Abstract:
OBJECTIVE:Postplacement cost of surveillance and secondary procedures over 5 years increases the global cost of endovascular aortic aneurysm repair (EVAR) by nearly 50%. This study identified and assessed the reimbursement received for long-term postplacement costs after EVAR. METHODS:Between December 1995 and June 2007, 360 patients underwent EVAR at a single institution. The reimbursement collected from charges of postplacement surveillance and secondary procedures related to the aneurysmal disease was evaluated and compared against the actual costs. All amounts were converted to year 2007 dollars. To minimize costs associated with the early learning curve, the initial 50 EVAR patients between December 1995 and 1998 were excluded. Patients with <1 year follow-up were also excluded. Data are expressed as mean +/- standard error. RESULTS:The mean follow up after EVAR for 152 patients was 38.8 +/- 1.8 months. Medicare, capitated insurance, and commercial insurance provided coverage for 85 (56.0%), 49 (32.2%), and 18 (11.8%) patients, respectively. The cumulative 5-year postplacement reimbursement received per patient was $9792 meeting 81.4% of the cumulative cost of $12,027 for a net loss of $2235 per patient. Although 123 (80.9%) patients without secondary procedures generated a 5-year cumulative gain of $1830 per patient, 29 (19.1%) patients with secondary procedures averaged a 5-year cumulative loss of $9378 per patient. The average reimbursement rate over the 5-year period was 35.8% +/- 0.6%, with the lowest reimbursement rate seen in patients with Medicare at 31.6% +/- 0.7%. CONCLUSION:Current reimbursement is not sufficient to meet the costs associated with long-term surveillance and needed secondary procedures after EVAR. Inadequate reimbursement of costs associated with secondary procedures was the primary driver for the net institutional loss. Reimbursement for outpatient radiological procedures generated a modest surplus.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Kim JK,Tonnessen BH,Noll RE Jr,Money SR,Sternbergh WC 3rddoi
10.1016/j.jvs.2008.07.064subject
Has Abstractpub_date
2008-12-01 00:00:00pages
1390-5issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(08)01223-8journal_volume
48pub_type
杂志文章abstract:PURPOSE:We evaluated the day-to-day variability of transcutaneous oxygen tension (tcPO2) in patients with diabetes mellitus and peripheral arterial occlusive disease who were at risk for chronic foot ulceration. METHODS:The tcPO2 was measured in the morning once daily for 3 consecutive days in 10 male patients with di...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115799
更新日期:2001-08-01 00:00:00
abstract:PURPOSE:This study was conducted to assess the efficacy of antibiotic-loaded polymethylmethacrylate (PMMA) beads in the management of lower extremity extracavitary prosthetic arterial graft infection. METHODS:This was a retrospective review of 34 patients treated for vascular surgical site (VSS) infections involving 3...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.056
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:Determining operative risk in patients undergoing aortic surgery is a difficult process, as multiple variables converge to affect overall mortality. Patient frailty is certainly a contributing factor, but is difficult to measure, with surgeons often relying on subjective or intuitive influences. We sought to...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.10.111
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:Creating a diverse workforce is paramount to the success of the surgical field. A diverse workforce allows us to meet the health needs of an increasingly diverse population and to bring new ideas to spur technical innovation. The purpose of this study was to assess trends in workforce diversity within vascul...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.12.063
更新日期:2020-12-18 00:00:00
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:OBJECTIVE:Deep venous arterialization (DVA) is a technique aimed at providing an option for chronic limb-threatening ischemia patients with no options except amputation. In patients with no outflow distal targets permitting bypass, DVA involves creating a connection between a proximal arterial inflow and a distal venou...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2019.10.085
更新日期:2020-06-01 00:00:00
abstract::Aneurysms of the infrapopliteal arteries are rare and commonly associated with trauma. Most appear as false aneurysms. Because they are quite rare events, we describe for the first time in the English-language literature two cases of a combination of true aneurysms of the popliteal and tibial arteries. Symptoms at ini...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(96)70104-0
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:Previous studies demonstrating a correlation between low shear stress (tau = 5-15 dyne/cm(2)) and experimental vein graft neointimal thickening (NIT) support the role of low tau in vein graft failure. However, a simple linear relationship between low tau and NIT would underestimate the degree of NIT evident i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.114819
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Human saphenous vein (HSV) is the autologous conduit of choice for peripheral vascular reconstructions. However, vasospasm can lead to early graft failure. The leading cause of delayed graft failure is intimal hyperplasia. OBJECTIVE:To develop a proteomic approach to prevent vein-graft spasm and intimal hyp...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.03.028
更新日期:2004-07-01 00:00:00
abstract::A nonrandomized prospective clinical study was undertaken to evaluate the technique and efficacy of in vitro endothelial cell lining of synthetic grafts. Twenty-six patients (10 men and 16 women with a mean age of 68.4 years; range, 49 to 80 years) with end stage chronic peripheral vascular disease requiring reoperati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1992-03-01 00:00:00
abstract:OBJECTIVE:The use of cross-sectional area (CSA) measurements obtained from computed tomographic angiography (CTA) for the calculation of carotid artery stenosis has been suggested but not yet validated in a large population. The objective of this study was to determine whether CTA-derived CSA measurements were able to ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.02.031
更新日期:2013-09-01 00:00:00
