Abstract:
OBJECTIVES:We undertook a quantitative systematic review of randomized controlled trials (RCTs) and observational studies to determine the effectiveness of cerebrospinal fluid (CSF) drainage to prevent paraplegia in thoracic aneurysm (TA) and thoracoabdominal aortic aneurysm (TAAA) surgery. METHODS:We included RCTs and cohort studies that met the following criteria: elective or emergent aneurysm surgery involving the thoracic or thoracoabdominal aorta, documentation of postoperative neurologic deficits, and patient age older than 18 years. We excluded studies that reported results in 10 or fewer patients and duplicate publications. We identified eligible studies by searching computerized databases, our own files, and the reference lists of relevant articles and review articles. Database searching, eligibility decisions, relevance and method quality assessments, and data extraction were performed in duplicate with prespecified criteria. RESULTS:Of 372 publications identified in our search, 14 met our eligibility criteria. Three RCTs reported 289 patients with type I or type II TAAA. Lower limb neurologic deficits occurred in 12% of patients who underwent CSF drainage and 33% of control subjects (number needed to treat, 9; 95% confidence interval [CI], 5-50). The pooled odds ratio (OR) for development of paraplegia in patients in the CSF drainage group was 0.35 (P =.05; 95% CI, 0.12-0.99). Similar results were found in five cohort studies with a control group (pooled OR, 0.26; P =.0002; 95% CI, 0.13-0.53). When all studies were considered together the pooled OR of TA and TAAA was 0.3 (95% CI, 0.17-0.54). There was no statistical heterogeneity among studies included in the meta-analysis. In six cohort studies without a control group, the incidence of paraplegia in high-risk TA and TAAA was 7.6%. CONCLUSIONS:Evidence from randomized and nonrandomized trials and from cohort studies support the use of CSF drainage as an adjunct to prevent paraplegia when this adjunct is used in centers with large experience in the management of TAAA.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Cinà CS,Abouzahr L,Arena GO,Laganà A,Devereaux PJ,Farrokhyar Fdoi
10.1016/j.jvs.2004.03.017subject
Has Abstractpub_date
2004-07-01 00:00:00pages
36-44issue
1eissn
0741-5214issn
1097-6809pii
S0741521404003829journal_volume
40pub_type
杂志文章,meta分析,评审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:BACKGROUND:Arterial disease in women will become a major issue in the near future. METHODS:A systemic review of existing literature was retrospectively conducted to collect information on the three most common entities of vascular disease: carotid atherosclerotic, abdominal aortic aneurismal, and lower extremity arter...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jvs.2007.07.057
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:To evaluate the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin A5 on treatment of venous malformation (VM) in cervical-facial region. METHODS:Seventy-five patients (32 male, 43 female), ranging in age from 13 to 60 years old, suffering from VM in cervical-facial region were ad...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.11.038
更新日期:2010-04-01 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:OBJECTIVE:A suitable ipsilateral great saphenous vein (GSV) autograft is widely considered the best material for arterial reconstruction of a popliteal artery aneurysm (PAA). There are, however, cases in which such a GSV is absent, diseased, or of too small diameter for this use. Alternatives to GSV are synthetic condu...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.12.049
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess long-term durability of bridging stents in branched and combined branched and fenestrated endovascular aneurysm repair (B/F-EVAR) for thoracoabdominal aortic aneurysm (TAAA) and pararenal abdominal aortic aneurysm. METHODS:A retrospective database analysis was perfor...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2018.12.023
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:Unquestionably, the federal government has created financial incentives for vascular interventionists to perform procedures in their offices rather than in a hospital setting. While office venous ablations have been widely embraced by the vascular community, those involving the arterial system have not. One i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2009.03.061
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:Wounding patterns, methods of repair, and outcomes from femoropopliteal injury have been documented in recent civilian literature. In Operation Iraqi Freedom, as in past conflicts, these injuries continue to be a therapeutic challenge. Therefore, the objective of the current study is to document the pattern o...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.01.052
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:This study validated duplex ultrasound measurement of brachial artery volume flow (VF) as predictor of dialysis access flow maturation and successful hemodialysis. METHODS:Duplex ultrasound was used to image upper extremity dialysis access anatomy and estimate access VF within 1 to 2 weeks of the procedure. ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2015.01.036
更新日期:2015-06-01 00:00:00
abstract:PURPOSE:This retrospective review describes the surgical management of 51 patients after failed percutaneous renal artery angioplasty (F-PTRA). METHODS:From January 1987 through June 1998, 51 consecutive patients underwent surgical repair of either atherosclerotic (32 patients) or fibromuscular dysplastic (FMD; 19 pat...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70074-1
更新日期:1999-09-01 00:00:00
abstract:OBJECTIVES:Increased utilization of computed tomography angiography (CTA) has increased the radiologic diagnosis of penetrating atherosclerotic ulcers (PAUs), which are defined as the ulceration of atherosclerotic plaque through the internal elastic lamina into the aortic media. However, the presentation, treatment ind...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.08.005
