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 quality assurance database for carotid revascularization procedures. Patients with SIE who had undergone CEA or CAS were included. The primary outcome was any new stroke or all-cause death until hospital discharge. Descriptive statistics were calculated using statistical standard methods. To identify factors that are associated with the primary or secondary outcomes, a multilevel multivariable regression analysis was performed (exploratory approach). RESULTS:Between 2009 and 2014, a total of 5058 patients (mean age, 70 ± 11 years; 68% male) with SIE were treated with CEA (n = 3176) or percutaneous transluminal angioplasty/CAS (n = 1882). The primary outcome occurred in 9.0% and 11.7% after CEA and CAS, respectively. The multivariable regression analysis revealed that age (per 10-year increase: risk ratio [RR], 1.30; 95% confidence interval [CI], 1.12-1.50), American Society of Anesthesiologists (ASA) class (ASA class 4 and 5 vs ASA class 3: RR, 2.34; 95% CI, 1.65-3.32), ipsilateral degree of stenosis (occlusion vs severe stenosis: RR, 1.90; 95% CI, 1.29-2.79; low grade vs severe stenosis: RR, 3.06; 95% CI, 1.55-6.02), and neurologic deficit on admission (modified Rankin scale score of 3-5 vs 0-2: RR, 1.48; 95% CI, 1.04-2.10) are significantly associated with the risk of stroke or death after emergency CEA for SIE. In patients treated with CAS, only age (per 10-year increase: RR, 1.58; 95% CI, 1.37-1.82), ASA class (ASA class 1 and 2 vs ASA class 3: RR, 0.66; 95% CI, 0.46-0.95; ASA class 4 and class 5 vs ASA class 3: RR, 1.91; 95% CI, 1.31-2.78), and ipsilateral degree of stenosis (moderate vs severe stenosis: RR, 0.19; 95% CI, 0.04-0.77; occlusion vs severe stenosis: RR, 1.63; 95% CI, 1.18-2.25) were significantly associated with the primary outcome rate. CONCLUSIONS:Emergency carotid revascularization is associated with a combined stroke or death rate of about 10% under routine conditions in Germany. Lower age, lower ASA class, moderate to high-grade stenosis, and less severe neurologic deficit preceding CEA potentially serve as protective factors.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Knappich C,Kuehnl A,Tsantilas P,Schmid S,Breitkreuz T,Kallmayer M,Zimmermann A,Eckstein HHdoi
10.1016/j.jvs.2017.10.085subject
Has Abstractpub_date
2018-08-01 00:00:00pages
436-444.e6issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(17)32685-Xjournal_volume
68pub_type
杂志文章abstract:OBJECTIVES:Increasing evidence points to the inflammatory character of atherosclerosis, and several parameters of inflammation have been proposed as cardiovascular risk markers. We analyzed associations among serum high-sensitivity C-reactive protein (hs-CRP) concentrations, carotid plaque structure, and immunocytology...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00709-2
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Considering the poor efficacy of local intramuscular injections with endothelial progenitor cells (EPCs) for critical limb ischemia in patients with diabetes, the study aimed to investigate the effect of α-tocopherol (α-T) and α-tocopherol phosphate (α-TP) on apoptosis and angiogenesis in a rat model under ox...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.051
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:The effect of a rat carotid endarterectomy (CEA) on homocysteine and the metabolic enzymes methylenetetrahydrofolate reductase (MTHFR) and cystathionine beta-synthase (CBS) was studied. METHODS:Rats were placed into 7 groups: (1) no anesthesia (NA), (2) anesthesia only (AO), (3) skin opened and closed (O/C),...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.07.011
更新日期:2004-10-01 00:00:00
abstract::We describe the surgical management of six patients with occlusive disease of the visceral arteries caused by Takayasu's arteritis. All patients suffered from renovascular hypertension and, in addition, three of the patients also had symptoms of mesenteric angina. Surgical repair is recommended in the "burn-out" phase...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030904
更新日期:1986-06-01 00:00:00
abstract:PURPOSE:This is a review of 100 consecutive supraaortic trunk reconstructions (SAT) performed over 16 years. METHODS:There were eight innominate endarterectomies and 92 bypass procedures based on the thoracic aorta (n = 86) or proximal innominate artery (n = 6) in 98 patients 24 to 79 years of age. Indications include...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70289-7
