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Lower extremity bypass

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https://www.readbyqxmd.com/read/29421418/fewer-complications-in-the-obese-following-lower-extremity-endovascular-interventions
#1
Katie E Shean, Sara L Zettervall, Sarah E Deery, Thomas F X O'Donnell, Peter A Soden, Joel M Johnson, Raul J Guzman, Marc L Schermerhorn
BACKGROUND: The prevalence of obesity is increasing in the United States; however its impact on adverse outcomes in patients with peripheral vascular disease is not well studied. Obesity is associated with higher rates of complications following open bypass surgery, but limited data are available on its effect on endovascular intervention. This study aimed to identify whether obese patients suffer the same complications when undergoing lower extremity endovascular interventions. METHODS: All patients who underwent femoropopliteal or tibial endovascular interventions between 2011 and 2013 were identified in the Targeted Vascular Module of the NSQIP...
February 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29373889/paraplegia-after-off-pump-coronary-artery-by-pass-grafting
#2
Aghigh Haidari, Feridoun Sabzi, Samsam Dabiri
Paraplegia is an exceedingly rare neurologic complication after off-pump coronary artery bypass graft (OPCAB) surgery commonly caused by spinal cord ischemia (SCI). SCI is not a well unknown clinical phenomenon in the postoperative course. SCI has been reported after noncardiac surgery in otherwise healthy subjects in whom only one risks factor i.e. severe hypotension has been documented. SCI has also been reported as a rare complication among the other neurologic sequels of cardiac surgery. We report a case of paraplegia in a patient with metabolic syndrome and multiples risk factors after an OPCAB...
December 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/29354626/intraoperative-vascular-surgical-consultation-during-non-vascular-surgeries-in-tertiary-centers-by-vascular-surgeon
#3
Sung-Bin Park, Keun-Myoung Park, Yong Sun Jeon, Soon Gu Cho, Kee Chun Hong
Purpose: There are many types of intraoperative consultations by vascular surgeons during non-vascular surgery. Therefore, we examined the current state of intraoperative consultations during non-vascular surgery in a single center. Materials and Methods: From January 2014 to December 2015, we reviewed records of 40 patients (0.3%) who received an intraoperative consultation from a vascular surgeon for 10,734 non-vascular surgeries in Inha University Hospital. We examined patient characteristics, operative details, and clinical results...
December 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/29342431/comparison-of-access-type-on-perioperative-outcomes-after-endovascular-aortic-aneurysm-repair
#4
Jeffrey J Siracuse, Alik Farber, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Gheorghe Doros, Salvatore T Scali, Marc L Schermerhorn
OBJECTIVE: Endovascular aneurysm repair (EVAR) can be performed through percutaneous or surgical access. Our goal was to assess the difference in perioperative outcomes based on access type in a real-world setting. METHODS: The Vascular Quality Initiative (VQI) database was queried for EVAR. Univariable analysis and multivariable analysis were used to determine the independent effect of access type. RESULTS: There were 8340 (64%) and 4747 (36%) EVAR procedures performed through percutaneous and surgical access (3395 [72%] transverse and 1352 [28%] vertical incisions)...
January 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29306852/trichosporon-asahii-septic-thrombophlebitis-following-lower-extremity-amputation-in-an-immunocompetent-host
#5
Pradeep Kumar Mada, Folusakin Ayoade, Ailing Li, John Todd
A 59-year-old man with a history of peripheral vascular disease status post femoral popliteal bypass presented with critical limb ischaemia of the left leg. An arterial Doppler ultrasound showed an occluded graft requiring an above knee amputation. Five days after surgery, the patient developed fever, leucocytosis, significant stump swelling and pain, and serosanguinous discharge from his wound. Wound swab cultures from the stump grew Trichosporon asahii A venous Doppler ultrasound revealed extensive thrombosis of the left lower extremity...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29288558/aggressive-infrainguinal-revascularization-in-renal-transplant-patients-is-justifiable
#6
Rebecca Craig-Schapiro, Besma Nejim, Isibor Arhuidese, Mahmoud B Malas
While studies demonstrate poor outcomes of lower extremity revascularization in end-stage renal disease patients, little is known about results in renal transplant patients. We analyzed 2-year primary patency and limb salvage outcomes and associated risk factors of transplant (N=202) and non-transplant patients (N=25,274) in the Vascular Quality Initiative database undergoing infrainguinal bypass from 2003-2016. Multivariable Cox regression analysis and coarsened exact matching with many-to-one were employed...
