Abstract:
BACKGROUND:The D-dimer (DD) level combined with the pretest Wells criteria probability (WCP) score can safely exclude deep venous thrombosis (DVT). The objective of this study was to examine the correlation between DD results alongside WCP score with findings on venous duplex ultrasound (VDU). The hypothesis is that VDU remains overutilized in low-risk patients with negative DD and that higher DD levels may correlate with thrombus burden and location. METHODS:Patients who presented to a high-volume tertiary care center with lower limb swelling with or without associated pain were retrospectively examined through June and July for 4 consecutive years (2012 to 2015). After calculating WCP, patients were divided into low-, moderate-, and high-risk categories. Electronic DD results utilizing enzyme linked immunosorbent assay, WCP data, and VDU analysis data were merged and analyzed based on receiver operator characteristic curve to determine the DD cutoff point for each WCP. Abnormal DD with an average value ≥ 0.6 mg/L fibrinogen equivalent units (FEUs) was correlated to positive DVT to differentiate proximal DVT (above popliteal vein) from distal DVT (below popliteal vein). RESULTS:Data of 1,909 patients were analyzed, and 239 (12.5%) patients were excluded secondary to serial repeat visits or follow-ups, surveillance screens, and if they had a previous history of DVT. The average age was 62.1 ± 16.3 years with more women (55.7%) and the majority presented with limb pain and edema (87%). DD studies were ordered and completed in 202 patients and correlated with all positive and negative DVT patients (100% sensitivity and negative predictive value, with specificity and positive predictive value of 14.9% and 15.9%, respectively). Twenty-six of 202 patients had DD that were in the normal range 0.1-0.59 mg/L (FEU), all of which were negative for DVT (100% sensitive). Fifty one of 202 patients had DD values of 0.6-1.2 mg/L FEU, of which only 3 DVTs were recorded, and all of them were distal DVTs. In addition, 685 patients with WCP <1 and negative DD were sent for VDU. Thus, 762 patients had an unnecessary immediate VDU (Wells ≤1 and -DD) study during their initial presentation. Potential charge savings for VDU for all patients are 762 × $1,557 = $1,186,434 and DD for all patients are 762 × $182 = $138,684, with total potential savings of $1,047,750 (USD 2016). CONCLUSIONS:This study suggests that DD is still underutilized, and DD in conjunction with WCP could significantly reduce the number of unnecessary immediate VDUs. Higher value of DD (>1.2 mg/L FEU) may raise concern for proximal DVT. Concern on cost-effectiveness exists and raises the demand for a proposed algorithm to be followed.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Mousa AY,Broce M,De Wit D,Baskharoun M,Abu-Halimah S,Yacoub M,Bates MCdoi
10.1016/j.avsg.2017.12.006subject
Has Abstractpub_date
2018-07-01 00:00:00pages
21-29eissn
0890-5096issn
1615-5947pii
S0890-5096(18)30180-8journal_volume
50pub_type
杂志文章abstract:BACKGROUND:This study examines the outcome of hybrid revascularization combining iliofemoral endarterectomy and iliac artery stenting using covered stents in TransAtlantic Inter-Society Consensus (TASC) C and D aortoiliac occlusive disease (AIOD) involving the common femoral artery (CFA). METHODS:A retrospective revie...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.11.061
更新日期:2018-07-01 00:00:00
abstract::Cases of malignant fibrous histiocytoma arising from the aorta are rare and have a dismal outlook despite treatment. The longest reported survival period following resection is only 28 months. A patient with malignant fibrous histiocytoma of the descending thoracic aorta was successfully treated with resection and rec...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02001377
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:To determine whether direct open repair of thoracoabdominal aortic aneurysms after previous abdominal aortic surgery is a safe option. METHODS:Ten patients were operated between January 2006 and January 2012. Mean age was 70 years (62-78 years). Four aneurysms (Crawford type III) were treated by firstly per...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.04.002
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Treatment of popliteal aneurysm (PA) includes exclusion and bypass graft. In excluded sac, persistent flow through collateral arteries (endoleak) could result in aneurysm growth. METHODS:We retrospectively reviewed PA treated by exclusion and bypass, using duplex ultrasound or computed tomography (CT) scans...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.02.016
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Endovascular therapy is first-line treatment for aortoiliac occlusive disease. This shift has altered case volume, patient selection, and risk profile for aortobifemoral bypass (ABF). Given this, we sought to investigate factors influencing morbidity and mortality after ABF in the endovascular era. METHODS:...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.03.040
