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Vascular Surgery Clinical Trials

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https://www.readbyqxmd.com/read/28993845/-new-experimental-strategies-in-cartilage-surgery
#1
REVIEW
L Rackwitz, J C Reichert, O Pullig, U Nöth
BACKGROUND: Cell and growth factor based strategies bear great potential to support the healing processes in cartilage repair and the therapy of osteoarthritic joints. OBJECTIVES: The following review provides an overview of novel experimental strategies for the therapy of focal cartilage defects and osteoarthritis, with emphasis on cell and growth factor based approaches. MATERIALS AND METHODS: The authors summarize their own data regarding the intraarticular injection of stem cells to treat osteoarthritis of the knee and provide a synopsis of the available literature discussing the most significant publications...
October 9, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28976426/blood-conservation-using-tranexamic-acid-is-not-superior-to-epsilon-aminocaproic-acid-after-total-knee-arthroplasty
#2
RANDOMIZED CONTROLLED TRIAL
Clifford Kent Boese, Leslie Centeno, Ryan W Walters
BACKGROUND: Epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) are synthetic amino acid derivatives that interfere with fibrinolysis, promoting hemostasis by pharmacological means. Although both drugs have been shown to decrease blood loss with a minimal risk of thromboembolic adverse events following cardiac and vascular surgery, we are aware of only 1 published trial that directly compared the antifibrinolytic effects of EACA with those of TXA after total knee arthroplasty (TKA)...
October 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28943515/bleeding-impacting-mortality-after-noncardiac-surgery-a-protocol-to-establish-diagnostic-criteria-estimate-prognostic-importance-and-develop-and-validate-a-prediction-guide-in-an-international-prospective-cohort-study
#3
Pavel S Roshanov, John W Eikelboom, Mark Crowther, Vikas Tandon, Flavia K Borges, Clive Kearon, Andre Lamy, Richard Whitlock, Bruce M Biccard, Wojciech Szczeklik, Gordon H Guyatt, Mohamed Panju, Jessica Spence, Amit X Garg, Michael McGillion, Tomas VanHelder, Peter A Kavsak, Justin de Beer, Mitchell Winemaker, Daniel I Sessler, Yannick Le Manach, Tej Sheth, Jehonathan H Pinthus, Lehana Thabane, Marko R I Simunovic, Ryszard Mizera, Sebastian Ribas, P J Devereaux
INTRODUCTION: Various definitions of bleeding have been used in perioperative studies without systematic assessment of the diagnostic criteria for their independent association with outcomes important to patients. Our proposed definition of bleeding impacting mortality after noncardiac surgery (BIMS) is bleeding that is independently associated with death during or within 30 days after noncardiac surgery. We describe our analysis plan to sequentially 1) establish the diagnostic criteria for BIMS, 2) estimate the independent contribution of BIMS to 30-day mortality and 3) develop and internally validate a clinical prediction guide to estimate patient-specific risk of BIMS...
August 4, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28943459/descriptive-cadaveric-study-comparing-the-accuracy-of-ultrasound-versus-fluoroscopic-guidance-for-first-sacral-transforaminal-injections
#4
Bradley F Thompson, Matthew J Pingree, Wenchun Qu, Naveen S Murthy, Nirusha Lachman, Mark Friedrich Hurdle
BACKGROUND: Ultrasound is rarely used for guiding lumbosacral epidural steroid injections due to its technical limitations. For example, sonographic imaging lacks the ability to confirm epidural spread and identify vascular uptake. The perceived risk that these limitations pose to human subjects has precluded any large scale clinical trials to date. OBJECTIVE: To compare the accuracy of ultrasound versus fluoroscopic guidance for first sacral transforaminal epidural injections DESIGN: Cadaveric comparative study using dichotomous outcomes...
