Abstract:
OBJECTIVE:Multiple vascular inflow reconstruction options exist for claudication, including aortofemoral bypass (AFB) and alternative inflow procedures (AIPs) such as femoral reconstruction with iliac stents, and femoral-femoral, iliofemoral, and axillofemoral bypass. Contemporary multi-institution comparison of these techniques is lacking. METHODS:The Veterans Affairs Surgical Quality Improvement Project (VASQIP) national database (2005-2013) was used to compare AFB vs AIP in a propensity-matched analysis. Primary outcome was mortality at 30 and 90 days. Secondary outcomes included rates of postoperative complications. Multivariable regression assessed the adjusted effect of inflow procedure type on mortality. RESULTS:A matched cohort of 748 claudicant patients (373 AFB, 375 AIP) was identified. The AFB and AIP groups had similar mean age (59.9 vs 60.8 years; P = .30), gender (P = .51), race (P = .52), recent smoking (79.1% vs 76.5%; P = .43), history of coronary artery disease (14.8% vs 14.7%; P > .99), chronic obstructive pulmonary disease (18.8% vs 18.4%; P = .92), renal insufficiency (5.9% vs 6.1%; P > .99), and diabetes (22% vs 20%; P = .53), and American Society of Anesthesiologists Physical Status Classification (P = .41). The AFB group had longer mean operative time (4.9 vs 3.5 hours; P < .0001), more senior resident assistants (72.4% vs 61.1%; P < .0001), and greater mean red blood cell transfusion (1.1 vs 0.12 units; P < .0001). AFB and AIP had similar rates of outflow bypass (1.9% vs 1.3%; P = .58) and outflow endovascular interventions (0.54% vs 1.6%; P = .29). AFB trended toward a higher rate of mortality at 30 days postoperatively (2.7% vs 0.8%; P = .06), but by 90 days, the crude mortality rates were similar for the two (2.9% vs 2.1%; P = .5). AFB had higher rates of pneumonia (5.9% vs 0.8%; P < .001), deep vein thrombosis/pulmonary embolism (1.3% vs 0%; P = .03), postoperative transfusion (2.7% vs 0.53%; P = .02), and urinary tract infection (3.5% vs 0.8%; P = .01), but similar rates of myocardial infarction (1.6% vs 0.8%; P = .34), stroke (0.8% vs 0%; P = .12), wound complications (13.1% vs 12.8%; P = .91), renal failure (1.1% vs 0.3%; P = .22), graft failure (1.3% vs 1.1%; P = .75), and return to the operating room (12.9% vs 9.6%; P = .17). Multivariable analysis showed AFB was not independently associated with mortality (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.1-3.0). Significant factors included age (OR, 1.2; 95% CI, 1.1-1.4), postoperative renal insufficiency (OR, 2.5; 95% CI, 1.6-4.0), and unplanned reintubation (OR, 35.5; 95% CI, 3.1-399). CONCLUSIONS:For claudicant patients with inflow disease, AFB has higher rates of 30-day complications and a trend toward higher mortality; however by 90 days postoperatively, the two procedure types have similar rates of mortality.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
McPhee JT,Madenci A,Raffetto J,Martin M,Gupta Ndoi
10.1016/j.jvs.2016.05.081subject
Has Abstractpub_date
2016-12-01 00:00:00pages
1660-1666issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(16)30414-1journal_volume
64pub_type
杂志文章abstract:BACKGROUND:Controversy exists surrounding gender outcome disparity and abdominal aortic aneurysm (AAA) repair. Previous reports have demonstrated worse outcomes for women undergoing open aneurysm repair (OAR); however, these differences are less evident with endovascular aneurysm repair (EVAR). Epidemiologic studies ha...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.086
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Almost two million individuals are undergoing renal replacement therapy worldwide, with hemodialysis being the common form. Many factors influence the primary patency of an arteriovenous fistula (AVF), including vessel size, fistula flow rates, cannulation practice, and thrombotic tendencies. Excess dilation ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.068
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVE:Usually, physicians base their practice on guidelines, but recommendations on the same topic may vary across guidelines. Given the uncertainties regarding abdominal aortic aneurysm (AAA) screening, physicians should be able to identify systematically and transparently developed recommendations. We performed a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2010.10.118
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:Surgical treatment of arterial lesions associated with Behçet disease (BD) is often complicated by graft occlusion and recurrence of aneurysms. The purpose of this study was to clarify the long-term outcome of surgical intervention for arterial involvement in BD. METHODS:Ten patients with BD (9 men, 1 woman)...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.03.019
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Aggressive endovascular interventions for patients without adequate full-length venous conduit have gained popularity. The purpose of this study is to evaluate the outcomes of spliced vein bypass (SVB) as primary treatment versus treatment after failed endovascular intervention (endovascular SVB [ESVB]) for i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.055
更新日期:2020-03-01 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::Injuries of the abdominal visceral vessels are uncommon but devastating entities resulting in extremely high rates of mortality. The most common cause of abdominal vascular injuries is penetrating trauma, accounting for 90% to 95% of these injuries. In contrast, blunt trauma accounts for 5% to 10% of all abdominal vas...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.04.041
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the fate of aneurysmal iliac arteries managed during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). METHODS:We analyzed data from the Cook Zenith trial. Follow-up was at 1 month, 6 months, 12 months, and then annually for 5 years. Patients w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.062
更新日期:2011-02-01 00:00:00
abstract::From 1957 to 1985, 116 consecutive operations for recurrent carotid stenosis were performed in 99 patients at the University of California, San Francisco. Ninety-four patients underwent 103 reoperations for primary recurrent stenosis (nine patients had bilateral repairs). Seventy-two operations (70%) were performed to...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::We used direct thrombin injection to occlude a pseudoaneurysm that formed from a contained rupture of a penetrating atherosclerotic ulcer at the junction of the thoracic and abdominal aorta after we failed to seal the perforation with an endovascular stent graft. The principles of thrombin injection and the technical ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.19
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Symptoms of pelvic venous congestion (chronic pelvic pain, dyspareunia, dysuria, and dysmenorrhea) have been attributed to massive gonadal reflux. However, obstruction of the gonadal outflow may produce similar symptoms. Mesoaortic compression of the left renal vein (nutcracker syndrome) produces both obstru...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.118802
