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Vascular surgery risk score

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https://www.readbyqxmd.com/read/29325843/preoperative-intra-aortic-counterpulsation-in-cardiac-surgery-insights-from-a-retrospective-series-of-588-consecutive-high-risk-patients
#1
Giuseppe Gatti, Laura Morra, Gianluca Castaldi, Luca Maschietto, Florida Gripshi, Enrico Fabris, Andrea Perkan, Bernardo Benussi, Gianfranco Sinagra, Aniello Pappalardo
OBJECTIVE: To support a rational use of preoperative intra-aortic balloon pump (IABP) in cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single university hospital. PARTICIPANTS: The study included 588 (mean age 68.5 ± 9.6 yr) consecutive patients who received IABP before cardiac surgery from 1999 to 2016. INTERVENTIONS: Coronary surgery was performed in 573 (97.4%) cases...
December 6, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29298873/multicentre-prospective-evaluation-of-real-time-optical-diagnosis-of-t1-colorectal-cancer-in-large-non-pedunculated-colorectal-polyps-using-narrow-band-imaging-the-optical-study
#2
Yara Backes, Matthijs P Schwartz, Frank Ter Borg, Frank H J Wolfhagen, John N Groen, Wouter H de Vos Tot Nederveen Cappel, Jeroen van Bergeijk, Joost M J Geesing, Bernhard W M Spanier, Paul Didden, Frank P Vleggaar, Miangela M Lacle, Sjoerd G Elias, Leon M G Moons
OBJECTIVE: This study evaluated the preresection accuracy of optical diagnosis of T1 colorectal cancer (CRC) in large non-pedunculated colorectal polyps (LNPCPs). DESIGN: In this multicentre prospective study, endoscopists predicted the histology during colonoscopy in consecutive patients with LNPCPs using a standardised procedure for optical assessment. The presence of morphological features assessed with white light, and vascular and surface pattern with narrow-band imaging (NBI) were recorded, together with the optical diagnosis, the confidence level of prediction and the recommended treatment...
January 3, 2018: Gut
https://www.readbyqxmd.com/read/29298372/multidisciplinary-perioperative-management-of-pulmonary-arterial-hypertension-in-patients-undergoing-noncardiac-surgery
#3
José L Díaz-Gómez, Juan G Ripoll, Isabel Mira-Avendano, John E Moss, Gavin D Divertie, Ryan D Frank, Charles D Burger
OBJECTIVES: To describe the effect of implementing a contemporary perioperative pulmonary hypertension (PH)-targeted protocol in patients with pulmonary arterial hypertension (PAH) undergoing noncardiac surgery (NCS). METHODS: The data of consecutive patients with PAH diagnosed by right heart catheterization who underwent NCS between January 1, 2006 and February 9, 2016 were reviewed. Patient demographics, etiology of PAH, clinical features, diagnostic data, utilization of PH-specific medications, and trend of perioperative complications rate were recorded during the study period...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29273883/calcification-of-the-iliac-arteries-a-marker-for-leakage-risk-in-rectal-anastomosis-a-blinded-clinical-trial
#4
Julius Pochhammer, Fridolin Tröster, Gunnar Blumenstock, Julienne Closset, Stefanie Lang, Marie-Pascale Weller, Michael Schäffer
PURPOSE: Anastomotic leakage (AL) is associated with increased morbidity and mortality after colorectal surgery. Calcification of the arteries has been identified as a risk factor for cardiovascular events and can be reliably measured on computed tomography using software assistance. The aim of this prospective study was to prove the value of calcium scoring of the iliac arteries as a predictor of AL after rectal anastomosis. METHODS: Consecutive patients who underwent colorectal resection with rectal anastomosis were analyzed...
