Abstract:
BACKGROUND:Objective scoring systems have been developed for risk stratification of open infrarenal aneurysm repair. To date, none have been applied for the selection of patients who would most benefit from either an open or an endovascular approach. This study assessed the utility of comorbidity-based objective scoring systems for defining subgroups of patients who might most benefit from open or endovascular aneurysm repair. METHODS:A retrospective database review was performed for the period January 1999 to December 2004 to identify patients who had undergone elective open aneurysm repair (open repair) or elective endovascular aneurysm repair (EVAR). Validation of the Glasgow Aneurysm Score (GAS), the Modified Leiden Score (M-LS), and the Modified Comorbidity Severity Score (M-CSS) was performed for perioperative mortality risk in the open repair group. GAS, M-LS, and M-CSS were then calculated for the EVAR group. Differences in open repair vs EVAR mortalities were evaluated. RESULTS:During the time period, 558 patients underwent open repair and 304 underwent EVAR. Overall mortality was 4.7% for open repair patients and 2.0% for EVAR. All three scoring systems were validated to our open repair data set (C statistic: GAS, 0.72; M-LS, 0.71; M-CSS, 0.74). A score was calculated for each system that separated patients into groups of either low or high risk of death for open repair. This score (cut point) was 76.5 for the GAS, 5.2 for the M-LS, and 8 for the M-CSS. Analysis of the EVAR population revealed that patients at low medical risk for open repair did not derive statistically significant mortality benefit with EVAR; however, patients at high medical risk for open repair derived significant benefit from EVAR (GAS>76.5 mortality: open repair, 7.8%; EVAR, 1.9% [P<.01]; M-LS mortality: open repair, 8.1%; EVAR, 2.5% [P<.01]; and M-CSS mortality: open repair, 10.3%; EVAR, 3.4% [P<.025]). Despite a very small number of deaths (n=6), receiver operator curve analysis identified M-LS and M-CSS as having some predictive ability for mortality risk with EVAR (C statistic: M-LS, 0.70; M-CSS, 0.69). CONCLUSION:Three validated objective scoring systems can be used to categorize patients into two groups of medical risk: one that has excellent outcome with open repair and derives no early mortality benefit from EVAR, and another that has significant mortality with open repair and derives important benefit with EVAR.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Faizer R,DeRose G,Lawlor DK,Harris KA,Forbes TLdoi
10.1016/j.jvs.2007.02.036subject
Has Abstractpub_date
2007-06-01 00:00:00pages
1102-1108issue
6eissn
0741-5214issn
1097-6809pii
S0741-5214(07)00324-2journal_volume
45pub_type
杂志文章abstract:PURPOSE:This study was performed to test whether tenascin, a large oligomeric glycoprotein of the extracellular matrix, is present in AAA disease and whether it could play a pathophysiologic role in the development of this disease. METHODS:Tenascin immunoreactivity was investigated from samples of the aneurysmal walls...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70068-5
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the safety and efficacy of a retrograde tibial approach in revascularization of lower extremities for treatment of ischemia in anatomically challenging patients. METHODS:This is a retrospective study of 57 procedures performed between 2012 and 2016 using the retrog...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.10.114
更新日期:2019-07-01 00:00:00
abstract:PURPOSE:Posterolateral thigh perforator (PLTP) veins are part of the lateral thigh venous system, which in most people remains undeveloped. This study was designed to determine the prevalence and clinical significance of these veins. METHODS:Over the past 6 years, 2820 lower limbs with signs and symptoms of chronic ve...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(97)70085-5
更新日期:1997-11-01 00:00:00
abstract::Recent reports have suggested that cerebral angiography may not be necessary before carotid endarterectomy is performed in selected patients. To determine if arteriography provides additional information that might influence the decision to operate or the conduct of the operation, a retrospective review was performed ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To evaluate early and mid-term results of endovascular repair of acute type B aortic dissection by stent graft. METHODS:From June 2001 to May 2005, 63 patients with acute type B aortic dissection underwent stent graft implantation. The study included 59 men and 4 women with an average age of 50.4 +/- 11.4 ye...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.12.070
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:Heart rate (HR) parameters are known indicators of cardiovascular complications after cardiac surgery, but there is little evidence of their role in predicting outcome after major vascular surgery. The purpose of this study was to determine whether arrival HR (AHR) and highest intraoperative HR are associated...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2015.03.071
更新日期:2015-09-01 00:00:00
abstract::The diagnosis-related groups have encouraged physicians to become more efficient in the care of their patients; often, however, raising the question of safety. For 3 years all patients undergoing carotid endarterectomy at our institution were monitored in the intensive care unit for 24 hours and the majority were disc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(92)90056-e
更新日期:1992-12-01 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: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:PURPOSE:Aortic Customize is a new concept for endovascular aortic aneurysm repair in which a non polymerized elastomer is injected to fill the aneurysm sac around a balloon catheter. The aim of this in vitro study was to investigate the extent of aneurysm wall stress reduction by the presence of a noncompliant elastome...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.08.093
更新日期:2010-05-01 00:00:00
abstract:INTRODUCTION:Despite the frequent performance of minor foot amputations in patients with lower extremity vascular disease, little is known regarding the rate of conversion to major amputations and the role of bypass graft timing in relation to amputation. METHODS:Between January 1990 and December 2001, 670 patients un...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.05.003
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Left renal vein division and ligation (LRVDAL) is performed to facilitate complex abdominal aortic surgery. Surgeons restore continuity of the vein due to concern that ligation could cause renal compromise or hematuria. However, we report the short and long-term safety of left renal vein division and ligatio...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.04.041
