Abstract:
OBJECTIVE:Current long-term surveillance after endovascular abdominal aortic aneurysm repair (EVAR) is based on high-resolution contrast-enhanced computed tomography (CT) scans at scheduled, lifelong intervals. The cancer and nephrotoxicity risks of interval CT scanning and prolonged radiation exposure are concerning. We sought to determine if surveillance CT angiography (CTA) can be safely reduced. METHODS:From July 2000 to November 2007, 345 patients were enrolled in U.S. Food and Drug Administration trials of the Powerlink System (Endologix, Irvine, Calif). An independent core laboratory analyzed 1519 post-EVAR CT scans (N=1519) to 5 years to evaluate aneurysm size, migration, presence of endoleak, and evidence of graft obstruction. Analyses were conducted to determine the value of the initial CTA scan in predicting future secondary procedures in enrolled patients. RESULTS:At any time during follow-up, CTA identified endoleak in 123 patients (36%), with 95% of endoleaks being type II. In addition, 49 patients underwent 72 secondary procedures at a mean of 22±21 months (range, 2-2007 days) after initial EVAR. These were based on clinical identification of limb ischemia in 13 interventions (18%) or core laboratory identification of abnormal CT finding in 58 interventions (81%). Of the 58 core laboratory identified findings, the inciting abnormality was present on the initial postoperative scan in 49 (84%). Of the remaining nine CT-driven procedures, three (5.2%) were due to late sac expansion attributed to type II endoleak (n=2) or endotension (n=1); two (3.4%) were for prophylactic reasons in the absence of endoleak; and four (6.8%) were in patients with type II endoleak not observed by the core laboratory and without sac expansion. The negative predictive value of the initial postoperative CTA for the need for a secondary procedure is therefore 96.4%, which can be improved to 97.6% with duplex ultrasound surveillance to detect sac expansion. Thus, a negative initial postoperative CTA is highly predictive of long-term freedom from secondary intervention. CONCLUSIONS:Among enrolled patients with suitable anatomy for EVAR, most abnormalities that result in a secondary procedure are detected on the initial postoperative CTA or present with clinical symptoms. Long-term surveillance CTA may therefore be replaced by duplex ultrasound imaging if the initial postoperative CTA shows no abnormalities.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Patel MS,Carpenter JPdoi
10.1016/j.jvs.2010.06.019subject
Has Abstractpub_date
2010-11-01 00:00:00pages
1135-9issue
5eissn
0741-5214issn
1097-6809pii
S0741-5214(10)01353-4journal_volume
52pub_type
杂志文章abstract:OBJECTIVE:Vein graft adaptation is characterized by loss of expression of the tyrosine kinase receptor Eph-B4, the embryonic determinant of venous identity, without increased expression of its ligand ephrin-B2, the embryonic determinant of arterial identity. Endothelial nitric oxide synthase (eNOS) is an important medi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.11.041
更新日期:2017-01-01 00:00:00
abstract:PURPOSE:To test the hypothesis that lower extremity transcutaneous oxygen (TcPO2) measurements can accurately predict severity of foot ischemia and can be used to select appropriate treatment (conservative versus operative) for patients with diabetes and tissue necrosis or ischemic rest pain. METHODS:Fifty-five patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(95)70018-8
更新日期:1995-10-01 00:00:00
abstract:PURPOSE:Treatment of aortoiliac prosthetic graft infections includes the removal of the infected material and repeat revascularization if necessary. The risk of infection of the graft material used for the repeat revascularization has been the drawback of its use in situ except with autografts. Good results were obtain...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(96)80013-9
更新日期:1996-03-01 00:00:00
abstract::Visceral artery aneurysms are rare in infants and children. The majority of cases are caused by genetic syndromes, trauma, or infection. Although the majority of aneurysms are asymptomatic, visceral artery aneurysms can present with abdominal pain, nausea/vomiting, or rupture. Aneurysm rupture can manifest as hemodyna...
