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Gilbert upchurch

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https://www.readbyqxmd.com/read/28890062/national-utilization-and-outcomes-of-redo-lower-extremity-bypass-vs-endovascular-intervention-after-previous-failed-bypass-redo-lower-extremity-bypass-superior-to-endovascular-intervention
#1
J Hunter Mehaffey, Alexander Shannon, Robert B Hawkins, Anna Fashandi, Margret C Tracci, Irving L Kron, Gilbert R Upchurch, William P Robinson
BACKGROUND: Redo Lower extremity bypass (LEB) and infrainguinal endovascular intervention (IEI) are options to treat critical limb ischemia after a failed prior lower extremity bypass but the utilization and outcomes of each are poorly described. The purpose of this study was to compare 30-day Major Adverse Limb Events (MALE) and Major Adverse Cardiovascular Events (MACE) after LEB and IEI in patients with a failed prior ipsilateral LEB and determine risk factors for each composite outcome...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28765077/resolution-of-vascular-injury-specialized-lipid-mediators-and-their-evolving-therapeutic-implications
#2
REVIEW
Bian Wu, Giorgio Mottola, Melinda Schaller, Gilbert R Upchurch, Michael S Conte
Acute vascular injury occurs in a number of important clinical contexts, including spontaneous disease-related events (e.g. plaque rupture, thrombosis) and therapeutic interventions such as angioplasty, stenting, or bypass surgery. Endothelial cell (EC) disruption exposes the underlying matrix, leading to a rapid deposition of platelets, coagulation proteins, and leukocytes. A thrombo-inflammatory response ensues characterized by leukocyte recruitment, vascular smooth muscle cell (VSMC) activation, and the elaboration of cytokines, reactive oxygen species and growth factors within the vessel wall...
August 3, 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28756047/effectiveness-of-surgical-interventions-for-thoracic-aortic-aneurysms-a-systematic-review-and-meta-analysis
#3
REVIEW
Mouaz Alsawas, Feras Zaiem, Laura Larrea-Mantilla, Jehad Almasri, Patricia J Erwin, Gilbert R Upchurch, M Hassan Murad
OBJECTIVE: A systematic review and meta-analysis was conducted to evaluate the effectiveness of thoracic endovascular aortic repair (TEVAR) and open repair in patients with descending thoracic aortic aneurysms (TAAs). METHODS: PubMed, Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from each database's inception to January 29, 2016. We selected studies that compared the two approaches in adults with TAAs and reported 30-day mortality or procedure complications...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#4
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28579290/improved-outcomes-and-value-in-staged-hybrid-extent-ii-thoracoabdominal-aortic-aneurysm-repair
#5
Robert B Hawkins, J Hunter Mehaffey, Adishesh K Narahari, Amit Jain, Ravi K Ghanta, Irving L Kron, John A Kern, Gilbert R Upchurch
OBJECTIVE: Complex Crawford extent II thoracoabdominal aortic aneurysms (TAAAs) can be treated in a hybrid manner with proximal thoracic endovascular aneurysm repair, followed by staged distal open thoracoabdominal repair. This study evaluated the outcomes and health care-associated value of this new method compared with traditional open repair over 10 years. METHODS: A prospectively collected database was used to identify all patients with an extent II TAAA undergoing repair at a single institution between 2005 and 2015...
May 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28559173/surgeon-not-institution-case-volume-is-associated-with-limb-outcomes-after-lower-extremity-bypass-for-critical-limb-ischemia-in-the-vascular-quality-initiative
#6
Lily E Johnston, Margaret C Tracci, John A Kern, Kenneth J Cherry, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Studies from large administrative databases have demonstrated associations between institutional case volume and outcomes after lower extremity bypass (LEB). We hypothesized that increased institutional and surgeon volume would be associated with improved outcomes after LEB. Using a national, prospectively collected clinical database, the objective of this study was to determine the effects of both surgeon and institutional volume on outcomes after LEB. METHODS: The Vascular Quality Initiative (VQI) was queried to identify all LEBs for critical limb ischemia or claudication between 2004 and 2014...
