Abstract:
OBJECTIVE:Intravascular ultrasound (IVUS) examination is an integral technique used for treating type B aortic dissection (TBAD) because it verifies true lumen access. The purpose of this study was to evaluate the use of IVUS, to determine factors associated with IVUS use, and to investigate the potential survival benefit associated with IVUS in the treatment of TBAD. METHODS:A retrospective review of TEVARs performed for TBAD in the national Vascular Quality Initiative was performed from January 2010 to August 2018. Data collected included demographics, intraoperative and postoperative variables, and long-term mortality. Multivariable logistic regression evaluated variables associated with IVUS the use and mortality, and Cox regression was performed for adjusted survival analysis. RESULTS:In this study of 2686 patients, the average age was 60.4 years, 69.3% were male, and IVUS examination was used in 74.6% of cases. IVUS patients were younger (60.0 years vs 61.7 years; P = .004), more often male (72.1% vs 61.3%; P < .001), exhibited less coronary disease, but had higher preoperative creatinine (1.27 ± 0.89 mg/dL vs 1.14 ± 0.68 mg/dL; P < .001) and were more often treated in the acute setting (55.2% vs 49.7%; P = .03). Interestingly, there were no differences in contrast use (117.4 ± 77.6 mL vs 123.0 ± 81.90.1 mL; P = .11) or fluoroscopy time (20.3 ± 16.5 minutes vs 19.0 ± 22.1 minutes; P = .10). However, IVUS cases had a greater number of devices implanted (1.84 vs 1.65; P < .001), higher rates of Zone 0 to 2 proximal seal (43.9% vs 30.7%; P < .001), higher rates of distal seal zones beyond the diaphragm (53.9% vs 37.4%; P = .001), and larger proximal and distal graft diameters, with no differences in postoperative renal function. IVUS patients notably also had higher rates of follow-up imaging (61.3% vs 54.8%; P = .003), larger maximum aortic diameters at follow-up, and more reinterventions over time. The number of aortic devices (odds ratio [OR] 1.56; 95% confidence interval [CI], 1.24-1.97; P < .001), malperfusion indication (OR, 1.68; 95% CI, 1.17-2.42; P = .005) and distal seal zone beyond the diaphragm (OR, 1.64; 95% CI, 1.30-2.07; P < .001) were independently associated with IVUS use, whereas female gender showed a trend towards less IVUS use (OR, 0.79; 95% CI, 0.62-1.01; P = .063). Even after controlling for age, preoperative comorbidities, and postoperative complications like spinal cord ischemia, IVUS was associated with a 61% decrease in the odds of mortality (OR, 0.39; 95% CI, 0.20-0.78; P = .008), with a clear survival advantage shown in adjusted survival curves. CONCLUSIONS:IVUS examination was used in the majority of TBAD, although not universally. IVUS examination was used more often in acute TBAD and more complex aortic repairs, and was independently associated with improved long-term survival. Further study is needed to understand these patterns.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Belkin N,Jackson BM,Foley PJ,Damrauer SM,Kalapatapu V,Golden MA,Fairman RM,Wang GJdoi
10.1016/j.jvs.2019.10.073subject
Has Abstractpub_date
2020-08-01 00:00:00pages
490-497issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(19)32623-0journal_volume
72pub_type
杂志文章abstract::Compartment syndrome of the leg is a well-recognized complication known to follow urgent revascularization done for acute limb ischemia, but compartment syndrome of the foot has not been reported after the ischemia-reperfusion sequence. Herein we report a case of foot fasciotomy done for compartment syndrome that occu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.01.043
更新日期:2016-03-01 00:00:00
abstract::Chronic aortic dissection is one of the most challenging pathologies faced by aortic surgeons. The variety of presentations and the multiple comorbidities of the patients make treatment and follow-up a subject of much debate. Historical data is difficult to interpret because of the heterogeneity of the included popula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2016.01.025
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2016.10.099
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to analyze the trend in inpatient vascular procedures in the United States over the past decade and predict the future demand for vascular surgeons. METHODS:The Healthcare Cost and Utilization Project Nationwide Inpatient Sample was queried to determine the weighted national est...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.061
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:Endoleak is a common complication of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) but can be detected only through prolonged follow-up with repeated aortic imaging. This study examined the potential for circulating matrix metalloproteinase 9 (MMP9), osteoprotegerin (OPG), D-dimer, h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.090
