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https://www.readbyqxmd.com/read/27887854/significant-regional-variation-exists-in-morbidity-and-mortality-after-repair-of-abdominal-aortic-aneurysm
#1
Sara L Zettervall, Peter A Soden, Dominique B Buck, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Limited data exist comparing perioperative morbidity and mortality after open and endovascular abdominal aortic aneurysm (AAA) repair (EVAR) among regions of the United States. This study evaluated the regional variation in mortality and perioperative outcomes after repair of AAAs. METHODS: The Vascular Quality Initiative (VQI) was used to identify patients undergoing open AAA repair and EVAR between 2009 and 2014. Ruptured and intact aneurysms were evaluated separately, and the analysis of intact aneurysms was limited to infrarenal AAAs...
November 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#2
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27865637/increased-risk-of-mortality-after-lower-extremity-bypass-in-individuals-with-acute-kidney-injury-in-the-vascular-quality-initiative
#3
Erica Flores, Juan Pablo Lewinger, Vincent L Rowe, Karen Woo, Fred A Weaver, David Shavelle, Leonardo Clavijo, Parveen K Garg
OBJECTIVE: The development of acute kidney injury (AKI) and its effect on prognosis after lower extremity bypass (LEB) surgery have not been well described. We determined risk factors associated with AKI in patients undergoing infrainguinal LEB surgery and whether individuals with AKI are at increased risk for cardiovascular events and mortality. METHODS: Data for 12,907 operations entered in the Vascular Quality Initiative (VQI) registry from January 2012 through April 2015 were retrospectively reviewed...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27707617/stenting-versus-endarterectomy-after-prior-ipsilateral-carotid-endarterectomy
#4
Isibor Arhuidese, Tammam Obeid, Besma Nejim, Satinderjit Locham, Caitlin W Hicks, Mahmoud B Malas
BACKGROUND: Restenosis after carotid endarterectomy (CEA) is associated with an increased risk of stroke, and the management of critical or symptomatic restenotic lesions poses a treatment challenge. The superiority of CEA vs carotid angioplasty and stenting (CAS) for restenosis remains debatable because existing studies are few and limited by small sample size or the inability to align interventions with ipsilateral events beyond the periprocedural period. We performed a population-based evaluation of CEA vs CAS in a large contemporary cohort of patients with carotid artery restenosis...
October 1, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27692467/regional-variation-in-patient-selection-and-treatment-for-lower-extremity-vascular-disease-in-the-vascular-quality-initiative
#5
Peter A Soden, Sara L Zettervall, Thomas Curran, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
OBJECTIVE: Prior studies on the cause and effect of surgical variation have been limited by utilization of administrative data. The Vascular Quality Initiative (VQI), a robust national clinical registry, provides anatomic and perioperative details allowing a more robust analysis of variation in surgical practice. METHODS: The VQI was used to identify all patients undergoing infrainguinal open bypass or endovascular intervention from 2009 to 2014. Asymptomatic patients were excluded...
September 27, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27449347/the-vascular-quality-initiative-cardiac-risk-index-for-prediction-of-myocardial-infarction-after-vascular-surgery
#6
Daniel J Bertges, Dan Neal, Andres Schanzer, Salvatore T Scali, Philip P Goodney, Jens Eldrup-Jorgensen, Jack L Cronenwett
OBJECTIVE: The objective of this study was to develop and to validate the Vascular Quality Initiative (VQI) Cardiac Risk Index (CRI) for prediction of postoperative myocardial infarction (POMI) after vascular surgery. METHODS: We developed risk models for in-hospital POMI after 88,791 nonemergent operations from the VQI registry, including carotid endarterectomy (CEA; n = 45,340), infrainguinal bypass (INFRA; n = 18,054), suprainguinal bypass (SUPRA; n = 2678), endovascular aneurysm repair (EVAR; n = 18,539), and open abdominal aortic aneurysm repair (OAAA repair; n = 4180)...