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Carotid endarterectomy (CEA) prevents the occurrence of stroke in the future, although its efficacy depends on the detection and control of high perioperative risk factors. We aimed to analyze the association between preoperative neurological deficit and the 30-day risk of major adverse cardiovascular events...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.11.045
更新日期:2021-01-04 00:00:00
abstract::Internal jugular vein (IJV) thrombosis is a rare vascular event. The most common causes of internal jugular vein thrombosis are prolonged central venous catheterization, infection, malignancy and ovarian hyperstimulation syndrome. We have presented here a case of an 82-year-old male with chronic kidney disease who pre...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2019.08.074
更新日期:2020-01-01 00:00:00
abstract::Information about the variations of the origins of subclavian and vertebral arteries and their course is of great importance for head and neck surgery. The normal vertebral arteries arise as the first branches of the corresponding subclavian arteries. In a minority of cases, the left vertebral artery could arise direc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.02.015
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:The pathophysiological mechanisms that induce postrevascularization edema after femoropopliteal bypass surgery are not completely understood. Reperfusion-associated injury to revascularized tissue and damage to lymphatic structures are both likely to play a role. Aim of this study was to study edema formatio...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.04.010
更新日期:2012-02-01 00:00:00
abstract::The combined presence of an inflammatory abdominal aortic aneurysm and a horseshoe kidney is a rare event with only one reported case in previously published data. We present a case of a horseshoe kidney with a concomitant 6-cm inflammatory abdominal aortic aneurysm and a 3.6-cm right iliac artery aneurysm repaired th...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2010.09.019
更新日期:2011-04-01 00:00:00
abstract::Current recommendations for follow-up after endovascular repair of abdominal aortic aneurysms (EVAR) include yearly computed tomographic (CT) scans after the first year. We hypothesize that this is unnecessary for patients who have aneurysm sacs that are stable or shrinking at 1 year and no evidence of endoleak. To ex...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2007.07.015
更新日期:2007-11-01 00:00:00
abstract::The purpose of this review is to define animal models of chronic venous disease and to demonstrate how animal studies can impact our understanding and treatment of this disorder. To this end an extensive literature search was conducted highlighting potential animal models of chronic lower extremity venous disease. Sci...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s100169900190
更新日期:1998-09-01 00:00:00
abstract:BACKGROUND:Loeys-Dietz syndrome (LDS) is characterized by a triad of aortic aneurysm, vessel tortuosity, and hypertelorism. LDS patients often harbor additional aneurysms and dissections throughout their vasculature. The optimal management of these additional lesions is poorly understood. Accordingly, we sought to anal...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.007
更新日期:2017-01-01 00:00:00
abstract::Use of the Neodymium: yttrium -aluminum -garnet (Nd:YAG) laser to recanalize stenosed arteries may require delivery of the beam through blood. To assess the degree of hemolysis and debris formation, 54 samples of citrated whole blood were exposed to Nd:YAG laser radiation of varying powers (10, 20 and 30 watts) and du...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60780-2
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Hepatocellular carcinoma (HCC) with tumor thrombus (TT) in hepatic vein, inferior vena cava (IVC), and right atrium (RA) portends a poor prognosis because of intravascular extension leading to rapid distal metastases. En bloc resection of cavoatrial TT without the use of cardiopulmonary bypass (CPB) is chall...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.02.021
更新日期:2014-08-01 00:00:00
abstract::The need to treat an abdominal aortic aneurysm (AAA) in kidney transplanted patient is a rare event. To date, no method to protect the kidney during the aneurysm treatment has been identified as undeniably relevant. On the other hand, the advantage of endovascular treatment of the aneurysm (EVAR) is to avoid transplan...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.058
更新日期:2015-08-01 00:00:00
abstract::We retrospectively reviewed perioperative cardiac complications in a series of 214 patients who underwent surgical treatment for infrarenal aortic aneurysm between 1992 and 1996. There were 192 men and 22 women, with a mean age of 68.3 years. Cardiac risk factors included angina in 28% of patients and previous myocard...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910060
更新日期:2000-09-01 00:00:00
abstract:BACKGROUND:Splanchnic artery aneurysms are relatively rare diseases. Pancreaticoduodenal arterial (PDA) aneurysms are especially uncommon and account for approximately 2% of all visceral aneurysms. However, rupture of a PDA aneurysm often results in fatal consequences. Intervention therapy has evolved as a mainstream m...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.09.033
