Abstract:
OBJECTIVE:The aim of this study was to evaluate the performance of paclitaxel-eluting stents (PESs) and paclitaxel-coated balloons (PCBs) on amputation-free survival in patients with critical limb ischemia (CLI). METHODS:A retrospective review of all patients with Rutherford stage 5 and 6 limb ischemia undergoing endovascular revascularization with paclitaxel-related technology, both PES and PCB, was carried out over a 4-year period. Clinical grading was determined by Rutherford classification and the Society for Vascular Surgery's Wound, Ischemia, and foot Infection (WIfI) scoring system. Clinical and angiographic follow-up was reviewed based on intention-to-treat analysis. The primary endpoint of this study was amputation-free survival at 12 months. Secondary endpoints included wound healing, freedom from target lesion revascularization, and patency of target vessels at 12 months. Follow-up occurred at 3, 6, and 12 months postoperatively. Target lesion patency was defined as <50% stenosis, based on a duplex velocity ratio of less than or equal to 2. Postoperative ankle-brachial index (ABI) and duplex ultrasound were performed to verify successful treatment. Outcomes were evaluated using Kaplan-Meier and Cox proportional-hazards models. RESULTS:A total of 88 limbs were revascularized in 88 patients. Drug-eluting stent (DES) was used as the sole drug technology in 56 patients (60.7% men, median age 70.5 years) and drug-coated balloon (DCB) was used as the sole drug technology in 32 patients (46.9% men, median age 66 years). Baseline demographics were well matched except for a higher prevalence of occluded target lesions in the DES group (41.1% vs. 12.5%; P = 0.004). Limbs were treated for Rutherford stage 5 CLI in 71.6% and stage 6 CLI in 28.4%. Univariate analysis identified no dependent factors affecting limb salvage, except for the use of DCBs. After 12 months of follow-up, amputation-free survival was significantly higher in the DES group than in the DCB group (88.5% vs. 71.1%; P = 0.0443). Wound healing rates after 1 year were also higher in the DES group (83.9% vs. 59.4%; P = 0.0198). Freedom from target lesion revascularization was no different between patients treated with DESs and patients treated with DCBs (90.6% vs. 85.7%; P = 0.518). Primary patency at 12 months in patients treated with DESs was significantly higher than in patients treated with PCBs (80.4% vs. 58.1%; P = 0.0255). CONCLUSIONS:Overall, drug technology represents a viable option for patients with CLI; a cohort not represented in major randomized trials. In our experience, femoropopliteal lesions treated with DESs have higher primary patency rates than those treated with DCBs. This was found to support higher amputation-free survival rates in patients treated with paclitaxel DESs than those treated with paclitaxel DCB. The use of paclitaxel DESs for CLI was also associated with significantly improved wound healing compared with DCBs. Our data suggest improved outcomes with DESs compared with DCBs; however, these patients represent a nonrandomized, heterogenous group that were treated with the operator's best judgment.
journal_name
Ann Vasc Surgjournal_title
Annals of vascular surgeryauthors
Phair J,Carnevale M,Lipsitz EC,Shariff S,Scher L,Garg Kdoi
10.1016/j.avsg.2019.05.013subject
Has Abstractpub_date
2020-01-01 00:00:00pages
8-14eissn
0890-5096issn
1615-5947pii
S0890-5096(19)30417-0journal_volume
62pub_type
杂志文章abstract:BACKGROUND:Noninvasive diagnostic testing may be beneficial to identify stenotic (failing) stents placed for occlusive lower extremity peripheral arterial disease (LEPAD), especially if subsequent intervention proves useful in maintaining prolonged stent patency. We previously documented the benefit of surveillance dup...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.08.086
更新日期:2020-02-01 00:00:00
abstract::This study evaluates the hemodynamic effects and safety of saline irrigation necessary to obtain high-quality completion angioscopic studies, as compared with standard completion arteriography during infrainguinal bypass grafting. One-hundred ten patients undergoing primary infrainguinal bypass grafting, were prospect...
