been ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.06.032
更新日期:2008-12-01 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::Peripheral arterial disease (PAD) is a highly prevalent public health problem associated with major detrimental effects on quality of life and functional status, and it is also the main cause of limb amputation. More importantly, PAD has been classified as a coronary artery disease equivalent, meaning that patients wi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2009.08.085
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:Despite the increased cardiovascular morbidity and mortality risk of patients with peripheral arterial disease, previous worldwide studies have documented undertreatment of cardiovascular risk factors in such patients. METHOD:The ATTEST study was an observational cross-sectional epidemiologic study. Patients...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.04.002
更新日期:2006-08-01 00:00:00
abstract:PURPOSE:Human vascular prostheses develop a pseudointima that after time is devoid of a complete endothelial lining. The composition of this pseudointima consists of both cellular and noncellular components such as coagulation proteins and extracellular matrix proteins. Of these extracellular molecules, type V collagen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.40730
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVE:In the absence of suitable autologous vein, the use of prosthetic grafts for infragenicular bypasses in peripheral arterial disease has become standard practice. The purpose of this study was to investigate whether creating a vein patch at the distal anastomosis would further improve patency and freedom from ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.11.073
更新日期:2018-07-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the results of carotid endarterectomy (CEA) in a young population with premature atherosclerosis with the results of an older control group, examining perioperative morbidity and mortality data, recurrent stenosis and symptoms, late stroke, and survival data. METHODS:We...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0741-5214(97)70037-5
更新日期:1997-09-01 00:00:00
abstract::Pulsed and continuous-wave Doppler examinations with spectral analysis were performed on 258 carotid arteries in 220 patients and compared with multiplane contrast angiography. Each artery was examined for stenosis and assigned to one of four groups: normal to 19%, 20% to 49%, 50% to 99%, and occlusion. The incidence ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020270
更新日期:1985-03-01 00:00:00
abstract::Isolated dissection of the superior mesenteric artery is an uncommon event, but many new cases have been reported recently, reflecting the progress of imaging and suggesting that this pathology is not as rare as previously thought. Here we report a case of superior mesenteric artery dissection where we performed, afte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.05.048
更新日期:2005-10-01 00:00:00