July 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27374064/vascular-quality-initiative-and-national-surgical-quality-improvement-program-registries-capture-different-populations-and-outcomes-in-open-infrainguinal-bypass
#7
Lily E Johnston, William P Robinson, Margaret C Tracci, John A Kern, Kenneth J Cherry, Irving L Kron, Gilbert R Upchurch
OBJECTIVE: Both the Vascular Quality Initiative (VQI) and the National Surgical Quality Improvement Program Procedure Targeted (NSQIP-PT) databases aim to track outcomes and to improve quality in vascular surgery. However, both registries are subject to significant selection bias. The objective of this study was to compare the populations and outcomes of a single procedure in VQI and NSQIP-PT and to identify areas of similarity and discrepancy. METHODS: Deidentified regional data were provided by VQI, and the public use files were provided by NSQIP...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27236090/relationships-between-2-year-survival-costs-and-outcomes-following-carotid-endarterectomy-in-asymptomatic-patients-in-the-vascular-quality-initiative
#8
Jessica B Wallaert, Karina A Newhall, Bjoern D Suckow, Benjamin S Brooke, Min Zhang, Adrienne E Farber, Donald Likosky, Philip P Goodney
BACKGROUND: Carotid endarterectomy (CEA) for asymptomatic patients with limited life expectancy may not be beneficial or cost-effective. The purpose of this study was to examine relationships among survival, outcomes, and costs within 2 years following CEA among asymptomatic patients. METHODS: Prospectively collected data from 3097 patients undergoing CEA for asymptomatic disease from Vascular Quality Initiative VQI registry were linked to Medicare. Models were used to identify predictors of 2-year mortality following CEA...
August 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/26926938/feasibility-of-endovascular-repair-of-ascending-aortic-pathologies-as-part-of-an-fda-approved-physician-sponsored-investigational-device-exemption
#9
Ali Khoynezhad, Carlos E Donayre, Irwin Walot, Matthew C Koopmann, George E Kopchok, Rodney A White
OBJECTIVE: Endovascular treatment of ascending aortic lesions has been reported, but to date, no FDA-approved studies have been conducted to define feasibility and the use of endografts in this particular location or to analyze the critical factors involved. METHODS: Patients were consented for entry into an FDA-approved physician-sponsored investigational device exemption study to investigate the outcome of those with ascending aortic pathologies. These patients were suitable according to the instructions for use for endovascular repair with a Valiant Captivia (Medtronic, Inc, Minneapolis, Minn) thoracic stent graft, a device designed specifically for deployment in the ascending aorta...
June 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26830690/comparison-of-open-and-endovascular-treatment-of-patients-with-critical-limb-ischemia-in-the-vascular-quality-initiative
#10
COMPARATIVE STUDY
Jeffrey J Siracuse, Matthew T Menard, Mohammad H Eslami, Jeffrey A Kalish, William P Robinson, Robert T Eberhardt, Naomi M Hamburg, Alik Farber
OBJECTIVE: There is significant controversy in the management of critical limb ischemia (CLI) arising from infrainguinal peripheral arterial disease. We sought to compare practice patterns and perioperative and long-term outcomes for patients undergoing lower extremity bypass (LEB) and percutaneous vascular interventions (PVIs) for CLI in the Vascular Quality Initiative (VQI). METHODS: The prospectively collected VQI (2010-2013) LEB and PVI databases were retrospectively queried...
April 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26813253/outcomes-of-endovascular-aortic-aneurysm-repair-in-kidney-transplant-recipients-results-from-a-national-quality-initiative
#11
I C Bostock, D S Zarkowsky, C W Hicks, D H Stone, M H Eslami, M B Malas, P P Goodney
Contrast-induced nephropathy after endovascular aortic aneurysm repair (EVAR) in kidney transplant recipients (KTRs) can have devastating consequences. The Vascular Quality Initiative (VQI) database was queried to select all KTRs who underwent EVAR between January 2003 and December 2014. Our primary outcome was renal dysfunction, defined as acute kidney injury (AKI; elevation of serum creatinine >0.5 mg/dL from baseline) or new postoperative hemodialysis requirement. Within the EVAR VQI dataset, 40 patients were KTRs (40 of 17 213, or 0...
