Abstract:
OBJECTIVE:To compare the safety and efficacy of coil embolization (COIL) to Amplatzer vascular plug embolization (PLUG) to achieve internal iliac artery (IIA) occlusion prior to endovascular aortiliac aneurysm repair (EVAR). METHODS:Data from consecutive patients who underwent IIA embolization prior to EVAR over a 6-year period (2004-2010) were retrospectively reviewed. Patient demographics, treatment modalities, and outcomes were compared. RESULTS:From January 1, 2004 to December 31, 2010, a total of 53 patients underwent percutaneous embolization of 57 IIAs prior to EVAR. Twenty-nine IIAs underwent COIL and 28 IIAs underwent PLUG embolization. Patient demographics and risk factors were similar between the two groups. Patients underwent repair for aneurysmal dilation of the infrarenal aorta in conjunction with the common or internal iliac arteries (n = 35, 62%) or isolated iliac artery aneurysms (n = 19, 38%). A significantly greater number of embolization devices were used in the COIL group (5.8 ± 3.8 vs 1.1 ± 0.4; P < .0001). Patients undergoing PLUG embolization demonstrated significantly shorter procedure times (118.4 ± 64.7 minutes vs 72.6 ± 22.4 minutes; P = .008) and fluoroscopy times (32.6 ± 14.6 vs 14.4 ± 8.6 minutes; P = .002). However, radiation dose between the groups did not differ (COIL: 470,192.7 ± 190,606.6 vs PLUG: 300,972.2 ± 191,815.7 mGycm(2); P = .10). Overall periprocedural morbidity did not differ between the groups (COIL: 11% vs PLUG: 6%; P = 1.0), and there were no perioperative mortalities or severe complications. Nontarget embolization occurred in two COIL and no PLUG cases (COIL: 6.9% vs PLUG: 0%; P = .49). Patient-reported buttock claudication at 1 month was 17.2% for COIL and 39.3% for PLUG patients (P = .08). At last follow-up, persistent buttock claudication was reported in 13.8% of COIL and in 14.3% of PLUG embolizations (P = 1.0). There was no significant difference in charges for the embolization material, operating room, or overall hospital charges (COIL: 44,720 ± 19,153 vs 37,367 ± 10,915; P = .22). Lastly, zero endoleaks in the COIL group and three in the PLUG group (P = .40) were detected on the most recent follow-up computed tomography imaging. No endoleak was related to the site of IIA embolization. CONCLUSIONS:COIL and PLUG embolization both provide effective IIA embolization with low complication rates when used for EVAR. Buttock claudication did occur in approximately one-third of patients but resolved in half of those affected. PLUG embolization took significantly less time to perform and required decreased fluoroscopy times. Based on outcomes and cost-analysis, COIL and PLUG embolization are equivalent methods to achieve IIA occlusion during EVAR.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ryer EJ,Garvin RP,Webb TP,Franklin DP,Elmore JRdoi
10.1016/j.jvs.2012.05.001subject
Has Abstractpub_date
2012-11-01 00:00:00pages
1239-45issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(12)01042-7journal_volume
56pub_type
杂志文章abstract:OBJECTIVE:The goal of this study was to select branched endograft designs that could fit most aortic arch anatomies. Such off-the-shelf endografts, once available, would be an endovascular therapeutic option to consider in the acute setting and would shorten the design and manufacturing process. METHODS:We retrospecti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.11.046
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Many authors report inferior patency rates of distal arteriovenous fistulas in elderly patients and others present contradictory results. A meta-analysis of available evidence was performed to assess (1) whether non-elderly adults have the same risk of forearm arteriovenous fistula failure as elderly patient...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2006.10.035
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Critical limb ischemia (CLI) continues to place a significant encumbrance on patients and the health care system as it progresses to limb loss and long-term disability. Traditional methods of revascularization offer a significant benefit; however, for one-third of CLI patients, these surgical options are not ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2017.01.054
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to provide an overview of evidence regarding exercise therapies for patients with lower extremity peripheral artery disease (PAD). METHODS:This manuscript summarizes the content of a lecture delivered as part of the 2016 Crawford Critical Issues Symposium. RESULTS:Multiple ra...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2017.05.111
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The clinical decision-making utility of scoring algorithms for predicting mortality after ruptured abdominal aortic aneurysms (rAAAs) remains unknown. We sought to determine the clinical utility of the algorithms compared with our clinical decision making and outcomes for management of rAAA during a 10-year p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.07.121
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to evaluate clinical, anatomic, and procedural characteristics of patients who developed retrograde type A dissection (RTAD) after thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). METHODS:Between January 2012 and January 2017, there were 186 pati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.04.047
更新日期:2019-01-01 00:00:00
abstract::A technique is presented for revascularization of patients having a groin wound infection, which minimizes the risk of recurrent graft infection. A femorofemoral bypass with a subcutaneous perineal tunnel is constructed farther from the infected groin wound than the standard subcutaneous suprapubic tunnel. The route o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1985.avs0020485
更新日期:1985-05-01 00:00:00
abstract::Tracheo-innominate artery fistula is a highly lethal complication after tracheostomy. A 37-year-old man who had undergone a tracheostomy 14 years earlier because of dysphagia after brain surgery had a tracheo-innominate artery fistula with exsanguinating hemorrhage from his tracheostomy site. After temporary control o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.114997
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVE:This study investigated the prevalence and distribution of deep vein thrombosis (DVT) in patients with symptomatic pulmonary embolism (PE) to establish a screening protocol to reduce unnecessary venous duplex scanning using different D-dimer level rather than single cutoff point of 0.5 microg/mL in patients w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.05.026
更新日期:2007-09-01 00:00:00
abstract::Popliteal artery aneurysms represent a common pathology that vascular surgeons are often confronted with. However, several issues remain incompletely understood, including indications for intervention and optimal methods of treatment. In the following article, our discussants debate the appropriate management of small...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.02.001