September 21, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28936594/transcatheter-aortic-valve-replacement-outcomes-indications-complications-and-innovations
#5
REVIEW
Michael N Young, Ignacio Inglessis
Transcatheter aortic valve replacement (TAVR) has become the standard of care for the treatment of severe aortic stenosis in individuals who are at prohibitive surgical risk and presents a viable alternative to surgery in selected patients who are at high operative risk. To date, outcomes from the PARTNER (Placement of AoRtic TraNscathetER Valve) and Medtronic CoreValve® US Pivotal trials continue to show the benefits of TAVR in these high-risk subgroups out to 5 and 3 years, respectively (as reported by Mack et al...
September 22, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28930755/vegf-and-igf-delivered-from-alginate-hydrogels-promote-stable-perfusion-recovery-in-ischemic-hind-limbs-of-aged-mice-and-young-rabbits
#6
Erin M Anderson, Eduardo A Silva, Yibai Hao, Kathleen D Martinick, Sarah A Vermillion, Alexander G Stafford, Elisabeth G Doherty, Lin Wang, Edward J Doherty, Paul M Grossman, David J Mooney
Biomaterial-based delivery of angiogenic growth factors restores perfusion more effectively than bolus delivery methods in rodent models of peripheral vascular disease, but the same success has not yet been demonstrated in clinically relevant studies of aged or large animals. These studies explore, in clinically relevant models, a therapeutic angiogenesis strategy for the treatment of peripheral vascular disease that overcomes the challenges encountered in previous clinical trials. Alginate hydrogels providing sustained release of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF) were injected into ischemic hind limbs in middle-aged and old mice, and also in young rabbits, as a test of the scalability of this local growth factor treatment...
2017: Journal of Vascular Research
https://www.readbyqxmd.com/read/28915508/preoperative-intraaortic-balloon-pump-improves-early-outcomes-following-high-risk-coronary-artery-bypass-graft-surgery-a-meta-analysis-of-randomized-trials-and-prospective-study-design
#7
Penelope P Rampersad, Jacob A Udell, Rami Zawi, Maral Ouzounian, Christopher B Overgaard, Vinoda Sharma, Vivek Rao, Michael E Farkouh, Vladimír Džavík
BACKGROUND: Despite widespread use, evidence to support preemptive intraaortic balloon pump (IABP) insertion for patients undergoing high-risk coronary artery bypass graft (CABG) surgery remains sparse, and in need of a well-defined clinical trial. To inform the design of a prospective trial, we sought to review outcomes in randomized controlled trials (RCTs) of anticipatory IABP use vs control in patients undergoing high-risk CABG through meta-analysis. The primary endpoint was all-cause mortality within 30 days of surgery...
September 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28905830/plication-as-an-alternative-to-resection-in-horizontal-strabismus-a-randomized-clinical-trial
#8
Prabha Sonwani, Abadan Khan Amitava, Adeeb Alam Khan, Shalini Gupta, Shivani Grover, Namita Kumari
PURPOSE: Resections and plications tighten recti although the latter are less traumatic, potentially reversible, quicker, and vascularity preserving. To compare inflammation, scarring, and alignment in horizontal strabismus, operated uniocularly by either resections or plications (with recessions): recession and resection (R&R) or recession and plication (R&P) groups. This was a prospective, patient and assessor blind, randomized trial. METHODS: All consenting strabismus patients qualifying for the first-time uniocular horizontal rectus surgeries underwent detailed ocular examination and were randomized into standard R&R or R&P groups...
