Abstract:
OBJECTIVE:Aneurysm rupture is a major cause of morbidity and mortality, and evidence suggests shared risk for both abdominal aortic aneurysms (AAAs) and intracranial aneurysms (IAs). We hypothesized that screening for AAA in patients with known IA is cost-effective. METHODS:We used a decision tree model to compare costs and outcomes of AAA screening vs no screening in a hypothetical cohort of patients with IA. We measured expected outcomes using quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER). We performed a Monte Carlo simulation and additional sensitivity analyses to assess the effects of ranging base case variables on model outcomes and identified thresholds where a decision alternative dominated the model (both less expensive and more effective than the alternative). RESULTS:In our base case analysis, screening for AAA provided an additional 0.17 QALY (2.5-97.5 percentile: 0.11-0.27 QALY) at a saving of $201 (2.5-97.5 percentile: $-127 to $896). This yielded an ICER of $-1150/QALY (2.5-97.5 percentile: $-4299 to $6374/QALY), that is, screening saves $1150 per QALY gained. CONCLUSIONS:Based on this model, screening for AAA in individuals with IA is cost-effective at an ICER of $1150/QALY, well below accepted societal thresholds estimated at $60,000/QALY. Cost-effectiveness of cross-screening in these populations is sensitive to aneurysm coprevalence and risk of rupture. Further prospective study is warranted to validate this finding.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ball BZ,Jiang B,Mehndiratta P,Stukenborg GJ,Upchurch GR Jr,Meschia JF,Worrall BB,Southerland AMdoi
10.1016/j.jvs.2016.05.065subject
Has Abstractpub_date
2016-09-01 00:00:00pages
811-818.e3issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(16)30393-7journal_volume
64pub_type
杂志文章,评审abstract:OBJECTIVES:We analyzed midterm durability of endovascular abdominal aortic aneurysm repair (EVAR) in octogenarians compared with younger patients. METHODS:Data for 182 consecutive patients who underwent elective EVAR between 1999 and 2003 were retrospectively reviewed. Forty-nine patients (27%) were 80 years or older ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.05.021
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:We placed temporary inferior vena cava filters to prevent pulmonary thromboembolism in patients with deep vein thrombosis (DVT) who were presumed to have an increased risk of pulmonary embolism in the perinatal period. These experiences of using temporary inferior vena cava filters in pregnant women are repor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.01.023
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Promising results of thoracic endovascular aortic repair (TEVAR) in patients with complicated type B aortic dissection (TBAD) have been well documented. However, whereas early results have led many to hypothesize a benefit of TEVAR in uncomplicated patients, the natural history of TEVAR after the treatment o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2017.06.067
更新日期:2017-09-01 00:00:00
abstract::We present a case of Viabahn (W. L. Gore & Associates, Flagstaff, Ariz) collapse during popliteal artery aneurysm treatment. An elderly man with severe comorbidities presented with a 34-mm popliteal artery aneurysm. Proximal and distal landing sites of 11 and 9 mm, respectively, demonstrated by preoperative computed t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.08.024
更新日期:2008-02-01 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:OBJECTIVE:The development of in-stent restenosis (ISR) hinders the long-term patency of carotid artery stenting (CAS), yet no optimal treatment has been established. In the present study, we compared the outcomes of redo CAS (rCAS) and carotid endarterectomy (CEA) for ISR. METHODS:A systematic search using the terms "...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2020.07.102
更新日期:2020-08-28 00:00:00
abstract:OBJECTIVE:Many patients with peripheral arterial occlusive disease who require a lower-limb bypass have no available autologous saphenous vein (ASV) for the procedure and thus require a prosthetic graft. Expanded polytetrafluoroethylene (ePTFE) grafts are commonly used, but results with these prostheses have varied, es...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.009
更新日期:2009-05-01 00:00:00
abstract:PURPOSE:A recent overview indicated that although routine patching is safer than routine primary closure after carotid endarterectomy (CEA), there is no systematic evidence that patch type influences outcome. However, most surgeons still believe that prosthetic patches are probably more thrombogenic than vein patches. ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1067/mva.2001.115005
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:The external carotid artery (ECA) serves as a major collateral pathway for ophthalmic and cerebral artery blood supply. It is routinely examined as part of carotid duplex ultrasound, but criteria for determining ECA stenosis are poorly characterized and typically extrapolated from internal carotid artery data...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.10.099
更新日期:2020-09-01 00:00:00
abstract:PURPOSE:The Asymptomatic Carotid Atherosclerosis Study (ACAS) showed that carotid endarterectomy reduces stroke risk in symptom-free patients with 60% or greater internal carotid artery (ICA) stenosis. This will surely lead to the performance of an increased number of screening duplex examinations. Assuming that positi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70228-8
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:Despite wide use, high initial success, and acceptable durability of endovascular therapy (EVT) for femoropopliteal (FP) lesions, the frequency of 30-day perioperative complications (POCs) and their effect on clinical outcomes have not been systematically evaluated, which is the subject of this study. METHOD...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.12.051
更新日期:2015-05-01 00:00:00
abstract:PURPOSE:The activation of cyclic nucleotide-dependent signaling pathways in vascular smooth muscle is important for the prevention of vein graft spasm and neointimal hyperplasia. Cyclic nucleotide-dependent relaxation is associated with an increase in the phosphorylation of a small heat shock-related protein (HSP20). I...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70385-x
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVES:Vascular surgery training has evolved from a single clinical year after general surgery training to a multi-year training program to encompass such entities as noninvasive vascular laboratory, office-based procedures, and endovascular techniques. Simultaneously, members of the vascular surgery community have...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.10.109
