Abstract:
PURPOSE:Although many studies have well established that carotid endarterectomy (CEA) is beneficial in selected patients with severe carotid disease, only a few large studies have focused on the durability of the surgical procedure. Carotid artery angioplasty and stenting (CAS) has recently been proposed as a potential alternative to CEA. We analyzed the incidence of late occlusion and recurrent stenosis after CEA. METHODS:Over 13 years 1000 patients underwent 1150 CEA procedures to treat symptomatic and asymptomatic high-grade carotid stenosis. CEA procedures involving either traditional CEA with patching (n = 302) or eversion CEA (n = 848) were all performed by the same surgeon, with patients under deep general anesthesia and cerebral protection involving continuous electroencephalographic monitoring for selective shunting. All patients underwent postoperative duplex ultrasound scanning and clinical follow-up at 1, 6, and 12 months, and yearly thereafter. New neurologic events, late occlusions, and recurrent stenoses 50% or greater were recorded. Complete follow-up (mean, 6.2 years; range, 6-156 months) was obtained in 95% of patients (949 of 1000), for an overall average of 95% of procedures (1092 of 1150). Survival analysis was performed with the Kaplan-Meier life table method. RESULTS:Perioperative (30-day) mortality rate was 0.3% (3 of 1000), and stroke rate was 0.9% (11 of 1150), with a combined mortality and stroke rate of 1.2%. The incidence of late occlusion and recurrent stenosis 70% or greater was 0.6% and 0.5%, respectively, with a combined occlusion and restenosis rate of 1.1%. Kaplan-Meier analysis showed that the rate of freedom from occlusion, restenosis 70% or greater, and combined occlusion and restenosis 70% or greater at 12 years was 99,4%, 99.5%, and 98.8%, respectively. Occlusion and restenosis developed asymptomatically. CONCLUSIONS:CEA is a low-risk procedure for treating severe symptomatic and asymptomatic carotid disease, with excellent long-term durability. Proponents of CAS should bear this in mind before considering CAS as a routine alternative to CEA.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Ballotta E,Da Giau G,Piccoli A,Baracchini Cdoi
10.1016/j.jvs.2004.04.005subject
Has Abstractpub_date
2004-08-01 00:00:00pages
270-8issue
2eissn
0741-5214issn
1097-6809pii
S0741521404005099journal_volume
40pub_type
杂志文章abstract:OBJECTIVE:The objective of this study was to assess the prognostic value of hemodynamic parameters measured with duplex ultrasound scan, together with other important graft and patient characteristics, in predicting lower extremity vein graft thrombosis. METHODS:A total of 165 lower extremity vein grafts were entered ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.112214
更新日期:2001-01-01 00:00:00
abstract::The ability to diagnose and localize vascular graft infections has been a major challenge. Recent studies in animal models and humans with focal bacterial infection have shown that radiolabeled, polyclonal, human immunoglobulin G accumulates at the site of inflammation and can serve as the basis for an imaging techniq...
journal_title:Journal of vascular surgery
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doi:
更新日期:1989-07-01 00:00:00
abstract:OBJECTIVE:Acute kidney injury (AKI) has been identified as a common complication after fenestrated and branched endovascular aneurysm repair (F/BEVAR), occurring in 5% to 29% of patients. Predictors of AKI and its impact on long-term outcomes remain unknown. We sought to identify independent predictors of AKI and its e...
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abstract:PURPOSE:Magnetic resonance angiography (MRA) is a developing technique that provides arteriograms without the risks associated with iodinated contrast and arterial puncture or the expense of hospitalization. Prior reports have demonstrated the accuracy of peripheral vessel MRA for evaluation of the aorta through pedal ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/0741-5214(94)90222-4
更新日期:1994-12-01 00:00:00
abstract::Aortoduodenal fistula is a well-known complication of abdominal aortic aneurysm repair and has been described after endovascular repair. A unique complication of duodenal perforation by intentionally placed embolic material in the aneurysm sac is described. Intentional off-label use of material to promote aneurysm sac...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2012.05.069
更新日期:2012-11-01 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::We previously described a para-anastomotic hypercompliant zone (PHZ), located 3 to 4 mm from end-to-end continuous anastomoses in canine femoral arteries, in which arterial compliance first increases approximately 50% above adjacent reference values before falling to a minimum at the anastomosis. To determine if PHZ i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1986.avs0030591
更新日期:1986-04-01 00:00:00
abstract:OBJECTIVE:Asymptomatic internal carotid artery occlusion (CO) presents a clinical dilemma, and presently, the natural history, stroke risk, and optimal management remain ill defined. This study compared outcomes, including neurovascular events (NVEs) and health care costs, between patients with CO and patients with asy...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.04.041
更新日期:2017-11-01 00:00:00
abstract::We have performed a prospective, randomized, multicenter study to compare in situ and reversed vein grafts for long limb salvage bypasses from the proximal thigh to an infrapopliteal artery. Three hundred eighty-four patients required an infrapopliteal bypass for critical lower extremity ischemia. Of these, 259 were e...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVE:Many factors impair healing of chronic venous ulcer (CVU), and many theories have been proposed to explain their pathogenesis. Coagulation factor XIII (FXIII) influences tissue regeneration and angiogenesis with effects on wound healing. Because FXIII properties depend upon its genetic variants, we investigat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.06.006
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Existing risk prediction models for contrast-induced nephropathy (CIN) are based on studies for percutaneous coronary interventions, with none validated for use in vascular procedures. We aim to validate existing CIN prediction models in patients who underwent aortic endovascular aneurysm repair (EVAR). MET...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.07.093
