Abstract:
OBJECTIVE:Failure of prior endovascular (EV) interventions for chronic limb ischemia has been reported to negatively affect patency and limb salvage after subsequent revascularization procedures. The goal of our study was to compare the clinical presentation of patients who failed infrainguinal EV and open revascularizations (OR) and the effect of the initial intervention on final outcomes. METHODS:From June 2001 to October 2010, 216 patients (237 limbs; 66 disabling claudication [DC], 171 critical limb ischemia [CLI]) presented with failed infrainguinal OR or EV revascularization for chronic limb ischemia. Clinical presentation, reinterventions, patency and limb salvage rates, and final outcomes were analyzed. RESULTS:The EV group (n = 143) had more diabetes (44% vs 57%; P = .048) and ulcers (26% vs 38%; P = .039), whereas the OR group (n = 94) had more multilevel revascularizations (59% vs 33%; P < .001), rest pain (23% vs 9%; P = .002), and infrapopliteal interventions (58% vs 38%; P = .038). Presentation at time of failure was non-limb-threatening ischemia in 70% of DC and 16% of CLI patients (P < .001), with no difference in those initially treated with EV or OR. In CLI, 23% presented with acute limb ischemia in the OR group vs 10% in the EV group (P = .024). Early failure (<3 months) occurred in 15% of DC and in 36% of CLI patients and was more in the OR than in the EV group (30% vs 7% for DC [P = .011] and 71% vs 38% for CLI [P = .024]). Overall, 195 (82%) had attempted reinterventions (79% in DC and 85% in CLI; P = .245). In DC patients, 48% of OR had OR + EV and 26% had EV; 32% of EV had OR + EV and 47% had EV reinterventions. In CLI patients, 40% of OR had OR + EV and 42% had EV; 17% of EV had OR + EV; and 70% had EV reinterventions. A patent revascularized limb was achieved in 66% of OR and in 92% of EV patients (P < .001). Patency and limb salvage were significantly better in the EV group, mainly due to the difference in CLI patients, whereas survival was identical. CONCLUSIONS:Clinical presentation after failed infrainguinal revascularization is determined by the initial indication. CLI patients are more likely to present early with acute limb ischemia, especially after OR. EV reinterventions play a significant role in the management of patients with failed revascularization, and EV failure is associated with better outcomes than those after OR failure, likely due to OR patients having more disadvantaged anatomy and advanced disease at the time of their initial presentation.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Dosluoglu HH,Lall P,Blochle R,Harris LM,Dryjski MLdoi
10.1016/j.jvs.2012.12.076subject
Has Abstractpub_date
2013-07-01 00:00:00pages
98-104.e1issue
1eissn
0741-5214issn
1097-6809pii
S0741-5214(13)00135-3journal_volume
58pub_type
杂志文章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::Serial platelet deposition, surface topography, and patency were evaluated in control (N = 28) and endothelial cell-seeded (N = 28) small-diameter (4 mm inner diameter) USCI Dacron grafts implanted in the carotid and femoral arteries of dogs. All dogs received aspirin (325 mg) daily for 2 weeks starting 24 hours prior...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:Lower limb ischemia-reperfusion results in skeletal muscle mitochondrial alterations, production of reactive oxygen species (ROS), and remote organ impairments that are largely involved in patient prognosis. However, whether ischemia without reperfusion increases ROS production and precedes mitochondrial alte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.100
更新日期:2014-10-01 00:00:00
abstract::To examine the effect of contralateral carotid artery stenosis on postoperative events, a retrospective review was made of 451 patients undergoing 510 carotid endarterectomies during a 6-year period. Three degrees of contralateral carotid stenosis were identified radiologically: 0% to 49%, 50% to 99%, and totally occl...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-05-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare 30-day postoperative mortality for patients undergoing endovascular repair of ruptured abdominal aortic aneurysm (rAAA) using locoregional vs general anesthesia. Unlike the open approach, endovascular repair of rAAA can be performed using either locoregional or gener...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.077
更新日期:2019-12-01 00:00:00
abstract::Pseudoaneurysm formation after carotid endarterectomy is a rare but potentially lethal complication. The risks for embolization and continued expansion necessitate repair. Traditional surgical repair of carotid pseudoaneurysms is often technically demanding, and is associated with relatively high morbidity and mortali...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.019
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVE:Whereas uncomplicated acute type B aortic dissections are often medically managed with good outcomes, a subset develop subacute or chronic aneurysmal dilation. We hypothesized that computational fluid dynamics (CFD) simulations may be useful in identifying patients at risk for this complication. METHODS:Pati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.02.048
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:Venoarterial extracorporeal membrane oxygenation (ECMO) is a salvage therapy in patients with severe cardiopulmonary failure. Owing to the large size of the cannulas inserted via the femoral vessels (≤24-F) required for adequate oxygenation, this procedure could result in significant limb ischemic complicatio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.059
更新日期:2017-04-01 00:00:00
abstract:PURPOSE:To evaluate complicated aortoiliac and lower extremity arterial bypass grafts with contrast-enhanced subtraction magnetic resonance angiography (MRA). METHODS:Twenty-three patients with 40 vascular grafts with either clinical symptoms or abnormal duplex findings were selected. They were examined using a fast T...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70017-x
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:Reoperative carotid endarterectomy (CEA) is an accepted treatment for recurrent carotid stenosis. With reports of a higher operative morbidity than primary CEA and the advent of carotid stenting, catheter-based therapy has been advocated as the primary treatment for this reportedly "high-risk" subgroup. This...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.02.047
