Abstract:
BACKGROUND:The national burden of venous disease and use of ultrasound (US) in the outpatient and emergency department (ED) settings has not been well described. The objective of this study is to describe venous disease in the outpatient and ED settings nationally as well as to characterize the use of US for diagnosis of venous disease, including phlebitis. METHODS:Data from the 1997 to 2006 National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) were compiled, and complex sampling methods were used to describe the number of outpatient and ED visits for adults given a diagnosis of venous disease or phlebitis by ICD-9 coding. Logistic regression analysis with calculated odds ratios are used to examined patient visit characteristics and use of US. RESULTS:During the 10 years studied, an office or ED visit for venous disease occurred over 46 million times, for an average of 4.6 million visits per year, with this rate increasing from 4.03 million to 5.71 million per year (odds ratio [OR] 1.01, confidence interval [CI] 1.00-1.01). The majority of these patients were seen by specialists, such as surgeons or cardiologists, but a significant number were also seen by primary care providers (PCP). There were 2 million office visits (PCP and specialists) on average per year with no significant increase. There were approximately 236,000 ED visits for deep vein thrombosis (DVT) on average per year, which showed a small increase (OR 1.01, CI 1.00-1.01). Visits for DVT and phlebitis were as likely to be seen by PCPs as ED physicians. Non-DVT venous disease is much more likely to be seen by a surgeon (OR 4.88, CI 3.53-6.74) than a PCP. DVT is much less likely to be diagnosed by a specialist (OR 0.27, CI 0.18-0.29) than a PCP. Insurance status and geographic region were not associated with DVT or non-DVT venous disease diagnosis. CONCLUSIONS:Nationally, a significant and growing number of patients with venous disease are being seen in the outpatient setting by PCPs and specialists. A significant number of patients with DVT are being seen in the outpatient setting, but without a trend away from care in the ED over the 10-year study period. Additionally, the majority of patients with DVT diagnosis do not seem to be getting ultrasounds at the same visit. Many of these patients are being seen by PCPs who may require additional training and infrastructure for appropriate patient care.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Barnes GD,Gafoor S,Wakefield T,Upchurch GR Jr,Henke P,Froehlich JBdoi
10.1016/j.jvs.2009.12.070subject
Has Abstractpub_date
2010-06-01 00:00:00pages
1467-73issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(10)00035-2journal_volume
51pub_type
杂志文章abstract:BACKGROUND:Patients with venous thromboembolic disease are treated with anticoagulation or vena cava filter placement to prevent pulmonary embolism. A recent report suggested that filter placement may increase the risk of recurrent deep venous thrombosis (DVT) and prompted a review of our experience. METHODS:Prospecti...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.111733
更新日期:2001-03-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the results of carotid endarterectomy (CEA) in a young population with premature atherosclerosis with the results of an older control group, examining perioperative morbidity and mortality data, recurrent stenosis and symptoms, late stroke, and survival data. METHODS:We...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0741-5214(97)70037-5
更新日期:1997-09-01 00:00:00
abstract:OBJECTIVE:The external carotid artery (ECA) serves as a major collateral pathway for ophthalmic and cerebral artery blood supply. It is routinely examined as part of carotid duplex ultrasound, but criteria for determining ECA stenosis are poorly characterized and typically extrapolated from internal carotid artery data...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.10.099
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:Critical limb ischemia (CLI) patients who are unsuitable for intervention face the dire prospect of primary amputation. Sequential compression biomechanical device (SCBD) therapy provides a limb salvage option for these patients. This study assessed the outcome of SCBD in severe CLI patients who otherwise wo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.02.057
更新日期:2011-08-01 00:00:00
abstract::Vascular reconstructions in heavily contaminated fields can be particularly challenging. Prosthetic grafts are rarely suitable because of the risk of infection, but the saphenous vein is usually too small for isodiametric replacement of large arteries and veins. Although surgeons rarely consider the use of spiral vein...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1988.avs0080442
更新日期:1988-10-01 00:00:00
abstract:OBJECTIVE:Lifelong imaging follow-up is essential to the safe and appropriate management of patients who undergo endovascular abdominal aortic aneurysm repair (EVAR). We sought to evaluate the rate of compliance with imaging follow-up after EVAR and to identify factors associated with being lost to imaging follow-up. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.06.006
更新日期:2015-01-01 00:00:00
abstract::Late presentation of aortic injuries secondary to internal fixation hardware is uncommon and generally associated with pseudoaneurysm formation. We herein present a case of transmural migration of a pedicle screw into the descending thoracic aorta, which was revealed incidentally by computed tomography scan after almo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.12.084
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of stripping the below knee great saphenous vein (GSV) segment on varicose vein recurrence as well as any disability induced after saphenous nerve injury (SNI) during a 5-year period. METHODS:One hundred and six limbs (86 patients, 64 female, mean age 46 years), that underwent GSV s...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/j.jvs.2007.07.055
更新日期:2007-12-01 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:Prospective validation of prognostic scoring systems for ruptured abdominal aortic aneurysm (AAA) is lacking. This study assesses the validity of three established risk scores and a new prognostic index. METHOD:Patients admitted with ruptured AAA during a 26-month period (August 2002-December 2004) were rec...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.10.031
更新日期:2008-02-01 00:00:00
abstract:PURPOSE:The clinical success and patency of central and peripheral venous stents in patients with symptomatic venous obstruction (SVO) were assessed. METHODS:The records of patients with SVO treated with venous stents from 1992 to 1999 were reviewed. Demographic and procedural variables were analyzed to determine thei...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1067/mva.2000.107988
