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Gilbert upchurch

Anahita Dua, Steven Koprowski, Gilbert Upchurch, Cheong J Lee, Sapan S Desai
BACKGROUND: In 2014, we published a series of articles in the Journal of Vascular Surgery that detailed the decrease in volume of open aneurysm repair (OAR) completed for abdominal aortic aneurysm (AAA) by vascular surgery trainees. At that time, only data points from 2000 through 2011 were available, and reliable predictions could only be made through 2015. Lack of data on endovascular aneurysm repair (EVAR) using fenestrated (FEVAR) and branched (BrEVAR) endografts also affected our findings...
October 12, 2016: Journal of Vascular Surgery
Basil Schaheen, Emily A Downs, Vlad Serbulea, Camila C P Almenara, Michael Spinosa, Gang Su, Yunge Zhao, Prasad Srikakulapu, Cherié Butts, Coleen A McNamara, Norbert Leitinger, Gilbert R Upchurch, Akshaya K Meher, Gorav Ailawadi
OBJECTIVE: B-cell depletion therapy is widely used for treatment of cancers and autoimmune diseases. B cells are abundant in abdominal aortic aneurysms (AAA); however, it is unknown whether B-cell depletion therapy affects AAA growth. Using experimental models of murine AAA, we aim to examine the effect of B-cell depletion on AAA formation. APPROACH AND RESULTS: Wild-type or apolipoprotein E-knockout mice were treated with mouse monoclonal anti-CD20 or control antibodies and subjected to an elastase perfusion or angiotensin II infusion model to induce AAA, respectively...
September 15, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
Gilbert R Upchurch
No abstract text is available yet for this article.
September 14, 2016: JAMA Surgery
Nicolas H Pope, Morgan Salmon, John P Davis, Anuran Chatterjee, Gang Su, Michael S Conte, Gorav Ailawadi, Gilbert R Upchurch
The role of resolvins in abdominal aortic aneurysm (AAA) has not been established. We hypothesized that treatment with D-series resolvins (RvD2 or RvD1) would attenuate murine AAA formation through alterations in macrophage polarization and cytokine expression. Male C57/B6 mice (n = 9 per group) 8 to 12 wk old received RvD2 (100 ng/kg/treatment), RvD1 (100 ng/kg/treatment), or vehicle only every third day beginning 3 d before abdominal aortic perfusion with elastase as prevention. Aortas were collected 14 d after elastase perfusion...
September 12, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Benjamin Z Ball, Boxiang Jiang, Prachi Mehndiratta, George J Stukenborg, Gilbert R Upchurch, James F Meschia, Bradford B Worrall, Andrew M Southerland
OBJECTIVE: Aneurysm rupture is a major cause of morbidity and mortality, and evidence suggests shared risk for both abdominal aortic aneurysms (AAAs) and intracranial aneurysms (IAs). We hypothesized that screening for AAA in patients with known IA is cost-effective. METHODS: We used a decision tree model to compare costs and outcomes of AAA screening vs no screening in a hypothetical cohort of patients with IA. We measured expected outcomes using quality-adjusted life-years (QALYs) and the incremental cost-effectiveness ratio (ICER)...
September 2016: Journal of Vascular Surgery
James H Mehaffey, Damien J LaPar, Margret C Tracci, Kenneth J Cherry, John A Kern, Irving Kron, Gilbert R Upchurch
BACKGROUND: Carotid endarterectomy (CEA) is a commonly performed vascular operation. Yet, postoperative length of stay (LOS) varies greatly even within institutions. In this study, the morbidity and mortality, as well as financial impact of increased LOS were reviewed to establish modifiable factors associated with prolonged hospital stay. METHODS: The Society for Vascular Surgery Vascular Quality Initiative database was used to identify all patients undergoing primary CEA at a single institution between June 1, 2011 and November 28, 2014...
August 20, 2016: Annals of Vascular Surgery
Foeke J H Nauta, Jip L Tolenaar, Himanshu J Patel, Jehangir J Appoo, Thomas T Tsai, Nimesh D Desai, Daniel G Montgomery, Firas F Mussa, Gilbert R Upchurch, Rosella Fattori, G Chad Hughes, Christoph A Nienaber, Eric M Isselbacher, Kim A Eagle, Santi Trimarchi
BACKGROUND: Optimal management of acute type B aortic dissection with retrograde arch extension is controversial. The effect of retrograde arch extension on operative and long-term mortality has not been studied and is not incorporated into clinical treatment pathways. METHODS: The International Registry of Acute Aortic Dissection was queried for all patients presenting with acute type B dissection and an identifiable primary intimal tear. Outcomes were stratified according to management for patients with and without retrograde arch extension...
July 14, 2016: Annals of Thoracic Surgery
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
Lily E Johnston, Gilbert R Upchurch
No abstract text is available yet for this article.
June 29, 2016: JAMA Surgery
Anahita Dua, Michael Romanelli, Gilbert R Upchurch, James Pan, Douglas Hood, Kim J Hodgson, Sapan S Desai
BACKGROUND: A variety of patient factors are known to adversely impact outcomes after carotid endarterectomy (CEA) or carotid artery stenting (CAS). However, their specific impact on complications and mortality and how they differ between CEA and CAS is unknown. The purpose of this study is to identify patient and hospital factors that adversely impact outcomes. METHODS: Patients who underwent CEA or CAS between 1998 and 2012 (N = 1,756,445) were identified using the Agency for Healthcare Research and Quality National Inpatient Sample and State Ambulatory Services Databases...
