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 patients. METHODS:The study enrolled 108 hemodialysis patients undergoing their first major amputation at Community Health Care Organization Sendai Hospital between January 2005 and December 2014 and monitored them until June 2015. All-cause mortality and additional amputation-free survival were evaluated by Kaplan-Meier analysis. RESULTS:The most dominant primary disease of renal failure was diabetes mellitus (77%), and the duration of hemodialysis was 8.5 ± 6.8 years. During the median follow-up period of 11.5 months (20.3 ± 22.6 months), 80 patients (74%) died, and the survival rates were 83% at 30 days, 56% at 1 year, and 15% at 5 years. The median time to death was 19.9 months (95% confidence interval, 9.8-30.0 months), and the causes of death were cardiac (45%), sepsis (29%), cerebrovascular (4%), and others (22%). Thirty-one patients underwent additional amputation, and the additional amputation-free survival rates were 39% at 1 year and 9% at 5 years. The median time between the first and second amputations was 2.5 months (5.7 ± 7.6 months). Univariate analysis showed previous minor amputation (P = .04) and low hematocrit level (P = .04) were associated with the 30-day mortality rate, and age (P = .05) was associated with the 5-year mortality rate. On multivariate Cox proportional hazard analysis, only age was associated with mortality rate (hazard ratio, 1.02; 95% confidence interval, 0.99-1.02; P = .04). We also compared walking ability before and after major amputation among patients who survived >60 days. The rate changed from 34% to 12% for of ambulatory patients, from 45% to 48% for wheelchair use, and from 21% to 40% for bedridden patients. Ambulatory patients had a significantly better survival rate than the others (P = .02). CONCLUSIONS:The mortality rate after major amputation in hemodialysis patients was high, and major amputation had a huge negative effect on patients' walking ability.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Serizawa F,Sasaki S,Fujishima S,Akamatsu D,Goto H,Amada Ndoi
10.1016/j.jvs.2016.03.452subject
Has Abstractpub_date
2016-10-01 00:00:00pages
1018-25issue
4eissn
0741-5214issn
1097-6809pii
S0741-5214(16)30037-4journal_volume
64pub_type
杂志文章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:OBJECTIVE:Surgical site infection (SSI) is an important complication of lower extremity bypass (LEB) and the rate of SSI after LEB varies widely in the existing literature, ranging from 4% to 31%. Prolonged length of stay (LOS) has been implicated in the occurrence of SSI across multiple surgical disciplines. The impac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.08.037
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:This study was performed to define the incidence of acute deep venous thrombosis (DVT) after endovascular treatment of abdominal aortic aneurysms (AAAs). Because aortic endograft placement requires prolonged femoral vessel instrumentation, it may be hypothesized that these patients are at increased risk for d...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.128640
更新日期:2002-11-01 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::Polytetrafluoroethylene interposition grafts were used for carotid reconstruction in 26 operations performed in 23 patients during a 7-year period. There were 10 men and 13 women with a mean age of 66 years. The indication for interposition graft placement was recurrent stenosis with inability to perform endarterectom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.39750
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVE:The Kidney Disease Outcome Quality Initiative and Fistula First Breakthrough Initiative call for the indiscriminate creation of arteriovenous fistulas (AVFs) over arteriovenous grafts (AVGs) without providing patient-specific criteria for vascular access selection. Although the U.S. AVF rate has increased dra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2016.10.099
更新日期:2017-04-01 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 purpose of this study was to compare findings at presentation and surgical outcomes in patients in whom abdominal aortic aneurysms (AAAs) ruptured after endovascular repair and in patients in whom AAAs ruptured before any treatment during a defined period at a single center. METHODS:This is a retrospecti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.05.090
更新日期:2017-01-01 00:00:00
abstract::There has been a resurgence of interest in the concept of presealing high-porosity knitted Dacron prostheses with an absorbable biologic material. Such a material should provide reliable porosity control, preferably reducing water porosity from 2000 ml/cm2/min to less than 50 ml/cm2/min. It should not interfere with t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0070414
更新日期:1988-03-01 00:00:00
abstract::This study tests the hypothesis that reperfusion injury is the principal cause of limb loss after acute arterial occlusion and that this injury is avoidable. Of 61 isolated hindlimbs amputated at the level of the hip joint, 17 were controls (group I), 5 were perfused without ischemia to establish the validity of the m...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1989-06-01 00:00:00
abstract:OBJECTIVE:Arteriovenous fistula (AVF) is the preferred access for hemodialysis. Percutaneous transluminal angioplasty(PTA) has become a choice for AVF stenosis and ultrasound has been used in PTA more frequently. METHODS:This single-center retrospective cohort study analyzed 129 patients who underwent PTA in the First...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.11.041
更新日期:2020-12-16 00:00:00
abstract:PURPOSE:Intraoperative duplex scanning (IDS) after carotid endarterectomy (CEA) has been shown to reliably identify major defects either by significant changes in peak systolic velocities or by B-mode imaging. To evaluate whether IDS could also predict postoperative strokes in technically flawless CEAs, we analyzed sev...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.120044
