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Vascular Surgery Clinical Trials

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https://www.readbyqxmd.com/read/27913755/applications-of-three-dimensional-printing-in-surgery
#1
REVIEW
Chi Li, Tsz Fung Cheung, Vei Chen Fan, Kin Man Sin, Chrisity Wai Yan Wong, Gilberto Ka Kit Leung
Three-dimensional (3D) printing is a rapidly advancing technology in the field of surgery. This article reviews its contemporary applications in 3 aspects of surgery, namely, surgical planning, implants and prostheses, and education and training. Three-dimensional printing technology can contribute to surgical planning by depicting precise personalized anatomy and thus a potential improvement in surgical outcome. For implants and prosthesis, the technology might overcome the limitations of conventional methods such as visual discrepancy from the recipient's body and unmatching anatomy...
December 2, 2016: Surgical Innovation
https://www.readbyqxmd.com/read/27905693/revisiting-the-cost-effectiveness-of-screening-65-year-old-men-for-abdominal-aortic-aneurysm-based-on-data-from-an-implemented-screening-programme
#2
Jakob Hager, Martin Henriksson, Per Carlsson, Toste Länne, Fredrik Lundgren
BACKGROUND: Health economic analyses based on randomized trials have shown that screening for abdominal aortic aneurysm (AAA) cost-effectively decreases AAA-related, as well as all- cause mortality. However, follow-up from implemented screening programmes now reveal substantially changed conditions in terms of prevalence, attendance rate, costs and mortality after intervention. Our aim was to evaluate whether screening for AAA among 65-year-old men is cost-effective based on contemporary data on prevalence and attendance rates from an ongoing AAA screening programme...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27902645/effect-of-nerve-stimulation-use-on-the-success-rate-of-ultrasound-guided-subsartorial-saphenous-nerve-block-a-randomized-controlled-trial
#3
Shaylyn H Montgomery, Colleen M Shamji, Grace S Yi, Cynthia H Yarnold, Stephen J Head, Scott C Bell, Stephan K W Schwarz
BACKGROUND AND OBJECTIVES: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus...
November 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27898181/endovenous-ablation-therapy-laser-or-radiofrequency-or-foam-sclerotherapy-versus-conventional-surgical-repair-for-short-saphenous-varicose-veins
#4
REVIEW
Sharath Chandra Vikram Paravastu, Margaret Horne, P Dominic F Dodd
BACKGROUND: Short (or small) saphenous vein (SSV) varices occur as a result of an incompetent sapheno-popliteal junction, where the SSV joins the popliteal vein, resulting in reflux in the SSV; they account for about 15% of varicose veins. Untreated varicose veins may sometimes lead to ulceration of the leg, which is difficult to manage. Traditionally, treatment was restricted to surgery or conservative management. Since the 1990s, however, a number of minimally invasive techniques have been developed; these do not normally require a general anaesthetic, are day-case procedures with a quicker return to normal activities and avoid the risk of wound infection which may occur following surgery...
November 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27897119/glaucoma-hot-topics-in-pharmacology
#5
Shiama I Balendra, Parth Arvind Shah, Mishank Jain, Andrzej Grzybowski, Francesca M Cordeiro
BACKGROUND: Glaucoma comprises a group of neurodegenerative diseases resulting in retinal ganglion cell death within the optic nerve head. It is projected to affect almost 80 million people worldwide by 2020. The condition's asymptomatic nature translates to over half of glaucoma sufferers being unaware of their condition. By the time of diagnosis, irreversible blindness is likely to have occurred. Prime areas of glaucoma research therefore include identification and optimization of risk factors for the disease, accurate and early diagnostic tools and novel therapeutic methods...