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:To describe our experience with endoluminal stent graft repair of aortobronchial fistulas. METHODS:We reviewed the records of patients treated with endoluminal stent grafting of aortobronchial fistulas at a private teaching hospital. All patients underwent the following diagnostic studies: computed tomograph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.118583
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:This study was undertaken to describe the technique of transfemoral superselective coil embolization of type II endoleak and its influence on abdominal aortic aneurysm diameter. METHODS:Over 23 months, 104 aortic stent grafts were deployed to exclude abdominal aortic aneurysms, at an academic medical center....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(02)75467-0
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:This study compared, at a national level, trends in utilization, mortality, and stroke after carotid angioplasty and stenting (CAS) and carotid endarterectomy (CEA) from 2005 to 2007. METHODS:The Nationwide Inpatient Sample (NIS) was queried for patient discharges with International Classification of Disease...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.080
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascular...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.01.025
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND:The Walking Impairment Questionnaire (WIQ) is used to estimate walking impairment in patients with peripheral artery disease; however, it faces frequent errors when self-completed and is complex to score. We aimed to validate an alternative, easily scored four-item tool, the Walking Estimated-Limitation Calc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2013.03.039
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:In-stent restenosis is a recognized complication of carotid angioplasty and stenting (CAS), and it is associated with an increased risk of stroke. Few case series have reported outcomes separately following carotid endarterectomy (CEA) and CAS for the treatment of in-stent restenosis. In this study, we perfor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.11.041
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:Ruptured descending thoracic aortic aneurysm (rDTAA) is associated with high mortality rates. Data supporting endovascular thoracic aortic aneurysm repair (TEVAR) to reduce mortality compared with open repair are limited to small series. We investigated published reports for contemporary outcomes of open a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2009.10.103
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:To assess the effect of extremity vascular complications (EVCs, including ischemia or vessel trauma) on the outcomes of patients receiving cardiac support devices (CSDs, including ventricular assist device [VAD] and extracorporeal membrane oxygenation [ECMO]). METHODS:Institutional Review Board-approved, ret...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.12.014
更新日期:2014-06-01 00:00:00
abstract::High-resolution magnetic resonance imaging was combined with computational modeling to create focused three-dimensional reconstructions of the distal anastomotic region of autologous vein peripheral bypass grafts in a preliminary series of patients. Readily viewed on a personal computer or printed as hard copies, a de...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(03)00604-9
更新日期:2003-09-01 00:00:00
abstract::Endovascular repair is a valid alternative for patients with abdominal aortic aneurysms. However, in patients with concomitant aortocaval fistulas, type II endoleaks may result in a persistent communication between the aneurysm sac and the inferior vena cava. In these patients, prompt closure of the persistent fistula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.138
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Reducing readmissions is an important target for improving patient care and enhancing health care quality and cost-effectiveness. The aim of this study was to assess rates, risk factors, and indications of 30-day readmission after open aortic repair (OAR) and endovascular aneurysm repair (EVAR) of infrarenal ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.07.106
更新日期:2018-03-01 00:00:00
abstract::Connective tissue disorders (CTDs) predispose patients to dilation of the entire aorta, resulting in the development of extensive aneurysms. Aortic reconstruction in CTD patients can be challenging and demands specific approaches to ensure initial success and lasting stability of aortic repair. Herein, we describe tec...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.04.044
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:The risk of patients dying of pulmonary embolism (PE) or bleeding during the treatment of deep vein thrombosis (DVT), and whether these risks are influenced by patient age, has not been thoroughly studied. METHODS:We used data from the Registro Informatizado de la Enfermedad TromboEmbólica (RIETE) to assess...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.05.114
更新日期:2011-12-01 00:00:00
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 betw...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2017.01.032
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:The outcome of leg bypass in women is unknown. To date, most series of lower extremity bypass have included few women, and the results in women compared with those in men have not been reported. The experience with infrainguinal arterial reconstruction in women treated at the Oregon Health Sciences University h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.48556
更新日期:1993-10-01 00:00:00
abstract::Lower extremity paraplegia or paraparesis is an extremely rare event after operative repair of infrarenal abdominal aortic aneurysms (AAAS). We report two such cases that occurred after endovascular repair or attempted endovascular repair of routine AAAS. To our knowledge, these are the first two cases reported specif...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111801
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Long-term results of the posterior approach (PA) for the treatment of popliteal artery aneurysms are lacking in the literature. We reviewed our experience during a 13-year period in patients with popliteal artery aneurysms, comparing those treated through a PA with those operated on through a standard medial...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.06.227
更新日期:2015-12-01 00:00:00