Abstract:
BACKGROUND:Carotid endarterectomy is the standard of care for most patients with severe extracranial carotid bifurcation disease. However, its safety and efficacy in patients with significant surgical risk are unclear. The ARCHeR (ACCULINK for Revascularization of Carotids in High-Risk patients) trial was performed to determine whether carotid artery stenting with embolic protection is a safe and effective alternative to endarterectomy in high-surgical-risk patients. METHODS:The ARCHeR trial is a series of three sequential, multicenter, nonrandomized, prospective studies. Forty-eight sites enrolled 581 high-surgical-risk patients between May 2000 and September 2003. Patients with severe carotid artery stenosis (angiographically defined, symptomatic > or =50%, or asymptomatic > or =80%) had an ACCULINK nitinol stent implanted. The ACCUNET filter embolic protection system was added to the procedure in the final 2 studies (422 patients). The primary efficacy end point was a composite of periprocedural (< or =30 days) death, stroke, and myocardial infarction, plus ipsilateral stroke between days 31 and 365. RESULTS:The 30-day rate of death/stroke/myocardial infarction was 8.3% (95% confidence interval [CI], 6.2%-10.8%), and that of stroke/death was 6.9% (95% CI, 5.0%-9.3%). Most (23/32) strokes were minor, of which more than half (12/23) returned to baseline National Institutes of Health Stroke Scale scores within 30 days. The 30-day major/fatal stroke rate was 1.5% (95% CI, 0.7%-2.9%). No hemorrhagic strokes were observed in the study. Ipsilateral cerebrovascular accident occurred in 1.3% between 30 days and 1 year, thus giving a primary composite end point of 30-day death/stroke/myocardial infarction plus ipsilateral stroke at 1 year of 9.6% (95% CI, 7.2%-12.0%), which is below the 14.4% historical control comparator. Target lesion revascularization at 12 months and 2 years was 2.2% and 2.9%, respectively. CONCLUSIONS:The ARCHeR results demonstrate that extracranial carotid artery stenting with embolic filter protection is not inferior to historical results of endarterectomy and suggest that carotid artery stenting is a safe, durable, and effective alternative in high-surgical-risk patients.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Gray WA,Hopkins LN,Yadav S,Davis T,Wholey M,Atkinson R,Cremonesi A,Fairman R,Walker G,Verta P,Popma J,Virmani R,Cohen DJ,ARCHeR Trial Collaborators.doi
10.1016/j.jvs.2006.03.044subject
Has Abstractpub_date
2006-08-01 00:00:00pages
258-68issue
2eissn
0741-5214issn
1097-6809pii
S0741-5214(06)00745-2journal_volume
44pub_type
杂志文章abstract::Despite the risks associated with renovascular hypertension and the durable benefits of revascularization, the detection of patients with renovascular hypertension and the selection of those who will benefit from interventional therapy remains a challenge. We have previously documented the reliability of captopril ren...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1990.20329
更新日期:1990-06-01 00:00:00
abstract::Von Recklinghausen's Type 1 neurofibromatosis (NF) is a genetic disorder of neuroectodermal tissue. Arterial involvement has also been recognized. Stenotic lesions predominate, but aneurysms have been documented as well. Aortoiliac, visceral, and cervical aneurysms are well represented in the literature. Rarely noted,...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.112704
更新日期:2001-05-01 00:00:00
abstract:PURPOSE:The purpose of this study was to evaluate prospectively the results of the bifurcated Vanguard endovascular graft for abdominal aortic aneurysm (AAA) repair. METHODS:Seventy-five patients, with a median age of 69.6 years (range, 48 to 88 years) and asymptomatic AAAs, were recruited in 14 French vascular instit...
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)70130-8
更新日期:1999-08-01 00:00:00
abstract:PURPOSE:We evaluated the effects of wearing 20 to 30 mm Hg gradient thigh-length stockings during daily activity on the lower leg venous system. METHODS:Twenty-one healthy women volunteers, aged 39 +/- 12 years, were examined. One subject was clinical class 4, one was class 2, two were class 1, and the remainder were ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70007-8
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVE:Few studies have examined factors that influence an individual's decision to enter an academic medical career after residency training. We sought to evaluate whether sex, ethnicity, child care issues, and debt burden influenced residents' choice for a career in academic vascular surgery. METHODS:A 39-item We...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.11.141
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the impact of pre-existing radial artery macrocalcification (Mönckeberg type of arteriosclerosis) on patency rates of radiocephalic fistulas (RCFs) in diabetic end-stage renal disease (ESRD) patients undergoing hemodialysis. METHODS:In this observational prospective stud...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.02.042
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:The prevailing evidence calls for using chimney/snorkel endovascular repair (ch-EVAR) with one or two chimney grafts. No studies up to now focus on its applicability and results for the treatment of suprarenal aortic pathologies (SRAP). Hence, we evaluated the clinical and radiologic results of ch-EVAR treat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.08.228
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Aggressive endovascular interventions for patients without adequate full-length venous conduit have gained popularity. The purpose of this study is to evaluate the outcomes of spliced vein bypass (SVB) as primary treatment versus treatment after failed endovascular intervention (endovascular SVB [ESVB]) for i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.05.055
更新日期:2020-03-01 00:00:00
abstract::Aneurysms of the inferior vena cava are very rare. We describe a case of a saccular aneurysm of the inferior vena cava that thrombosed after vigorous exercise. This presented as deep venous thrombosis associated with a retroperitoneal mass. Laparotomy with biopsy confirmed the benign nature of this lesion, and symptom...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract:BACKGROUND:Compared with angiogenesis, arteriogenesis is a distinct process based on the remodeling and maturation of pre-existing arterioles into large conductance arteries. Therapeutic angiogenesis has been proposed as a potential treatment for ischemic atherosclerotic diseases. Since a variety of angiogenic factors ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.11.004
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to evaluate the difference in outcomes after endovascular intervention in patients with complicated type B aortic dissection (TBAD) based on ethnicity and blood pressure control. METHODS:Between 2012 and 2016, there were 126 patients who underwent endovascular procedures for c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.083