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Ankle-brachial pressure index (ABI) is a simple, inexpensive, and useful tool in the detection of peripheral arterial occlusive disease (PAD). The current guidelines published by the American Heart Association define ABI as the quotient of the higher of the systolic blood pressures (SBPs) of the two ankle ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.016
更新日期:2006-09-01 00:00:00
abstract::Endofibrosis of the external iliac artery is an uncommon disease affecting primarily young, otherwise healthy, endurance athletes. Thigh pain during maximal exercise with quick resolution postexercise is characteristic of the so-called cyclist's iliac syndrome. We report an unusual case in which the typical endofibrot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2010.02.259
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.12.123
更新日期:2017-06-01 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::Lauded alike by ancient civilizations and modern society, pharaonic Egyptian medicine remains an object of fascination today. This article discusses its surprisingly sophisticated understanding of a cardiovascular system. The term "cardiovascular system," however, carries assumptions and meanings to a modern audience,...
journal_title:Journal of vascular surgery
pub_type: 历史文章,杂志文章
doi:10.1016/j.jvs.2014.04.056
更新日期:2014-07-01 00:00:00
abstract:PURPOSE:The antiproliferative and antisecretory effects of somatostatin have many potential uses in the clinical setting. Retroviral gene transfer of somatostatin to endothelium is a potential means of local delivery of this peptide to specific vascular beds. This investigation was designed to determine whether transdu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70278-2
更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Genetic testing to identify succinate dehydrogenase (SDH) mutations in patients with head and neck paraganglioma (HNP) has been in clinical practice for more than a decade. However, the recurrence and metachronous tumor occurrence risks in surgically treated mutation-positive patients are not well studied. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.08.232
更新日期:2020-05-01 00:00:00
abstract::Occasionally symptomatic kinking of the internal carotid artery will require correction. More frequently one must rectify a kink that occurs after bifurcation endarterectomy when associated with a redundant internal carotid artery. Most procedures described for shortening of the carotid artery are somewhat cumbersome ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060197
更新日期:1987-08-01 00:00:00
abstract::The 10-year experience of a single community was reviewed and a multivariate analysis was performed to determine the relative importance of clinical and environmental factors in mortality after ruptured abdominal aortic aneurysm resection. Ruptured aneurysms were repaired in 243 patients in six area hospitals (one uni...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.18639
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:The number of hemodialysis patients with peripheral artery disease is increasing, and critical limb ischemia develops in some of these patients. The clinical outcomes in such patients after major amputation remain unclear. We therefore examined the mortality rates after major amputation in hemodialysis patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.03.452
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:This study was conducted to determine the outcomes and predictive factors for success during percutaneous endovascular aneurysm repair (PEVAR) using vascular closure devices (VCDs). METHODS:The clinical data of patients who underwent PEVAR between 2005 and 2012 were retrospectively reviewed. Patient demograp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.028
更新日期:2013-11-01 00:00:00
abstract:PURPOSE:The purpose of this study was the report of the results of a consecutive series of carotid endarterectomy (CEA), performed by one surgeon and independently assessed by a neurologist, in which the achievability of selective early control of the distal internal carotid artery (ICA) was prospectively recorded. ME...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.122028
更新日期:2002-07-01 00:00:00
abstract:PURPOSE:To evaluate the patency and hemodynamic impact of a cryopreserved allograft venous valve transplanted to the superficial femoral vein (SFV) of a canine insufficiency model aided by a distal arteriovenous fistula (dAVF). METHODS:Eight greyhounds had intravenous hemodynamic parameters measured (venous filling ti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70095-8
更新日期:1997-11-01 00:00:00