November 29, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27884849/access-hd-pilot-a-randomised-feasibility-trial-comparing-catheters-with-fistulas-in-elderly-patients-starting-haemodialysis
#6
Robert Quinn, Pietro Ravani
INTRODUCTION: The selection of the type of vascular access for haemodialysis is an important intervention question. However, only observational studies are available to inform decision-making in this area, and they are at high risk of selection bias. While a clinical trial comparing the effects of the 2 most frequently chosen strategies for haemodialysis access (fistulas and catheters) on patient important and 'hard' clinical end points is needed, the feasibility of such a trial is uncertain...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27871211/registry-and-health-insurance-claims-data-in-vascular-research-and-quality-improvement
#7
Christian-Alexander Behrendt, Franziska Heidemann, Henrik Christian Rieß, Konstanze Stoberock, Sebastian Eike Debus
The expansion of procedures in multidisciplinary vascular medicine has sparked a controversy regarding measures of quality improvement. In addition to primary registries, the use of health insurance claims data is becoming of increasing importance. However, due to the fact that health insurance claims data are not collected for scientific evaluation but rather for reimbursement purposes, meticulous validation is necessary before and during usage in research and quality improvement matters. This review highlights the advantages and disadvantages of such data sources...
November 22, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27829449/efficacy-of-brief-behavioral-counselling-by-allied-health-professionals-to-promote-physical-activity-in-people-with-peripheral-arterial-disease-bipp-study-protocol-for-a-multi-center-randomized-controlled-trial
#8
Nicola W Burton, Zanfina Ademi, Stuart Best, Maria A Fiatarone Singh, Jason S Jenkins, Kenny D Lawson, Anthony S Leicht, Yorgi Mavros, Yian Noble, Paul Norman, Richard Norman, Belinda J Parmenter, Jenna Pinchbeck, Christopher M Reid, Sophie E Rowbotham, Lisan Yip, Jonathan Golledge
BACKGROUND: Physical activity is recommended for people with peripheral arterial disease (PAD), and can improve walking capacity and quality of life; and reduce pain, requirement for surgery and cardiovascular events. This trial will assess the efficacy of a brief behavioral counselling intervention delivered by allied health professionals to improve physical activity in people with PAD. METHODS: This is a multi-center randomised controlled trial in four cities across Australia...
November 9, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27799170/troponin-elevations-after-non-cardiac-non-vascular-surgery-are-predictive-of-major-adverse-cardiac-events-and-mortality-a-systematic-review-and-meta-analysis
#9
REVIEW
S Ekeloef, M Alamili, P J Devereaux, I Gögenur
BACKGROUND: Patients undergoing non-cardiac, non-vascular surgery are at risk of major cardiovascular complications. In non-cardiac surgery, troponin elevation has previously been shown to be an independent predictor of major adverse cardiac events and postoperative mortality; however, a majority of studies have focused on vascular surgery patients. The aim of this meta-analysis was to determine whether troponin elevation is a predictor of major adverse cardiac events and mortality within 30 days and 1 yr after non-cardiac, non-vascular surgery...
November 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27797404/pentasaccharides-for-the-prevention-of-venous-thromboembolism
#10
REVIEW
Kezhou Dong, Yanzhi Song, Xiaodong Li, Jie Ding, Zhiyong Gao, Daopei Lu, Yimin Zhu
BACKGROUND: Venous thromboembolism (VTE) is a common condition with potentially serious and life-threatening consequences. The standard method of thromboprophylaxis uses an anticoagulant such as low molecular weight heparin (LMWH) or warfarin. In recent years, another type of anticoagulant, pentasaccharide, an indirect factor Xa inhibitor, has shown good anticoagulative effect in clinical trials. Three types of pentasaccharides are available: short-acting fondaparinux, long-acting idraparinux and idrabiotaparinux...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27797116/methods-to-decrease-blood-loss-during-liver-resection-a-network-meta-analysis
#11
REVIEW
Elisabetta Moggia, Benjamin Rouse, Constantinos Simillis, Tianjing Li, Jessica Vaughan, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: Liver resection is a major surgery with significant mortality and morbidity. Specialists have tested various methods in attempts to limit blood loss, transfusion requirements, and morbidity during elective liver resection. These methods include different approaches (anterior versus conventional approach), use of autologous blood donation, cardiopulmonary interventions such as hypoventilation, low central venous pressure, different methods of parenchymal transection, different methods of management of the raw surface of the liver, different methods of vascular occlusion, and different pharmacological interventions...
