Abstract:
INTRODUCTION:Ruptured descending thoracic aortic aneurysm (rDTAA) is associated with high mortality rates. Data supporting endovascular thoracic aortic aneurysm repair (TEVAR) to reduce mortality compared with open repair are limited to small series. We investigated published reports for contemporary outcomes of open and endovascular repair of rDTAA. METHODS:We systematically reviewed all studies describing the outcomes of rDTAA treated with open repair or TEVAR since 1995 using MEDLINE, Cochrane Library CENTRAL, and Excerpta Medica Database (EMBASE) databases. Case reports or studies published before 1995 were excluded. All articles were critically appraised for relevance, validity, and availability of data regarding treatment outcomes. All data were systematically pooled, and meta-analyses were performed to investigate 30-day mortality, myocardial infarction, stroke, and paraplegia rates after both types of repair. RESULTS:Original data of 224 patients (70% male) with rDTAA were identified: 143 (64%) were treated with TEVAR and 81 (36%) with open repair. Mean age was 70 +/- 5.6 years. The 30-day mortality was 19% for patients treated with TEVAR for rDTAA compared 33% for patients treated with open repair, which was significant (odds ratio [OR], 2.15, P = .016). The 30-day occurrence rates of myocardial infarction (11.1% vs 3.5%; OR, 3.70, P < .05), stroke (10.2% vs 4.1%; OR, 2.67; P = .117), and paraplegia (5.5% vs 3.1%; OR, 1.83; P = .405) were increased after open repair vs TEVAR, but this failed to reach statistical significance for stroke and paraplegia. Five additional patients in the TEVAR group died of aneurysm-related causes after 30 days, during a median follow-up of 17 +/- 10 months. Follow-up data after open repair were insufficient. The estimated aneurysm-related survival at 3 years after TEVAR was 70.6%. CONCLUSION:Endovascular repair of rDTAA is associated with a significantly lower 30-day mortality rate compared with open surgical repair. TEVAR was associated with a considerable number of aneurysm-related deaths during follow-up.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Jonker FH,Trimarchi S,Verhagen HJ,Moll FL,Sumpio BE,Muhs BEdoi
10.1016/j.jvs.2009.10.103subject
Has Abstractpub_date
2010-04-01 00:00:00pages
1026-32, 1032.e1-1032.e2issue
4eissn
0741-5214issn
1097-6809pii
S0741-5214(09)02250-2journal_volume
51pub_type
杂志文章,meta分析,评审abstract:OBJECTIVE:Myocardial ischemia and infarction after surgery remain leading causes of morbidity and mortality in patients undergoing major vascular surgery. B-type natriuretic peptide has been shown to predict early postoperative cardiac events in patients undergoing major noncardiac surgery. We aimed to determine if N-t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.015
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVE:The absence of endothelial cells at the luminal surface of a prosthetic vascular graft potentiates thrombosis and neointimal hyperplasia, which are common causes of graft failure in humans. This study tested the hypothesis that pretreatment with chronic in vitro shear stress enhances subsequent endothelial ce...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70357-5
更新日期:1999-01-01 00:00:00
abstract:PURPOSE:Prognostic information about graft outcome, obtained by using a new method for intraoperative measurement of vascular impedance, was evaluated. METHODS:Hydraulic impedance was measured in 136 infrainguinal bypass grafts that were entered into a multicenter trial. Seventy femoropopliteal and 66 femorocrural pol...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0741-5214(99)70141-2
更新日期:1999-08-01 00:00:00
abstract:PURPOSE:It has been suggested that propranolol has unique effects that slow aneurysm expansion by remodeling the structural proteins of the aorta. These effects are believed to be independent of blood pressure reduction, a hypothesis we tested in this investigation with a rat model of abdominal aortic aneurysm (AAA). ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90004-3
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVES:To assess outcomes and develop duplex scan criteria that will reliably determine the luminal status of covered and uncovered renal stents following fenestrated and branched endovascular repair. METHODS:A prospective database of patients treated with fenestrated and branched endografts between 2001 and 2006 ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.11.024
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:Locoregional anesthesia is an effective method for evaluating cerebral function during carotid endarterectomy (CEA). Landmark-guided regional anesthesia (RA) is currently used for CEA and can provoke substantial perioperative hypertension. Ultrasound-guided RA (US-RA) is a new method for performing RA in CEA;...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2015.02.036
更新日期:2015-07-01 00:00:00
abstract::An 86-year-old man presented with a recurrent groin lymphocele following endovascular abdominal aortic aneurysm repair using an aorto-uni-iliac reconstruction with polytetrafluoroethylene femoral-femoral crossover. Following this procedure, the patient developed a groin lymphocele. This fluid collection was treated wi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.04.049
更新日期:2014-04-01 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::Polytetrafluoroethylene interposition grafts were used for carotid reconstruction in 26 operations performed in 23 patients during a 7-year period. There were 10 men and 13 women with a mean age of 66 years. The indication for interposition graft placement was recurrent stenosis with inability to perform endarterectom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1992.39750
更新日期:1992-10-01 00:00:00
abstract::Two hundred seventy-one of 1509 patients who underwent thoracoabdominal aortic repairs had either celiac or superior mesenteric or renal artery occlusive disease. These latter patients were treated by endarterectomy or bypass between June 20, 1960 and Jan. 10, 1991. After 1987, the 30-day survival rate was 93% (79 of ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Diabetic foot problems and their complications are a medical and economic challenge to the health care system and require an aggressive multidisciplinary approach to achieve limb salvage. The goals of this review article are to delve into this comprehensive topic and summarize key points regarding diabetic f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2009.08.043
更新日期:2010-02-01 00:00:00
abstract::Despite the proven experimental success of endothelial cell seeding of prosthetic vascular grafts, the process has not been widely accepted for clinical use because of its complexity and the need for a relatively large length of autologous vein to provide the requisite number of cells. Using autologous endothelial cel...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030264