更新日期:2011-04-01 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::To define better the short-term risk and long-term benefit of carotid endarterectomy opposite an occluded carotid artery, we reviewed our experience since 1961. Angiographic data are available for 598 of 670 (89.3%) patients in our carotid registry. In 63 (10.5%) patients the internal or common carotid artery on the s...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.20249
更新日期:1990-06-01 00:00:00
abstract:OBJECTIVE:Hyperhomocysteinemia has been implicated as a causative factor in intimal hyperplasia development. The addition of dietary folate in a hyperhomocysteinemia, carotid endarterectomy rat model is postulated to decrease plasma homocysteine levels and, in turn, reduce post-carotid endarterectomy intimal hyperplasi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.117144
更新日期:2001-09-01 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:OBJECTIVE:Of 125 surgical patients with abdominal aortic aneurysm (AAA) treated from 1999, 11 patients with deep shock from ruptured AAAs who underwent aortic occlusion balloon catheter (AOBC) insertion before laparotomy were studied. METHODS:With the patients under local anesthesia, the brachial artery was exposed an...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00774-2
更新日期:2003-12-01 00:00:00
abstract::The hypothesis of the present study is that axillofemoral bypass grafting for acute vascular occlusion has results significantly inferior to an elective procedure. We reviewed 53 patients undergoing primary axillofemoral bypass grafting at the University of Virginia from 1984 to 1989. We found that patients who were a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.29422
更新日期:1991-08-01 00:00:00
abstract::Two elderly men were referred to our vascular clinic for the management of bilateral lower extremity edema of 2 to 3 months' duration. Their evaluation included phlebograms, which demonstrated external compression of their iliac veins. CT scans of the pelvis suggested that large bladders caused the compression. Each p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0070778
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:Distal cerebral embolization is a known complication of carotid interventions. We prospectively investigated whether subclinical microembolization seen on postoperative magnetic resonance imaging (MRI) leads to cognitive deficits in patients undergoing carotid revascularization procedures. METHODS:Patients u...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.05.092
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:Prior studies have suggested improved wound complication rates but decreased primary patency in lower extremity bypasses performed with endoscopic vein harvest (EVH) vs open vein harvest (OVH). We hypothesize that the inferior patency reflects the initial learning curve for EVH and that improved patency can b...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.02.043
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:This randomized clinical trial compared endovenous laser ablation (EVLA) and surgical ligation with attempted stripping in the treatment of small saphenous vein (SSV) insufficiency. The early results demonstrated that EVLA was more likely to eradicate axial reflux and was also associated with a faster recove...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2014.09.037
更新日期:2015-03-01 00:00:00
abstract::Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular tumor of intermediate malignancy. Generally it develops from the peripheral veins (usually the femoral vein). We report on a case of EHE of the radial artery, developed in a 26-year-old male patient, which presented as a solitary painless mass. He ha...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.10.036
更新日期:2005-01-01 00:00:00
abstract::From 1995 through 1998, we encountered eight patients with infected Dacron patches after previous carotid endarterectomy. Two of the original operations had been done elsewhere, but the six patients who were collected from our own series represented 0.5% of the 1258 carotid endarterectomies we performed and 1.8% of th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.107567
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze our 25-year experience with surgical treatment of visceral artery aneurysms (VAAs), with particular attention paid to early and long-term results. MATERIALS AND METHODS:From January 1982 to September 2007, 55 patients (32 males, 58%, and 23 females, 42%) underwent surgica...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.043
更新日期:2008-08-01 00:00:00
abstract::Spontaneous dissection of the abdominal aorta originating from the suprarenal aorta is very rare. Previous reports attest to the lethal nature of this disorder. This case represents the first report of successful repair of a spontaneous suprarenal abdominal aortic dissection by graft insertion with obliteration of bot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(94)70222-5
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:Reconstruction of infected aortic cases has shifted from extra-anatomic to in situ. This study reports the surgical strategy and early outcomes of abdominal aortic reconstruction in both native and graft-related aortic infection with in situ xenopericardial grafts. METHODS:Included in the analysis are 21 con...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.04.513
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS:Infants (aged ≤12 months) diag...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.036
更新日期:2018-05-01 00:00:00
abstract::Takayasu aortitis (TA) is a chronic inflammatory disease predominantly seen in young Asian women. The disease is idiopathic and largely affects the aorta and its major branches. The basic pathologic changes in TA are fibrosis and subsequent occlusion of the large arteries. TA is classically termed "pulseless" disease,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.158
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVE:The effects of a new long-term subcutaneous vascular access device were studied in access-challenged patients who were poor candidates for fistulas or grafts due to venous obstruction. Bacteremia rates, patency, and function of the Hemodialysis Reliable Outflow (HeRO) Vascular Access Device (Hemosphere Inc, M...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jvs.2009.04.014
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:The endovascular approach to external iliac artery (EIA) disease extending into the common femoral artery (CFA) has been avoided because of problems with stent placement across the inguinal ligament. Surgical treatment for this disease distribution includes extensive endarterectomy or bypass procedures or both....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.124374
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:The benefit of carotid endarterectomy (CEA) in female patients has been questioned by various randomized, prospective trials, particularly in asymptomatic cases; several have noted an increase in perioperative stroke among women after CEA. The outcome of carotid angioplasty and stenting (CAS) has not been ex...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.02.029
更新日期:2011-06-01 00:00:00