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Vascular surgery risk score

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https://www.readbyqxmd.com/read/28171827/vascular-inflammation-and-media-calcification-are-already-present-in-early-stages-of-chronic-kidney-disease
#1
Kerstin Benz, Ildiko Varga, Daniel Neureiter, Valentina Campean, Christoph Daniel, Christian Heim, Albrecht Reimann, Michael Weyand, Karl F Hilgers, Kerstin Amann
BACKGROUND: While patients with chronic kidney disease (CKD) have a high prevalence of classical coronary risk factors, there is increasing evidence that atherosclerosis is different in renal compared to nonrenal patients. Therefore, the present study compares changes in different vessels obtained at cardiac surgery between patients with early and advanced CKD and nonrenal control patients. METHODS AND RESULTS: Fifty patients undergoing cardiac bypass surgery were divided into three groups: (i) 24 control patients with creatinine <1...
January 23, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28132013/new-predictive-model-for-microsurgical-outcome-of-intracranial-arteriovenous-malformations-study-protocol
#2
Xianzeng Tong, Jun Wu, Yong Cao, Yuanli Zhao, Shuo Wang
INTRODUCTION: Although microsurgical resection is currently the first-line treatment modality for arteriovenous malformations (AVMs), microsurgery of these lesions is complicated due to the fact that they are very heterogeneous vascular anomalies. The Spetzler-Martin grading system and the supplementary grading system have demonstrated excellent performances in predicting the risk of AVM surgery. However, there are currently no predictive models based on multimodal MRI techniques. The purpose of this study is to propose a predictive model based on multimodal MRI techniques to assess the microsurgical risk of intracranial AVMs...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28128541/fenestrated-and-chimney-endovascular-aneurysm-repair-versus-open-surgery-for-complex-abdominal-aortic-aneurysms
#3
Vicente A Sala-Almonacil, José M Zaragozá-García, Mauricio Ramírez-Montoya, Vicente Molina-Nácher, Inmaculada Martínez-Perelló, Francisco J Gómez-Palonés
BACKGROUND: Many patients with complex abdominal aortic aneurysms are unfit for open repair. New endovascular technologies and bailout techniques are being used for managing those complex anatomies. The purpose of this study is to compare the results obtained with advanced endovascular aneurysm repair techniques (fenestrated and chimney endografts) to those obtained with open repair for the treatment of complex abdominal aortic aneurysms not anatomically suitable for standard endovascular exclusion (infrarenal neck <10 mm, juxtarenal, suprarenal and Crawford's type IV thoracoabdominal aneurysms)...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28119385/anaesthesia-modalities-during-laser-photocoagulation-for-retinopathy-of-prematurity-a-retrospective-longitudinal-study
#4
Jing-Bo Jiang, Randy Strauss, Xian-Qiong Luo, Chuan Nie, Yan-Li Wang, Jia-Wen Zhang, Zhi-Wei Zhang
OBJECTIVES: Laser photocoagulation surgery is a routine treatment for threshold retinopathy of prematurity (ROP). However, little is known about which anaesthesia protocols provide efficient pain control while minimising exposure risk to vulnerable infants. In this study, therefore, we assessed the efficacy and tolerability of multiple anaesthesia techniques used on premature infants during laser therapy. DESIGN AND MAIN OUTCOME MEASURES: Anaesthesia modalities consisted of topical eye drops anaesthesia, general anaesthesia and intravenous fentanyl sedation with mechanical ventilation...
January 24, 2017: BMJ Open
https://www.readbyqxmd.com/read/28109568/one-or-two-internal-thoracic-grafts-long-term-follow-up-of-957-off-pump-coronary-bypass-surgeries
#5
Dmitry Pevni, Yanai Ben-Gal, Rephael Mohr, Amir Ganiel, Yosef Paz, Amir Kramer, Nahum Nesher
BACKGROUND: The potential survival benefit of bilateral internal thoracic artery (BITA) grafting in patients undergoing off-pump coronary artery bypass graft surgery (OPCABG) is controversial owing to the technical complexity of these operations. Our objective was to compare the outcome of patients undergoing OPCABG with BITA to the outcome of patients undergoing OPCABG with a single internal thoracic artery (SITA) and saphenous vein grafts or radial artery. METHODS: Five hundred and thirty-five consecutive patients who underwent OPCABG BITA at our institute between 2000 and 2008 were compared with 422 patients who underwent OPCABG with SITA...
January 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28096064/evaluation-of-financial-burdens-following-complications-after-major-surgery-in-france-potential-returns-after-perioperative-goal-directed-therapy
#6
Alain Landais, Morgane Morel, Jacques Goldstein, Jerôme Loriau, Annie Fresnel, Corinne Chevalier, Gilles Rejasse, Pascal Alfonsi, Claude Ecoffey
OBJECTIVE: Perioperative goal directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. METHODS: The billing of 2,388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public - teaching, one public, and one private hospital)...