abstract::Among various methods to achieve rapid occlusion of the aorta during endovascular repair for ruptured abdominal aortic aneurysm, particular emphasis is placed on two techniques that have been incorporated into our endovascular repair practice. The sheath-over-balloon technique (the Loan SOB technique) facilitates hemo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.03.033
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:The sandwich technique is an endovascular off-the-shelf solution for patients with thoracoabdominal aortic aneurysms (TAAAs). In a sandwich configuration, the chimney stent runs in the middle of a space created by two or three aortic endografts. METHODS:All patients with TAAAs who were treated with the sand...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.12.044
更新日期:2014-06-01 00:00:00
abstract:PURPOSE:Although routine noninvasive surveillance is recommended after carotid endarterectomy (CEA), there are little data to show that identification and eradication of recurrent carotid artery stenosis are necessary to avoid the risk of subsequent neurologic complications. METHODS:We reviewed our experience over a 1...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::True aneurysms of the pancreaticoduodenal artery are a rare form of visceral artery aneurysm. Two cases are presented and options for treatment are reviewed. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(96)80054-1
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:Endovascular aneurysm repair (EVAR) of abdominal aortic aneurysms (AAAs) that also involve the common iliac artery (CIA) typically is accomplished by endograft limb extension into the external iliac artery (EIA). In order to prevent endoleak, the internal iliac artery (IIA) is usually embolized, or alternativ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.063
更新日期:2012-08-01 00:00:00
abstract::Pseudoaneurysms represent a well-recognized vascular complication of renal transplantation, but true aneurysms involving the donor renal artery have not been described. We report a patient who had a de novo aneurysm of the donor renal artery 6 years after receiving a cadaveric renal transplant from a child. The aneury...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.106943
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:To compare the safety and efficacy of coil embolization (COIL) to Amplatzer vascular plug embolization (PLUG) to achieve internal iliac artery (IIA) occlusion prior to endovascular aortiliac aneurysm repair (EVAR). METHODS:Data from consecutive patients who underwent IIA embolization prior to EVAR over a 6-y...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.05.001
更新日期:2012-11-01 00:00:00
abstract::Endovascular techniques with coil embolization have been used in certain visceral aneurysm cases, often resulting in sacrifice of the involved visceral vessel and end-organ thrombosis. We describe two cases in which stent grafts were used to treat these aneurysms, allowing preservation of visceral artery and end-organ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.129645
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:To evaluate our experience with the endovascular treatment of total occlusions of the mesenteric and celiac arteries. METHODS:We performed a retrospective review of endovascular stenting of 27 nonembolic total occlusions of the superior mesenteric artery (SMA) and celiac artery (CA) between July 2004 and Jul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.12.013
更新日期:2012-06-01 00:00:00
abstract::Aortoduodenal fistula is a well-known complication of abdominal aortic aneurysm repair and has been described after endovascular repair. A unique complication of duodenal perforation by intentionally placed embolic material in the aneurysm sac is described. Intentional off-label use of material to promote aneurysm sac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.05.069
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:Pre-emptive selective embolization of inferior mesenteric artery (IMA), lumbar arteries (LAs), and perigraft sac for prevention of type II endoleak (T2EL) has not been widely adopted. We perform pre-emptive nonselective perigraft aortic sac embolization with coils (PNPASEC) in patients at high risk for develo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.054
更新日期:2019-06-01 00:00:00
abstract:INTRODUCTION:In some community-based studies, lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) has been shown to be independently predictive of future fatal and nonfatal cardiovascular disease (CVD) events. We tested the hypothesis that Lp-PLA(2) is independently predictive of mortality in high-risk patients from ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.04.038
更新日期:2007-09-01 00:00:00