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Accessory renal arteries are frequently encountered when patients are evaluated for endovascular abdominal aortic aneurysm repair (EVAR). Some have considered their presence a contraindication to EVAR in fear of endoleak and the end result of renal function. We sought to determine whether the coverage of acce...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2005.09.008
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:Despite vast improvement in the field of vascular surgery, elective abdominal aortic aneurysm (AAA) repair still leads to perioperative death. Patients with asymptomatic AAAs, therefore, would benefit from an individual risk assessment to help with decisions regarding operative intervention. The purpose of th...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.07.103
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Percutaneous transluminal angioplasty ± stent (PTA/S) and surgical bypass are both accepted treatments for claudication due to superficial femoral artery (SFA) occlusive disease. However, long-term results comparing these modalities for primary intervention in patients who have had no prior intervention have...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.10.128
更新日期:2012-04-01 00:00:00
abstract:PURPOSE:We present a review of 35 patients who underwent an operation for subclavian (n = 18) or axillary (n = 17) vessel injury. In some patients, both an artery and a vein were damaged, resulting in a total of 30 arterial and 16 venous injuries. METHODS:The wounding source included a gunshot (n = 19), a stab wound (...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70268-x
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVE:The use of sirolimus eluting stent (SES) has strongly limited the incidence of in-stent restenosis that still remains a problem at the stent edge. The aim of this study was to analyze the neointimal thickening after implantation of SES and to assess the influence of the stent implantation procedure on the neo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.04.063
更新日期:2007-08-01 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:BACKGROUND:Atherosclerosis is a major risk factor for morbidity and mortality. However, epidemiologic data are sparse regarding risk factors for superior mesenteric artery calcification (SMAC), the association between SMAC and disease in other arterial beds, or the independent contribution of SMAC to risk of mortality....
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.08.081
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:Chronic limb-threatening ischemia (CLTI) is associated with high morbidity and mortality rates. More than 50% of all CLTI patients die within 5 years after presentation. Patient-specific survival prediction is critical for informing treatment strategies, even for those without a clear option for revasculariza...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2020.02.018
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVE:Aortic arch aneurysmal disease remains a therapeutic challenge. For patients unsuitable for standard open surgery, hybrid repair with debranching of the supra-aortic arteries followed by thoracic endovascular grafting has been shown to be an effective solution. The aim of this study was to report the clinical...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.11.033
更新日期:2020-09-01 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::A specific inhibitory factor was isolated from human serum of a patient who manifested impaired prosthetic graft tissue incorporation. The latter reaction was hypothesized to be related to inhibiting fibroblast proliferation by a specific humoral factor. The crude inhibitory serum was tested against a pool of normal h...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1991-07-01 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::Bacillus Calmette-Guérin (BCG) is a live attenuated strain of Mycobacterium bovis that has proven effective in the treatment of early-stage bladder cancer. Although intravesical therapy with BCG is generally considered safe, serious complications including hematuria, granulomatous pneumonitis, hepatitis, and life-thre...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.01.054
更新日期:2007-07-01 00:00:00
abstract::Tracheo-innominate artery fistula is a highly lethal complication after tracheostomy. A 37-year-old man who had undergone a tracheostomy 14 years earlier because of dysphagia after brain surgery had a tracheo-innominate artery fistula with exsanguinating hemorrhage from his tracheostomy site. After temporary control o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.114997
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Endovascular procedure simulators are now commercially available and in use for physician training. The purpose of this study was to evaluate the role of simulation-based training in vascular surgery residencies. METHODS:Residents from vascular surgery programs in a five-state area were invited to participa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.09.003
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:This study was performed for the determination of the expansion rates and outcomes and for recommendations for the surveillance of the 3.0-cm to 3.9-cm abdominal aortic aneurysm (AAA). DESIGN:The study was observational with data from patients screened with ultrasound scanning for AAA at five Veterans Affair...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1067/mva.2002.121572
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report a feasibility trial approved by the Institutional Review Board for insertion of inferior vena cava (IVC) filters with intravascular ultrasound (IVUS) guidance in the intensive care unit. METHODS:Between October 1998 and May 2000, 26 patients (15 men, 11 women; age rang...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2001.115599
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVE:Our aim was to evaluate the effect of gender on early and late procedural and functional outcomes of lower extremity bypass (LEB). METHODS:We reviewed the records of 2576 patients (828 women; 32%) who underwent LEB for claudication or critical limb ischemia (CLI) in the Vascular Study Group of New England fr...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2014.05.008
更新日期:2014-11-01 00:00:00
abstract:PURPOSE:Asymptomatic morphologic popliteal vein entrapment is frequently found in the healthy population (27%). In our institution, popliteal vein compression on plantar flexion was observed in 42% of all ascending venograms. Some authorities consider the lesion benign, without pathologic significance. This study exami...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2000.103786
更新日期:2000-04-01 00:00:00