September 2016: Journal of Vascular Surgery
Lily E Johnston, Barclay T Stewart, Herve Yangni-Angate, Martin Veller, Gilbert R Upchurch, Adam Gyedu, Adam L Kushner
IMPORTANCE: Peripheral arterial disease (PAD) causes significant morbidity and is an important risk factor for cardiovascular disease-related mortality. However, the burden of PAD in sub-Saharan Africa is poorly understood. OBJECTIVE: To assess epidemiological and clinical reports regarding PAD from sub-Saharan Africa such that the regional epidemiology and management of PAD could be described and recommendations offered. EVIDENCE REVIEW: A systematic search in PubMed, Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, and Google Scholar for reports pertaining to the epidemiology and/or management of PAD in sub-Saharan Africa was performed...
June 1, 2016: JAMA Surgery
William P Robinson, Gilbert R Upchurch
No abstract text is available yet for this article.
August 1, 2016: JAMA Surgery
Ashish K Sharma, Morgan D Salmon, Guanyi Lu, Gang Su, Nicolas H Pope, Joseph R Smith, Mark L Weiss, Gilbert R Upchurch
OBJECTIVE: Abdominal aortic aneurysm (AAA) formation is characterized by inflammation, smooth muscle activation, and matrix degradation. This study tests the hypothesis that macrophage-produced high mobility group box 1 (HMGB1) production is dependent on nicotinamide adenine dinucleotide phosphate oxidase (Nox2), which leads to increase in interleukin (IL)-17 production resulting in AAA formation and that treatment with human mesenchymal stem cells (MSCs) can attenuate this process thereby inhibiting AAA formation...
May 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
J Hunter Mehaffey, Robert Jason Perry, Nicolas H Pope, Gilbert R Upchurch
A 32-year-old male presented with a large locally advanced sarcomatoid right renal cell carcinoma invading the duodenum and IVC. Due to persistent symptomatic gastrointestinal bleeding requiring repeat blood transfusion and the inability to utilize appropriate systemic chemotherapy, the patient was taken for palliative resection. En bloc pancreaticoduodenectomy, right nephrectomy and IVC resection were performed with reconstruction of the IVC with tubularized bovine pericardium. Widespread availability, ease and speed of tubularized graft creation, lack of morbidity to the patient and its inherent resistance to infection in contaminated fields make bovine pericardium an expedient reconstructive option in these challenging cases...
March 1, 2016: Journal of Vascular Surgery Cases
Robert Jason Perry, Gilbert R Upchurch
No abstract text is available yet for this article.
April 2016: JAMA Surgery
John P Davis, Morgan Salmon, Nicolas H Pope, Guanyi Lu, Gang Su, Akshaya Meher, Gorav Ailawadi, Gilbert R Upchurch
BACKGROUND: Testosterone is theorized to play a major role in the pathophysiology of abdominal aortic aneurysms (AAAs) because this disease occurs primarily in men. The role of the androgen receptor (AR) in the formation of AAAs has not been well elucidated, and therefore, it is hypothesized that androgen blockade will attenuate experimental aortic aneurysm formation. METHODS: Aortas of 8- to 12-week-old male C57Bl/6 wild-type (WT) mice or male AR knockout (AR(-/-)) mice were perfused with purified porcine pancreatic elastase (0...
June 2016: Journal of Vascular Surgery
Gilbert R Upchurch
No abstract text is available yet for this article.
May 1, 2016: JAMA Surgery
Tanya R Flohr, Klaus D Hagspiel, Amit Jain, Margaret C Tracci, John A Kern, Irving L Kron, Kenneth J Cherry, Gilbert R Upchurch
BACKGROUND: The management of incidentally discovered penetrating ulcers of the abdominal aorta (PUAA) is not well described. METHODS: A search of computed tomography (CT) angiography imaging reports for the words "penetrating ulcer" was performed from October 2010 to August 2011. Patients with a PUAA were identified, and their clinical course was followed through December 2014 (n = 53). No specific intervention for the ulcers was sought unless additional aortic pathology necessitated intervention...
February 2016: Annals of Vascular Surgery
P Michael Grossman, Emile R Mohler, Blake J Roessler, Robert L Wilensky, Bruce L Levine, Edward Y Woo, Gilbert R Upchurch, Jacob Schneiderman, Belly Koren, Marina Hutoran, Diana Gershstein, Moshe Y Flugelman
UNLABELLED: Alternative treatment strategies for claudication are needed and cell-based therapies designed to induce angiogenesis are promising. The purpose of this report was to conduct a Phase I safety, dose-escalating, non-randomized, open-label study of autologous, fully differentiated venous endothelial and smooth muscle cells called MultiGeneAngio (MGA) for claudication due to peripheral artery disease. Twelve subjects, at two centers, received a single intra-arterial infusion of a suspension of equal amounts of transduced autologous venous smooth muscle cells expressing vascular endothelial growth factor (VEGF165) and endothelial cells expressing angiopoietin-1 (Ang-1) (Cohort 1: 1 × 10(7), Cohort 2: 2 × 10(7), Cohort 3: 5 × 10(7), Cohort 4: 7 × 10(7))...
February 2016: Vascular Medicine
Anthony P King, James L Abelson, Bardia Gholami, Gilbert R Upchurch, Peter Henke, Linda Graham, Israel Liberzon
OBJECTIVES: Major life stressors, including major surgeries, are often followed by psychiatric symptoms and disorders. Prior retrospective work found abdominal aortic aneurysm (AAA) repair is followed by increased psychiatric morbidity, which may adversely influence physical and functional recovery. Identifying risk factors before surgery, such as dysregulation in stress response systems, might be useful in improving preventative intervention. METHODS: Two hundred sixteen patients receiving open AAA or aortofemoral bypass surgeries, endovascular AAA repair, or nonsurgical AAA treatment were recruited from two vascular surgery services...
November 2015: Psychosomatic Medicine
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