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/BF02000670
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:Smartphone apps provide novel ways for triggering lifestyle change by coupling objective measurements of health behavior with tailored feedback. Little is known about end-user preferences regarding the content of mobile health (mHealth) interventions. The aim of this study was to assess smartphone use and pr...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.08.020
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The frequency of the occurrence of adverse events associated with carotid artery stenting (CAS) is usually low, but serious adverse events such as cerebral hyperperfusion syndrome (CHS) may occur. Real-time monitoring is ideal for the early detection of adverse events during the surgical procedure. This stud...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2017.10.034
更新日期:2018-05-01 00:00:00
abstract::The purpose of this study was to estimate the frequency of and review the treatment options for intraoperative endograft access-related vascular complications and early postoperative vascular complications of endovascular repair for aortoiliac aneuryms (EVAR). Between February 1998 and April 2000, 53 patients (46 male...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/s10016-001-0092-x
更新日期:2001-11-01 00:00:00
abstract::The aim of this article is to describe a new open surgical technique for revascularization of renal arteries. Several interventions for surgical revascularization of renal arteries have been proposed. We suggest to perform an alternative technique if the described inflow vessels are not suitable because of severe athe...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.03.051
更新日期:2015-08-01 00:00:00
abstract::Our case of primary leiomyosarcomas involved retrohepatic, suprarenal, and infrarenal inferior vena cava (IVC). Preoperative phlebography proved that there was adequate collateral circulation formed, which allowed us to achieve en bloc resection including segment I and II IVC without either extracorporeal circulation ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2009.12.015
更新日期:2010-08-01 00:00:00
abstract::Certain patients have atherosclerosis in both aortoiliac and femoropopliteal segments of the arterial tree and thus do not have a good result from reconstruction of the aortoiliac segment. No method has been developed to identify these patients and we do not know whether, by combining a femoropopliteal bypass with an ...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60730-9
更新日期:1987-05-01 00:00:00
abstract:BACKGROUND:To compare aortic sac changes after endovascular aneurysm repair (EVAR) assessed by three-dimensional ultrasound (3D-US), two-dimensional ultrasound (2D-US), and traditional computed tomographic angiography (CTA). METHODS:Using volume assessment with three-dimensional CTA (3D-CTA-volume) as the gold standar...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2020.09.061
更新日期:2020-11-04 00:00:00
abstract::Parkes Weber syndrome (PWS) is characterized by the association of high flow vascular malformation and overgrowth of a part of the body, usually a limb. In a previous review of 10 patients with PWS from our hospital we described a case of congenital short femur and four cases of severe lymphedema. We present a case of...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.06.015
更新日期:2017-01-01 00:00:00
abstract::We report a case of a compassionate treatment of a ruptured thoracoabdominal aortic aneurysm in a 92-year-old patient. The patient was admitted to our emergency department for acute onset of pain irradiating to the back. Computed tomography angiography showed the presence of a thoracoabdominal aortic aneurysm with a c...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2016.07.102
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:Postmenopausal women taking hormone replacement therapy (HRT) require secondary intervention after vascular reconstruction more frequently than women not taking HRT, often due to increased development of intimal hyperplasia (IH). Matrix metalloproteinases (MMPs) play a role in IH by degradation and remodelin...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2012.05.010
更新日期:2013-04-01 00:00:00
abstract::The etiology of varicose veins remains elusive. We hypothesized that abnormal cell cycle events in the vein wall may contribute to changes in its structural integrity predisposing to varicosity development. Since cell cycle checkpoint controls are linked to the signaling and execution of apoptotic cascades, possibly a...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s100169910005
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:In a number of relatively small-size studies, investigators have measured and compared circulating interleukin-6 (IL-6) levels in cases with abdominal aortic aneurysm (AAA) and controls without AAA to assess its possible role in the pathogenesis or progression of AAA. To summarize the present evidence for an...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.avsg.2014.06.058
更新日期:2014-11-01 00:00:00
abstract::Hyperparathyroidism in association with carotid body tumor is a rare combination. A common embryologic cellular origin was postulated previously to explain this unusual occurrence. We report a case of left carotid body tumor and left inferior parathyroid adenoma. We believe this to be the sixth reported case in the li...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,评审
doi:10.1007/BF02017418
更新日期:1994-11-01 00:00:00
abstract::Ischemia occurring during hyperextension of the upper limb in a 25-year-old woman led to the discovery of a supracondylar spur responsible for compression of the brachial artery with anomalous insertion of the pronator teres muscle. Resection of all abnormal structures provided immediate relief of symptoms. When atypi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/S0890-5096(06)60736-X
更新日期:1987-05-01 00:00:00
abstract::Ultrasound screening for abdominal aortic aneurysm (AAA) has been shown to be beneficial and cost-effective for men aged 65-74. However, most screening studies have been conducted in Europe and Australia, where attendance for screening was higher than the single large U.S. study involving only veterans. The prevalence...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2007.07.026
更新日期:2008-01-01 00:00:00
abstract::Perforation of inferior vena cava (IVC) by filter struts ranges from 9% to 24%, and clinical sequelae and complications are unpredictable. The aim of this article was to report an unusual case of late complication of IVC filter that caused an IVC wall perforation and penetration of the filter's hooks in the aorta, whi...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2011.11.044
更新日期:2012-08-01 00:00:00
abstract::Behcet disease (BD) is a chronic systemic inflammatory disorder characterized by recurrent oral and genital ulcerations, üveitis, and skin lesions. Vascular system involvement is common in BD. Aneurysm formation appears to be more common than arterial occlusion. Extracranial carotid aneurysms in BD are extremely rare....