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVES:To compare the pattern of daily ambulatory activity in men and women with intermittent claudication, and to determine whether calf muscle hemoglobin oxygen saturation (StO2) is associated with daily ambulatory activity. METHODS:Forty men and 41 women with peripheral arterial disease limited by intermittent ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.05.115
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the clinical value and reproducibility of laser Doppler (LD) versus photoplethysmography (PPG) in the measurement of the systolic toe blood pressure. METHODS:Toe blood pressure was measured in 60 patients in different stages of peripheral vascular disease with simult...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.108009
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVE:This study was conducted to investigate factors influencing the outcome of all open operations for aortoiliofemoral (AIF) revascularization performed by a single surgeon at a tertiary referral center. METHODS:The series included 355 direct reconstructions and 181 extra-anatomic bypass (EAB) grafts in 339 men...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.09.065
更新日期:2007-03-01 00:00:00
abstract::Several different modes of achieving a bloodless operating field by proximal and distal occlusion of blood vessels have been described. Vascular clamps, vessel loops, intraluminal occluding devices, and tourniquets have been used to control the tibial and pedal vessels but may cause injury or fail to control heavily c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.03.055
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:Whereas thermal ablation of incompetent saphenous veins is highly effective, all heat-based ablation techniques require the use of perivenous subfascial tumescent anesthesia, involving multiple needle punctures along the course of the target vein. Preliminary evidence suggests that cyanoacrylate embolization...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jvs.2014.11.071
更新日期:2015-04-01 00:00:00
abstract::An aberrant right subclavian artery arising distal to the origin of the left subclavian artery is the most common anomaly of the aortic arch. Degenerative diseases of aberrant subclavian arteries including aneurysms and occlusive disease have been reported previously. We believe that this case is the first reported ca...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70173-3
更新日期:1994-11-01 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: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::Previous studies have suggested that topically applied platelet-derived wound healing factors (PDWHF) accelerate wound healing by stimulating angiogenesis, fibroblast proliferation, and collagen synthesis. To assess the ability of platelet factors to facilitate healing of chronic cutaneous ulcers we performed a random...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-10-01 00:00:00
abstract::The endothelial injury induced by the placement of a synthetic graft has been implicated as a stimulus for the development of MIH. In this study we compared the degree of EC coverage and the early SMC-PR in the arterial segments proximal and distal to 2 mm diameter PTFE grafts that had been placed in rabbit carotid ar...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0050389
更新日期:1987-02-01 00:00:00
abstract::Aortobifemoral bypass (ABF) is the preferred operation for patients with bilateral aortoiliac occlusive disease, but for those with unilateral occlusion without significant stenosis of the contralateral iliac artery, alternative reconstructions, such as femorofemoral (FF) or iliofemoral (IF) bypass have been advocated...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.1988.avs0080211
更新日期:1988-09-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate the long-term safety and efficacy of the titanium Greenfield filter-modified hook for prevention of pulmonary embolism. METHODS:We conducted a prospective study in 173 patients from four institutions who underwent clinical examination, abdominal radiography, and duplex...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90146-5
更新日期:1994-09-01 00:00:00
abstract:PURPOSE:To describe an exclusion endoluminal technique for management of abdominal aortic aneurysms among high-risk patients with complex anatomic features. METHODS:From January 1995 to December 1996, among 143 patients with infrarenal abdominal aortic aneurysm treated by means of endograft placement, 9 (6.3%) had com...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70090-4
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the clinical outcome of patients undergoing catheter-directed thrombolysis (CDT) for lower extremity arterial bypass (LEAB) occlusion. METHODS:A retrospective review was performed of two university-based practices from 1988 to 2001. All patients with LEAB occlusion ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2003.42
更新日期:2003-01-01 00:00:00
abstract::As CT scanning has evolved as a reliable clinical tool, the use of angiography in the diagnosis of aortic aneurysmal disease has diminished. Fewer than 25% of patients with aortic aneurysmal disease undergo aortic angiographic evaluation at our institution. A prospective clinical study was undertaken to assess the val...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to analyze our 25-year experience with surgical treatment of visceral artery aneurysms (VAAs), with particular attention paid to early and long-term results. MATERIALS AND METHODS:From January 1982 to September 2007, 55 patients (32 males, 58%, and 23 females, 42%) underwent surgica...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.03.043
更新日期:2008-08-01 00:00:00
abstract::Arterial-ureteral fistulas are rare complications of iliac artery reconstruction or ureteral manipulation. The diagnosis should be considered in patients with intermittent hematuria who have had ureteral catheterization, arterial bypass, or nephrectomy. The following case demonstrates the difficulty in making the diag...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::In 2008, the top priority in our division's 5-year strategic plan was "to become an internationally recognized center of excellence for the endovascular treatment of complex aortic pathology extending from the aortic valve to the external iliac artery." Five components were identified as "most critical" to achieve thi...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.08.121
更新日期:2015-03-01 00:00:00