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:Critical limb ischemia (CLI) is associated with high morbidity and mortality. Because most patients with CLI will eventually undergo some type of revascularization, the natural history of CLI is not well defined, although it is important to know when patients decide to pursue treatment. METHODS:We systematic...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2015.07.065
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:The objective of this report is to emphasize the importance of saphenopopliteal junction (SPJ) reflux in the genesis of lateral leg ulcers and to suggest a proper diagnostic and therapeutic approach. METHODS:Twenty legs with isolated lateral perimalleolar ulcers from the basis for this report. None had medial ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70291-x
更新日期:1997-04-01 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::Type B aortic dissections continue to be one of the most challenging clinical scenarios confronting vascular surgeons. In the era of open surgery, the therapeutic options were limited to medical management of hypertension and large open thoracoabdominal operations. In the current endovascular era, the operative strate...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.06.023
更新日期:2013-09-01 00:00:00
abstract::In 1945 Martorell described ischemic leg ulcers in patients with hypertension and suggested that the ischemic necrosis was secondary to hypertensive arteriolar disease. The aim of the study was to examine the minimum vascular resistance in the skin of patients with these ulcers. Twelve control subjects (median age 52 ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020581
更新日期:1985-07-01 00:00:00
abstract::Abnormalities of the fibrinolytic system can result in unusual or unexplained clotting that occurs spontaneously or after minor trauma. We identified five patients with limb-threatening arterial thrombosis of the upper extremity associated with either a low level of plasminogen or an abnormal immunoreactive plasminoge...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0070661
更新日期:1988-05-01 00:00:00
abstract:INTRODUCTION:Arterial endarterectomy and reconstruction during carotid endarterectomy (CEA) can be performed in a variety of ways, including standard endarterectomy with primary closure, standard endarterectomy with patch angioplasty, and eversion endarterectomy. The optimal method of arterial reconstruction remains a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.07.043
更新日期:2005-11-01 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:OBJECTIVE:Treatment of type B aortic dissections with thoracic endovascular aortic repair (TEVAR) has been adopted in many centers with the goal of covering the proximal entry tear. Coverage of the left subclavian artery (LSCA) is commonly required to achieve a dissection-free proximal seal zone. A novel thoracic singl...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.04.461
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:Endovascular treatment of peripheral artery aneurysms (PAAs) in patients with Behçet disease is controversial. We report a single-institution experience of primary stent graft repair of PAAs in Behçet patients. METHODS:Behçet patients who had endovascular stent graft repair of PAAs at a single center between...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.03.031
更新日期:2021-01-01 00:00:00
abstract::The patient with bilateral internal carotid artery occlusion is at high risk for development of stroke. Medical management and extracranial-intracranial bypass do not appear to offer these patients any protection from symptoms of cerebrovascular insufficiency. Our initial treatment in 11 of 12 patients who had this pa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050715
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:The optimal role for bare metal stents (BMS) or stent grafts (SG) in femoropopliteal occlusive disease (FPOD) is as of yet undefined. Understanding the clinical consequences of failure can help guide initial treatment decisions. The goal of this study was to define the nature, frequency, and risk factors for ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.05.094
更新日期:2013-12-01 00:00:00
abstract:PURPOSE:This study evaluated perioperative variables to predict death in nonruptured and ruptured abdominal aortic aneurysm (AAA) surgery. METHODS:A consecutive review of all patients who underwent AAA surgery from January 1984 to December 1993 was carried out. Perioperative variables were analyzed with univariate and...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)70077-0
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVE:Vasculogenesis relies on the recruitment of bone marrow-derived endothelial progenitor cells (BMD EPCs) and is stimulated by tissue-level ischemia. We hypothesized that the BMD EPC response is impaired in ischemic wounds and studied the relationship between BMD EPCs and wound healing. METHODS:We used transge...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.038
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:This study assessed the effect of cellular and humoral autoimmune response inhibition after immunization with β2-glycoprotein I (β2-GPI) and the effect of immunomodulation with interleukin (IL)-2 and IL-10 in the development of early atherosclerotic vascular lesion in a murine model. Atherosclerosis is increa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.05.096
更新日期:2015-12-01 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:Peripheral artery disease is the second most common cardiovascular disease. It can often occur in complex form when there is a presence of long, diffuse, and multiple lesions. Current treatments use either single long drug-coated balloons (DCBs) or multiple DCBs; however, treatment success is limited. The pur...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.04.494
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Patients with venous thromboembolic disease are treated with anticoagulation or vena cava filter placement to prevent pulmonary embolism. A recent report suggested that filter placement may increase the risk of recurrent deep venous thrombosis (DVT) and prompted a review of our experience. METHODS:Prospecti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111733
更新日期:2001-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness of endovascular stent grafting for surgical management of aortic pseudoaneurysm in patients with Behcet's disease (BD). METHODS:We present a single-institution retrospective cohort of patients with aortic pseudoaneurysm and BD treated with aortic stent grafting. Computed tomogra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.09.052
更新日期:2014-03-01 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