更新日期:2000-10-01 00:00:00
abstract:PURPOSE:Recently, we have reported that lipid peroxidation specific to oxygen free radical-mediated injury increased immediately after reperfusion of human liver allografts. However, in the human liver transplantation setting it was impossible to disassociate the contributions to lipid peroxidation caused by the warm a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70074-5
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:The optimal prophylactic strategy and treatment regimen for deep venous thrombosis (DVT) in hospitalized pediatric patients is not clearly established. This study assessed the incidence, risk factors, and treatment patterns for DVT among pediatric patients admitted to a hospital ward. METHODS:Children (aged ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.11.054
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Integrity of the abdominal aortic aneurysm (AAA) neck is crucial for the long-term success of endovascular AAA repair (EVAR). However, suitable tools for reliable assessment of changes in small aortic volumes are lacking. The purpose of this study was to assess the intraobserver and interobserver variability...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.10.004
更新日期:2007-02-01 00:00:00
abstract:PURPOSE:The purpose of this study was to investigate the hypothesis that abdominal aortic aneurysm (AAA) expansion may be slowed by beta-adrenergic antagonists. METHODS:One hundred twenty-one patients with infrarenal AAA were monitored with serial aortic ultrasound examinations. Eighty-three patients received no beta-...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70048-6
更新日期:1994-04-01 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:PURPOSE:To determine which patients require subfascial endoscopic perforator surgery (SEPS) in addition to saphenous surgery to correct pathologic outward flow within incompetent medial calf perforating veins (IPVs). METHODS:Sixty-two limbs of 47 patients undergoing sapheno-femoral ligation, stripping of the long saph...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70058-8
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to examine the fate of aneurysmal iliac arteries managed during endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm (AAA). METHODS:We analyzed data from the Cook Zenith trial. Follow-up was at 1 month, 6 months, 12 months, and then annually for 5 years. Patients w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.08.062
更新日期:2011-02-01 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:BACKGROUND:Endovascular intervention has become a frequently used treatment of critical limb ischemia (CLI) in recent times. The recent Bypass vs Angioplasty in Severe Ischaemia of the Leg (BASIL) trial consensus recommended endovascular treatment as a first-line treatment in patients who have a life expectancy that wa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.03.277
更新日期:2014-09-01 00:00:00
abstract::Patency of vein grafts may be influenced by the medium in which they are stored temporarily. We compared saline solution vs blood on prostanoid production and maintenance of endothelium in canine veins after 1 hour of storage at 23 degrees C with 0.2 mg/ml of papaverine. Spontaneous and arachidonate-stimulated prostag...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract::Eighteen patients whose mean age was 61 years were referred to us with acute aortic occlusion from 1977 to 1985. Ten patients had cardiac emboli (group I) and eight had aortoiliac occlusive disease (group II). Fourteen of these patients had paresis or paralysis. Diagnosis was prompt but the time lapse from onset of sy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
abstract:PURPOSE:The outcome of infrainguinal bypass surgery for limb salvage has traditionally been assessed by graft patency rates, limb salvage rates, and patient survival rates. Recently, functional outcome of limb salvage surgery has been assessed by patient ambulatory status and independent living status. These assessment...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70356-8
更新日期:1998-02-01 00:00:00
abstract:PURPOSE:A prospective controlled study was undertaken to determine how peripheral vascular disease (PVD) influences flow in the deep veins of the leg. METHODS:Eighty-nine patients with peripheral vascular disease and 35 age-matched control subjects were studied. The popliteal vein diameter and flow velocity were measu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70247-8
更新日期:1999-06-01 00:00:00
abstract:PURPOSE:Over the past 20 years, there have been numerous advances in our ability to detect and to treat abdominal aortic aneurysms (AAAs). We hypothesized that these advances would lead to (1) an increase in the rate of elective repair and a decrease in the incidence of ruptured AAA (rAAA) and (2) a decrease in operati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.111691
更新日期:2000-12-01 00:00:00
abstract:BACKGROUND:Peripheral arterial disease is a significant problem worldwide. In developing countries such as India, the increased incidence of smoking and other forms of nicotine intake has resulted in a large proportion of young individuals with Buerger's disease. The results of surgical and endovascular treatment for t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.09.005
更新日期:2008-12-01 00:00:00
abstract:BACKGROUND:We explored the role of angiotensin II in determining the histomorphometric features of plaque stability in apolipoprotein E-deficient mice submitted to ligation of the carotid artery. METHODS:Six-month-old apolipoprotein E-deficient mice underwent ligation of the common left carotid artery and were immedia...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.04.033
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Prostaglandin (PG) E(2) (PGE(2)) appears to have a role in stimulating production of interleukin-6 (IL-6) and apoptosis of smooth muscle cells in diseased aortic tissue. These actions are mediated by cellular receptors for PGE(2) EP receptors. OBJECTIVE:This study was undertaken to identify EP receptors ass...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00339-2
更新日期:2003-08-01 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:OBJECTIVE:Peripheral artery disease is the second most common cardiovascular disease. It can often occur in complex form when there is a presence of long, diffuse, and multiple lesions. Current treatments use either single long drug-coated balloons (DCBs) or multiple DCBs; however, treatment success is limited. The pur...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.04.494
更新日期:2020-05-01 00:00:00