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze radiation risk to patients during endovascular aneurysm repair (EVAR) using mobile C-arm (MA) or fixed C-arm (FA) fluoroscopes and to describe the dose distribution during the different phases of the procedure. METHODS:Patients treated with EVAR using a single stent...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.05.020
更新日期:2018-12-01 00:00:00
abstract::Thirty-nine patients with renal artery aneurysm (RAA) were seen over a period of 15 years. Among 20 women and 19 men, 31 were found to have solitary aneurysms, and eight had multiple RAA. Thirty-three patients had diastolic hypertension; nine of them proved to be of renovascular origin. Of the 18 patients who underwen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1989-01-01 00:00:00
abstract::Lymphoceles and lymph fistulas are common complications of femoral exposure for vascular procedures. Three patients who required readmission after their vascular interventions were treated with negative pressure wound therapy. Once adequate control of the drainage was obtained, the patients were discharged home with a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.10.043
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Endovascular treatment of ruptured abdominal aortic aneurysms (r-AAAs) has the potential to offer improved outcomes. As our experience with endovascular repair of r-AAA evolved, we recognized that the development of abdominal compartment syndrome (ACS) led to an increase in morbidity and mortality. We theref...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.08.033
更新日期:2005-12-01 00:00:00
abstract::Aortic and renal vascular reconstruction often involve significant renal ischemia. Profound hypothermia during renal ischemia preserves renal tissue. However, in the clinical setting of vascular reconstruction specific attempts at cooling the kidney are often impractical, and renal ischemia frequently occurs at physio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1992-04-01 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::Pseudoaneurysm formation after carotid endarterectomy is a rare but potentially lethal complication. The risks for embolization and continued expansion necessitate repair. Traditional surgical repair of carotid pseudoaneurysms is often technically demanding, and is associated with relatively high morbidity and mortali...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.08.019
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Previous studies have suggested that open repair of arterial injuries in very young children often leads to less satisfactory outcomes. The aim of this study is to describe a decade's experience in the management of pediatric arterial trauma of the limbs, with an additional specific objective to evaluate the...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.09.031
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to develop a protocol for evaluation of patients suspected of having deep venous thrombosis (DVT) who came to the hospital after normal noninvasive vascular laboratory (NIVL) working hours in an attempt to both retain registered vascular therapists and provide excellent patient c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.125021
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:Preoperative testing for carotid endarterectomy (CEA) often includes blood typing and antibody screen (T&S). In our institutional experience, however, transfusion for CEA is rare. We assessed transfusion rate and risk factors in a national clinical database to identify a cohort of patients in whom T&S can saf...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.04.059
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:Endoleak is a common complication of endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA) but can be detected only through prolonged follow-up with repeated aortic imaging. This study examined the potential for circulating matrix metalloproteinase 9 (MMP9), osteoprotegerin (OPG), D-dimer, h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.06.090
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Because vein graft neointimal hyperplasia engenders vein graft failure, and because most vein graft neointimal cells derive from outside the vein graft, we sought to determine whether vein graft neointimal hyperplasia is affected by activity of the CXC chemokine receptor-4 (CXCR4), which is important for bone...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.03.254
更新日期:2012-11-01 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:BACKGROUND:Patients with tumors in the limbs who undergo surgical treatment may have involvement of major vessels. Major arteries are always reconstructed for limb salvage. Major veins may be reconstructed to avoid the onset of venous hypertension signs and symptoms. The objective of this study was to analyze the resul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.07.033
更新日期:2006-11-01 00:00:00
abstract::This article is a report on a case of a giant pseudoaneurysm of the inferior gluteal artery where important features of the diagnosis, with special mention of magnetic resonance imaging and arteriography, are discussed. Surgical therapy is the treatment of choice for these lesions. Historically, proximal arterial cont...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080716
更新日期:1988-12-01 00:00:00
abstract::Large veins (superior and inferior vena cava, portal vein) have been replaced successfully with lower extremity deep veins (superficial femoral-popliteal). Femoropopliteal bypass with superficial femoral-popliteal veins has been reported to give excellent long-term results. Nevertheless, this source of autogenous vein...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1991.31965
更新日期:1991-11-01 00:00:00
abstract:OBJECTIVES:Carotid artery stenting (CAS) has been recommended as an alternative to carotid endarterectomy (CEA) by some clinicians. However, recently published clinical trials have reported 30-day stroke and death rates of 10% to 12%. This prompted review of our experience with CAS in patients at high risk, to document...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(02)75448-7
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:Distal embolization (DE) during peripheral arterial endovascular interventions is a well-known complication that is poorly studied. The goal of this study was to determine the incidence, risk factors, and effect of DE on the outcomes of lower extremity endovascular interventions (LEIs). METHODS:All LEIs betw...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2017.01.032
更新日期:2017-07-01 00:00:00