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 extensively examined in women. This study examined the outcome of CEA and CAS in women vs men by using a national database. METHODS:Outcomes of CEA and CAS were stratified by sex using discharge data from the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. The NIS was used to identify patient discharges that occurred during 2004 and 2005. Appropriate International Classification of Diseases, 9th Revision (ICD-9) procedure and diagnosis codes were used to identify CEA and CAS cases. Outcome measures included in-hospital perioperative stroke and death. Comparisons of demographics, procedures, and outcome were performed between men and women. Additional analysis was performed among women alone to attempt to identify whether improved outcome was noted with either procedure. RESULTS:Of 54,658 procedures, 94.2% were CEA and 5.8% were CAS. Women comprised 42.3% of the analyzed cases. Women and men were equally likely to be symptomatic (5.3% vs 5.3%, P = .8). Women were significantly less likely to undergo CAS than men (5.4% vs 6.1%, P < .001). Women and men had equivalent rates of perioperative stroke when undergoing CEA (1.0% vs 1.0%, P = .9) and CAS (2.7% vs 2.0%, P = .2). Symptomatic women had a significantly higher rate of perioperative stroke overall than did symptomatic men (3.8% vs 2.3%, P = .03). Asymptomatic women had a significantly lower perioperative stroke rate after CEA than after CAS (0.9% vs 2.1%, P < .001). Rates of perioperative showed a trend favoring CEA vs CAS among symptomatic women (3.4% vs 6.2%, P = .1). CONCLUSIONS:The concern regarding an increased perioperative stroke rate after CEA among asymptomatic women appears to be unfounded. The perioperative stroke rate among symptomatic women was higher than that of symptomatic men, but still well within the acceptable range for symptomatic patients undergoing a cerebrovascular intervention. Nationally, women underwent CAS significantly less frequently than did men. Outcome among women for perioperative stroke favored CEA over CAS, particularly in asymptomatic patients. CEA may be the preferred treatment in women seeking intervention for cerebrovascular disease, unless compelling reasons exist to perform CAS.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Rockman CB,Garg K,Jacobowitz GR,Berger JS,Mussa FF,Cayne NS,Adelman MA,Maldonado TSdoi
10.1016/j.jvs.2011.02.029subject
Has Abstractpub_date
2011-06-01 00:00:00pages
1457-64issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(11)00325-9journal_volume
53pub_type
杂志文章abstract:PURPOSE:This study compared the volume and morphology of intraluminal thrombus (ILT) in intact and ruptured abdominal aortic aneurysms (AAAs). METHODS:ILT volume in 67 intact AAAs and in 31 ruptured AAAs was assessed by using computed tomography (CT) angiography to measure the major and minor diameter of the outer wal...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.01.004
更新日期:2005-04-01 00:00:00
abstract::Mycotic aneurysms have a high mortality rate, predominantly driven by sepsis. We present a 61-year-old patient who was treated with a hybrid open-endovascular repair using autologous femoral vein as a single channel revascularization. This provided a practical and innovative approach to a high-risk situation. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.11.051
更新日期:2011-04-01 00:00:00
abstract:PURPOSE:Endovascular repair (EVR) is a less-invasive method for the treatment of abdominal aortic aneurysms (AAAs) as compared with open surgical repair (OSR). The potential benefits of EVR include increased patient acceptance, less resource utilization, and cost savings. This study was designed to determine whether th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70237-5
更新日期:1999-06-01 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:OBJECTIVE:Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascular...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.01.025
更新日期:2017-06-01 00:00:00
abstract:PURPOSE:The role of arterial stenting in the treatment of femoral and popliteal arterial disease is controversial and has been hampered by recommendations for patients to be given anticoagulants (oral warfarin) for several months or more. This study was undertaken to evaluate the immediate and midterm outcomes of vascu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70268-7
更新日期:1995-02-01 00:00:00
abstract:PURPOSE:Surgical revascularization of intestinal arteries is an effective long-term treatment for chronic intestinal ischemia (CII) regardless of the technique used. Conventional antegrade or retrograde bypass techniques are the most common modalities for extensive lesions that cannot be treated by endarterectomy or tr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.12.031
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:Approximately 10% of infrainguinal bypass surgeries are complicated by early conduit failure. The cause is unclear in most cases. A prospective study was conducted to monitor the development and function of platelet factor 4 (PF4)/heparin antibodies after infrainguinal bypass procedures and to evaluate their ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.028
更新日期:2008-08-01 00:00:00
abstract:PURPOSE:Asymptomatic morphologic popliteal vein entrapment is frequently found in the healthy population (27%). In our institution, popliteal vein compression on plantar flexion was observed in 42% of all ascending venograms. Some authorities consider the lesion benign, without pathologic significance. This study exami...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.103786
更新日期:2000-04-01 00:00:00
abstract::A 52-year-old man had an extensive right adrenal pheochromocytoma with invasion of the pararenal inferior vena cava (IVC). Tumor resection required en bloc resection of the infrahepatic IVC. The right kidney was not involved with tumor. Reconstruction of the IVC was performed with an externally supported, expanded pol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70132-6
更新日期:1994-01-01 00:00:00
abstract::Paper-based information systems are cumbersome and inefficient. The microcomputer is an attractive, affordable, and powerful alternative to traditional paper-based record keeping. This article reviews fundamentals of data base management and microcomputer technology for the surgeon interested in microcomputer-based in...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1984.avs0010585
更新日期:1984-07-01 00:00:00
abstract:BACKGROUND:Abdominal aortic aneurysm (AAA) rupture occurs when wall stress exceeds wall strength. Engineering principles suggest that aneurysm diameter is only one aspect of its geometry that influences wall stress. Finite element analysis considers the complete geometry and determines wall stresses throughout the stru...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.09.002