September 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28879167/vascular-endothelial-growth-factor-irradiation-and-axitinib-have-diverse-effects-on-motility-and-proliferation-of-glioblastoma-multiforme-cells
#9
Reinhardt Krcek, Veronika Matschke, Verena Theis, Irenäus Anton Adamietz, Helmut Bühler, Carsten Theiss
Glioblastoma multiforme (GBM) is the most common primary brain tumor. It is highly aggressive with an unfavorable prognosis for the patients despite therapies including surgery, irradiation, and chemotherapy. One important characteristic of highly vascularized GBM is the strong expression of vascular endothelial growth factor (VEGF). VEGF has become a new target in the treatment of GBM, and targeted therapies such as the VEGF-receptor blocker axitinib are in clinical trials. Most studies focus on VEGF-induced angiogenesis, but only very few investigations analyze autocrine or paracrine effects of VEGF on the tumor cells...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28865981/randomized-clinical-trial-of-negative-pressure-wound-therapy-for-high-risk-groin-wounds-in-lower-extremity-revascularization
#10
Kevin Lee, Patrick B Murphy, Matthew V Ingves, Audra Duncan, Guy DeRose, Luc Dubois, Thomas L Forbes, Adam Power
OBJECTIVE: The surgical site infection (SSI) rate in vascular surgery after groin incision for lower extremity revascularization can lead to significant morbidity and mortality. This trial was designed to study the effect of negative pressure wound therapy (NPWT) on SSI in closed groin wounds after lower extremity revascularization in patients at high risk for SSI. METHODS: A single-center, randomized, controlled trial was performed at an academic tertiary medical center...
August 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28854779/patients-opinions-regarding-research-and-management-of-abdominal-aortic-aneurysms
#11
Regent Lee, Amy Jones, Ismail Cassimjee, Ashok Handa
BACKGROUND: The epidemiology of abdominal aortic aneurysm (AAA) is changing. Outcomes for aortic surgery have improved. Biomarkers of AAA progression are emerging. We recently reported the opinions of international vascular surgery colleagues regarding research and management for AAAs. This study aimed to ascertain a real-world patients' opinion regarding the same questions. METHODS: We administered a survey to patients with AAAs. We first ascertained their views on the priority topics for research in AAA...
August 30, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28822586/intravenous-mannitol-versus-placebo-during-partial-nephrectomy-in-patients-with-normal-kidney-function-a-double-blind-clinically-integrated-randomized-trial
#12
Massimiliano Spaliviero, Nicholas E Power, Katie S Murray, Daniel D Sjoberg, Nicole E Benfante, Melanie L Bernstein, James Wren, Paul Russo, Jonathan A Coleman
BACKGROUND: Mannitol is currently used as a renal protective agent to mitigate the effects of renal ischemia during nephron-sparing surgery (NSS). This routine practice lacks rigorous methodological study. OBJECTIVE: To assess the effect on renal function outcomes after surgery of mannitol infusion prior to renal ischemia during NSS. DESIGN, SETTING, PARTICIPANTS: This prospective, randomized, placebo-controlled, double-blind trial included 199 patients with a preoperative estimated glomerular filtration rate (eGFR) >45ml/min/1...
August 16, 2017: European Urology
https://www.readbyqxmd.com/read/28807598/effectiveness-of-edema-management-techniques-for-subacute-hand-edema-a-systematic-review
#13
Leanne K Miller, Christina Jerosch-Herold, Lee Shepstone
STUDY DESIGN: Systematic review. INTRODUCTION: Prolonged hand edema can have detrimental effects on range of motion and function. There is no consensus on how best to manage traumatic subacute edema. This is the first systematic review which examines the clinical effectiveness of edema treatments on hand volume. PURPOSE OF THE STUDY: The purpose of this systematic review was to examine the evidence of effectiveness of treatments for sub-acute hand edema...
August 11, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28795108/data-for-the-oxford-abdominal-aortic-aneurysm-study-international-survey-of-vascular-surgery-professionals
#14
Regent Lee, Amy Jones, Felicity Woodgate, Nicholas Killough, Kirthi Bellamkonda, Matthew Williams, Katherine Hurst, Lucy Fulford-Smith, Ismail Cassimjee, Ashok Handa
As part of the Oxford Abdominal Aortic Aneurysm (OxAAA) Study, we conducted an international survey of vascular surgery professionals. One aspect of the survey is as published in the International Journal of Cardiology: "International Opinion on Priorities in Research for Small Abdominal Aortic Aneurysms and the Potential Path for Research to Impact Clinical Management". This Data-in-Brief article contains a detailed method for the conduct of this survey and additional original data. In this survey, we also provided vascular surgery colleagues with contemporary epidemiologic and surgical outcome data...