更新日期:2018-03-01 00:00:00
abstract::The lack of a rapid, noninvasive, and accurate method to confirm or rule out prosthetic graft infection continues to constitute a compelling and vexing clinical problem. A host of adjunctive diagnostic techniques has been used in the past, but early promising results subsequently have usually not yielded acceptable se...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030042
更新日期:1986-01-01 00:00:00
abstract:PURPOSE:To validate the accuracy of previously established duplex ultrasound criteria for > or =50% superior mesenteric artery (SMA) and celiac artery (CA) stenosis by comparison with arteriography. METHODS:Duplex criteria established retrospectively in our laboratory in 1991 identified an end-diastolic velocity (EDV)...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)60010-0
更新日期:1998-06-01 00:00:00
abstract::In a 34-year-old woman with intermittent calf claudication, cystic adventitial disease of the popliteal artery was demonstrated by intravascular ultrasound imaging. Multiple intramural cystic masses were seen to be compressing the arterial lumen. The diagnoses of cystic adventitial disease was confirmed by surgery. In...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(96)80023-1
更新日期:1996-03-01 00:00:00
abstract::Pulsed Doppler ultrasonography (UA), sound spectrum analysis, and subjective interpretation of the audible signal are valuable methods for assessing carotid arterial disease; however, the relative contribution of each in making a diagnosis is disputed. To investigate this issue, 258 noninvasive carotid studies with me...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030502
更新日期:1986-03-01 00:00:00
abstract::The long-term patency of the internal mammary artery graft is better than that of the saphenous vein graft in coronary bypass surgery because of a low incidence of atherosclerosis in the internal mammary artery. In search of a possible biochemical explanation of the low degree of atherosclerosis in the internal mammar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.17248
更新日期:1990-03-01 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:PURPOSE:This study compared the volume and morphology of intraluminal thrombus (ILT) in intact and ruptured abdominal aortic aneurysms (AAAs). METHODS:ILT volume in 67 intact AAAs and in 31 ruptured AAAs was assessed by using computed tomography (CT) angiography to measure the major and minor diameter of the outer wal...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.01.004
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVE:Lower extremity bypass grafts that develop stenoses are commonly treated with either open surgical or endovascular revision. Vein graft stenoses with unfavorable lesions (multiple lesions, lesions >2 cm in length, lesions in grafts <3 months old, lesions in grafts <3 mm in diameter) fare worse than those with...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.08.065
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The main cause of occlusion and vein graft failure after peripheral and coronary arterial reconstruction is intimal hyperplasia. Transforming growth factor beta-1 (TGF-beta1) is a pleiotropic cytokine known to have powerful effects on cell growth, apoptosis, cell differentiation, and extracellular matrix syn...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.01.016
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:To compare the results of emergency open repair of acute (ruptured or symptomatic intact) abdominal aortic aneurysms with that of endovascular repair. METHODS:A systematic literature search was performed to identify series that reported comparative outcomes. PubMed, Embase, the randomized controlled trial (R...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2007.11.028
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To characterize radiation exposure to patients and operating room personnel during fluoroscopic procedures. METHODS:Patient dose information was collected from the imaging equipment. Real-time dosimetry was used to measure doses to the operators, scrub nurse, radiologic technologist (RT), and anesthesiologis...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jvs.2013.02.032
更新日期:2013-09-01 00:00:00
abstract::Advances in venous reconstruction have been limited by inherent venous thrombogenicity and the absence of a suitable prosthetic material for use in the venous system. We have designed an in vivo experimental model to evaluate early blood-material interactions within the venous system and to quantitate drug efficacy in...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080049
更新日期:1988-07-01 00:00:00