更新日期:2008-01-01 00:00:00
abstract::During the last decade, new information and reports have been published regularly describing endovascular and open repair of ruptured abdominal aortic aneurysms, but despite this, disagreement persists over which therapy is best. At the root of the problem is the discrepancy between the findings of multiple well-perfo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.11.042
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Endovascular strategies have been increasingly used to manage patients with ruptured abdominal aortic aneurysm (AAA) in an attempt to improve patient survival. We analyzed the evidence to support such an approach. METHODS:We performed a systematic literature review of endovascular aneurysm repair (EVAR) o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2009.02.005
更新日期:2009-04-01 00:00:00
abstract::Although the Heimlich maneuver is considered the best intervention for relieving acute upper airway obstruction, several complications have been reported in the literature. These complications can occur as a result of an increase in abdominal pressure leading to a variety of well-documented visceral injuries, includin...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.061
更新日期:2008-11-01 00:00:00
abstract::A case is reported of a woman with an ischemic arm as a result of damage to the subclavian artery by the clavicular anomaly associated with cleidocranial dysostasis. Only one similar case has been reported previously. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70105-8
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:Brachiobasilic arteriovenous fistulas (BBAVF) can be performed in one or two stages. We compared primary failure rates, as well as primary and secondary patency rates of one- and two-stage BBAVF at two institutions. METHODS:Patients undergoing one- and two-stage BBAVF at two institutions were compared retro...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.01.064
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:This review describes the clinical outcome of surgical intervention for atherosclerotic renovascular disease in 500 consecutive patients with hypertension. METHODS:From January 1987 to December 1999, 626 patients underwent operative renal artery (RA) repair at our center. A subgroup of 500 patients (254 wome...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.120376
更新日期:2002-02-01 00:00:00
abstract::Although the laser has been demonstrated to vaporize coronary artery plaque, there is little information about its ability to resect or vaporize the range of plaques present in peripheral vessels. This study attempts to determine the ability of the argon laser to resect all grades of atherosclerotic plaque, the risk o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1984.avs0010852
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVE:The purpose of our study was to investigate the effect of adipose-derived stem cells (ASCs), endothelial-differentiated ASCs (EC/ASCs), and various conditioned media (CM) on wound healing in a diabetic swine model. We hypothesized that ASC-based therapies would accelerate wound healing. METHODS:Diabetes was ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.01.065
更新日期:2018-12-01 00:00:00
abstract:PURPOSE:In the presence of carotid occlusion, the external carotid artery (ECA) becomes an important source of cerebral blood flow, especially if the circle of Willis is incomplete. The contribution of the ECA to hemispheric blood flow in patients with severe ipsilateral carotid stenosis has never been previously inves...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.104598
更新日期:2000-05-01 00:00:00
abstract::Although endothelial cell seeding has been demonstrated to be effective in producing uniform endothelial coverage on prosthetic grafts, no one has demonstrated that the seeded cells are the genetic precursors of the endothelial cells that ultimately line the graft. This study was performed to determine whether seeded ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract:OBJECTIVE:Arteriovenous fistula (AVF) is the preferred access for hemodialysis. Percutaneous transluminal angioplasty(PTA) has become a choice for AVF stenosis and ultrasound has been used in PTA more frequently. METHODS:This single-center retrospective cohort study analyzed 129 patients who underwent PTA in the First...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.11.041
更新日期:2020-12-16 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the stenosis-free patency of open repair (vein-patch angioplasty, interposition, jump grafting) and percutaneous transluminal balloon angioplasty (PTA) of 144 vein graft stenoses that were detected during duplex scan surveillance after infrainguinal vein bypass grafting...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70361-7
更新日期:1999-01-01 00:00:00
abstract::Reliable enzymatic endothelial cell (EC) harvest methods are required for clinical EC seeding of vascular prostheses by methods analogous to those demonstrated in dogs. But crude collagenases used for EC harvest vary in efficacy and cytotoxicity, and purified collagenases reportedly give low EC yields. To compare diff...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:PURPOSE:Occlusion of the common carotid artery (CCA) is generally associated with occlusion of the ipsilateral internal carotid artery (ICA) and external carotid artery (ECA). Occasionally, however, collateral circulation to the ECA may preserve patency of the ICA via retrograde perfusion through the bulb. These patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:Guidelines from the Society for Vascular Surgery and the Choosing Wisely campaign recommend that peripheral vascular interventions (PVIs) be limited to claudication patients with lifestyle-limiting symptoms only after a failed trial of medical and exercise therapy. We sought to explore practice patterns and p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.005
更新日期:2020-01-01 00:00:00
abstract::Endovascular repair is a valid alternative for patients with abdominal aortic aneurysms. However, in patients with concomitant aortocaval fistulas, type II endoleaks may result in a persistent communication between the aneurysm sac and the inferior vena cava. In these patients, prompt closure of the persistent fistula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.138
更新日期:2013-10-01 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:BACKGROUND:Thrombolysis is a common method in the treatment of lower extremity bypass graft occlusion. The purpose of this study was to investigate the results of thrombolytic therapy in the management of acute bypass graft occlusion and to identify risk factors for technical failure and amputation. METHODS:All patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2011.05.008
更新日期:2011-11-01 00:00:00