abstract::True aneurysms of the innominate artery are rare. Successful axial reconstruction in the past has required a combined cervical and transthoracic approach with placement of a prosthetic graft. We describe herein the occurrence of an innominate artery aneurysm that extended to and involved the proximal common carotid ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.06.034
更新日期:2007-12-01 00:00:00
abstract::Heavily calcified aortic and iliac arteries are occasionally encountered that will not yield to currently available needles and sutures. The use of the Hall drill to penetrate such arterial walls, stopping short of the adventitial layer, and Teflon strips to buttress the anastomosis, is an effective means of dealing w...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract:OBJECTIVE:We sought to determine the effects of renal insufficiency on thoracic endovascular aortic repair (TEVAR) outcome and to identify predictors for adverse events. METHODS:Eighty-four patients with renal insufficiency (creatinine >or=1.5 mg/dL) were analyzed from a prospective TEVAR database from April 1, 1999, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.07.070
更新日期:2009-01-01 00:00:00
abstract::The patient with bilateral internal carotid artery occlusion is at high risk for development of stroke. Medical management and extracranial-intracranial bypass do not appear to offer these patients any protection from symptoms of cerebrovascular insufficiency. Our initial treatment in 11 of 12 patients who had this pa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050715
更新日期:1987-05-01 00:00:00
abstract::Carotid body tumors (CBTs) are rare, usually benign, neoplasms of the extra-adrenal paraganglion system. They are almost always nonfunctional. The diagnosis is generally confirmed by an angiogram that shows a vascular tumor enlarging the space between the internal and external carotid arteries. A 55-year-old man with ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:
更新日期:1987-03-01 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: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:BACKGROUND:Midaortic syndrome (MAS) is a rare condition characterized by stenosis of the abdominal aorta. Patients with disease refractory to medical management will usually require either endovascular therapy or surgery with use of prosthetic graft material for bypass or patch angioplasty. We report our early experien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.09.052
更新日期:2018-06-01 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:Black patients have a higher mortality rate than nonblacks after abdominal aortic aneurysm repair. We sought to understand the factors responsible for this racial disparity in the mortality rate after aneurysm repair. METHODS:The Medicare database (2001-2006) was used to identify 160,785 patients undergoing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.05.020
更新日期:2009-10-01 00:00:00
abstract::Antithrombin (AT III), a major circulating anticoagulant, may be influenced by ischemia-induced changes in microvascular integrity and contribute to localized hypercoagulability. In a nonheparinized intact canine hindlimb model we determined AT III activity by chromogenic substrate assay (S-2238); coagulation changes ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1989.vs0090740
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVE:This randomized prospective study was designed to compare the effectiveness of treating superficial femoral artery occlusive disease percutaneously with expanded polytetrafluoroethylene (ePTFE)/nitinol self-expanding stent grafts vs surgical femoral-to-above knee (AK) popliteal artery bypass with synthetic gr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2006.08.074
更新日期:2007-01-01 00:00:00
abstract:BACKGROUND:Surgical skills and simulation courses are emerging to meet the demand for vascular simulation training for vascular surgical skills, but their educational effect has not yet been described. We sought to determine the effect of an intensive vascular surgical skills and simulation course on the procedural kno...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.12.065
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVES:Recurrent stenosis after carotid endarterectomy (CEA), previously reported to occur in 1%/year after operation, is the finite limitation of CEA. Eversion endarterectomy has a perceived lower incidence of recurrent stenosis, although data to support this contention are conflicting. The goal of the present stu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.02.055
更新日期:2007-07-01 00:00:00
abstract:PURPOSE:The geometry of carotid endarterectomy (CEA) reconstruction is a major determinant of carotid bifurcation hemodynamics that, in turn, may play a significant role in the likelihood of early postoperative thrombosis and early and late restenosis. The purpose of this study was to measure the geometry of various ty...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70259-3
更新日期:1997-03-01 00:00:00
abstract::Peripheral arterial disease (PAD) is well recognized as a marker for systemic atherosclerosis. Platelets play an essential role in all stages of the disease, contributing to both thrombosis and the development of atherosclerosis. Medication regimens to optimize outcomes in both patients who are to undergo revasculariz...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2014.07.006
更新日期:2014-10-01 00:00:00
abstract:PURPOSE:The purpose of this article is to assess the healing qualities of presealed knitted polyester prostheses. METHODS:Thoracic aortic replacement was performed with grafts with four different coating materials-collagen (CP), albumin (AP), and two with gelatin (GP1/GP2)-in four groups of 15 pigs each. Two weeks, 6 ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1993.39245
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:Postoperative ischemic colitis (IC) can be a serious complication following infrarenal abdominal aortic aneurysm (AAA) repair. We sought to identify risk factors and outcomes in patients developing IC after open AAA repair and endovascular aneurysm repair (EVAR). METHODS:The American College of Surgeons Nati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.10.064
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate early and late results of the Anaconda aortic endograft (Vascutek, Terumo, Inchinnan, Scotland) in a single-center experience. METHODS:From September 2005 to March 2012, patients underwent endovascular aortic repair for abdominal aortic aneurysm (AAA) with Anaconda...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.04.073
更新日期:2014-11-01 00:00:00