Abstract:
BACKGROUND:Carotid endarterectomy (CEA) for asymptomatic patients with limited life expectancy may not be beneficial or cost-effective. The purpose of this study was to examine relationships among survival, outcomes, and costs within 2 years following CEA among asymptomatic patients. METHODS:Prospectively collected data from 3097 patients undergoing CEA for asymptomatic disease from Vascular Quality Initiative VQI registry were linked to Medicare. Models were used to identify predictors of 2-year mortality following CEA. Patients were classified as low, medium, or high risk of death based on this model. Next, we examined costs related to cerebrovascular care, occurrence of stroke, rehospitalization, and reintervention within 2 years following CEA across risk strata. RESULTS:Overall, 2-year mortality was 6.7%. Age, diabetes, smoking, congestive heart failure (CHF), chronic obstructive pulmonary disease, renal insufficiency, absence of statin use, and contralateral internal carotid artery (ICA) stenosis were independently associated with a higher risk of death following CEA. In-hospital costs averaged $7500 among patients defined as low risk for death, and exceeded $10,800 among high risk patients. Although long-term costs related to cerebrovascular disease were 2 times higher in patients deemed high risk for death compared with low risk patents ($17,800 vs. $8800, P = 0.001), high risk of death was not independently associated with a high probability of high cost. Predictors of high cost at 2 years were severe contralateral ICA stenosis, dialysis dependence, and American Society for Anesthesia Class 4. Both statin use and CHF were protective of high cost. CONCLUSIONS:Greater than 90% of patients undergoing CEA live long enough to realize the benefits of their procedure. Moreover, the long-term costs are supported by the effectiveness of this procedure at all levels of patient risk.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Wallaert JB,Newhall KA,Suckow BD,Brooke BS,Zhang M,Farber AE,Likosky D,Goodney PP,Vascular Quality Initiative.doi
10.1016/j.avsg.2016.01.024subject
Has Abstractpub_date
2016-08-01 00:00:00pages
174-82eissn
0890-5096issn
1615-5947pii
S0890-5096(16)30338-7journal_volume
35pub_type
杂志文章abstract:BACKGROUND:We studied the relationship between serum levels of small, dense low-density lipoprotein cholesterol (sdLDL-C) and carotid stenosis in elderly patients with ischemic cerebral infarction. METHODS:All patients >65 years of age with newly diagnosed ischemic cerebral infarction were enrolled. None received stat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.01.029
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Early identification of carotid and vertebral artery dissections has been advocated to reduce stroke among trauma patients. We sought to characterize trends in the diagnosis of traumatic carotid and vertebral artery dissections and association changes in stroke rate among Medicare beneficiaries. METHODS:Usi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.001
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study is to evaluate 2 patients who underwent endovascular repair directly after acute life-threatening vascular injury complicating lumbar disc surgery, and to update an overview of the literature from 2002 to gain insights into characteristics, diagnosis, treatment, and outcomes of this...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2012.07.019
更新日期:2013-08-01 00:00:00
abstract::We report a massive infected pseudoaneurysm of the right external iliac artery in the setting of Girdlestone pseudoarthroplasty (GSA) for chronic infection. Around the time of her GSA, the patient underwent cardiac catheterization with resultant pseudoaneurysm formation. Infection was likely due to spread from her pre...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.070
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Distal aortic retrograde perfusion systems like the left heart bypass or femoro-femoral extracorporeal circulation are the methods of reference for organ protection during direct approaches to thoracoabdominal aortic aneurysms. The aim of this work was to evaluate the use of a passive arterial shunt to reduc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.03.031
更新日期:2016-10-01 00:00:00
abstract::Spontaneous venous aneurysms of the upper extremities and neck are rare and typically asymptomatic. We present the first reported case of a symptomatic, primary upper extremity venous aneurysm in a patient who initially presented with pulmonary emboli. A 22-year-old patient was admitted with chest pain, dyspnea, and a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.019
更新日期:2013-02-01 00:00:00