journal_title:Journal of vascular surgery
pub_type:
doi:10.1016/j.jvs.2019.06.106
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:Diabetic foot disease poses a significant and rising financial burden on health care systems worldwide. This study investigated the effect of a new multidisciplinary diabetic foot clinic (MDDFC) in a large tertiary hospital on patient outcomes and treatment cost. METHODS:Patients' records were retrospectivel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.11.032
更新日期:2019-09-01 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
abstract:PURPOSE:The purpose of this study was to assess the short-term and mid-term results of endovascular aneurysm repair with the Zenith stent graft in a single-center prospective study. METHOD:Between October 1998 and July 2001, we used the Zenith stent graft for elective endovascular aneurysm repair in 116 patients, six ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.125032
更新日期:2002-08-01 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::Abdominal aortic aneurysm with spontaneous aorto-left renal vein fistula is a rare but well-described clinical entity usually with abdominal pain, hematuria, and a nonfunctioning left kidney. This report describes a 44-year-old man with left-sided groin pain and varicocele who was treated with conservative measures on...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.102330
更新日期:2000-04-01 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:PURPOSE:Cyclooxygenase, either the cox1 or cox2 isoform, controls synthesis of prostaglandin E2 (PGE2), which regulates expression of matrix metalloprotease-9 (MMP-9). PGE2 and MMP-9 are elevated in aortic aneurysms. The mechanisms and time course of the inhibition of aneurysm expansion with a nonspecific cyclooxygenas...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70216-8
更新日期:1999-05-01 00:00:00
abstract:PURPOSE:This study is an analysis of the outcome of a common method of management of the external carotid artery (ECA) during routine carotid endarterectomy (CEA). METHODS:Between 1986 and 1997, 1069 primary CEAs were performed with a combination of proximal eversion technique and blind distal endarterectomy on the EC...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70080-1
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:In the last decade, there has been a dramatic increase in the number of women entering vascular surgery. Our goal was to evaluate the differences in career paths based on gender and to determine some of the factors that influence career decisions among young vascular surgeons. METHODS:A 17-item web-based sur...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.02.055
更新日期:2017-08-01 00:00:00
abstract:PURPOSE:The purpose of this study was to assess the accuracy of intravascular ultrasound (IVUS) parameters of abdominal aortic aneurysm, used for endovascular grafting, in comparison with computed tomographic angiography (CTA). METHODS:This study was designed as a descriptive study. Between March 1997 and March 1998, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70308-3
更新日期:1999-04-01 00:00:00
abstract:PURPOSE:Two of three patients with vertebrobasilar stroke harbor a stenosis of the vertebral or basilar arteries. The best treatment for secondary prophylaxis in vertebrobasilar occlusive disease has not been defined. In patients with high-grade stenoses, and especially those refractory to medication, stenting offers t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2006.02.027
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to describe characteristics and in-hospital outcomes of patients treated with carotid endarterectomy (CEA) and carotid artery stenting (CAS) for stroke in evolution (SIE) under routine conditions in Germany. METHODS:This secondary data analysis is based on the German statutory...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.085
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to su...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.02.033
更新日期:2015-07-01 00:00:00
abstract:OBJECTIVE:Prosthetic femoral-popliteal bypasses are performed by using an end-to-side anastomosis, and disease can develop at the distal end; this can lead to poor long-term patency rates. Disturbed flow characteristics are hypothesized as being a major factor in promoting disease development. The objective of this stu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.016
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:Hybrid repair of thoracoabdominal aortic aneurysms (TAAA) may reduce morbidity and mortality in high-risk candidates for open repair. This study reviews the outcomes of hybrid TAAA repair for Crawford extent I-III TAAA in high-risk patients in comparison to patients who underwent concurrent open TAAA repair. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.12.051
更新日期:2009-07-01 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: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: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:OBJECTIVE:To define diameter at three levels along the popliteal artery and its relation to the inflow arteries in the normal state and in popliteal aneurysms. METHODS:The external diameter of the arteries was determined by duplex ultrasound scanning at the common femoral (CFA), superficial femoral artery (SFA), proxi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.11.026
更新日期:2006-03-01 00:00:00
abstract:PURPOSE:Although routine noninvasive surveillance is recommended after carotid endarterectomy (CEA), there are little data to show that identification and eradication of recurrent carotid artery stenosis are necessary to avoid the risk of subsequent neurologic complications. METHODS:We reviewed our experience over a 1...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Women with abdominal aortic aneurysms less often meet anatomic criteria for endovascular repair and experience worse perioperative and long-term survival. METHODS:We compared long-term survival, aneurysm-related mortality, and rates of endoleaks and reinterventions between male and female patients in the En...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.065
更新日期:2020-04-01 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:OBJECTIVE:Endovascular therapy for chronic mesenteric ischemia (CMI) has been increasingly utilized. Early outcomes compare favorably with open mesenteric bypass--the current gold standard. The goal of this study is documentation of intermediate-term anatomic and functional outcomes of endovascular mesenteric revascula...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.06.064
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:As first-line treatment for type 2 diabetes, metformin has gained a strong position. In addition, type 2 diabetics benefit from the fact that metformin is associated with a reduction in cardiovascular events. Nevertheless, there is a dearth of information concerning the functional role of metformin in regulat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.09.061
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Impaired venous drainage in severe chronic venous insufficiency (CVI) leads to microcirculatory overload, characterized by erythrocyte diapedesis and subsequent extravascular hemolysis, resulting in typical dermal hemosiderin deposition. We hypothesized that hemosiderin, normally absent, could be present in t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.64
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Endovascular aneurysm repair (EVAR) is an accepted approach for patients presenting with ruptured abdominal aortic aneurysm (rAAA) and suitable anatomy. The effect of anesthesia modality on mortality outcomes in rAAA has not been well described. Using the Vascular Quality Initiative database, this study comp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.090
更新日期:2019-07-01 00:00:00