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:Our aim was to identify the incidence of and predictors for common carotid artery (CCA) stent fractures (SFs) and to examine the effect of SFs on the development of in-stent restenosis (ISR). METHODS:Seventy patients (37 women; median age, 60.9 years) who were stented for significant (≥60%) proximal CCA sten...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.04.492
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:The use of radiation for medical purposes falls under the purview of the Food and Drug Administration (FDA) and individual states. Enhanced regulations are in place to promote the right exam for the right reason at the right time for every patient exposed to medical x-rays. METHODS:The February 2010 FDA ini...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.177
更新日期:2011-01-01 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:OBJECTIVE:Lower extremity arterial injury may result in limb loss after blunt or penetrating trauma. This study examined outcomes of civilian lower extremity arterial trauma and predictors of delayed amputation. METHODS:The records of patients presenting to a major level I trauma center from 2004 to 2014 with infraing...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.04.052
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:The problems with first-generation stent grafts for endovascular aneurysm repair are well known, but their long-term outcome remains to be established. The purpose of the study was to characterize the outcome of patients treated for abdominal aortic aneurysm (AAA) with a first-generation stent graft, Vanguard...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.11.027
更新日期:2020-09-01 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:BACKGROUND:This is a randomized prospective study comparing the treatment of superficial femoral artery occlusive disease percutaneously with an expanded polytetrafluoroethylene (ePTFE)/nitinol self-expanding stent graft (stent graft) versus surgical femoral to above-knee popliteal artery bypass with synthetic graft ma...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2010.03.071
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:The clinical decision-making utility of scoring algorithms for predicting mortality after ruptured abdominal aortic aneurysms (rAAAs) remains unknown. We sought to determine the clinical utility of the algorithms compared with our clinical decision making and outcomes for management of rAAA during a 10-year p...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.07.121
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:Although all areas of the body are susceptible to radiation injury, different tissues have varying tolerances for radiation exposure. The goal of this summary is to introduce basic concepts of radiation biology and discuss the effects of radiation on various tissues. METHODS:Reference texts and literature...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.06.175
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVE:Arteriovenous grafts remain reliable substitutes for permanent hemodialysis access in patients without a suitable autogenous conduit. Advances in conduit design and endovascular management of access-related complications question the preference for synthetic conduits over biologic grafts in contemporary pract...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.10.080
更新日期:2017-03-01 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: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::A case of popliteal entrapment syndrome is reported, in which the patient experienced symptoms of tibial nerve entrapment. Exploratory surgery revealed an abnormal fibrous band between the heads of the gastrocnemius muscle that was compressing both the tibial nerve and popliteal artery. Division of this band provided ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1985-03-01 00:00:00
abstract:OBJECTIVE:Immediate type I and type III endoleaks after endovascular aneurysm repair (EVAR) could be persistent or temporary. Reintervention is necessary for persistent ones. Color-coded quantitative digital subtraction angiography (CQDSA) could provide a quantitative evaluation of the endoleak hemodynamics. We aimed t...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2016.11.048
更新日期:2017-09-01 00:00:00
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 scorin...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.02.036
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Remodeling of the aortoiliac anatomy is a challenge to the long-term performance of stent grafts for endovascular aneurysm repair. Changes in vessel diameter and length can result in loss of seal at attachment sites, limb disunion, or kinking, with the development of high-pressure endoleaks, migration, or li...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2018.09.059
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:The purpose of this exploratory study was to determine whether a single session of vibration therapy (VT) would improve muscular and functional performance in individuals with symptomatic peripheral artery disease (PAD). METHODS:In a randomized, balanced cross-over design fourteen PAD participants with inter...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jvs.2019.06.214
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to define a normal range of distal graft velocity (DGV) and peak systolic velocity (PSV) on the basis of outflow level and maximum graft diameter for infrainguinal reversed vein bypass grafting (RVG). METHODS:This study was designed as a prospective study of consecutive patien...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(99)70172-2
更新日期:1999-07-01 00:00:00
abstract::Acquired factor VIII inhibitor is increasingly recognized as a cause of major soft tissue hemorrhage. The laboratory diagnosis can be obscured by the synchronous presence of the lupus anticoagulant, an extremely rare occurrence that has been reported outside the vascular surgery literature. Vascular surgeons should be...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.127336
更新日期:2002-10-01 00:00:00