December 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29242656/single-bolus-dose-of-epidural-magnesium-prolongs-the-duration-of-analgesia-in-cardiac-patients-undergoing-vascular-surgeries
#5
Amarja Sachin Nagre, Nagesh Jambure
Background and Aims: Magnesium, a physiological antagonist of calcium and N-methyl-d-aspartate, has a role in the prevention of pain in patients undergoing surgery for peripheral vascular diseases with cardiac comorbidities such as ischaemic heart disease and coronary artery disease. The objective of our study was assessment of effects of epidural magnesium in cardiac patients undergoing vascular surgery. Methods: Sixty patients of either sex American Society of Anesthesiologists physical status III undergoing surgeries for peripheral vascular diseases were enrolled...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29171682/in-hospital-outcomes-of-transcatheter-versus-surgical-aortic-valve-replacement-in-end-stage-renal-disease
#6
Ahmad Alkhalil, Shervin Golbari, David Song, Harveen Lamba, Anas Fares, Amer Alaiti, Salil Deo, Guilherme F Attizzani, Homam Ibrahim, Carlos E Ruiz
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is an alternative to surgical aortic valve replacement (SAVR) for patients with severe symptomatic aortic stenosis (AS) who are at intermediate and high risk for surgery. Commercial use of TAVR has expanded to patients with end stage renal disease (ESRD). OBJECTIVES: Compare in-hospital outcomes of TAVR versus SAVR in ESRD patients requiring hemodialysis (HD). METHODS: ESRD patients on HD undergoing TAVR (n = 328) or SAVR (n = 697) between 2012 and 2014 were identified in the National Inpatient Sample (NIS)...
November 24, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29169796/physiological-and-operative-severity-score-for-the-enumeration-of-mortality-and-morbidity-possum-system-for-outcome-prediction-in-elderly-patients-undergoing-major-vascular-surgery
#7
Inês M Teixeira, Ana R Teles, José M Castro, Luís F Azevedo, Joana B Mourão
OBJECTIVE: POSSUM system is widely used and validated for 30-day mortality and morbidity prediction. The aim of this study was to evaluate the performance of five POSSUM's equations (POSSUM, P-POSSUM, V-POSSUM, V-POSSUM physiology and V-POSSUM Cambridge) on predicting 30-day mortality and morbidity in elderly patients undergoing major elective vascular surgery. DESIGN: A retrospective longitudinal cohort study. SETTING: A study conducted at an University Hospital...
August 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29167026/safety-of-moderate-hypothermia-with-antegrade-cerebral-perfusion-in-total-aortic-arch-replacement
#8
W Brent Keeling, David H Tian, Brad G Leshnower, Satoshi Numata, G Chad Hughes, George Matalanis, Yutaka Okita, Tristan D Yan, Nicholas Kouchoukos, Edward P Chen
BACKGROUND: Total aortic arch replacement (TOTAL) is a complicated operation and has traditionally required deep hypothermic circulatory arrest. In this study, the impact of moderate hypothermic circulatory arrest (MHCA) and antegrade cerebral perfusion (ACP) for TOTAL were examined. METHODS: The ARCH International aortic database was queried and 3,265 patients undergoing TOTAL using ACP were identified. Patients were divided into groups based on lowest cooling temperature: MHCA (20° to 28°C) or deep hypothermia (DHCA) (12° to 20°C)...
November 19, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29133751/shanghai-score-a-prognostic-and-adjuvant-treatment-evaluating-system-constructed-for-chinese-patients-with-hepatocellular-carcinoma-after-curative-resection
#9
Hui-Chuan Sun, Lu Xie, Xin-Rong Yang, Wei Li, Jian Yu, Xiao-Dong Zhu, Yong Xia, Ti Zhang, Yang Xu, Bo Hu, Li-Ping Du, Ling-Yao Zeng, Jian Ouyang, Wei Zhang, Tian-Qiang Song, Qiang Li, Ying-Hong Shi, Jian Zhou, Shuang-Jian Qiu, Qian Liu, Yi-Xue Li, Zhao-You Tang, Yu Shyr, Feng Shen, Jia Fan
BACKGROUND: For Chinese patients with hepatocellular carcinoma (HCC), surgical resection is the most important treatment to achieve long-term survival for patients with an early-stage tumor, and yet the prognosis after surgery is diverse. We aimed to construct a scoring system (Shanghai Score) for individualized prognosis estimation and adjuvant treatment evaluation. METHODS: A multivariate Cox proportional hazards model was constructed based on 4166 HCC patients undergoing resection during 2001-2008 at Zhongshan Hospital...