October 2017: Data in Brief
https://www.readbyqxmd.com/read/28756647/mid-urethral-sling-operations-for-stress-urinary-incontinence-in-women
#15
REVIEW
Abigail A Ford, Lynne Rogerson, June D Cody, Patricia Aluko, Joseph A Ogah
BACKGROUND: Urinary incontinence is a very common and debilitating problem affecting about 50% of women at some point in their lives. Stress urinary incontinence (SUI) is a predominant cause in 30% to 80% of these women imposing significant health and economic burden on society and the women affected. Mid-urethral sling (MUS) operations are a recognised minimally invasive surgical treatment for SUI. MUS involves the passage of a small strip of tape through either the retropubic or obturator space, with entry or exit points at the lower abdomen or groin, respectively...
July 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28754230/tissue-engineered-vascular-grafts-for-congenital-cardiac-disease-clinical-experience-and-current-status
#16
REVIEW
Joseph D Drews, Hideki Miyachi, Toshiharu Shinoka
Congenital heart disease is a leading cause of death in the newborn period, and man-made grafts currently used for reconstruction are associated with multiple complications. Tissue engineering can provide an alternative source of vascular tissue in congenital cardiac surgery. Clinical trials have been successful overall, but the most frequent complication is graft stenosis. Recent studies in animal models have indicated the important role of the recipient׳s immune response in neotissue formation, and that modulating the immune response can reduce the incidence of stenosis...
November 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28750481/aqueous-shunts-for-glaucoma
#17
REVIEW
Victoria L Tseng, Anne L Coleman, Melinda Y Chang, Joseph Caprioli
BACKGROUND: Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. OBJECTIVES: To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase...
July 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28738862/impact-of-ischemic-preconditioning-on-surgical-treatment-of-brain-tumors-a-single-center-randomized-double-blind-controlled-trial
#18
Arthur H A Sales, Melanie Barz, Stefanie Bette, Benedikt Wiestler, Yu-Mi Ryang, Bernhard Meyer, Martin Bretschneider, Florian Ringel, Jens Gempt
BACKGROUND: Postoperative ischemia is a frequent phenomenon in patients with brain tumors and is associated with postoperative neurological deficits and impaired overall survival. Particularly in the field of cardiac and vascular surgery, the application of a brief ischemic stimulus not only in the target organ but also in remote tissues can prevent subsequent ischemic damage. We hypothesized that remote ischemic preconditioning (rIPC) in patients with brain tumors undergoing elective surgical resection reduces the incidence of postoperative ischemic tissue damage and its consequences...
July 25, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28691229/desmopressin-use-for-minimising-perioperative-blood-transfusion
#19
REVIEW
Michael J Desborough, Kathryn Oakland, Charlotte Brierley, Sean Bennett, Carolyn Doree, Marialena Trivella, Sally Hopewell, Simon J Stanworth, Lise J Estcourt
BACKGROUND: Blood transfusion is administered during many types of surgery, but its efficacy and safety are increasingly questioned. Evaluation of the efficacy of agents, such as desmopressin (DDAVP; 1-deamino-8-D-arginine-vasopressin), that may reduce perioperative blood loss is needed. OBJECTIVES: To examine the evidence for the efficacy of DDAVP in reducing perioperative blood loss and the need for red cell transfusion in people who do not have inherited bleeding disorders...
July 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28682127/factors-influencing-the-choice-of-treatment-modality-for-individual-patients-with-varicose-veins
#20
B Campbell, N Chinai, P Hollering, H Wright, R McCarthy
INTRODUCTION There is evidence of effectiveness for a range of different treatment modalities for varicose veins but limited information about factors that influence treatment choice for individual patients. METHODS A postal survey was sent to 438 UK members of the Vascular Society of Great Britain and Ireland. RESULTS Overall, 251 responses were received (response rate 57%). A total of 222 respondents treated varicose veins using conventional surgery (84%), endothermal ablation (82%) and foam sclerotherapy (68%)...
July 6, 2017: Annals of the Royal College of Surgeons of England
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