October 31, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27781197/surgery-for-intermediate-and-advanced-hepatocellular-carcinoma-a-consensus-report-from-the-5th-asia-pacific-primary-liver-cancer-expert-meeting-apple-2014
#12
Ming-Chih Ho, Kiyoshi Hasegawa, Xiao-Ping Chen, Hiroaki Nagano, Young-Joo Lee, Gar-Yang Chau, Jian Zhou, Chih-Chi Wang, Young Rok Choi, Ronnie Tung-Ping Poon, Norihiro Kokudo
BACKGROUND: The Barcelona Clinic Liver Cancer (BCLC) staging and treatment strategy does not recommended surgery for treating BCLC stage B and C hepatocellular carcinoma (HCC). However, numerous Asia-Pacific institutes still perform surgery for this patient group. This consensus report from the 5th Asia-Pacific Primary Liver Cancer Expert Meeting aimed to share opinions and experiences pertaining to liver resection for intermediate and advanced HCCs and to provide evidence to issue recommendations for surgery in this patient group...
October 2016: Liver Cancer
https://www.readbyqxmd.com/read/27775997/withholding-versus-continuing-angiotensin-converting-enzyme-inhibitors-or-angiotensin-ii-receptor-blockers-before-noncardiac-surgery-an-analysis-of-the-vascular-events-in-noncardiac-surgery-patients-cohort-evaluation-prospective-cohort
#13
Pavel S Roshanov, Bram Rochwerg, Ameen Patel, Omid Salehian, Emmanuelle Duceppe, Emilie P Belley-Côté, Gordon H Guyatt, Daniel I Sessler, Yannick Le Manach, Flavia K Borges, Vikas Tandon, Andrew Worster, Alexandra Thompson, Mithin Koshy, Breagh Devereaux, Frederick A Spencer, Robert D Sanders, Erin N Sloan, Erin E Morley, James Paul, Karen E Raymer, Zubin Punthakee, P J Devereaux
BACKGROUND: The effect on cardiovascular outcomes of withholding angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers in chronic users before noncardiac surgery is unknown. METHODS: In this international prospective cohort study, the authors analyzed data from 14,687 patients (including 4,802 angiotensin-converting enzyme inhibitor/angiotensin II receptor blocker users) at least 45 yr old who had in-patient noncardiac surgery from 2007 to 2011...
October 24, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27770853/external-mechanical-devices-and-vascular-surgery-for-erectile-dysfunction
#14
Landon W Trost, Ricardo Munarriz, Run Wang, Allen Morey, Laurence Levine
INTRODUCTION: The field of sexual medicine is continuously advancing, with novel outcomes reported on a regular basis. Given the rapid evolution, updated guidelines are essential to inform practicing clinicians on best practices. AIM: To summarize the current literature and provide clinical guidelines on penile traction therapy, vacuum erection devices, and penile revascularization. METHODS: A consensus panel was held with leading sexual medicine experts during the 2015 International Consultation on Sexual Medicine (ICSM)...
November 2016: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/27759614/magnetic-surgery-results-from-first-prospective-clinical-trial-in-50-patients
#15
Homero Rivas, Ignacio Robles, Francisco Riquelme, Marcelo Vivanco, Julio Jiménez, Boris Marinkovic, Mario Uribe
OBJECTIVE: To evaluate a new magnetic surgical system during reduced-port laparoscopic cholecystectomy in a prospective, multicenter clinical trial. BACKGROUND: Laparoscopic instrumentation coupled by magnetic fields may enhance surgeon performance by allowing for shaft-less retraction and mobilization. The movements can be performed under direct visualization, generating different angles of traction and reducing the number of trocars to perform the procedure. This may reduce well-known associated complications of trocars, including incisional pain, scarring, infection, bowel, and vascular injuries, among others...
