Background: Accurate adjustment of surgical outcome data for risk is vital in an era of surgeon-level reporting. Current risk prediction models for abdominal aortic aneurysm (AAA) repair are suboptimal. We aimed to develop a reliable risk model for in-hospital mortality after intervention for AAA, using rigorous contemporary statistical techniques to handle missing data.
Objective Prior analysis in the Open vs Endovascular Repair Veterans Affairs (VA) Cooperative Study (CSP #498) demonstrated that survival, quality of life, and total health care costs are not significantly different between the open and endovascular methods of repair of abdominal aortic aneurysm. The device is a major cost of this method of repair, and the objective of this study was to evaluate the costs of the device, abdominal aortic aneurysm repair, and total health care costs when different endograft systems are selected for the endovascular repair (EVR). Within each selected system, EVR costs are compared with open repair costs.
Background: Thoracic endovascular aortic repair (TEVAR) is widely used for treatment of traumatic aortic injury (TAI). Stent graft coverage of the left subclavian artery (LSA) may be required in up to 40% of patients. We evaluated the long-term effects of intentional LSA coverage (LSAC) on symptoms and return to normal activity in TAI patients compared with a similarly treated group whose LSA was uncovered (LSAU).
Objective Fenestrated endovascular aortic aneurysm repair (FEVAR) is an alternative to open repair in patients with complex abdominal aortic aneurysms who are neither fit nor suitable for standard open or endovascular repair. Chimney and snorkel grafts are other endovascular alternatives but frequently require bilateral upper extremity access that has been associated with a 3% to 10% risk of stroke. However, upper extremity access is also frequently required for FEVAR because of the caudal orientation of the visceral vessels. The purpose of this study was to assess the use of upper extremity access for FEVAR and the associated morbidity.
Objective: The aim of this study was to evaluate the midterm clinical outcomes of various approaches, including hybrid procedures, to aortic arch pathologies.
Objective: The value of prophylactic atropine use during carotid artery stenting (CAS) in primary carotid stenosis to prevent procedural hemodynamic depression is well accepted. However, its impact in case of recurrent stenosis after eversion carotid endarterectomy (E-CEA), which is known to be associated with decreased baroreflex function due to discontinuation of the carotid sinus nerve, has not been investigated so far.
Objective: The external carotid artery (ECA) can be an important source of cerebral blood flow in cases of high-grade internal carotid artery stenosis or occlusion. However, the treatment of the ECA is fundamentally different between carotid endarterectomy (CEA) and carotid artery stenting (CAS). CEA is routinely associated with endarterectomy of the ECA, whereas CAS excludes the ECA from direct flow. We hypothesize that these differences make ECA occlusion more common after CAS. Further, the impact of CAS on blood flow into the ECA is interesting because the flow from the stent into the ECA is altered in a way that may promote local inflammation and may influence in-stent restenosis (ISR). Thus, our objective was to use our institutional database to identify whether CAS increased the rate of ECA occlusion and, if it did, whether ECA occlusion was associated with ISR.
Objective: Thrombolysis and open surgical revascularization are current options for the treatment of acute limb ischemia (ALI). Despite the several randomized controlled trials comparing the two options, no single treatment can yet be recommended as a universal initial management of ALI. The purpose of this study was to evaluate contemporary endovascular and surgical revascularization for ALI.
Background: The risk of recurrent venous thrombosis is 2-fold higher in men than in women. In contrast, no such sex difference in the risk of first venous thrombosis has been reported. We hypothesized that, for a first event, a risk difference between the sexes is masked by female exposure to reproductive factors (oral contraception, pregnancy/puerperium, and postmenopausal hormone therapy).
With 100% clinical success during a prospective evaluation of early user experiences involving 206 cases performed in five United States hospitals, the next-generation MYNX ACE® Vascular Closure Device (VCD) (AccessClosure, Inc., a Cardinal Health Company) (Figure 1) demonstrated strong potential as a safe and reliable closure device (Table 1). In addition, the new device displayed the benefits of versatility and patient satisfaction in a diverse and challenging patient population.
Revascularization in a patient with inflow disease of a left-to-right femoral-femoral bypass utilizing multiple access locations.
Creating rigorous studies to produce meaningful data for use in everyday clinical practice.
The latest data demonstrating the benefit of including drug-coated balloons in the interventionist’s toolbox.
The patient was a 62-year-old man who was a current smoker. He had a baseline ankle-brachial index of 0.73 and a Rutherford category of 3. His preprocedure reference vessel diameter was 4.86 mm.
A panel of experts discusses recommendations for optimizing outcomes when treating complex SFA and popliteal lesions with drug-coated balloon technology.
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