更新日期:2001-11-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to report the early and late results of primary stenting for focal atherosclerotic lesions of the infrarenal aorta. METHODS:A retrospective analysis of 52 consecutive patients treated for infrarenal occlusive aortic disease with primary stenting between January 2002 and Novem...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.02.007
更新日期:2011-06-01 00:00:00
abstract:PURPOSE:The purpose of this article is to assess the healing qualities of presealed knitted polyester prostheses. METHODS:Thoracic aortic replacement was performed with grafts with four different coating materials-collagen (CP), albumin (AP), and two with gelatin (GP1/GP2)-in four groups of 15 pigs each. Two weeks, 6 ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.39245
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:The optimal method of operative management of complex branch renal artery aneurysms (RAAs) remains unclear, with recent reports predominantly espousing endovascular and ex vivo repair. We sought to determine the long-term outcome of RAA repair performed with autogenous in situ techniques. METHODS:This was a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.050
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:Open surgery has given way to endovascular grafting in patients with aortoiliac occlusive disease. The growing use of endovascular grafts means that fewer patients with aortoiliac occlusive disease have open surgery. The declining open surgery caseload challenges the surgeon's operative skills, particularly b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.02.025
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVES:There has been a rapid increase in the number of endovascular procedures performed for peripheral artery disease, and especially aorto-iliac occlusive disease (AIOD). Results from single-center reports suggest a benefit for endovascular procedures; however, these benefits may not reflect general practice. We...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.05.100
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Our aim was to identify the incidence of and predictors for common carotid artery (CCA) stent fractures (SFs) and to examine the effect of SFs on the development of in-stent restenosis (ISR). METHODS:Seventy patients (37 women; median age, 60.9 years) who were stented for significant (≥60%) proximal CCA sten...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.04.492
更新日期:2020-03-01 00:00:00
abstract::Aggressive revascularization of the ischemic lower extremity in atherosclerotic occlusive disease by femoropopliteal (FP) and femorotibial (FT) bypass or profundaplasty (P), as indicated, has been advocated by some authors for all patients. Others have recommended primary amputation, particularly for tibial occlusive ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020174
更新日期:1985-01-01 00:00:00
abstract::The lack of a rapid, noninvasive, and accurate method to confirm or rule out prosthetic graft infection continues to constitute a compelling and vexing clinical problem. A host of adjunctive diagnostic techniques has been used in the past, but early promising results subsequently have usually not yielded acceptable se...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030042
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:Transcarotid artery revascularization (TCAR) with flow reversal offers a less invasive option for carotid revascularization in high-risk patients and has the lowest reported overall stroke rate for any prospective trial of carotid artery stenting. However, outcome comparisons between TCAR and carotid endarter...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.11.029
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVE:Accessory renal arteries are frequently encountered when patients are evaluated for endovascular abdominal aortic aneurysm repair (EVAR). Some have considered their presence a contraindication to EVAR in fear of endoleak and the end result of renal function. We sought to determine whether the coverage of acce...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.09.008
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the effect of patient compliance on a program of watchful waiting in cases of small abdominal aortic aneurysms and to document the proportion of patients who become prohibitive operative risks during follow-up. STUDY DESIGN:A retrospective review was conducted at a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.108635
更新日期:2000-09-01 00:00:00
abstract::The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.047
更新日期:2009-05-01 00:00:00
abstract::The collapse or compression of a thoracic endograft represents a potentially fatal complication that normally requires endovascular or open surgical correction. We present the first report of a compressed thoracic endograft that spontaneously re-expanded without surgical or endovascular intervention. The possible mech...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.11.003
更新日期:2009-03-01 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:To study the prevalence of and risk factors associated with carotid artery stenosis (CAS) after radiotherapy (RT) for head and neck cancer. METHODS: DESIGN OF STUDY:Prospective, cross-sectional study. SETTING:Patients recruited from a hospital Radiation-Oncology department. SUBJECTS:From March 2002 to Aug...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.01.033
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Credentialing of vascular surgeons to perform carotid artery stenting (CAS) continues to be a major issue confronting the specialty of Vascular Surgery. Cannulation of aortic arch branches, and placement of carotid antiembolic devices and stents constitute the major technical challenges to vascular surgeons ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.039
更新日期:2004-11-01 00:00:00
abstract:INTRODUCTION:Although lower-extremity bypass grafting has been the gold standard for infrainguinal revascularization, endovascular therapies have been increasingly applied to avoid operative morbidities. This study addresses the initial results of an implementation of infrainguinal percutaneous transluminal angioplasty...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.06.024
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Lipid-modifying drug therapy (LMDT) is recommended in all patients having coronary or noncoronary atherosclerotic disease. However, the effect of LMDT after abdominal aortic aneurysm (AAA) repair, especially in the absence of other atherosclerotic manifestations, is unclear. We examined the distribution of p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.01.036
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:International guidelines recommend carotid revascularization within 14 days for patients with a symptomatic transient ischemic attack (TIA) or stroke event. However, significant delays in care persist, with only 9% of outpatients and 36% of inpatients in Ontario meeting this target. The study objective was t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.02.024
更新日期:2020-11-01 00:00:00