Abstract:
OBJECTIVE:Neck radiation therapy (XRT) can induce carotid artery stenosis and may increase the technical difficulty of endarterectomy. It is considered a relative indication for carotid angioplasty and carotid artery stenting (CAS). This study sought to evaluate differences in CAS embolic potential and restenosis performed on XRT and non-XRT patients. METHODS:At three institutions, 366 CAS procedures were performed on 321 patients (XRT, n = 43; non-XRT, n = 323). Mean follow-up was 410 days (median, 282 days; range, 7-1920 days). Patients were observed with duplex ultrasound to assess for restenosis. Additional end points included target lesion revascularization (TLR), myocardial and cerebrovascular events, and perioperative complications. Captured particulate from embolic protection filters was analyzed with photomicroscopy and image analysis software for 27 XRT and 214 non-XRT filters. RESULTS:XRT patients were more likely to be male and had lower rates of hypertension, coronary artery disease, and diabetes mellitus, although the mean age at procedure did not differ. There was no increase in severe internal carotid tortuosity among XRT patients (XRT: 50% vs non-XRT: 34.7%; P = .06). Indication for CAS did not differ between the two groups, including the number of CAS procedures performed for symptomatic carotid stenosis (XRT: 39.7% vs non-XRT: 39.0%; P = NS). Perioperative outcomes, including the composite 30-day stroke, myocardial infarction, and mortality, were not significantly different (XRT: 2.6% vs non-XRT: 3.9%; P = NS.) There were no significant differences in restenosis rate at the 50% (XRT: 9.4% vs non-XRT: 8.6%; P = NS) or 70% (XRT: 3.5% vs non-XRT: 8.6%; P = NS) threshold. Filter particle analysis revealed that filters from XRT patients had more numerous large particles per filter (1.4 vs 0.7; P < .05) and larger mean particle size (464.1 μm vs 320.0 μm; P < .05). TLR did not differ significantly between the groups. CONCLUSIONS:In contrast to earlier studies, this analysis reveals that there are significant differences in XRT and non-XRT patients undergoing CAS in terms of medical comorbidities and embolic material captured in embolic protection filters. The decreased incidence of atherosclerotic risk factors was observed in XRT patients probably because XRT was the primary factor responsible for carotid stenosis. Despite increased embolic particle size, CAS can be performed safely with no increased morbidity, TLR, or restenosis in XRT patients.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ravin RA,Gottlieb A,Pasternac K,Cayne N,Schneider D,Krishnan P,Marin M,Faries PLdoi
10.1016/j.jvs.2015.04.390subject
Has Abstractpub_date
2015-09-01 00:00:00pages
624-30issue
3eissn
0741-5214issn
1097-6809pii
S0741-5214(15)00905-2journal_volume
62pub_type
杂志文章,多中心研究abstract:OBJECTIVE:One limitation of the use of robotic catheters is the lack of real-time three-dimensional (3D) localization and position updating: they are still navigated based on two-dimensional (2D) X-ray fluoroscopic projection images. Our goal was to evaluate whether incorporating an electromagnetic (EM) sensor on a rob...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.01.045
更新日期:2017-02-01 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::A 71-year-old woman came to the hospital with a 24-hour-old occlusion of the left limb of an aortoiliac knitted Dacron graft and was treated with an intra-arterial infusion of urokinase, 40,000 U/hr. Although the graft limb was successfully recanalized in 16 hours, the patient suffered a massive retroperitoneal hemorr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:To examine the outcome of a comprehensive follow-up program for autogenous arteriovenous hemodialysis access (AVF) when performed by the hemodialysis access surgeon. METHODS:Patients with first time AVFs between 2000 and 2005 underwent history and physical examination between the third and sixth postoperativ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.013
更新日期:2007-05-01 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::The role of balloon catheter femoropopliteal percutaneous transluminal angioplasty (FP PTA) continues to be controversial 14 years after its initial description. In high-risk patients with limb-threatening ischemia, the role of FP PTA is unknown. We reviewed the cases of 27 patients in whom high operative risk and adv...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::In the classic subclavian steal syndrome, vertebrobasilar insufficiency is caused by reverse flow in the vertebral artery ipsilateral to a subclavian stenosis or occlusion. We present two patients with vertebrobasilar insufficiency and ipsilateral vertebral and subclavian occlusive disease. The postulated mechanism of...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020913
更新日期:1985-11-01 00:00:00
abstract::Endovascular treatment of aneurysmal disease has become the predominant form of repair for all aneurysms. Some areas continue to pose specific challenges to stay within the general tenets of successful repair, mainly achieving adequate seal without sacrificing other arterial pathways. Following aortic aneurysm repair,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.03.005
更新日期:2014-02-01 00:00:00
abstract::Three patients with juxtarenal para-anastomotic aortic aneurysms after previous open abdominal aortic aneurysm repair were treated with custom-designed fenestrated and branched Zenith endovascular stent grafts. Six renal arteries and two superior mesenteric arteries were targeted for incorporation by graft fenestratio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.05.062
更新日期:2005-11-01 00:00:00
abstract::Wound complications after in situ saphenous vein bypass occur frequently, lengthen hospitalization, and threaten graft viability. From May 1981 to March 1991, 117 consecutive male patients underwent 126 in situ operations: 45 (36%) femoropopliteal, 75 (59%) femorotibial, and 6 (5%) grafts to the dorsal pedal artery fo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.36658
更新日期:1992-05-01 00:00:00
abstract::A prospective, randomized study was conducted to compare the retroperitoneal versus transperitoneal approach for elective aortic reconstruction. One hundred thirteen patients (transperitoneal = 59, retroperitoneal = 54) were randomized between March 1987 and October 1988. In addition, to assess the changing course of ...
