Abstract:
OBJECTIVE:The annual number of open abdominal aortic aneurysm (AAA) repairs has decreased dramatically over the last decade, making the search for physician case volume thresholds more important. The purpose of this study was to identify a minimum threshold for annual surgeon case volume in open AAA repair. METHODS:The New York Statewide Planning and Research Cooperative System inpatient database was used to identify all patients undergoing open repair of an intact AAA between 2000 and 2008. Thirty-day survival was calculated using New York State vital records, which contain all New York State death certificates. The annual case volume for each surgeon was defined as the number of open AAA repairs performed in the year of the index procedure. The Contal and O'Quigley method was used to identify a minimum volume threshold. RESULTS:A total of 11,086 patients were included in the analysis. The selected cutpoint was six or more cases per year based on maximization of the Contal and O'Quigley test statistic. The high-volume group had comparable rates of cardiovascular comorbidities, but significantly improved 30-day and 5-year survival rates as well as shorter lengths of stay in the hospital. CONCLUSIONS:This study identifies an ideal threshold for minimum annual surgeon case volume for open AAA repair. Over the study period, perioperative mortality would not have occurred in up to 150 patients if all procedures had been done by high-volume surgeons performing at least six repairs per year. However, even a minimum annual threshold of at least two repairs per year provided a mortality benefit. Ideal minimum volume thresholds should be developed using rigorous statistical analysis as well as local information about practice patterns.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Esce A,Medhekar A,Fleming F,Glocker R,Ellis J,Raman K,Stoner M,Doyle Adoi
10.1016/j.jvs.2018.11.027subject
Has Abstractpub_date
2019-09-01 00:00:00pages
762-767issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(19)30056-4journal_volume
70pub_type
杂志文章abstract:OBJECTIVE:It has been previously shown that the SCD Response Compression System, by sensing the postcompression refill time of the lower limbs, delivers more compression cycles over time, resulting in as much as a 76% increase in the total volume of blood expelled per hour. Extended indications for pneumatic compressio...
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/j.jvs.2005.03.031
更新日期:2005-08-01 00:00:00
abstract::A study was designed to compare platelet deposition between knitted and woven Dacron grafts in the same patient. Twenty patients received aortoiliac or aortofemoral bifurcated Dacron grafts, each composed of one woven and one double-velour knitted limb. External nuclear graft imaging was carried out after injection of...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050833
更新日期:1987-06-01 00:00:00
abstract:OBJECTIVE:This study assessed the risk of left subclavian artery (LSA) coverage and the role of revascularization in a large population of patients undergoing thoracic endovascular aortic aneurysm repair. METHODS:A retrospective multicenter review of 1189 patient records from 2000 to 2010 was performed. Major adverse ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2012.06.101
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease (PAD) can be diagnosed noninvasively by segmental blood pressure measurement and calculating an ankle-brachial index (ABI) or toe-brachial index (TBI). The ABI is known to be unreliable in patients with vascular stiffness and fails to detect the early phase of arteriosclerotic dev...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2013.03.044
更新日期:2013-07-01 00:00:00
abstract:PURPOSE:We analyzed the short- and long-term results for patients undergoing thrombolysis of occluded infrainguinal bypass grafts at our institution over a 62-month period. METHODS:Thirty-one patients with 40 episodes of graft thrombosis in 33 grafts managed by thrombolysis were retrospectively reviewed. The effects o...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/0741-5214(94)90283-6
更新日期:1994-10-01 00:00:00
abstract::Cystic adventitial disease of veins is a rare condition. We report the case of a 28-year-old man who presented with a swollen leg secondary to obstruction of the common femoral vein as a result of this disease. He underwent excision of the cyst and made a full recovery. The presentation, investigation, treatment and p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.034
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:Diabetic foot disease poses a significant and rising financial burden on health care systems worldwide. This study investigated the effect of a new multidisciplinary diabetic foot clinic (MDDFC) in a large tertiary hospital on patient outcomes and treatment cost. METHODS:Patients' records were retrospectivel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.11.032
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Studies have shown that a sizable percentage of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysms (AAAs) is performed outside the instructions for use (IFU). We report our long-term outcomes after EVAR with respect to device-specific IFU. METHODS:Computed tomography angiography data from a c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.01.034
更新日期:2016-07-01 00:00:00
abstract:PURPOSE:Initiation of hemodialysis frequently requires temporary central venous catheterization, which leads to subsequent venous stenosis in 50% of patients. These lesions severely limit upper extremity dialysis fistula creation. The present study was undertaken to determine whether early cannulation (EC) allowed omis...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0741-5214(97)70123-x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:We examined the protective effects of the new selective spinal cord cooling by using cold saline infusion into the cross-clamped aorta and a transvertebral cooling pad placed over the lumbar vertebral column from paraplegia caused by ischemic spinal cord injury on thoracoabdominal aortic surgery. METHODS:Eig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.02.017
更新日期:2006-06-01 00:00:00
abstract:PURPOSE:Many viruses have evolved mechanisms to evade detection by the host immune system. The herpes simplex gene ICP47 encodes a protein that binds to the host antigen-processing transporter, inhibiting the formation of major histocompatibility complex class I (MHC-I) antigens in infected cells. MHC-I antigen express...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:INTRODUCTION:Fenestrated endovascular aneurysm repair (FEVAR) is the highest radiation dose procedure performed by vascular surgeons. We sought to characterize the radiation dose to patients and staff during FEVAR procedures with different premanufactured devices. METHODS:A single-center prospective study of FEVARs wa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.02.031