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:Repair of saccular aortic aneurysms (SAAs) is frequently recommended based on a perceived predisposition to rupture, despite little evidence that these aneurysms have a more malignant natural history than fusiform aortic aneurysms. METHODS:The radiology database at a single university hospital was searched f...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.07.002
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:Although peripheral arterial occlusive disease (PAOD) is a public health issue in the elderly population, limited population-based data are available on use of interventional procedures in Canada. We describe trends in use of interventional procedures to treat PAOD in Ontario over the past decade. METHODS:A re...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00273-8
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:Volume-outcome relationships for open abdominal aortic aneurysm (AAA) repair have received less attention in publicly funded health systems. Furthermore, the roles of surgeon seniority (years of experience) and composite volume (encompassing all major arterial cases) on outcomes after open AAA repair are less...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.10.050
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Plasma 25 hydroxycholecalciferol (vitamin D) deficiency has been associated with adverse cardiovascular outcomes in epidemiologic studies. Chronic kidney disease is associated with loss of 1α-hydroxylase and consequently vitamin D deficiency. We hypothesized that vitamin D deficiency was associated with incr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.01.037
更新日期:2014-07-01 00:00:00
abstract::Treating flush iliac artery occlusion by endovascular means can be very challenging and is a cause of technical failure requiring open surgical intervention. We describe a simple endovascular technique that can be valuable in increasing technical success and avoiding the use of a re-entry device. The technique involve...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.10.029
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVE:This study examined the outcomes of our novel concept of expanded provisional extension to induce complete attachment strategy (Petticoat) for safety, durability, and remodeling of chronic type B dissections. METHODS:Twenty patients with chronic type B aortic dissection with aneurysmal degeneration qualified...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.073
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:This study investigated the diameter of internal iliac artery (IIA) aneurysms (IIAAs) at the time of rupture to evaluate whether the current threshold diameter for elective repair of 3 cm is reasonable. The prevalence of concomitant aneurysms and results of surgical treatment were also investigated. METHODS:...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2016.06.109
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Atherosclerotic occlusive disease of the proximal vertebral artery is an important cause of cerebrovascular ischemic events with a significant associated morbidity and mortality. Endovascular treatment has emerged as a promising tool of the therapeutic armamentarium, along with medical therapy and surgical r...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2011.09.084
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:Percutaneous intervention for symptomatic renal artery atherosclerosis is rapidly replacing surgery in many centers. This study evaluated the anatomic and functional outcomes of endovascular therapy for atherosclerotic renal artery stenosis on a combined vascular surgery and interventional radiology service a...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2003.09.024
更新日期:2004-03-01 00:00:00
abstract::Mesenteric prosthetic graft infection is a rare and challenging clinical scenario. A patient is described who developed recurrent abdominal pain after occlusion of an iliomesenteric prosthetic bypass. Endovascular recanalization of the native superior mesenteric artery, which had been occluded for more than 10 years, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.10.069
更新日期:2013-05-01 00:00:00
abstract:BACKGROUND:Obesity is recognized as an independent predictor of coronary artery disease; however, its importance in peripheral arterial disease is less clear. The aim of this study was to assess the association between obesity and the severity and outcome of intermittent claudication. METHODS:This study was a prospect...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.09.006
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Thrombus extension into a deep vein after superficial venous thermoablation remains a unique complication in the treatment of superficial reflux disease of the great saphenous vein (GSV). In this study, we evaluate if catheter tip positioning or vein diameter correlate with the length of proximal patent segme...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.06.115
更新日期:2011-12-01 00:00:00
abstract::Patent false lumen after endovascular stent graft treatment of type B aortic dissection is a predictor for late death and retreatment. Between June 2008 and March 2010, five men with patent false lumen, due to a type B dissection previously treated with thoracic stent graft, underwent endovascular coiling treatment. W...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.11.110
更新日期:2011-07-01 00:00:00
abstract::This study evaluated the role of duplex scanning in the management of patients with normal or minimally diseases carotid arteries. Carotid duplex scans were interpreted according to previously established criteria and considered normal when pulsed Doppler spectral waveforms showed laminar flow or only minor flow distu...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:
更新日期:1990-10-01 00:00:00
abstract:PURPOSE:Noninvasive tests for the evaluation of chronic venous insufficiency (CVI) include quantitative photoplethysmography (QPG), air plethysmography, and duplex ultrasonography measurement of valve closure time (VCT). These tests have been shown to accurately identify the presence of CVI, define the disease, and loc...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(94)70211-x
更新日期:1994-06-01 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 effect of a rat carotid endarterectomy (CEA) on homocysteine and the metabolic enzymes methylenetetrahydrofolate reductase (MTHFR) and cystathionine beta-synthase (CBS) was studied. METHODS:Rats were placed into 7 groups: (1) no anesthesia (NA), (2) anesthesia only (AO), (3) skin opened and closed (O/C),...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2004.07.011
更新日期:2004-10-01 00:00:00
abstract::The need for quality assurance in vascular surgery can be deduced from the variability in unruptured abdominal aneurysm operative death rates in a group of patients large enough that factors influencing mortality rates other than quality of care can be controlled. Operative mortality rate for 3570 patients undergoing ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-04-01 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