Abstract:
OBJECTIVE:Distal embolization (DE) during peripheral arterial endovascular interventions is a well-known complication that is poorly studied. The goal of this study was to determine the incidence, risk factors, and effect of DE on the outcomes of lower extremity endovascular interventions (LEIs). METHODS:All LEIs between 2010 and 2014 in the Vascular Study Group of New England (VSGNE) database were reviewed. Patient characteristics were analyzed to determine predictors of DE. LEIs involving the superficial femoral artery (SFA) were reviewed to assess the effect of type of treatment on DE. The outcomes examined were loss of patency, limb loss, and mortality after LEI involving the SFA. A multivariable regression was used to determine predictors of DE. RESULTS:There were 10,875 procedures. The incidence of DE was 17.3 per 1000 procedures, and 68% required treatment (57% endovascular, 11% open surgery). DE was more common in patients treated for critical limb ischemia compared with claudication (relative risk [RR], 2.06; 95% confidence interval [CI], 1.24-3.45; P = .006) and for emergency interventions compared with elective (RR, 2.98; 95% CI, 1.22-7.30; P = .017). DE increased with the number of arteries treated (P < .0001) and with the length of occlusion (P < .0001). The SFA was the most commonly treated artery (4751 [43.7%]). In comparison with atherectomy and balloon angioplasty, stenting alone (RR, 0.36; 95% CI, 0.17-0.73; P = .005), balloon angioplasty alone (RR, 0.23; 95% CI, 0.13-0.41; P < .0001), and combined stenting and balloon angioplasty (RR, 0.29; 95% CI, 0.17-0.49; P < .0001) were associated with a significantly lower risk of DE. DE was not significantly associated with loss of patency, major amputation, or mortality. CONCLUSIONS:The incidence of DE during LEIs is 1% to 2% in the VSGNE database, and most patients are treated with additional endovascular interventions. The incidence increases in patients with critical limb ischemia and with the use of atherectomy.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ochoa Chaar CI,Shebl F,Sumpio B,Dardik A,Indes J,Sarac Tdoi
10.1016/j.jvs.2017.01.032subject
Has Abstractpub_date
2017-07-01 00:00:00pages
143-150issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(17)30203-3journal_volume
66pub_type
杂志文章,多中心研究abstract:OBJECTIVE:The objective of this study was to define a normal range of distal graft velocity (DGV) and peak systolic velocity (PSV) on the basis of outflow level and maximum graft diameter for infrainguinal reversed vein bypass grafting (RVG). METHODS:This study was designed as a prospective study of consecutive patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70172-2
更新日期:1999-07-01 00:00:00
abstract:BACKGROUND:The neoaortoiliac system (NAIS) has gained popularity as a durable procedure for treating aortic graft infections. However, one of the disadvantages has been a long operation that can take up to 10 hours. The goal of this study was to assess the feasibility of staging the NAIS procedure with deep vein harves...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.06.067
更新日期:2008-11-01 00:00:00
abstract::A 15-year-old male complained of easy fatigability, leg weakness, and pain on exertion with episodes of syncope while playing baseball. His past medical history was significant for aortic coarctation associated with a congenital bovine hypoplastic aortic arch. A recent arteriogram revealed innominate and left common c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.09.035
更新日期:2005-03-01 00:00:00
abstract::Infected lower extremity bypass grafts have been associated with high rates of limb loss. Traditionally treatment has included graft excision. To compare aggressive local treatment, without graft removal, with more conventional graft excision, we reviewed 38 consecutive patients with 39 infected lower extremity bypass...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.33846
更新日期:1992-02-01 00:00:00
abstract:PURPOSE:We evaluate here whether serial changes in the concentration of the aminoterminal propeptide of type III procollagen (PIIINP) in serum bear any relationship to the rate of abdominal aortic aneurysm (AAA) expansion and whether serum PIIINP has any predictive value with respect to the rupture event. METHODS:One ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70222-2
更新日期:1997-05-01 00:00:00
abstract::With the use of a multifinger photoplethysmography system, finger systolic blood pressures were measured before and after cooling in patients with Raynaud's disease. In 30 patients with arteriographically documented arterial obstructions, significantly low digital pressures were found in 91% of fingers with cold sensi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030456