abstract::Transcatheter embolization of hypogastric artery aneurysms has become an attractive therapeutic alternative for many patients with this difficult lesion. Because of the increasing use of stent grafting for treatment of abdominal aortic aneurysms, transcatheter embolization of normal-caliber hypogastric arteries has be...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0032-7
更新日期:2004-07-01 00:00:00
abstract::Between 1982 and 1991 we performed eight operations on seven patients with carotid artery aneurysms. Their mean age was 52.8 years (range: 20-67 years). Five aneurysms were atherosclerotic, one was associated with Marfan's syndrome, and two were pseudoaneurysms, one occurring after Dacron patch angioplasty and the oth...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02015273
更新日期:1991-11-01 00:00:00
abstract::Perforation of inferior vena cava (IVC) by filter struts ranges from 9% to 24%, and clinical sequelae and complications are unpredictable. The aim of this article was to report an unusual case of late complication of IVC filter that caused an IVC wall perforation and penetration of the filter's hooks in the aorta, whi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.11.044
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Concern exists about durability of stent grafts used to bridge aortic grafts to visceral and renal arteries during fenestrated and branched endovascular aneurysm repair (F/B-EVAR). There are no guidelines regarding the ideal technique for joining target vessels (TVs). METHODS:We systematically reviewed data...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2020.10.052
更新日期:2021-01-05 00:00:00
abstract::Iliac artery aneurysms are rare in the absence of concomitant abdominal aortic aneurysm (AAA), and isolated internal iliac (hypogastric) aneurysms in particular are extremely rare. From 1986 to 1997 we repaired 572 aortic and/or iliac artery aneurysms in 440 patients. Among these there were only seven hypogastric aneu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s100169900296
更新日期:1999-09-01 00:00:00
abstract::Acute occlusion of the visceral arteries is a threatening complication following branched endovascular aortic repair (EVAR). Its prompt diagnosis and treatment are mandatory to restore renal function. Several techniques have been used to manage this complication. We report 2 clinical cases of patients, previously trea...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.07.015
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Open repair of juxta-renal abdominal aortic aneurysms (AAA) sometimes involves the ligation and division of the left renal vein (LRV). Some surgeons advocate repair, but this is not common practice. The aim was to study the effect of LRV ligation on renal function. METHODS:A retrospective audit of all open ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.008
更新日期:2010-08-01 00:00:00
abstract::Open surgical repair of complex abdominal aortic aneurysms requires more extensive dissection and aortic clamping above the renal or mesenteric arteries. Although results of open surgical series have shown variation, morbidity and mortality is higher compared with infrarenal aortic aneurysm repair. Potential complicat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2010.10.005
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:The acute exacerbations and progressive deterioration seen in thromboangiitis obliterans (TAO) have been related to poor clinical outcomes. Here, we have studied the association of laboratory biomarkers with the acute phase of TAO (AP-TAO). METHODS/RESULTS:We conducted a retrospective case-contro...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.11.020
更新日期:2020-05-01 00:00:00
abstract::Fibro-adipose vascular anomaly (FAVA) is a painful complex vascular malformation, characterized by muscle fibrofatty infiltration, usually in lower limb, associated with contracture of the ipsilateral extremity. This article describes the first case of FAVA reported in Portugal successfully treated with surgery. A 9-y...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.01.089
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:To determine whether the formation of an integrated vascular surgery residency (0 + 5) has negatively impacted the case volume and diversity of the vascular surgery fellows (5 + 2) and chief general surgeons at the same institution. METHODS:Operative data from the vascular integrated (0 + 5), independent (5...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.03.010
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:The incidence of localized popliteal disease is rare. Currently, patients presenting with symptomatic popliteal disease are offered femoropopliteal or tibial bypass if the disease is not amenable to radiologic intervention. We feel that popliteal endarterectomy by means of a posterior approach with patch ang...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.09.005
