Abstract:
OBJECTIVE:In 2007, Medicare guidelines were established to identify persons at risk for the presence of an abdominal aortic aneurysm (AAA). The purpose of this study is to evaluate the 5-year outcomes of an AAA screening program in a regional Veterans Affairs (VA) health care system. METHODS:Data were extracted from a regional VA health care network identifying all veteran males 65 to 75 years of age who smoked at least 100 cigarettes during their lifetime. In 2007, an AAA screening mandate was implemented allowing patients meeting screening criteria to be evaluated for AAA as part of the patient's health maintenance. AAA is identified as an aortic diameter size of 3.0 cm or greater. Clinician adherence to screening protocols and referral to a vascular surgeon for aneurysms >5.5 cm were also evaluated. RESULTS:A total of 9751 patients (71.5 ± 5.6 standard deviation years of age) were screened for an AAA over a 5-year period from January 1, 2007 to December 31, 2011. A total of 698 aneurysms (7.1%) were found. Referrals to a vascular surgeon were made on 45 patients with aneurysms >5.5 cm. Over a 5-year period, a total of 2754 patients (28.2%) were inappropriately screened: 416 patients were under 65 years old, 2243 patients were over 75 years old, 36 patients were women, and 123 patients without aneurysms had multiple screenings. In 2007, during the first year of implementation, 39.2% of patients were inappropriately screened. Over the next 4 years, inappropriate screenings decreased with 33.7% in 2008, 28.6% in 2009, 17.7% in 2010, and 14.3% in 2011. CONCLUSIONS:A large AAA screening program at the VA detects more aneurysms, but at smaller diameters than that published in clinical trials. Over time, the number of inappropriate AAA screenings has continued to decrease, demonstrating greater awareness and application of the AAA screening guidelines by primary care providers. Developing surveillance guidelines for small and medium aneurysms is a potential area for future research.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Chun KC,Teng KY,Van Spyk EN,Carson JG,Lee ESdoi
10.1016/j.jvs.2012.08.038subject
Has Abstractpub_date
2013-02-01 00:00:00pages
376-81issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(12)01749-1journal_volume
57pub_type
杂志文章abstract:OBJECTIVE:Volume-outcome relationships for open abdominal aortic aneurysm (AAA) repair have received less attention in publicly funded health systems. Furthermore, the roles of surgeon seniority (years of experience) and composite volume (encompassing all major arterial cases) on outcomes after open AAA repair are less...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.050
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:We tested whether fasting and postprandial triglyceride-rich lipoprotein elevations are gender specific (1) in patients with carotid artery stenosis >or=50% vs controls, and (2) in patients with echolucent, rupture-prone plaques compared with controls. METHODS AND RESULTS:We studied 66 controls and 323 pati...
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:The purpose of this study was to investigate the roles of the kallikrein-kinin system and matrix metalloproteinases (MMPs) in the development of arterial restenosis attributable to intimal hyperplasia in the femoropopliteal arteries. METHODS:This report describes a single-center prospective study of 27 patie...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.06.106
更新日期:2017-01-01 00:00:00
abstract::Carotid endarterectomy was performed in 152 patients during a 27-month period. The first 82 patients had primary closure of the arteriotomy, whereas the subsequent 70 patients underwent closure with Dacron patch angioplasty. Duplex scanning was undertaken postoperatively in 102 of these patients with a mean follow-up ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1987-05-01 00:00:00
abstract::Over a 12-year period, 160 transmetatarsal amputations were performed in patients with peripheral vascular occlusive disease. The following groups were defined: group 1 - nonreconstructable disease (n = 40); group 2 - transmetatarsal amputation in conjunction with distal revascularization (n = 99); group 3 - reconstru...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Black patients have a higher mortality rate than nonblacks after abdominal aortic aneurysm repair. We sought to understand the factors responsible for this racial disparity in the mortality rate after aneurysm repair. METHODS:The Medicare database (2001-2006) was used to identify 160,785 patients undergoing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.05.020
更新日期:2009-10-01 00:00:00
abstract::A vascular rehabilitation program was designed to increase exercise tolerance and reduce the risk of cardiovascular disease in patients with lower extremity arterial occlusive disease. Sixty-eight patients (32 men, 36 women); ages 55 to 85 years (mean, 68 years) with claudication 30 (44%), or recovering from lower ext...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-09-01 00:00:00
abstract:BACKGROUND:The Centers for Medicare and Medicaid Services (CMS) have established guidelines that outline patients who are considered "high risk" for complications after carotid endarterectomy (CEA) for which carotid artery stenting (CAS) may provide benefit. The validity of these high-risk criteria are yet unproven. In...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.12.075
更新日期:2013-07-01 00:00:00
abstract::Scalp arteriovenous malformations are treated by surgical excision in many patients. We report a patient with a scalp arteriovenous malformation who was successfully treated by a combination of ultrasound-guided thrombin injection (UGTI) and transarterial coil embolization. This patient was a 52-year-old man with a su...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.013
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:Acute kidney injury (AKI) has been identified as a common complication after fenestrated and branched endovascular aneurysm repair (F/BEVAR), occurring in 5% to 29% of patients. Predictors of AKI and its impact on long-term outcomes remain unknown. We sought to identify independent predictors of AKI and its e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.09.034
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) is a novel coronavirus that has typically resulted in upper respiratory symptoms. However, we have encountered acute arterial and venous thrombotic events after COVID-19 infection. Managing acute thrombotic events from the novel virus has presented unprecedented challenges...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.08.038