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2014.10.033
更新日期:2015-01-01 00:00:00
abstract::The use of a patch after carotid endarterectomy (CE) is recommended to reduce the incidence of restenosis. Most studies on this subject report the implantation of saphenous vein or PTFE patches, because polyester has always been considered to be a thrombogenic material. The purpose of this study was to evaluate the th...
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/s100160010129
更新日期:2001-11-01 00:00:00
abstract::We report a case of secondary rupture of a common iliac artery aneurysm into the common iliac vein. Exclusion of the iliac aneurysm had been performed 2 years earlier in association with reconstruction of an aortic aneurysm that had ruptured into the interior vena cava. After closure of the aortocaval fistula by the e...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02001897
更新日期:1996-05-01 00:00:00
abstract::The surgical management of aortic prosthesis infection remains an enormous challenge for the vascular surgeon and a critical issue for the patient's well-being and life. Several techniques for its management have been devised and employed over the years, but none of them has been totally satisfactory. Thus new alterna...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-004-0080-z
更新日期:2004-09-01 00:00:00
abstract::Compression of adjacent anatomic structures by an abdominal aortic aneurysm (AAA) can result in a variety of symptoms. We describe the case of an 88-year-old Caucasian woman with jaundice, elevated laboratory parameters for extrahepatic and intrahepatic cholestasis, and concomitant juxtarenal AAA compressing the liver...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2015.04.080
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Common femoral artery is still the most frequently used site for vascular access, mostly for peripheral arterial interventions, and its puncture remains a significant source of patient's morbidity. Manual compression (MC) has been the gold standard for hemostasis after femoral catheterization until recently,...
journal_title:Annals of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.avsg.2018.02.016
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:Almost 80% of patients with end-stage renal disease (ESRD) initiate dialysis via a central venous catheter (CVC). CVCs are associated with multiple complications and a high cost of care. The purpose of our project is to determine the impact of early cannulation arteriovenous grafts (ECAVGs) on quality of car...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2019.02.007
更新日期:2019-08-01 00:00:00
abstract::We report a 5.8 cm left renal artery aneurysm in a 71-year-old male with IgG4-related disease. To our knowledge, this is the first reported renal artery aneurysm associated with this condition. After being considered for nephrectomy, the patient underwent ex-vivo left renal artery aneurysm repair to preserve renal fun...
journal_title:Annals of vascular surgery
pub_type:
doi:10.1016/j.avsg.2020.12.013
更新日期:2021-01-24 00:00:00
abstract::Regional anesthesia (RA) is the gold standard of neuromonitoring during carotid endarterectomy (CEA). Recent data show that RA for CEA is associated with fewer postoperative complications. The aim of the present study was to assess hemodynamic stability and vasoactive drug use for CEA performed under RA versus general...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2008.05.015
更新日期:2009-05-01 00:00:00
abstract::A synthetic, monofilament, absorbable suture material, polytrimethylene carbonate, was tested to determine its suitability for use in arterial anastomoses. The material studied is a copolymer made of trimethylene carbonate and polyglycolic acid, with a retention time in the tissue of up to six months. In an experiment...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/BF02329383
更新日期:1991-05-01 00:00:00
abstract::A rare case of bovine aortic arch aneurysm accompanied by patent ductus Botalli aneurysm was treated using an off-pump hybrid procedure including supraaortic debranching combined with aortic stent grafting and oversewing of pulmonary artery end of the aneurysm. Postoperative computed tomography angiography showed pers...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.avsg.2013.12.016
更新日期:2014-08-01 00:00:00
abstract::Between November 2000 and January 2002, two patients with aneurysms that involved the distal part of the aortic arch including the left subclavian artery were treated at our institution. Patient 1 had an aneurysm of 5.8 cm extending to the proximal descending aorta. Patient 2 had a 6.8 cm type II thoracoabdominal aneu...
journal_title:Annals of vascular surgery
pub_type: 杂志文章
doi:10.1007/s10016-001-0399-7
更新日期:2003-03-01 00:00:00