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to review our 27-year clinical experience with open proximal abdominal aortic aneurysm repairs, with a focus on long-term survival. METHODS:A retrospective cohort study was undertaken of all patients who underwent proximal abdominal aortic aneurysm repair between 1986 and 2013...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.01.008
更新日期:2014-06-01 00:00:00
abstract::An aberrant right subclavian artery arising distal to the origin of the left subclavian artery is the most common anomaly of the aortic arch. Degenerative diseases of aberrant subclavian arteries including aneurysms and occlusive disease have been reported previously. We believe that this case is the first reported ca...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70173-3
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVE:The Risk Analysis Index (RAI) has been used to evaluate preoperative frailty, which is associated with poor short- and long-term outcomes. We assessed this tool's ability to predict postoperative outcomes after endovascular aortic aneurysm repair. METHODS:Institutional Review Board approval was obtained for ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.01.045
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:To compare the results of emergency open repair of acute (ruptured or symptomatic intact) abdominal aortic aneurysms with that of endovascular repair. METHODS:A systematic literature search was performed to identify series that reported comparative outcomes. PubMed, Embase, the randomized controlled trial (R...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2007.11.028
更新日期:2008-07-01 00:00:00
abstract:PURPOSE:This study is an analysis of the outcome of a common method of management of the external carotid artery (ECA) during routine carotid endarterectomy (CEA). METHODS:Between 1986 and 1997, 1069 primary CEAs were performed with a combination of proximal eversion technique and blind distal endarterectomy on the EC...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70080-1
更新日期:1998-10-01 00:00:00
abstract::Vascular smooth muscle cells exhibit varied responses after vessel injury and surgical interventions, including phenotypic switching, migration, proliferation, protein synthesis, and apoptosis. Although the source of the smooth muscle cells that accumulate in the vascular wall is controversial, possibly reflecting mig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.02.061
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:Macrophages play a critical role in the initiation and progression of abdominal aortic aneurysm (AAA) and are classically distinguished into M1 "proinflammatory" and M2 "anti-inflammatory" macrophages. Topical application of elastase associated with transforming growth factor β (TGF-β) systemic neutralization...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.09.045
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:This study was undertaken to assess the effect on renal function of open surgery and endovascular abdominal aortic aneurysm (AAA) repair with suprarenal fixation with the Zenith device. METHODS:Data for 279 patients with similar preoperative comorbid conditions were prospectively analyzed after AAA repair. One...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jvs.2004.02.033
更新日期:2004-06-01 00:00:00
abstract:PURPOSE:Changes in microvascular permeability play a critical role in the inflammatory sequence of tissue injury leading to leakage of proteins and subsequent edema. Primed responses induced by topical applications of platelet-activating factor (PAF) and histamine greatly increase microvascular permeability and mimic i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70056-0
更新日期:1995-12-01 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:PURPOSE:The purpose of this study was to utilize an objective endpoint analysis of aneurysm treatment, which is based on the primary objective of aneurysm repair, and to apply it to a consecutive series of patients undergoing open and endovascular repair. METHOD:Aneurysm-related death was defined as any death that occ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126314
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the safety and efficacy of a retrograde tibial approach in revascularization of lower extremities for treatment of ischemia in anatomically challenging patients. METHODS:This is a retrospective study of 57 procedures performed between 2012 and 2016 using the retrog...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.114
更新日期:2019-07-01 00:00:00
abstract:INTRODUCTION:Thoracoabdominal aortic replacement requires visceral vessel revascularization and is usually performed with Crawford's inclusion technique or a large Carrel patch. This segment of retained native aorta may be prone to recurrent aneurysmal disease. We reviewed our experience with patients in whom aneurysma...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.117149
更新日期:2001-09-01 00:00:00
abstract:INTRODUCTION:Endovascular strategies have been increasingly used to manage patients with ruptured abdominal aortic aneurysm (AAA) in an attempt to improve patient survival. We analyzed the evidence to support such an approach. METHODS:We performed a systematic literature review of endovascular aneurysm repair (EVAR) o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2009.02.005
更新日期:2009-04-01 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::We have performed a prospective, randomized, multicenter study to compare in situ and reversed vein grafts for long limb salvage bypasses from the proximal thigh to an infrapopliteal artery. Three hundred eighty-four patients required an infrapopliteal bypass for critical lower extremity ischemia. Of these, 259 were e...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2017.04.057
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:This study analyzed predictors and the long-term consequence of type II endoleak in a large series of elective endovascular abdominal aneurysm repairs (EVARs). METHODS:Baseline characteristics and operative and follow-up data of consecutive patients undergoing EVAR were prospectively collected. Patients who...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.10.092
更新日期:2014-04-01 00:00:00