May 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28342506/invited-commentary
#7
Gilbert R Upchurch
No abstract text is available yet for this article.
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28318554/decubitus-ulcers-in-patients-undergoing-vascular-operations-do-not-influence-mortality-but-affect-resource-utilization
#8
COMPARATIVE STUDY
J Hunter Mehaffey, Amani D Politano, Castigliano M Bhamidipati, Margaret C Tracci, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch
BACKGROUND: While it is anticipated that decubitus ulcers are detrimental to outcomes after vascular operations, the contemporary influence of perioperative decubitus ulcers in vascular surgery remains unknown. METHODS: Using the National Impatient Survey, all adult patients who underwent vascular operation were selected. Patients were stratified by the presence or absence (non-decubitus ulcers) of decubitus ulcer. Case-mix adjusted hierarchical mixed-models examined in-hospital mortality, the occurrence of any complication, and discharge disposition...
June 2017: Surgery
https://www.readbyqxmd.com/read/28274752/a-novel-chronic-advanced-stage-abdominal-aortic-aneurysm-murine-model
#9
Guanyi Lu, Gang Su, John P Davis, Basil Schaheen, Emily Downs, R Jack Roy, Gorav Ailawadi, Gilbert R Upchurch
OBJECTIVE: The purpose of this study was to establish a reliable, chronic model of abdominal aortic aneurysm (AAA). METHODS: Wild-type 8-week-old C56BL/6 male mice (n = 120) were equally divided into three groups: (1) BAPN group: 0.2% 3-aminopropionitrile fumarate salt (BAPN) drinking water was provided to mice 2 days before surgery until the end of study. Sham aneurysm induction surgery was performed using 5 μL of heat deactivated elastase. (2) Elastase group: mice were given regular drinking water without BAPN...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#10
MULTICENTER STUDY
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27825698/comparing-and-contrasting-endovascular-and-open-abdominal-aortic-aneurysm-repair-what-truths-have-we-learned-and-where-did-we-learn-them
#11
EDITORIAL
Gilbert R Upchurch
No abstract text is available yet for this article.
November 5, 2016: Surgery
https://www.readbyqxmd.com/read/27743805/progressive-shortfall-in-open-aneurysm-experience-for-vascular-surgery-trainees-with-the-impact-of-fenestrated-and%C3%A2-branched-endovascular-technology
#12
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...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27634836/b-cell-depletion-promotes-aortic-infiltration-of-immunosuppressive-cells-and-is-protective-of-experimental-aortic-aneurysm
#13
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...
November 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27627460/the-balance-of-open-vs-endovascular-aneurysm-repair-cost-equipoise
#14
Gilbert R Upchurch
No abstract text is available yet for this article.
December 1, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27619672/d-series-resolvins-inhibit-murine-abdominal-aortic-aneurysm-formation-and-increase-m2-macrophage-polarization
#15
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...
December 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27565600/screening-individuals-with-intracranial-aneurysms-for-abdominal-aortic-aneurysms-is-cost-effective-based-on-estimated-coprevalence
#16
REVIEW
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
https://www.readbyqxmd.com/read/27554691/modifiable-factors-leading-to-increased-length-of-stay-after-carotid-endarterectomy
#17
COMPARATIVE STUDY
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...
February 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27424469/impact-of-retrograde-arch-extension-in-acute-type-b-aortic-dissection-on-management-and-outcomes
#18
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...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27374064/vascular-quality-initiative-and-national-surgical-quality-improvement-program-registries-capture-different-populations-and-outcomes-in-open-infrainguinal-bypass
#19
COMPARATIVE STUDY
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
https://www.readbyqxmd.com/read/27367826/high-risk-patients-in-the-evolving-landscape-of-carotid-revascularization
#20
Lily E Johnston, Gilbert R Upchurch
No abstract text is available yet for this article.
June 29, 2016: JAMA Surgery
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