December 29, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29276108/sex-based-outcomes-of-lower-extremity-bypass-surgery-in-hemodialysis-patients
#7
Isibor Arhuidese, Amber Kernodle, Besma Nejim, Satinderjit Locham, Caitlin Hicks, Mahmoud B Malas
OBJECTIVE: The objective of this study was to compare conduit use and surgical outcomes of hemodialysis-dependent men and women after open lower extremity bypass surgery. METHODS: Using the United States Renal Data System, we studied all hemodialysis patients in the United States who underwent infrainguinal bypass surgery between January 1, 2006, and December 31, 2011. Univariate methods (χ2, analysis of variance) were employed to compare patient and bypass characteristics between men and women...
December 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29248245/outcomes-of-tibial-endovascular-intervention-in-patients-with-poor-pedal-runoff
#8
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
OBJECTIVE: Tibial interventions for critical limb ischemia are now commonplace. The aim of this study was to examine the impact of pedal runoff on patient-centered outcomes after tibial endovascular intervention. METHODS: A database of patients undergoing lower extremity endovascular interventions at a single urban academic medical center between 2006 and 2016 was retrospectively queried. Patients with critical ischemia (Rutherford 5 and 6) were identified. Preintervention angiograms were reviewed in all cases to assess pedal runoff...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29235151/one-stage-ascending-to-abdominal-aortic-bypass-with-concomitant-aortic-valve-procedures-for-aortic-coarctation-combined-with-aortic-valve-pathology-in-adult-patients
#9
Ren Changwei, Lizhong Sun, Shangdong Xu, Yongqiang Lai
OBJECTIVE: This study aims to evaluate the results of one-stage ascending-to-abdominal aortic bypass and aortic valve replacement for concomitant aortic coarctation combined with aortic valve pathology. METHODS: From June 2009 to March 2017, 28 consecutive adult patients (23 males and five females) with aortic coarctation combined with aortic valve pathology underwent one-stage ascending-to-abdominal aorta bypass and aortic valve replacement or a Bentall procedure...
December 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29226477/cell-therapy-for-critical-limb-ischemia-an-integrated-review-of-pre-clinical-and-clinical-studies
#10
REVIEW
Mohammad Qadura, Daniella C Terenzi, Subodh Verma, Mohammed Al-Omran, David A Hess
Critical limb ischemia (CLI), the most severe form of peripheral artery disease, is characterized by pain at rest and non-healing ulcers in the lower extremities. For patients with CLI, where the extent of atherosclerotic artery occlusion is too severe for surgical bypass or percutaneous interventions, limb amputation remains the only treatment option. Thus, cell-based therapy to restore perfusion and promote wound healing in patients with CLI is under intense investigation. Despite promising preclinical studies in animal models, transplantation of bone marrow (BM) derived cell populations in patients with CLI has shown limited benefit preventing limb amputation...
