Abstract:
PURPOSE:The purpose of this study was to utilize an objective endpoint analysis of aneurysm treatment, which is based on the primary objective of aneurysm repair, and to apply it to a consecutive series of patients undergoing open and endovascular repair. METHOD:Aneurysm-related death was defined as any death that occurred within 30 days of primary aneurysm treatment (open or endovascular), within 30 days of a secondary aneurysm or graft-related treatment, or any death related to the aneurysm or graft at any time following treatment. We reviewed 417 consecutive patients undergoing elective infrarenal aortic aneurysm repair: 243 patients with open repair and 174 patients with endovascular repair. RESULTS:There was no difference between the groups (open vs endovascular) with regard to mean age +/- standard deviation (73 +/- 8 years vs 74 +/- 8 years) or aneurysm size (64 +/- 2 mm vs 58 +/- 10 mm) (P = not significant [NS]). The 30-day mortality for the primary procedure after open repair was 3.7% (9/243) and after endovascular repair was 0.6% (1/174, P <.05). The 30-day mortality for secondary procedures after open repair was 14% (6/41) compared to 0% after endovascular repair (P <.05). The aneurysm-related death rate was 4.1% (10/243) after open surgery and 0.6% (1/174) after endovascular repair (P <.05). Mean follow-up was 5 months longer following open repair (P <.05). Secondary procedures were performed in 41 patients following open surgery and 27 patients following endovascular repair (P = NS). Secondary procedures following open repair were performed for anastomotic aneurysms (n = 18), graft infection (n = 6), aortoenteric fistula (n = 5), anastomotic hemorrhage (n = 4), lower extremity amputation (n = 4), graft thrombosis (n = 3), and distal revascularization (n = 1). Secondary procedures following endovascular repair consisted of proximal extender cuffs (n = 11), distal extender cuffs (n = 11), limb thrombosis (n = 3), and surgical conversion (n = 2). The magnitude of secondary procedures following open repair was greater with longer operative time 292 +/- 89 minutes vs 129 +/- 33 minutes (P <.0001), longer length of stay 13 +/- 10 days vs 2 +/- 2 days (P <.0001) and greater blood loss 3382 +/- 4278 mL vs 851 +/- 114 mL (P <.0001). CONCLUSIONS:The aneurysm-related death rate combines early and late deaths and should be used as the primary outcome measure to objectively compare the results of open and endovascular repair in the treatment of infrarenal abdominal aortic aneurysms. In our experience, endovascular aneurysm repair reduced the overall aneurysm-related death rate when compared to open repair. Secondary procedures are required after both open and endovascular repair. However, the magnitude, morbidity, and mortality of secondary procedures are reduced significantly with endovascular repair.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Arko FR,Lee WA,Hill BB,Olcott C 4th,Dalman RL,Harris EJ Jr,Cipriano P,Fogarty TJ,Zarins CKdoi
10.1067/mva.2002.126314subject
Has Abstractpub_date
2002-08-01 00:00:00pages
297-304issue
2eissn
0741-5214issn
1097-6809pii
S0741521402000472journal_volume
36pub_type
杂志文章abstract::Mesenteric vein thrombosis is a rare disorder that is often the first manifestation of a systemic condition such as a hypercoagulable state or cancer. In particular, myeloproliferative disorders can present as mesenteric vein thrombosis even in the setting of relatively normal peripheral blood counts. A recent novel m...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.01.097
更新日期:2010-07-01 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::An infected pseudoaneurysm of the right common femoral artery in a 69-year-old patient receiving methotrexate therapy was confirmed to have been caused by Mycobacterium tuberculosis. After surgical excision of the aneurysm and revascularization using femoral vein, cutaneous manifestations of M tuberculosis infection i...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.05.024
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to develop a protocol for evaluation of patients suspected of having deep venous thrombosis (DVT) who came to the hospital after normal noninvasive vascular laboratory (NIVL) working hours in an attempt to both retain registered vascular therapists and provide excellent patient c...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.2002.125021
更新日期:2002-07-01 00:00:00