August 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/26804216/an-externally-validated-robust-risk-predictive-model-of-adverse-outcomes-after-carotid-endarterectomy
#12
Mohammad H Eslami, Denis Rybin, Gheorghe Doros, Alik Farber
BACKGROUND: The goal of this study was to construct and externally validate a risk prediction model for patients who undergo carotid endarterectomy (CEA). METHODS: The Vascular Study Group of New England (VSGNE) and Vascular Quality Initiative (VQI) databases were queried for patients who underwent CEA. Data on perioperative variables, comorbidities, and medications were entered into a logistic regression model as predictors of the composite adverse outcomes in the VSGNE sample...
February 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26655053/using-the-vascular-quality-initiative-to-improve-quality-of-care-and-patient-outcomes-for-vascular-surgery-patients
#13
Rodney P Bensley, Adam W Beck
The Society for Vascular Surgery Vascular Quality Initiative (VQI) is a collaborative network of vascular specialists from various specialties that seeks to improve the quality and safety of vascular care by sharing data among physicians, medical centers, and regions. Working under a Patient Safety Organization designation by the Agency for Healthcare Research and Quality, the VQI provides a protected environment where data can be pooled and evaluated for trends that might provide opportunities to improve the care we provide our patients...
June 2015: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/26603547/a-comparative-evaluation-of-risk-adjustment-models-for-benchmarking-amputation-free-survival-after-lower-extremity-bypass
#14
COMPARATIVE STUDY
Jessica P Simons, Philip P Goodney, Julie Flahive, Andrew W Hoel, John W Hallett, Larry W Kraiss, Andres Schanzer
BACKGROUND: Providing patients and payers with publicly reported risk-adjusted quality metrics for the purpose of benchmarking physicians and institutions has become a national priority. Several prediction models have been developed to estimate outcomes after lower extremity revascularization for critical limb ischemia, but the optimal model to use in contemporary practice has not been defined. We sought to identify the highest-performing risk-adjustment model for amputation-free survival (AFS) at 1 year after lower extremity bypass (LEB)...
April 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26463296/regional-quality-groups-enhance-effectiveness-of-vascular-quality-initiative%C3%A2
#15
Joie Dunn, Fred A Weaver, Karen Woo
The Vascular Quality Initiative (VQI)® is a national collaborative of regional quality groups that collect and analyze data to improve vascular health care. The Southern California Vascular Outcomes Improvement Collaborative (So Cal VOICe) is the regional quality group for southern California. Initial quality initiatives chosen by the So Cal VOICe are preoperative and discharge antiplatelet and statin therapy and vascular access guidance during percutaneous endovascular procedures. The objective of this study is to examine the influence of the regional quality group structure on the effectiveness of the So Cal VOICe...
October 2015: American Surgeon
https://www.readbyqxmd.com/read/26409843/preoperative-antiplatelet-and-statin-treatment-was-not-associated-with-reduced-myocardial-infarction-after-high-risk-vascular-operations-in-the-vascular-quality-initiative
#16
Randall R De Martino, Adam W Beck, Andrew W Hoel, John W Hallett, Shipra Arya, Gilbert R Upchurch, Jack L Cronenwett, Philip P Goodney
OBJECTIVE: Medical management with antiplatelet (AP) and statin therapy is recommended for nearly all patients undergoing vascular surgery to reduce cardiovascular events. We assessed the association between preoperative use of AP and statin medications and postoperative in-hospital myocardial infarction (MI) in patients undergoing high-risk open surgery. METHODS: We studied patients who underwent elective suprainguinal (n = 3039) and infrainguinal (n = 8323) bypass and open infrarenal abdominal aortic aneurysm repair (n = 3007) in the Vascular Quality Initiative (VQI, 2005-2014)...