October 24, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27755162/subtenon-injections-of-ranibizumab-arrest-growth-in-early-recurrent-pterygium
#16
Linda Rose, Julia M Byrd, Yousuf Qaseem
IMPORTANCE: Currently the only treatment for recurrent pterygium is surgery. This is a phase 1 trial investigating ranibizumab as a medical treatment for recurrent pterygium. OBJECTIVE: To assess the safety and efficacy of subtenon Ranibizimab for recurrent pterygia. DESIGN: Subjects with recurrent pterygium received subtenon ranibizumab and were followed for 1 year. Safety parameters were measured. Photographs were taken and quantitatively analyzed to measure the short-term (2 months) and long-term (5-26 months) response to treatment...
October 7, 2016: Eye & Contact Lens
https://www.readbyqxmd.com/read/27743809/initial-clinical-experience-with-a-polytetrafluoroethylene-vascular-dialysis-graft-reinforced-with-nitinol-at-the-venous-end
#17
Filippo Benedetto, Domenico Spinelli, Narayana Pipitò, Giambattista Gagliardo, Alberto Noto, Simona Villari, Antonio David, Francesco Spinelli
OBJECTIVE: The purpose of this study was to examine the outcomes of a vascular hybrid polytetrafluoroethylene (PTFE) graft, provided with a nitinol-reinforced section (NRS) on one end, in hemodialysis vascular access placement. METHODS: A retrospective study was conducted including all the consecutive patients who underwent Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) implantation for hemodialysis access placement between October 2013 and November 2015...
October 12, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27731522/the-novel-treatment-of-svf-enriched-fat-grafting-for-painful-end-neuromas-of-superficial-radial-nerve
#18
Maurizio Calcagni, Simon Zimmermann, Mario F Scaglioni, Thomas Giesen, Pietro Giovanoli, Richard M Fakin
INTRODUCTION: None of the existing treatments in the management of painful end-neuromas of the superficial branch of the radial nerve (SBRN) has been proven superior due to high levels of pain relapse. Fat grafts enriched with the stromal vascular fraction (SVF) could act as a mechanic barrier with biological effects decreasing the resorption rate and boosting the graft's regenerative potential. This study describes the novel surgical treatment technique of SVF-enriched fat grafting. PATIENTS AND METHODS: In this clinical study, five consecutive patients treated for painful end-neuromas of the SBRN between 2012 and 2013 were analyzed retrospectively...
October 12, 2016: Microsurgery
https://www.readbyqxmd.com/read/27726853/frequency-of-increase-in-cardiac-troponin-levels-after-peripheral-arterial-operations-carotid-endarterectomy-abdominal-aorta-procedure-distal-bypass-and-their-effect-on-medical-management
#19
Yader Sandoval, Marina Zakharova, Thomas S Rector, Emmanouil S Brilakis, Todd Drexel, Edward O McFalls, Santiago Garcia
The utility of measuring cardiac troponins (cTn) in asymptomatic patients during the perioperative period has been controversial. In the present substudy of the Cardiac Remote Ischemic Preconditioning Prior to Elective Vascular Surgery Trial (NCT01558596), we hypothesized that surveillance of myocardial injury with cTnI in the perioperative period would lead to initiation or intensification of medical therapies for coronary artery disease. Increases in cTnI ≥0.01 μg/l in the perioperative period were considered clinically significant...
September 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27720318/heterogeneous-histomorphology-yet-homogeneous-vascular-smooth-muscle-cell-dedifferentiation-characterize-human-aneurysm-disease
#20
Albert Busch, Elena Hartmann, Caroline Grimm, Süleyman Ergün, Ralph Kickuth, Christoph Otto, Richard Kellersmann, Udo Lorenz
OBJECTIVE: Abdominal aortic aneurysm (AAA) is a frequent, potentially life-threatening, disease that can only be treated by surgical means such as open surgery or endovascular repair. No alternative treatment is currently available, and despite expanding knowledge about the pathomechanism, clinical trials on medical aneurysm abrogation have led to inconclusive results. The heterogeneity of human AAA based on histologic examination is thereby generally neglected. In this study we aimed to further elucidate the role of these differences in aneurysm disease...
October 5, 2016: Journal of Vascular Surgery
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