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVE:The primary purpose of the current study was to evaluate the safety and effectiveness of selective coverage of the left subclavian artery (LSCA) without revascularization during thoracic endovascular aortic repair (TEVAR) in patients with bilateral patent vertebrobasilar junctions. The secondary purpose was t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.110
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:The technique of balloon angioplasty of infrainguinal arteries requires standard arteriography and fluoroscopic guidance. We attempted to perform this procedure under duplex guidance to avoid the use of nephrotoxic contrast material and radiation exposure in patients with renal insufficiency. METHODS:Over 1...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.024
更新日期:2005-12-01 00:00:00
abstract::Abdominal aortic aneurysm (AAA) enlarges after successful endovascular repair, because of persistent blood flow within the aneurysm sac, or endoleak. In the absence of detectable endoleak, AAA may still expand, in part because of persistent pressurization within the excluded aneurysm, or endotension. We report three p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00468-3
更新日期:2003-10-01 00:00:00
abstract::Vascular surgeons are often called emergently to help treat bleeding patients. These cases may involve unexpected intraoperative bleeding, bleeding in the pregnant patient, or bleeding in patients in the emergency room. In many instances, the vascular surgeon is not "on call" and therefore has no legal duty to assist ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.02.028
更新日期:2010-06-01 00:00:00
abstract:PURPOSE:This study was done to evaluate the use of published standardized risk factors for venous thromboembolism (VTE) in patients admitted to a trauma intensive care unit (ICU) and to derive guidelines for the use of low molecular weight heparin (LMWH) and surveillance venous Doppler ultrasound scanning (VDUS). METH...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70161-2
更新日期:1998-08-01 00:00:00
abstract::The literature contains conflicting reports about the potential value of the processed human umbilical vein graft as an arterial substitute. With a view to a better understanding of the ultimate fate of this device, a series of long-term implantation was undertaken with a nonhuman primate model. Dardik Biografts were ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020715
更新日期:1985-09-01 00:00:00
abstract:BACKGROUND:Surgical skills and simulation courses are emerging to meet the demand for vascular simulation training for vascular surgical skills, but their educational effect has not yet been described. We sought to determine the effect of an intensive vascular surgical skills and simulation course on the procedural kno...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.12.065
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to review our experience over the last decade with the dorsalis pedis bypass for ischemic limb salvage in patients with diabetes mellitus. METHODS:The study was a retrospective analysis of a computerized vascular registry and chart review. From January 10, 1990 to January 11, 20...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.125
更新日期:2003-02-01 00:00:00
abstract::The hypothesis of the present study is that axillofemoral bypass grafting for acute vascular occlusion has results significantly inferior to an elective procedure. We reviewed 53 patients undergoing primary axillofemoral bypass grafting at the University of Virginia from 1984 to 1989. We found that patients who were a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.29422
更新日期:1991-08-01 00:00:00
abstract:OBJECTIVE:To compare outcomes of mesenteric angioplasty and stenting using iCAST covered stents (CS; Atrium, Hudson, NH) or bare metal stents (BMS) in patients with chronic mesenteric ischemia (CMI). METHODS:We reviewed the clinical data of 225 patients (65 male and 160 female; mean age, 72 ± 12 years) treated for CMI...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2013.05.013
更新日期:2013-11-01 00:00:00
abstract::Among 42 patients who had undergone portacaval shunt (PCS) to treat bleeding esophageal varices, shunt patency was assessed with duplex sonography 1 month to 5 years postoperatively. Patency was confirmed in all patients (100%). Correlative angiograms confirming the sonographic findings were obtained in 24 patients. D...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080657
更新日期:1988-12-01 00:00:00
abstract:BACKGROUND:Spinal cord ischemia is a rare complication after open surgical repair for ruptured abdominal aortic aneurysms (rAAA). The use of emergency endovascular aortic aneurysm repair (eEVAR) is increasing, and paraplegia has been observed in a few patients. The objective of this study was to assess the incidence an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.06.023
更新日期:2005-10-01 00:00:00