November 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/29129358/indocyanine-green-fluorescence-guided-parathyroidectomy-for-primary-hyperparathyroidism
#10
Jonathan C DeLong, Erin P Ward, Thinzar M Lwin, Kevin T Brumund, Kaitlyn J Kelly, Santiago Horgan, Michael Bouvet
BACKGROUND: Our aim was to evaluate the ease and utility of using indocyanine green fluorescence angiography for intraoperative localization of the parathyroid glands. METHODS: Indocyanine green fluorescence angiography was performed during 60 parathyroidectomies for primary hyperparathyroidism during a 22-month period. Indocyanine green was administered intravenously to guide operative navigation using a commercially available fluorescence imaging system. Video files were graded by 3 independent surgeons for strength of enhancement using an adapted numeric scoring system...
November 9, 2017: Surgery
https://www.readbyqxmd.com/read/29112544/european-guidelines-on-perioperative-venous-thromboembolism-prophylaxis-day-surgery-and-fast-track-surgery
#11
Linas Venclauskas, Juan V Llau, Jean-Yves Jenny, Per Kjaersgaard-Andersen, Øivind Jans
: In recent years, day surgery and fast-track surgery have experienced a continuous increase in volume. Many procedures are now performed on an outpatient protocol, including general, orthopaedic, oncological, reconstructive or vascular surgery. The management of these patients is safe, but the incidence of venous thromboembolism in this population remains unknown. Several risk factors can be identified and stratified derived from studies of inpatient surgical management (e.g. Caprini score). Recommendations for thromboprophylaxis should be tailored from the assessment of both personal and procedure-related risk factors, although with a lack of evidence for application in outpatient management...
February 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29095313/treatment-of-type-ii-odontoid-fracture-with-a-novel-technique-titanium-cable-dragged-reduction-and-cantilever-beam-internal-fixation
#12
Ce Zhu, Lei Wang, Hao Liu, Yueming Song, Limin Liu, Tao Li, Quan Gong
Surgical methods for type II odontoid fracture can be classified into 2 main groups: anterior or posterior approach. A more effective way to achieve bone fusion with the lowest possible surgical risk is needed. Therefore, the aim of our study was to describe and evaluate a novel technique, cable-dragged reduction/cantilever beam internal fixation for the treatment of type II odontoid fracture.This was a retrospective study enrolled 34 patients underwent posterior cable-dragged reduction/cantilever-beam internal fixation surgery...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29057349/clinical-evaluation-of-microendoscopy-assisted-extreme-lateral-interbody-fusion
#13
Tomohide Segawa, Hirohiko Inanami, Hisashi Koga
BACKGROUND: Extreme lateral interbody fusion (XLIF) has rapidly become a popular operative procedure for lumbar canal stenosis and scoliosis. This approach provides direct access to the lateral aspect of the disc with minimal disruption of spinal structures, including ligaments and muscles. However, it involves risk of injuries to the lumbar nerve plexus, segmental artery and intestinal tract because of the limited surgical field. This study aimed to clarify the benefit of using a microendoscope to prevent these injuries...
September 2017: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29055710/remote-ischemic-preconditioning-in-high-risk-cardiovascular-surgery-patients-a-randomized-controlled-trial
#14
Nicole S Coverdale, Andrew Hamilton, Dimitri Petsikas, R Scott McClure, Paul Malik, Brian Milne, Tarit Saha, David Zelt, Peter Brown, Darrin M Payne
Remote ischemic preconditioning (RIPC) may reduce biomarkers of ischemic injury after cardiovascular surgery. However, it is unclear whether RIPC has a positive impact on clinical outcomes. We performed a blinded, randomized controlled trial to determine if RIPC resulted in fewer adverse clinical outcomes after cardiac or vascular surgery. The intervention consisted of 3 cycles of RIPC on the upper limb for 5 minutes alternated with 5 minutes of rest. A sham intervention was performed on the control group. Patients were recruited who were undergoing (1) high-risk cardiac or vascular surgery or (2) cardiac or vascular surgery and were at high risk of ischemic complications...
