Abstract:
OBJECTIVE:Our aim was to evaluate the effect of gender on early and late procedural and functional outcomes of lower extremity bypass (LEB). METHODS:We reviewed the records of 2576 patients (828 women; 32%) who underwent LEB for claudication or critical limb ischemia (CLI) in the Vascular Study Group of New England from 2003 to 2010. Logistic regression and proportional hazards models were used to adjust for potential confounding differences between genders. Morbidity, mortality, graft patency, freedom from major amputation, ambulation, and living status were analyzed postoperatively and over 1 year. RESULTS:Women were older (70 vs 68 years; P < .001), had more hypertension (89% vs 85%; P = .006), less coronary artery disease (35% vs 39%; P = .03), smoking (73% vs 88%; P < .001), and preoperative statin use (60% vs 64%; P = .04). Women were more likely to have CLI (76% vs 71%; P = .003), and ambulate with assistance at presentation (19% vs 16%; P = .02). Morbidity was similar except women had higher rates of reoperation for thrombosis (4% vs 2%; P < .001) without differences in major amputation (2% vs 1%; P = .13) or in-hospital mortality (1.7% vs 1.7%; P = .96). Women and men with claudication had similar 1-year graft patency rates. Women with CLI had lower rates of primary (hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.03-1.48; P = .02), assisted primary (HR, 1.42; 95% CI, 1.15-1.76; P = .001) and secondary patency (HR, 1.40; 95% CI, 1.10-1.77; P = .006) during the first year compared with men. Freedom from amputation was similar for men and women with CLI (HR, 1.17; 95% CI, 0.84-1.63; P = .36). There were no differences in late survival between women and men with claudication (HR, 0.89; 95% CI, 0.60-1.31; P = .36) or CLI (HR, 0.94; 95% CI, 0.81-1.09; P = .39). More female claudicants were not independently ambulatory at discharge (30% vs 19%; P = .002) and were discharged to a nursing home (15% vs 5%; P < .001) but these differences did not persist at 1 year. Women with CLI were more likely to be nonambulatory at discharge (13% vs 9%; P = .006) and at 1 year (13% vs 8%; P < .001). More women with CLI were discharged to a nursing home (44% vs 35%; P = .01) and resided there at 1 year (11% vs 7%; P = .02). CONCLUSIONS:Women have complication rates similar to men with inferior early and late functional outcomes after LEB. The reduced patency rates in women with CLI did not translate into differences in limb salvage. These findings might help define physician and patient expectations for women before revascularization.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Duffy RP,Adams JE,Callas PW,Schanzer A,Goodney PP,Ricci MA,Cronenwett JL,Bertges DJ,Vascular Study Group of New England.doi
10.1016/j.jvs.2014.05.008subject
Has Abstractpub_date
2014-11-01 00:00:00pages
1282-1290.e1issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(14)00988-4journal_volume
60pub_type
杂志文章,多中心研究abstract:OBJECTIVE:The objective of this study was to assess long-term durability of bridging stents in branched and combined branched and fenestrated endovascular aneurysm repair (B/F-EVAR) for thoracoabdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm. METHODS:A retrospective database analysis was perfor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.12.023
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:Although patency data for lower extremity bypass grafts are readily available, few reports have focused on patients' satisfaction after surgical reconstruction for claudication. We reviewed our experience with surgical treatment for claudication, focusing on late outcome from the patients' perspective to furthe...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70146-5
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:Three-dimensional ultrasound (3D-US) examination is a relatively new modality that can be used for abdominal aortic aneurysm (AAA) surveillance, and may offer improved reproducibility over conventional two-dimensional ultrasound (2D-US) examination. The aim of this study was to evaluate the interoperator repr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.03.066
更新日期:2020-01-01 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:PURPOSE:Vascular procedures reoxygenate ischemic endothelial cells (EC) and arterialize saphenous vein (HSV) EC. The balance between the EC-derived fibrinolytic components, plasminogen activator (tPA), and plasminogen inhibitor (PAI-1) contributes to maintaining thromboresistance. This balance also affects proteolysis ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Endovascular repair of complex abdominal aortic aneurysms has become increasingly common, but reports have mostly been limited to single centers and single devices. METHODS:We studied all endovascular repairs of complex abdominal aortic aneurysms (zone 6 or caudal) from 2014 to 2018 in the Vascular Quality ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.11.021
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:Outcome and venous patency after reconstruction in major pelvic and extremity venous injuries was studied. METHODS:We retrospectively reviewed 46 patients with 47 venous injuries. RESULTS:Injuries were caused by penetrating trauma in 37 extremities, blunt trauma in 6 patients, and were iatrogenic in 4 patient...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70068-0
更新日期:1998-11-01 00:00:00
abstract:BACKGROUND:Oxidative stress is an important determinant in atherosclerosis development. Various markers of oxidative stress, such as oxidation of low-density lipoprotein (LDL), nitrosative stress, lipid peroxidation, and protein oxidation, have been implicated in the initiation and/or progression of atherosclerosis, bu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.03.047
更新日期:2010-09-01 00:00:00
abstract::Techniques for exposure of the popliteal artery via lateral approaches above and below the knee are described. These techniques were used successfully in 21 patients who required secondary arterial reconstructions in the presence of extensive scarring, infection, or both in the standard medial access routes. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060119
更新日期:1987-08-01 00:00:00
abstract::Mesenteric artery pseudoaneurysms are a rare and complex complication after abdominal trauma, surgery, or inflammatory disease. These lesions can be associated with compression or erosion into adjacent structures and may result in life-threatening hemorrhage. Traditional management has been open surgical ligation, ane...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2006.09.010
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Renal artery aneurysms (RAAs) are uncommon, and rates of growth and rupture are unknown. Limited evidence therefore exists to guide clinical management of RAAs, particularly small aneurysms that are asymptomatic. To further characterize the natural history of RAAs, we studied anatomic characteristics and chan...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.03.006