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.1990.17353
更新日期:1990-02-01 00:00:00
abstract::We report the case of a 78-year-old man with coronary artery disease, chronic obstructive pulmonary disease, and chronic renal insufficiency with an enlarging 6.7-cm infrarenal abdominal aortic aneurysm. He also had a 4-cm right common iliac artery aneurysm, and right external iliac artery occlusion. The patient had a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.105
更新日期:2014-06-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the stenosis-free patency of open repair (vein-patch angioplasty, interposition, jump grafting) and percutaneous transluminal balloon angioplasty (PTA) of 144 vein graft stenoses that were detected during duplex scan surveillance after infrainguinal vein bypass grafting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70361-7
更新日期:1999-01-01 00:00:00
abstract::Spontaneous dissection of the abdominal aorta originating from the suprarenal aorta is very rare. Previous reports attest to the lethal nature of this disorder. This case represents the first report of successful repair of a spontaneous suprarenal abdominal aortic dissection by graft insertion with obliteration of bot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(94)70222-5
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:It has been previously shown that the SCD Response Compression System, by sensing the postcompression refill time of the lower limbs, delivers more compression cycles over time, resulting in as much as a 76% increase in the total volume of blood expelled per hour. Extended indications for pneumatic compressio...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jvs.2005.03.031
更新日期:2005-08-01 00:00:00
abstract:PURPOSE:A review of popliteal-crural bypasses via the posterior approach was done to evaluate the results of this technique. METHODS:During a period of 36 months, 21 patients with limb-threatening ischemia underwent 21 popliteal-crural bypasses via the posterior approach in the prone position with reversed lesser saph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:Arterial thoracic outlet syndrome (TOS) is a rare condition characterized by subclavian artery pathology associated with a bony abnormality. This study assessed contemporary clinical management of arterial TOS at a high-volume referral center. METHODS:A prospectively maintained database was used to conduct a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.11.039
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:We have purified and partially sequenced a protein from the adventitia of the human aorta (aortic aneurysm antigenic protein 40 kDa; AAAP-40) that has homologies to bovine aortic microfibril-associated glycoprotein (MAGP-36). It is immunoreactive with immunoglobulin G (IgGs) purified from the serum and aortic w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70194-0
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:It is well known that the clinical outcome of patients with critical limb ischemia (CLI) is poor. However, the relationship between stress-related hormone levels and CLI outcome remains unclear. The aim of this study was to reveal the association of stress hormones with the risk of a perioperative major adve...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.11.044
更新日期:2019-09-01 00:00:00
abstract::Bungee jumping is a popular recreational activity in which participant experiences transient freefall while connected to a bungee cord. The rapid freefall and the resultant rebound force created by the bungee cord can result in a variety of bodily injuries. We report herein a case of traumatic carotid artery dissectio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.06.026
更新日期:2007-11-01 00:00:00
abstract::Peripheral artery disease is growing in global prevalence and is estimated to afflict between 8 and 12 million Americans. Its most severe form, critical limb ischemia (CLI), is associated with high rates of limb loss, morbidity, and mortality. Revascularization is the cornerstone of limb preservation in CLI, and has t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2012.05.114
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Lower extremity bypass grafts that develop stenoses are commonly treated with either open surgical or endovascular revision. Vein graft stenoses with unfavorable lesions (multiple lesions, lesions >2 cm in length, lesions in grafts <3 months old, lesions in grafts <3 mm in diameter) fare worse than those with...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.08.065
更新日期:2016-01-01 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:OBJECTIVE:Vein graft adaptation is characterized by loss of expression of the tyrosine kinase receptor Eph-B4, the embryonic determinant of venous identity, without increased expression of its ligand ephrin-B2, the embryonic determinant of arterial identity. Endothelial nitric oxide synthase (eNOS) is an important medi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.11.041
更新日期:2017-01-01 00:00:00
abstract::Dr F. Inest practices surgery at a renowned medical center but is concerned because increasing numbers of medical insurers are excluding his institution from coverage. Many of his former referring physicians are beginning to send their patients elsewhere for this reason. The marketing people have been busy increasing ...
journal_title:Journal of vascular surgery
pub_type: 社论
doi:10.1016/j.jvs.2016.02.001
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:Several trials have reported early superior patency of stenting over isolated angioplasty (plain old balloon angioplasty [POBA]) for infra-inguinal occlusive disease, yet long-term data are sparse. The purpose of this study was to contrast long-term clinical outcomes and costs of angioplasty alone vs angiopla...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.03.283
更新日期:2011-10-01 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:BACKGROUND:Prosthetic graft infection is a major complication of peripheral vascular surgery. We investigated the experience of a single institution over 10 years with bypass grafts involving the femoral artery to determine the incidence and risk factors for prosthetic graft infection. METHODS:A retrospective cohort s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.09.049
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE:In peripheral arterial disease (PAD) patients, a limiting factor in the success of percutaneous transluminal angioplasty (PTA) is the development of restenosis secondary to vascular smooth muscle cell (SMC) proliferation. Following endothelial damage and platelet activation, there is release of factors and ad...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2009.06.017
更新日期:2009-10-01 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