abstract::Based on our previous study that the outcome of reconstructive surgery for lower limbs could well be predicted by flow waveforms and that this state was defined by variation of wall shear stress (tau) in a cardiac cycle, we set up a desktop computer that could calculate wall shear stress in a given patient. This work ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract:PURPOSE:The feasibility and safety of combining carotid surgery and thrombolysis for occlusions of the internal carotid artery (ICA) and the middle cerebral artery (MCA), either as a simultaneous or as a staged procedure in acute ischemic strokes, was studied. METHODS:A nonrandomized clinical pilot study, which includ...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1016/s0741-5214(99)70274-0
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:In 2007, Medicare established ultrasound screening guidelines to identify patients at risk for abdominal aortic aneurysm (AAA). The purpose of this study was to evaluate AAA diagnosis rates and compliance with screening during 10 years (2007-2016) of the Screen for Abdominal Aortic Aneurysms Very Efficiently ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.01.053
更新日期:2019-10-01 00:00:00
abstract::Spontaneous dissection of the abdominal aorta originating from the suprarenal aorta is very rare. Previous reports attest to the lethal nature of this disorder. This case represents the first report of successful repair of a spontaneous suprarenal abdominal aortic dissection by graft insertion with obliteration of bot...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1016/s0741-5214(94)70222-5
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVES:The Hardman index, which has five variables, has been recommended as a predictor of outcome after open repair of ruptured abdominal aortic aneurysms (RAAAs). It has been reported that the presence of three or more variables is uniformly fatal. The aim of this study was to test the same model in an independen...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2008.05.065
更新日期:2008-10-01 00:00:00
abstract:BACKGROUND:Prostaglandin (PG) E(2) (PGE(2)) appears to have a role in stimulating production of interleukin-6 (IL-6) and apoptosis of smooth muscle cells in diseased aortic tissue. These actions are mediated by cellular receptors for PGE(2) EP receptors. OBJECTIVE:This study was undertaken to identify EP receptors ass...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00339-2
更新日期:2003-08-01 00:00:00
abstract:INTRODUCTION:Arterial endarterectomy and reconstruction during carotid endarterectomy (CEA) can be performed in a variety of ways, including standard endarterectomy with primary closure, standard endarterectomy with patch angioplasty, and eversion endarterectomy. The optimal method of arterial reconstruction remains a ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2005.07.043
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the role of endovascular and open surgical reconstructions in patients with superior vena cava (SVC) syndrome caused by nonmalignant disease. METHODS:Clinical data from 32 consecutive patients who underwent endovascular or open surgical reconstruction of central vei...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(03)00331-8
更新日期:2003-08-01 00:00:00
abstract::One hundred nine percutaneous catheterizations of synthetic vascular grafts in 89 patients who had angiographic procedures were reviewed to determine the risk of major complications. Ninety-six of the catheterizations were inserted into the inguinal portion of aortofemoral grafts. There were no instances of hematoma, ...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:End-stage renal disease (ESRD) imparts a significant survival disadvantage to individuals undergoing lower extremity revascularization; however, the influence of lesser degrees of renal impairment remains unclear. This study examined the prognostic significance of the chronic kidney disease (CKD) classificati...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2007.01.025
更新日期:2007-05-01 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:OBJECTIVE:This study aimed to determine predictors and outcomes associated with bleeding or anemia requiring transfusion (BAT) after fenestrated or branched endovascular aneurysm repair (FB-EVAR). METHODS:Health insurance claims data of Germany's third largest insurance provider, DAK-Gesundheit, were used to investiga...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jvs.2019.02.059
更新日期:2020-02-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the midline retroperitoneal approach with the midline transperitoneal approach for abdominal aortic aneurysm (AAA) repair with respect to operative details, gastrointestinal complications, and wound complications. METHODS:From January 1990 through January 1998, 128 pati...