更新日期:2014-08-01 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::Aortoduodenal fistula is a well-known complication of abdominal aortic aneurysm repair and has been described after endovascular repair. A unique complication of duodenal perforation by intentionally placed embolic material in the aneurysm sac is described. Intentional off-label use of material to promote aneurysm sac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.05.069
更新日期:2012-11-01 00:00:00
abstract:PURPOSE:Atherosclerotic lesions of the aortic arch are potential sources of arterial embolism. Here we investigate whether surgery, with the necessary circulatory supports, can be proposed as a good option for treatment of this problem. Study of these lesions on a national scale in France has made possible the assessme...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.128933
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to define a normal range of distal graft velocity (DGV) and peak systolic velocity (PSV) on the basis of outflow level and maximum graft diameter for infrainguinal reversed vein bypass grafting (RVG). METHODS:This study was designed as a prospective study of consecutive patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70172-2
更新日期:1999-07-01 00:00:00
abstract::Contrast angiography with carbon dioxide (CO2) is frequently used in patients with renal dysfunction or iodinated contrast allergies, as CO2 is nonallergenic, nontoxic, and rapidly absorbed in the blood. However, when delivered intra-arterially, there is a possibility that CO2 may create a vapor lock with resultant tr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.06.075
更新日期:2012-12-01 00:00:00
abstract:PURPOSE:Magnetic resonance angiography (MRA) is a developing technique that provides arteriograms without the risks associated with iodinated contrast and arterial puncture or the expense of hospitalization. Prior reports have demonstrated the accuracy of peripheral vessel MRA for evaluation of the aorta through pedal ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90222-4
更新日期:1994-12-01 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:OBJECTIVE:Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared wit...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.03.420
更新日期:2017-11-01 00:00:00
abstract::Although there have been previous cases of ascending (type I) aortic dissection recognized in young weight lifters, this is the first reported instance of a descending (type III) dissection in such an individual. Successful treatment included aortic fenestration and an aortoiliac bypass. A new entity of aortic dissect...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1993.40230
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to investigate the effects of gene transfection of endothelial cells with vascular endothelial growth factor (VEGF) on re-endothelialization and inhibiting in-stent restenosis. METHODS:Stents coated with human umbilical vein endothelial cells (HUVECs) transfected with VEGF(121)...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.020
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Ankle-brachial pressure index (ABI) is a simple, inexpensive, and useful tool in the detection of peripheral arterial occlusive disease (PAD). The current guidelines published by the American Heart Association define ABI as the quotient of the higher of the systolic blood pressures (SBPs) of the two ankle ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.016
更新日期:2006-09-01 00:00:00
abstract:PURPOSE:Thoracic endovascular aortic repair is increasingly becoming the standard treatment of many thoracic aortic pathologies. New reliable and accurate stent grafts are emerging to widen the endovascular treatment options. We report the results of RELAY (Bolton Medical, Barcelona, Spain) in the large RELAY Endovascu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2010.09.050
更新日期:2011-03-01 00:00:00
abstract:PURPOSE:Underdeployment of an intravascular stent has been identified as a cause of restenosis or occlusion of a treated arterial lesion. Intravascular ultrasound (IVUS) has been shown to initially improve the anatomic and clinical stenting. The purpose of this study was to determine whether the use of IVUS increased l...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.119755
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:During the last decade, endovascular repair (EV) has replaced open surgical repair (OSR) as the preferred method of treatment of blunt traumatic thoracic aortic injuries (BTAIs) at many trauma centers. This has resulted in reductions in mortality, length of stay, and major complications, including paraplegia...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.01.087
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:We examined the protective effects of the new selective spinal cord cooling by using cold saline infusion into the cross-clamped aorta and a transvertebral cooling pad placed over the lumbar vertebral column from paraplegia caused by ischemic spinal cord injury on thoracoabdominal aortic surgery. METHODS:Eig...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.02.017
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND:Atherosclerotic occlusive disease of the proximal vertebral artery is an important cause of cerebrovascular ischemic events with a significant associated morbidity and mortality. Endovascular treatment has emerged as a promising tool of the therapeutic armamentarium, along with medical therapy and surgical r...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2011.09.084
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE AND METHOD:In this retrospective review, we report the surgical results of infected aortic aneurysms treated at a single center over 5 years. RESULTS:From October 1996 to October 2001, 19 patients with infected aortic aneurysm were treated with surgery, nine with suprarenal infections (four proximal descendi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.126557
更新日期:2002-10-01 00:00:00
abstract::Popliteal artery aneurysms rarely rupture. We treated a 91-year-old man who presented with a deep venous thrombosis and anemia; rupture of a popliteal artery aneurysm was suspected only after compartment syndrome isolated to the thigh developed as the result of bleeding. Although fasciotomy was required on the basis o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70251-4
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND:Cold-induced injury to various cell types has been shown to be mediated predominantly by chelatable iron. For endothelial cells, this type of injury has so far only been shown in cultured cells. Hypothesizing that this iron-dependent cold-induced injury might also occur in the endothelium of intact vessels, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.09.048
更新日期:2008-02-01 00:00:00