abstract::Among 1500 carotid endarterectomies performed between 1975 and 1984, 11 ipsilateral intracranial hemorrhages (IH) occurred between the first and tenth postoperative days for an incidence of 0.7%. The mortality rate among these patients was 36%. The only recognizable predisposing factor was relief of high-grade carotid...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1988-02-01 00:00:00
abstract:PURPOSE:Percutaneous angioplasty and stenting (PTAS) is emerging as a therapeutic option for patients with chronic mesenteric ischemia. This study evaluated patency and mortality, and their relationship between degree of vessel occlusion (stenotic or totally occluded), stent characteristics, and comorbidities in patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.11.046
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Open bypass is the gold standard for treatment of mesenteric ischemia. With the refinement of endovascular therapy, visceral stenting is an attractive minimally invasive alternative, but the data are limited and which vessel responds best to stenting has not been addressed. This study compares the outcomes o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.081
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Endovascular treatment of ruptured abdominal aortic aneurysms (r-AAAs) has the potential to offer improved outcomes. As our experience with endovascular repair of r-AAA evolved, we recognized that the development of abdominal compartment syndrome (ACS) led to an increase in morbidity and mortality. We theref...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.033
更新日期:2005-12-01 00:00:00
abstract::We performed radiofrequency ablation to treat a symptomatic facial venous malformation of a 24-year-old woman under ultrasound scan-guidance. The 20.25-cm sized original facial venous malformation in her right cheek markedly reduced without any scar formation and was grossly not visible after 1 month of the procedure....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.03.047
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:The hemodynamic effects of carotid angioplasty with stent placement (CAS) on the collateral blood supply and on the regional cerebral blood flow (rCBF) have not been established. Recently, arterial spin-labeling (ASL) magnetic resonance imaging (MRI) has been introduced as the first method to quantify the ac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2006.11.067
更新日期:2007-06-01 00:00:00
abstract:PURPOSE:Fifty-one consecutive patients with premature lower extremity atherosclerosis were prospectively evaluated for atherogenic risk factors and primary or acquired hypercoagulability, which might contribute to early ischemia and revascularization failure. METHODS:Laboratory tests included plasma assays of (1) natu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(05)80033-3
更新日期:1996-01-01 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:The purpose of this study was to develop an angioscopic technique to visualize the endoluminal surface of the aorta and to guide vascular stent placement. METHODS:A fiberoptic angioscope, fitted with a balloon at its tip, was passed via a carotid arteriotomy into the abdominal aorta of seven anesthetized pigs....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(05)80013-8
更新日期:1995-05-01 00:00:00
abstract::Spontaneous arterial dissection may occur in a dramatic fashion and is often fatal if treatment is not instituted promptly. Diagnosis may be particularly difficult when cases of arterial dissection appear in unusual locations. We report a rare case of atraumatic dissection of the splenic artery that occurred in a 66-y...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1992.30864
更新日期:1992-01-01 00:00:00
abstract::Although Buerger's disease is known to be closely related to smoking, no objective analysis of the smoke-associated problems has been performed. In this study, cotinine, the major metabolite of nicotine, was used as a sensitive marker to measure levels of active smoking and the exposure of nonsmokers to tobacco smoke ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract::Acquired factor VIII inhibitor is increasingly recognized as a cause of major soft tissue hemorrhage. The laboratory diagnosis can be obscured by the synchronous presence of the lupus anticoagulant, an extremely rare occurrence that has been reported outside the vascular surgery literature. Vascular surgeons should be...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.127336
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:Fenestrated and branched endovascular devices are increasingly used for complex aortic diseases, and despite the challenging nature of these procedures, early experiences from pioneering centers have been encouraging. The objectives of this retrospective study were to report our experience of intraoperative a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.02.065
更新日期:2014-09-01 00:00:00