journal_title:Journal of vascular surgery
pub_type: 临床试验,杂志文章
doi:10.1067/mva.2000.106946
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVE:The optimal revascularization strategy in diabetic patients with chronic critical limb ischemia (CLI) is unclear. This study assessed the efficacy of tailored endovascular-first vs surgical-first revascularization stratified for the presence of diabetes. METHODS:This prospective cohort study, with 1-year fol...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2006.12.022
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVE:Lingual arteriovenous malformations (AVMs) are extremely rare in clinical practice, which has limited comprehensive research to find standard treatment protocols. This study summarizes the clinical features of lingual AVMs and assesses the safety and efficacy of ethanol embolotherapy in the management of thes...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2019.08.286
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:Contralateral stroke is an infrequent cause of perioperative stroke after carotid endarterectomy (CEA). Whereas the risks of ipsilateral stroke complicating CEA have been discriminated, factors that lead to contralateral stroke are poorly defined. The purpose of this study was to identify the risk of perioper...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2017.04.059
更新日期:2017-11-01 00:00:00
abstract::Tinnitus and hearing loss can occur in patients with a high-riding abnormal jugular bulb. Jugular vein ligation in selected patients can cure tinnitus and reverse hearing loss. A 39-year-old woman reported a 4-year history of right-sided tinnitus of increasing intensity associated with a mild hearing loss. Extensive e...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1067/mva.1987.avs0060248
更新日期:1987-09-01 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:OBJECTIVE:This study assessed the effect of cellular and humoral autoimmune response inhibition after immunization with β2-glycoprotein I (β2-GPI) and the effect of immunomodulation with interleukin (IL)-2 and IL-10 in the development of early atherosclerotic vascular lesion in a murine model. Atherosclerosis is increa...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2014.05.096
更新日期:2015-12-01 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:OBJECTIVE:Several trials have reported early superior patency of stenting over isolated angioplasty (plain old balloon angioplasty [POBA]) for infra-inguinal occlusive disease, yet long-term data are sparse. The purpose of this study was to contrast long-term clinical outcomes and costs of angioplasty alone vs angiopla...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2011.03.283
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:We investigated the outcomes of hybrid repair of thoracoabdominal aortic aneurysms and performed meta-analyses and meta-regressions to assess whether the number of stages during hybrid repair is associated with mortality. METHODS:Review methods were according to the Preferred Reporting Items for Systematic R...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jvs.2013.04.061
更新日期:2013-11-01 00:00:00
abstract::Although abdominal aortic aneurysm (AAA) is a common problem in elderly patients, AAA is rare in children. Despite its rarity, early diagnosis is imperative to prevent limb-threatening or fatal complications. The treatment may be complicated, because it must allow for the growth of the child. A saccular AAA in an 11-y...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/s0741-5214(98)70100-4
更新日期:1998-10-01 00:00:00
abstract::Arterial tumor embolization is a rare complication of neoplasms. This report describes a 64-year-old female with metastatic melanoma and acute arterial embolization to the left lower extremity. With surgical embolectomy, a clot was retrieved that had an atypical bland solid lead point. Pathologic examination confirmed...
journal_title:Journal of vascular surgery
pub_type: 杂志文章,评审
doi:10.1067/mva.2002.123327
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:Thoracic endograft placement has become an acceptable treatment alternative to open repair of the thoracic aorta. Cerebral embolization when manipulating the aortic arch during cardiac catheterization is well described, but the influence of thoracic endovascular aortic repair (TEVAR) on this event remains poo...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2010.12.063
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVE:This study was conducted to determine the sensitivity and specificity of laser Doppler flowmetry (LDF) measurements for digital obstructive arterial disease (DOAD) using angiography as the reference standard and to compare the accuracy of different classical tests used to assess DOAD. Diagnosis of vascular ab...
journal_title:Journal of vascular surgery
pub_type: 杂志文章
doi:10.1016/j.jvs.2013.10.076
更新日期:2014-04-01 00:00:00