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:The aim of this study is to present midterm results of thoracic endovascular aortic repair (TEVAR) using scalloped or fenestrated custom-made endovascular grafts (CMEGs) in aortic arch Zones 0 and 1. METHODS:A retrospective review of prospectively collected data involving consecutive patients with aortic ar...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.06.009
更新日期:2020-11-01 00:00:00
abstract::During the last 20 years, we encountered 14 arterioportal fistulas in 12 patients. Gastrointestinal hemorrhage or mesenteric artery insufficiency were the most frequent conditions found after the diagnosis. Arterioportal arterial fistulas were congenital in two cases and acquired in 10; seven of these 10 were iatrogen...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60834-0
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to report the 5-year outcome relative to endovascular repair of the common femoral artery (CFA) for occlusive disease. METHODS:Thirty-six consecutive patients (40 limbs) underwent stenting for CFA lesions. Patients were followed up systematically within a prospectively maintain...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.088
更新日期:2017-04-01 00:00:00
abstract::Bier spots represent a benign vascular mottling characterized by multiple irregular white macules along the extensor surfaces of the arms and legs. They have been reported in a variety of diverse conditions with no consistent disease association. We have identified a novel association between these physiologic anemic ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2014.07.005
更新日期:2014-11-01 00:00:00
abstract::We describe a case of high-dose regional intraoperative thrombolysis subsequent to mechanical thrombectomy for the treatment of postoperative distal extremity embolization of the right lower limb owing to open repair of a ruptured abdominal aortic aneurysm. Mechanical thrombectomy was performed from the popliteal arte...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.03.010
更新日期:2011-10-01 00:00:00
abstract::A 38-year-old hemodialysis-dependent diabetic female patient underwent a laparoscopic cholecystectomy for symptomatic cholelithiasis. Postoperatively, she developed chronic back pain. Eight months following laparoscopic cholecystectomy, she developed fevers and recurrent bacteremia with methicillin-resistant Staphyloc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100160010124
更新日期:2001-07-01 00:00:00
abstract::The purpose of this study was to investigate the presence of, and to identify factors associated with carotid atherosclerosis in patients, previously operated on for lower extremity ischemia before the age of 50. Forty-eight patients were compared to sex- and age-matched controls. All subjects were examined with duple...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169900180
更新日期:1998-09-01 00:00:00
abstract::We report a case of a 55-year-old woman who was referred to us with a huge chronic postdissection thoracoabdominal aneurysm of a maximal intrathoracic diameter of 13.5 cm and signs of intrathoracic imminent rupture with subparietal pleural hemorrhagic effusion. Computed tomography examination revealed that the left lu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.02.049
更新日期:2012-02-01 00:00:00
abstract::A rare case of bovine aortic arch aneurysm accompanied by patent ductus Botalli aneurysm was treated using an off-pump hybrid procedure including supraaortic debranching combined with aortic stent grafting and oversewing of pulmonary artery end of the aneurysm. Postoperative computed tomography angiography showed pers...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.12.016
更新日期:2014-08-01 00:00:00
abstract::Aortic stent graft infection is uncommon. Most cases have been described anecdotaly in single-case reports. After observing one case in our experience, we decided to review the literature and contact centers performing endovascular aortic repair to determine the frequency, risk factors, and current treatment of stent ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0075-9
更新日期:2004-09-01 00:00:00
abstract:BACKGROUND:Increasing evidence supports that urgent carotid endarterectomy (CEA), defined as CEA during the index hospitalization, may be undertaken in select patients with acute carotid-related neurologic symptoms to prevent recurrent ischemic events. We aimed to determine the effect of a stroke/vascular neurology ser...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.10.002
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Phleboliths are a common finding, especially in the pelvic veins. There are generally multiple thrombi associated with vascular malformations, trauma, or iatrogenic or noniatrogenic intravenous foreign bodies. METHODS:Herein, we report a unique case of a single moving phlebolith in the cephalic vein of a 65...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.10.055
更新日期:2019-07-01 00:00:00