January 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26115922/preoperative-%C3%AE-blockers-do-not-improve-cardiac-outcomes-after-major-elective-vascular-surgery-and-may-be-harmful
#17
MULTICENTER STUDY
Salvatore Scali, Virendra Patel, Daniel Neal, Daniel Bertges, Karen Ho, Jens-Eldrup Jorgensen, Jack Cronenwett, Adam Beck
OBJECTIVE: Routine initiation β-blocker medications before vascular surgery is controversial due to conflicting data. The purpose of this analysis was to determine whether prophylactic use of β-blockers before major elective vascular surgery decreased postoperative cardiac events or mortality. METHODS: The Society for Vascular Surgery Vascular Quality Initiative (SVS-VQI) data set was used to perform a retrospective cohort analysis of infrainguinal lower extremity bypass (LEB), aortofemoral bypass (AFB), and open abdominal aortic aneurysm (AAA) repair patients...
July 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26067201/national-variation-in-preoperative-imaging-carotid-duplex-ultrasound-criteria-and-threshold-for-surgery-for-asymptomatic-carotid-artery-stenosis
#18
Edward J Arous, Jessica P Simons, Julie M Flahive, Adam W Beck, David H Stone, Andrew W Hoel, Louis M Messina, Andres Schanzer
OBJECTIVE: Carotid endarterectomy (CEA) for asymptomatic carotid artery stenosis is among the most common procedures performed in the United States. However, consensus is lacking regarding optimal preoperative imaging, carotid duplex ultrasound criteria, and ultimately, the threshold for surgery. We sought to characterize national variation in preoperative imaging, carotid duplex ultrasound criteria, and threshold for surgery for asymptomatic CEA. METHODS: The Society for Vascular Surgery Vascular Quality Initiative (VQI) database was used to identify all CEA procedures performed for asymptomatic carotid artery stenosis between 2003 and 2014...
October 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26067200/heart-rate-variables-in-the-vascular-quality-initiative-are-not-reliable-predictors-of-adverse-cardiac-outcomes-or-mortality-after-major-elective-vascular-surgery
#19
MULTICENTER STUDY
Salvatore Scali, Daniel Bertges, Daniel Neal, Virendra Patel, Jens Eldrup-Jorgensen, Jack Cronenwett, Adam Beck
OBJECTIVE: Heart rate (HR) parameters are known indicators of cardiovascular complications after cardiac surgery, but there is little evidence of their role in predicting outcome after major vascular surgery. The purpose of this study was to determine whether arrival HR (AHR) and highest intraoperative HR are associated with mortality or major adverse cardiac events (MACEs) after elective vascular surgery in the Vascular Quality Initiative (VQI). METHODS: Patients undergoing elective lower extremity bypass (LEB), aortofemoral bypass (AFB), and open abdominal aortic aneurysm (AAA) repair in the VQI were analyzed...
September 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/25925539/a-comparison-of-results-with-eversion-versus-conventional-carotid-endarterectomy-from-the-vascular-quality-initiative-and-the-mid-america-vascular-study-group
#20
COMPARATIVE STUDY
Joseph R Schneider, Irene B Helenowski, Cheryl R Jackson, Michael J Verta, Kimberly C Zamor, Nilesh H Patel, Stanley Kim, Andrew W Hoel
OBJECTIVE: Carotid endarterectomy (CEA) is usually performed with eversion (ECEA) or conventional (CCEA) technique. Previous studies report conflicting results with respect to outcomes for ECEA and CCEA. We compared patient characteristics and outcomes for ECEA and CCEA. METHODS: Deidentified data for CEA patients were obtained from the Society for Vascular Surgery Vascular Quality Initiative (SVS VQI) database for years 2003 to 2013. Second (contralateral) CEA, reoperative CEA, CEA after previous carotid stenting, or CEA concurrent with cardiac surgery were excluded, leaving 2365 ECEA and 17,155 CCEA for comparison...
May 2015: Journal of Vascular Surgery
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