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVE:This study aimed to address the shortcomings of previous clinical trials that were inadequate to prove the superiority of thoracic endovascular aortic repair (TEVAR) in managing type B aortic dissection (TBAD) over open surgery (OS) or best medical treatment (BMT). The comparative effectiveness of these three...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.02.062
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Spinal cord ischemia is a rare complication after open surgical repair for ruptured abdominal aortic aneurysms (rAAA). The use of emergency endovascular aortic aneurysm repair (eEVAR) is increasing, and paraplegia has been observed in a few patients. The objective of this study was to assess the incidence an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.06.023
更新日期:2005-10-01 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:OBJECTIVE:Patients presenting with occluded aortobifemoral (ABF) bypass grafts are managed with a variety of techniques. Redo ABF (rABF) bypass procedures are infrequently performed because of concerns about procedural complexity and morbidity. The purpose of this analysis was to compare midterm results of rABF bypass ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.02.002
更新日期:2014-08-01 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:OBJECTIVE:Intimal hyperplasia (IH) continues to plague the durability of vascular interventions. Employing a validated murine model, ultrasound biomicroscopy, and speckle-tracking algorithms, we tested the hypothesis that reduced cyclic arterial wall strain results in accentuated arterial wall IH. METHODS:A 9-0 suture...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.07.113
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the cardiopulmonary morbidity and mortality rates after endovascular abdominal aortic aneurysm (EAAA) repair with local anesthesia (LA) with intravenous sedation versus general anesthesia (GA). METHODS:Data from patients who underwent elective infrarenal EAAA repair bet...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.128314
更新日期:2002-11-01 00:00:00
abstract:PURPOSE:This study compares the accuracy of various duplex parameters in grading ipsilateral carotid stenoses in patients with contralateral severe stenoses or occlusion. METHODS:Four duplex criteria were correlated to arteriography in 356 carotid arteries in blind fashion: (1) standard criteria: a peak systolic frequ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70066-8
更新日期:1995-12-01 00:00:00
abstract::We describe the surgical management of six patients with occlusive disease of the visceral arteries caused by Takayasu's arteritis. All patients suffered from renovascular hypertension and, in addition, three of the patients also had symptoms of mesenteric angina. Surgical repair is recommended in the "burn-out" phase...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030904
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Gold coating improves stent visibility under fluoroscopy. This is particularly valuable for precise stent placement during renal artery stenting (RAS). There is conflicting evidence regarding restenosis with gold-coated stents. To evaluate the effect of gold coating on restenosis after renal stenting, we rev...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.03.038
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:This study examined the outcomes of our novel concept of expanded provisional extension to induce complete attachment strategy (Petticoat) for safety, durability, and remodeling of chronic type B dissections. METHODS:Twenty patients with chronic type B aortic dissection with aneurysmal degeneration qualified...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.073
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:We investigated whether routine ligation of incompetent perforator veins is necessary in treatment of symptomatic chronic venous insufficiency (CVI) due to combined superficial and perforator vein incompetence, without deep venous insufficiency. METHODS:This was a retrospective review of prospectively collecte...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00933-9
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.04.041
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:Data from multicenter studies support observation of small abdominal aortic aneurysms (AAAs) over open repair (OR), but the role of endovascular repair (EVAR) is unclear pending outcome of the Positive Impact of EndoVascular Options for Treating Aneurysm earLy (PIVOTAL) trial. Our goal was to predict the outc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.07.085
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate outcomes of fenestrated-branched endovascular aortic repair (F-BEVAR) of pararenal abdominal aortic aneurysms or thoracoabdominal aortic aneurysms (TAAAs) in patients with a solitary functional kidney (SFK). METHODS:We analyzed the outcomes of 287 consecutive patients (2...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.10.062
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:Much of the brain is perfused by penetrating arteries that are the "single source" of blood to their surrounding tissues. These tissues should be equally vulnerable to ischemia from embolic occlusion, but there are questions about whether emboli have access to the penetrating arteries serving the deep brain ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.091
更新日期:2011-04-01 00:00:00
abstract::This article has been retracted: please see Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.04.054
更新日期:2010-07-10 00:00:00
abstract:PURPOSE:The activation of cyclic nucleotide-dependent signaling pathways in vascular smooth muscle is important for the prevention of vein graft spasm and neointimal hyperplasia. Cyclic nucleotide-dependent relaxation is associated with an increase in the phosphorylation of a small heat shock-related protein (HSP20). I...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70385-x
更新日期:1999-02-01 00:00:00
abstract::Thrombolysis for the treatment of occluded bypass grafts is used in selected clinical circumstances. Unfortunately, a minority of these procedures are technical failures because of the inability to access the occluded graft. We describe a technique that greatly increases the chances of technical success. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70328-9
更新日期:1999-04-01 00:00:00