更新日期:2019-05-01 00:00:00
abstract::Tuberculous aneurysms of the aorta are rare and give rise to various issues related to their diagnosis and treatment. In this article, we report on an exceptional case concerning a patient who presented with a false tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aort...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2010.12.034
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:This retrospective study evaluated the long-term results of endovascular repair in the management of arterial stenosis caused by Takayasu's arteritis (TA). METHODS:Sixty-seven endovascular procedures (percutaneous transluminal balloon angioplasty or stenting) were performed for 49 arterial lesions in 35 pat...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.10.066
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:The aim of this study was to review the literature on the association between hypothermia and outcomes in open and endovascular abdominal aortic aneurysm (AAA) repair. The secondary aim was to determine whether there is a difference in body temperature in patients undergoing either transperitoneal (TP), retr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.avsg.2016.05.121
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Carotid endarterectomy (CEA) is the gold standard for treatment of carotid artery stenosis. CEA can be challenging, even technically impossible. Prosthetic carotid bypass grafting is a proven and safe alternative when CEA is hazardous. An alternative technique that is prosthetic carotid bifurcation resection...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.05.025
更新日期:2015-11-01 00:00:00
abstract::We report a case of post-traumatic chronic false aneurysm of the aortic isthmus in a 34-year-old man who had been involved in a car accident 10 years earlier. An initial chest X-ray demonstrated a calcified mass in the upper mediastinum and computed tomography scan revealed a false aneurysm of the aortic isthmus arisi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.07.048
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to characterize utilization and outcomes of thoracic endovascular aortic aneurysm repair (TEVAR) in New York State during the first decade of commercial availability, with respect to evolving indications, results, and costs. Of specific interest was evaluation of the volume-outc...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2018.03.029
更新日期:2019-01-01 00:00:00
abstract::Aortic wall tension was determined in 40 patients to assess its predictive value in abdominal aortic aneurysm (AAA) rupture. A 3-year retrospective analysis of 243 patients with ruptured AAAs and 45 patients with intact AAAs was conducted. The 288 patient sample was limited to the 40 patients with an abdominal CT scan...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910027
更新日期:2000-03-01 00:00:00
abstract::Advanced complicated atherosclerotic lesions have been related to many factors, including inflammation, infectious agents, and growth factors. Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP), inflammation, and growth factors have been associated with severe atherosclerotic lesions in necropsy material in rece...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-006-9076-1
更新日期:2006-09-01 00:00:00
abstract::One hundred and twenty-three axillofemoral or bifemoral bypasses were performed in the Department of Cardiovascular and Thoracic Surgery of the Catholic University of Louvain, Belgium between 1975 and 1986. Three cases of perigraft seroma were noted. A polytetrafluoroethylene (PTFE) graft had been inserted in all thre...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60137-4
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Surgical site infections (SSIs) are a significant burden to patients and health care systems. This retrospective study evaluates the observed rates of SSI after our institution implemented chlorhexidine gluconate-impregnated (CHG) cloth as a preoperative antiseptic preparation in elective vascular surgery. ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.11.011
更新日期:2017-08-01 00:00:00
abstract::Thirty-two patients undergoing elective infrarenal aortic surgery were randomly assigned to receive a perioperative infusion of either dopexamine hydrochloride at a rate of 2 micrograms/kg/min (n = 15) or 0.9% saline solution as placebo (n = 17). Renal function was monitored by regular measurements of serum creatinine...
journal_title:Annals of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02143865
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Massive bleeding in patients with aortoenteric fistula (AEF) may be preceded by minor, intermittent gastrointestinal (GI) blood loss, termed the "herald bleed." The aims of this retrospective study were to: (i) analyze the interval between the herald bleed and onset of major GI hemorrhage and/or diagnosis of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.03.028
更新日期:2016-10-01 00:00:00