January 13, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28092285/perioperative-%C3%AE-blockers-in-patients-undergoing-noncardiac-surgery-scientific-misconduct-and-clinical-guidelines
#7
Dhauna Karam, Rohit Arora
BACKGROUND: β-blocker use in perioperative period of noncardiac surgeries has been a topic of debate since many years. Earlier studies conducted in the 90s showed decreased cardiac adverse events and improved postoperative outcomes with β-blocker use. Based on this, the ACCF and ESC published guidelines strongly supporting β-blocker use. But contemporaneous studies conducted revealed conflicting evidence and have also proven some of the earlier studies to be fraudulent. Although ACCF guidelines have been updated to partially reflect the changes, ESC guidelines continue to support β-blocker use...
January 10, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#8
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28045412/transcatheter-aortic-valve-implantation-with-the-edwards-sapien-3-valve-first-experiences-in-turkey
#9
Abdullah Nabi Aslan, Serdal Baştuğ, Hacı Ahmet Kasapkara, Hüseyin Ayhan, Hakan Süygün, Telat Keleş, Tahir Durmaz, Nihal Akar Bayram, Emine Bilen, Engin Bozkurt
OBJECTIVE: Transcatheter aortic valve implantation (TAVI) has shown promising results in patients with severe aortic stenosis (AS) at high risk for open heart surgery. We aimed to evaluate outcomes of patients who underwent TAVI with Edwards SAPIEN 3 Transcatheter Heart Valve (S3), a second-generation TAVI device. METHODS: Between November 2014 and June 2016, 31 high-risk patients received balloon-expandable S3 valve at Atatürk Training and Research Hospital that has the largest case series in Turkey...
December 2016: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28004457/clinical-and-ultrasound-characteristics-of-surgically-removed-adnexal-lesions-with-a-largest-diameter-%C3%A2-2-5-cm-a-pictorial-essay
#10
A Di Legge, P Pollastri, R Mancari, M Ludovisi, F Mascilini, D Franchi, D Jurkovic, M E Coccia, D Timmerman, G Scambia, A Testa, L Valentin
OBJECTIVES: The aim was to describe the ultrasound characteristics, the indications for surgery and the histological diagnoses of surgically removed adnexal masses with largest diameter <2.5 cm ("very small tumors"), to estimate sensitivity and specificity with regard to malignancy of subjective assessment of ultrasound images of very small tumors, and to present a gallery of ultrasound images of surgically removed very small tumors especially those causing diagnostic difficulties...
December 22, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27998608/a-score-to-estimate-30-day-mortality-after-intensive-care-admission-after-cardiac-surgery
#11
Yoan Lamarche, Mahsa Elmi-Sarabi, Lillian Ding, James G Abel, Demetrios Sirounis, André Y Denault
OBJECTIVE: Several risk-scoring systems have been developed to predict surgical mortality and complications in cardiac surgical patients, but none of the current systems include factors related to the intraoperative period. The purpose of this study was to develop a score that incorporates both preoperative and intraoperative factors so that it could be used for patients admitted to a cardiac surgical intensive care unit (ICU) immediately after surgery. METHOD: Preoperative and intraoperative data from 30,350 patients in four hospitals were used to build a multiple logistic regression model estimating 30-day mortality after cardiac surgery...
November 23, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27992624/association-of-perioperative-statin-use-with-mortality-and-morbidity-after-major-noncardiac-surgery
#12
Martin J London, Gregory G Schwartz, Kwan Hur, William G Henderson
Importance: The efficacy of statins in reducing perioperative cardiovascular and other organ system complications in patients undergoing noncardiac surgery remains controversial. Owing to a paucity of randomized clinical trials, analyses of large databases may facilitate informed hypothesis generation and more efficient trial design. Objective: To evaluate associations of early perioperative statin use with outcomes in a national cohort of veterans undergoing noncardiac surgery...
February 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27929930/validation-of-a-predictive-scoring-system-for-deep-sternal-wound-infection-after-bilateral-internal-thoracic-artery-grafting-in-a-cohort-of-french-patients
#13
Andrea Perrotti, Giuseppe Gatti, Enrica Dorigo, Gianfranco Sinagra, Aniello Pappalardo, Sidney Chocron
BACKGROUND: The Gatti score is a weighted scoring system based on risk factors for deep sternal wound infection (DSWI) that was created in an Italian center to predict DSWI risk after bilateral internal thoracic artery (BITA) grafting. No external evaluation based on validation samples derived from other surgical centers has been performed. The aim of this study is to perform this validation. PATIENTS AND METHODS: During 2015, BITA grafts were used as skeletonized conduits in all 255 consecutive patients with multi-vessel coronary disease who underwent isolated coronary bypass surgery at the Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besançon, France...
February 2017: Surgical Infections
https://www.readbyqxmd.com/read/27907828/surgical-apgar-score-in-patients-undergoing-lumbar-fusion-for-degenerative-spine-diseases
#14
Chien-Yu Ou, Shih-Yuan Hsu, Jian-Hao Huang, Yu-Hua Huang
OBJECTIVE: Lumbar fusion is a procedure broadly performed for degenerative diseases of spines, but it is not without significant morbidities. Surgical Apgar Score (SAS), based on intraoperative blood loss, blood pressure, and heart rate, was developed for prognostic prediction in general and vascular operations. We aimed to examine whether the application of SAS in patients undergoing fusion procedures for degeneration of lumbar spines predicts in-hospital major complications. METHODS: One hundred and ninety-nine patients that underwent lumbar fusion operation for spine degeneration were enrolled in this retrospective study...