September 11, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049809/association-of-quality-improvement-registry-participation-with-appropriate-follow-up-after-vascular-procedures
#15
Benjamin S Brooke, Adam W Beck, Larry W Kraiss, Andrew W Hoel, Andrea M Austin, Amir A Ghaffarian, Jack L Cronenwett, Philip P Goodney
Importance: Ensuring that patients undergo surveillance imaging after surgery is a key quality metric after many vascular procedures. It is unclear whether hospital participation in a national quality improvement registry such as the Vascular Quality Initiative (VQI) achieves this goal. Objective: To determine if hospital participation in the VQI registry is associated with increased rates of surveillance imaging after vascular procedures. Design, Setting, and Participants: A quasi-experimental study used Medicare claims to study 2174 US hospitals in which 1 530 102 patients had undergone an endovascular abdominal aortic aneurysm repair (EVAR), 1 403 067 patients had undergone a lower extremity bypass (LEB) or peripheral vascular intervention (PVI), and 294 942 patients had undergone carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedures between January 1, 2007, and December 31, 2012...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28987845/recurrent-cerebral-hemorrhages-in-normal-pregnancy-secondary-to-mycotic-pseudoaneurysms-related-to-choriocarcinoma
#16
Crystal Jing Jing Yeo, Gavin W Britz, Suzanne Z Powell, R Glenn Smith, Yi J Zhang
BACKGROUND: Choriocarcinoma coexisting with or after normal pregnancy is extremely rare. To our knowledge, our case report is the first time cerebral mycotic pseudoaneurysms from choriocarcinoma have been proven angiographically. CASE DESCRIPTION: A 38-week pregnant 26-year old woman presented with an acute left frontal hemorrhage. She underwent emergency Caesarian, followed by hematoma evacuation and resection of what grossly appeared to be a medium-sized arteriovenous malformation at the time of surgery...
October 5, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28967720/current-multivariate-risk-scores-in-patients-undergoing-non-cardiac-surgery
#17
Gian Francesco Mureddu
Several indexes to predict perioperative cardiovascular risk have been proposed overtime. The most widely used is the Revised Cardiac Risk Index (RCRI) developed by Lee since 1999. It predicts major cardiac outcomes from five independent clinical determinants: history of ischemic heart disease, history of cardiovascular disease, heart failure, insulin-dependent diabetes mellitus, and chronic renal failure (i.e. serum creatinine >2 mg/dl). In external validation studies, the RCRI showed high negative predictive value in all groups of age, indicating that it may be used to identify people at low risk for perioperative adverse cardiovascular events in noncardiac surgery...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28942855/a-systematic-review-and-meta-analysis-of-factors-for-delirium-in-vascular-surgical-patients
#18
REVIEW
Christopher Oldroyd, Anna F M Scholz, Robert J Hinchliffe, Kathryn McCarthy, Jonathan Hewitt, Terrence J Quinn
BACKGROUND: Delirium is a common syndrome responsible for a large burden of morbidity and mortality. In surgical settings, research into risk factors for postoperative delirium has largely focused on elective orthopedic patients. We performed a systematic review and meta-analysis to evaluate the evidence surrounding risk factors for delirium in vascular surgical populations. METHODS: Two independent reviewers searched five databases (MEDLINE, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO) from January 1987 to December 2015...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28925651/exercise-stress-testing-indications-and-common-questions
#19
Kathryn K Garner, William Pomeroy, James J Arnold
Exercise stress testing is a validated diagnostic test for coronary artery disease in symptomatic patients, and is used in the evaluation of patients with known cardiac disease. Testing of asymptomatic patients is generally not indicated. It may be performed in select deconditioned adults before starting a vigorous exercise program, but no studies have compared outcomes from preexercise testing vs. encouraging light exercise with gradual increases in exertion. Preoperative exercise stress testing is helpful for risk stratification in patients undergoing vascular surgery or who have active cardiac symptoms before undergoing nonemergent noncardiac surgery...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28919267/post-carotid-endarterectomy-hypertension-part-2-association-with-peri-operative-clinical-anaesthetic-and-transcranial-doppler-derived-parameters
#20
Jeremy E Newman, Mathew J Bown, Robert D Sayers, Jonathan P Thompson, Thompson G Robinson, Bryan Williams, Ronney Panerai, Peter Lacy, A Ross Naylor
OBJECTIVE/BACKGROUND: The first paper in this series observed that pre-operative baroreceptor dysfunction and poorly controlled hypertension were independently predictive for identifying patients who went on to require treatment for post-endarterectomy hypertension (PEH). The second paper examines the influence of intra-operative patient, transcranial Doppler (TCD) ultrasound, and anaesthetic variables on the incidence of PEH. METHODS: In total, 106 patients underwent carotid endarterectomy (CEA) under general anaesthesia...
November 2017: European Journal of Vascular and Endovascular Surgery
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