更新日期:2018-11-01 00:00:00
abstract::In 1945 Martorell described ischemic leg ulcers in patients with hypertension and suggested that the ischemic necrosis was secondary to hypertensive arteriolar disease. The aim of the study was to examine the minimum vascular resistance in the skin of patients with these ulcers. Twelve control subjects (median age 52 ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020581
更新日期:1985-07-01 00:00:00
abstract::We report the fifth case of a graft appendiceal fistula. The four previously reported cases are reviewed. This is the first report of the utility of the tagged red blood cell study in the evaluation of a patient with a graft appendiceal fistula. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0070814
更新日期:1988-06-01 00:00:00
abstract::Although abdominal aortic aneurysm (AAA) is a common problem in elderly patients, AAA is rare in children. Despite its rarity, early diagnosis is imperative to prevent limb-threatening or fatal complications. The treatment may be complicated, because it must allow for the growth of the child. A saccular AAA in an 11-y...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70100-4
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:Dual antiplatelet therapy (DAPT) usually refers to the administration of aspirin plus a platelet P2Y12 receptor blocker. This combination is commonly prescribed after revascularization procedures in patients with peripheral arterial disease (PAD) to prevent failure of the intervention. However, there is not ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2018.02.047
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:Little is known about acute peripheral arterial thrombosis in patients with concomitant cancer. Small studies suggest that revascularization in this patient group is associated with thrombosis and increased risk of amputation and death. We investigated the frequency of cancer in patients operated on for acute...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.223
更新日期:2015-12-01 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:BACKGROUND:This randomized clinical trial compared endovenous laser ablation (EVLA) and surgical ligation with attempted stripping in the treatment of small saphenous vein (SSV) insufficiency. The early results demonstrated that EVLA was more likely to eradicate axial reflux and was also associated with a faster recove...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2014.09.037
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the anatomic distribution and associated mortality of combat-related vascular injuries comparing them to a contemporary civilian standard. DESIGN:The Joint Trauma Theater Registry (JTTR) was queried to identify patients with major compressible arterial injury (CAI) an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.02.048
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:In the era of rising endovascular treatment of thoracoabdominal aortic aneurysms (TAAAs), the analysis of visceral vessel (VV) patency after open surgical repair is crucial to provide a future benchmark between these different approaches. This study reports the late outcomes of a single-center experience wit...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.08.067
更新日期:2018-04-01 00:00:00
abstract::To determine optimal fluid management after elective aortic surgery we compared postoperative administration of 5% dextrose Ringer's lactate solution (102 patients) with 5% dextrose half-normal saline solution (80 patients). For 72 hours after operation, intravenous fluids were titrated to maintain urine output betwee...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0040164
更新日期:1986-08-01 00:00:00
abstract::In this article we describe a method for assembling an endovascular graft within the aorta with a graft and then a stent introduced sequentially over a guidewire as separate components. In the ex vivo study, an endovascular graft that was 25 mm in diameter was introduced through a 9F introducer. In the in vivo study, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115814
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVE:Little is known about the natural history and management of aneurysmal aortic arch branch vessels (AABVs). The objectives of this study were to assess the natural history of aneurysmal AABVs and to examine the outcomes of operative intervention. METHODS:A retrospective review of the Yale radiologic database ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.03.412
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:While autogenous arteriovenous access is preferred, prosthetic arteriovenous grafts (AVG) are still required in a large number of patients. Infection of AVGs occurs frequently and may cause life-threatening bleeding or sepsis. Multiple treatment strategies have been advocated (ranging from graft preservation ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.04.030
更新日期:2008-09-01 00:00:00
abstract:PURPOSE:Mesenteric arterial reconstruction in patients with acute or chronic intestinal ischemia is associated with significant morbidity and mortality rates. Reperfusion of ischemic bowel in animals leads to release of multiple factors that cause organ dysfunction. Similar phenomena potentially occur in human beings a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.48586
更新日期:1993-09-01 00:00:00
abstract::Throughout our medical training, we are taught how to manage patients who present with symptoms, which usually leads to a clinical examination, a diagnosis, and a management plan. However, virtually no time is spent on teaching how to manage patients who have no symptoms because they have lost the ability to feel pain...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2010.06.005
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine whether calf muscle hemoglobin oxygen saturation (Sto2) obtained during a standardized treadmill test is associated with ambulatory function and health-related quality of life (HRQoL) in patients with symptomatic peripheral artery disease (PAD). We hypothesized tha...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.057
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:The effects of a new long-term subcutaneous vascular access device were studied in access-challenged patients who were poor candidates for fistulas or grafts due to venous obstruction. Bacteremia rates, patency, and function of the Hemodialysis Reliable Outflow (HeRO) Vascular Access Device (Hemosphere Inc, M...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jvs.2009.04.014
更新日期:2009-09-01 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