January 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27871490/predictive-models-for-mortality-after-ruptured-aortic-aneurysm-repair-do-not-predict-futility-and-are-not-useful-for-clinical-decision-making
#15
Patrick C Thompson, Ronald L Dalman, E John Harris, Venita Chandra, Jason T Lee, Matthew W Mell
OBJECTIVE: The clinical decision-making utility of scoring algorithms for predicting mortality after ruptured abdominal aortic aneurysms (rAAAs) remains unknown. We sought to determine the clinical utility of the algorithms compared with our clinical decision making and outcomes for management of rAAA during a 10-year period. METHODS: Patients admitted with a diagnosis rAAA at a large university hospital were identified from 2005 to 2014. The Glasgow Aneurysm Score, Hardman Index, Vancouver Score, Edinburgh Ruptured Aneurysm Score, University of Washington Ruptured Aneurysm Score, Vascular Study Group of New England rAAA Risk Score, and the Artificial Neural Network Score were analyzed for accuracy in predicting mortality...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27858894/preoperative-deep-vein-thrombosis-in-patients-with-cervical-spondylotic-myelopathy-scheduled-for-spinal-surgery
#16
Le Liu, Yan-Bin Liu, Jian-Min Sun, Hai-Feng Hou, Chen Liang, Tao Li, Heng-Tao Qi
INTRODUCTION: The prevalence of deep vein thrombosis (DVT) and its risk factors in patients with cervical spondylotic myelopathy (CSM) before spinal surgery are poorly understood. We investigated this association with a retrospective cross-sectional study. PATIENTS CONCERNS: The study cohort consisted of all consecutive patients with CSM who were scheduled for spinal surgery at our institution from 2013 to 2015. DVT was defined as an intraluminal filling defect in a lower extremity vein identified by Doppler ultrasonography...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27832989/risk-stratification-for-the-development-of-respiratory-adverse-events-following-vascular-surgery-using-the-society%C3%A2-of-vascular-surgery-s-vascular-quality-initiative
#17
Elizabeth A Genovese, Larry Fish, Rabih A Chaer, Michel S Makaroun, Donald T Baril
OBJECTIVE: Postoperative respiratory adverse events (RAEs) are associated with high rates of morbidity and mortality in general surgery, however, little is known about these complications in the vascular surgery population, a frail subset with multiple comorbidities. The objective of this study was to describe the contemporary incidence of RAEs in vascular surgery patients, the risk factors for this complication, and the overall impact of RAEs on patient outcomes. METHODS: The Vascular Quality Initiative was queried (2003-2014) for patients who underwent endovascular abdominal aortic repair, open abdominal aortic aneurysm repair, thoracic endovascular aortic repair, suprainguinal bypass, or infrainguinal bypass...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27831826/hospitalist-vascular-surgery-comanagement-effects-on-complications-and-mortality
#18
Colin T Iberti, Alan Briones, Erin Gabriel, Andrew S Dunn
OBJECTIVES: Hospitalized vascular surgery patients have multiple severe comorbidities, poor functional status, and high perioperative cardiac risk. Thus they may be ideal patients for a collaborative care model. However, there is little evidence for a comanagement model on clinical outcomes. METHODS: The two-year pre-post study consisted of a comanagement model where a hospitalist actively participated in the medical care of American Society of Anesthesiologist Physical Status Classification scale 3 or 4 vascular surgery patients...
December 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27829447/autologous-bone-graft-in-the-treatment-of-post-traumatic-bone-defects-a-systematic-review-and-meta-analysis
#19
Matheus Lemos Azi, Alessandro Aprato, Irene Santi, Mauricio Kfuri, Alessandro Masse, Alexander Joeris
BACKGROUND: This meta-analysis aimed to determine the bone union rate of bone defects treated with the different autologous bone graft techniques. METHODS: The PubMed and the Cochrane Library databases were searched using the terms: 'fracture' AND ('bone loss' OR 'defect' OR 'defects') AND 'bone graft', restricted to English language, to human species, and to a publication period from January 1999 to November 2014. Data were extracted by one of the reviewers and then checked by the second...
9, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27792099/indications-for-elective-tracheostomy-in-reconstructive-surgery-in-patients-with-oral-cancer
#20
Yoav Leiser, Michal Barak, Yasmine Ghantous, Noam Yehudai, Imad Abu El-Naaj
BACKGROUND: Oral cancer surgery carries a high risk of upper airway obstruction; yet optimal airway management approach remains controversial. AIM OF STUDY: The purpose of the present study was to evaluate the use of tracheostomy in oncological patients undergoing oral cancer surgery with intra oral flap reconstruction. METHODS: The study cohort included 75 patients with oral cancer, who underwent major intraoral resections and reconstruction with vascularized flaps...
January 2017: Journal of Craniofacial Surgery
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