abstract:AIM:To identify in patients with recurrent varices after surgery (REVAS) the clinical, etiologic, anatomic, and pathophysiologic patterns according to the CEAP classification, as well as the site, source, causes of recurrence, and contributory factors by using the REVAS classification. METHODS:Centers from eight count...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.10.053
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To assess the long-term results of elective abdominal aortic aneurysm (AAA) repair with a single stent graft system. METHODS:Patients undergoing elective, infrarenal endovascular aneurysm repair (EVAR) with a single-stent graft system between 1998 and 2012 were analyzed retrospectively registering pre-, intr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.061
更新日期:2020-08-01 00:00:00
abstract:PURPOSE:The efficacy of carotid endarterectomy in the prevention of strokes mandates low perioperative morbidity, as well as a low incidence of late ipsilateral stroke. This prospective study involving 430 patients (461 carotid endarterectomies) correlated the results of intraoperative assessment with end points of str...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.44844
更新日期:1993-05-01 00:00:00
abstract:PURPOSE:The outcome of infrainguinal bypass surgery for limb salvage has traditionally been assessed by graft patency rates, limb salvage rates, and patient survival rates. Recently, functional outcome of limb salvage surgery has been assessed by patient ambulatory status and independent living status. These assessment...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70356-8
更新日期:1998-02-01 00:00:00
abstract:PURPOSE:Although many studies have well established that carotid endarterectomy (CEA) is beneficial in selected patients with severe carotid disease, only a few large studies have focused on the durability of the surgical procedure. Carotid artery angioplasty and stenting (CAS) has recently been proposed as a potential...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.04.005
更新日期:2004-08-01 00:00:00
abstract::We report a case of primary aortoappendiceal fistula in a patient with chronic, relapsing abdominal symptoms and acute lower gastrointestinal hemorrhage. The diagnosis was evident with abdominal computed tomographic scan results. The patient's condition was successfully managed with appendectomy, abdominal aortic aneu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2002.121751
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Percutaneous transluminal angioplasty (PTA) and primary stenting are commonly used endovascular therapeutic procedures for the treatment of infrapopliteal arterial occlusive disease. However, which procedure is more beneficial for patients with infrapopliteal arterial occlusive disease is unknown. METHODS A...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2014.03.012
更新日期:2014-06-01 00:00:00
abstract::Cystic adventitial disease is a rare non-atheromatous cause of popliteal artery disease. We report a case of a 54-year-old patient with claudication of the right calf caused by cystic adventitial disease. Intra-operatively, a communication between the adventitia and the knee joint was identified. Connections between t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.051
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Repair of saccular aortic aneurysms (SAAs) is frequently recommended based on a perceived predisposition to rupture, despite little evidence that these aneurysms have a more malignant natural history than fusiform aortic aneurysms. METHODS:The radiology database at a single university hospital was searched f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.07.002
更新日期:2013-01-01 00:00:00
abstract::The expansion of an abdominal aortic aneurysm sac after conventional repair has been rarely described. All cases in the literature have been associated with polytetrafluoroethylene grafts and perigraft seromas. We present a patient with a recurrent, symptomatic periaortic graft seroma after conventional repair. The et...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.02.031
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:Disparities in limb salvage procedures may be driven by socioeconomic status (SES) and access to high-volume hospitals. We sought to identify SES factors associated with major amputation in the setting of critical limb ischemia (CLI). METHODS:The 2003-2007 Nationwide Inpatient Sample was queried for discharg...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.077
更新日期:2011-02-01 00:00:00
abstract:PURPOSE:We reviewed our experience of the resection of renal tumors involving the inferior vena cava (IVC) from 1987 to 1992 with the hypothesis that retrohepatic IVC involvement of renal tumors can be managed without cardiopulmonary bypass (CPB) and circulatory arrest with acceptable morbidity and mortality rates. ME...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90136-8
更新日期:1994-09-01 00:00:00