December 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#11
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29169544/systematic-review-and-meta-analysis-of-duplex-ultrasound-surveillance-for-infrainguinal-vein-bypass-grafts
#12
REVIEW
Abd Moain Abu Dabrh, Khaled Mohammed, Wigdan Farah, Qusay Haydour, R Eugene Zierler, Zhen Wang, Larry J Prokop, M Hassan Murad
OBJECTIVE: Duplex ultrasound (DUS) surveillance of infrainguinal vein bypass grafts is widely practiced, but the evidence of its effectiveness compared with other methods of surveillance remains unclear. METHODS: Following an a priori protocol developed by the guidelines committee from the Society for Vascular Surgery, this systematic review and meta-analysis included randomized and nonrandomized comparative studies that enrolled patients who underwent infrainguinal arterial reconstruction and received DUS surveillance for follow-up compared with any other method of surveillance...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29162367/arterial-reconstructions-for-chronic-lower-extremity-ischemia-in-preadolescent-and-adolescent-children
#13
Jonathan L Eliason, Dawn M Coleman, Adam Gumushian, James C Stanley
OBJECTIVE: Chronic lower extremity ischemia in pediatric patients is uncommon. The intent of this study was to better define the arterial reconstructive options and their long-term durability in preadolescent and adolescent children having clinically relevant arterial occlusions affecting the lower extremity. METHODS: The medical records of 33 consecutive pediatric patients who underwent lower extremity revascularization for chronic ischemia at the University of Michigan from 1974 to 2016 were reviewed...
November 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29155119/high-serum-bilirubin-is-associated-with-lower-prevalence-of-peripheral-arterial-disease-among-cardiac-patients
#14
Michishige Ozeki, Hideaki Morita, Masatoshi Miyamura, Tomohiro Fujisaka, Shu-Ichi Fujita, Takahide Ito, Kensaku Shibata, Suguru Tanaka, Koichi Sohmiya, Masaaki Hoshiga, Nobukazu Ishizaka
Several studies have shown that subjects with higher serum bilirubin may have a lower risk of cardiovascular disorders. We herein investigated whether serum bilirubin concentration is associated with lower extremity ischemia among cardiology patients. In total, 935 patients without a history of angioplasty or bypass surgery of the lower limb arteries and who had bilateral ankle-brachial index measurements were included in the study. Peripheral arterial disease (PAD) was defined to be present when ABI of either or both sides was <0...
January 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#15
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29104204/-surgical-treatment-of-systemic-and-left-circumflex-coronary-pulmonary-artery-fistulas-with-aneurysm-report-of-a-case
#16
Hiroki Nakabori, Katsuyuki Miyazu, Masahiro Ikeda
Congenital coronary-pulmonary artery fistulas complicated by continuity to a systemic artery and aneurysm are extremely rare. A 78-year-old woman was admitted to our hospital with a complaint of chest discomfort. Coronary angiography showed a coronary aneurysm and coronary-pulmonary artery fistula arising from the left circumflex artery and entering into the right lower pulmonary artery. Computed tomography angiography revealed a left subclavian artery-pulmonary artery fistula communicating with the coronary-pulmonary artery fistula...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29079006/risk-factors-for-unplanned-readmission-and-stump-complications-after-major-lower-extremity-amputation
#17
John Phair, Charles DeCarlo, Larry Scher, Issam Koleilat, Saadat Shariff, Evan C Lipsitz, Karan Garg
OBJECTIVE: The unplanned 30-day readmission rate is a marker of quality of patient care across many disciplines. Data regarding risk factors for unplanned readmission after major lower extremity amputation (LEA) are limited. We evaluated predictors of readmission at our institution after major LEA. METHODS: We conducted a retrospective review of all patients undergoing above-knee amputation (AKA) or below-knee amputation (BKA) between November 2009 and November 2014...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074114/regional-variation-in-the-cost-of-infra-inguinal-lower-extremity-bypass-surgery-in-the-united-states
#18
Besma J Nejim, Sophie Wang, Isibor Arhuidese, Tammam Obeid, Husain Nader Alshaikh, Hanaa Dakour Aridi, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: Lower extremity bypass (LEB) remains the gold standard revascularization procedure in patients with peripheral arterial disease. The cost of LEB substantially varies based on patient's characteristics and comorbidities. The aim of this study was to assess regional variation in infra-inguinal LEB cost and to identify the specific health care expenditures per service that are associated with the highest cost in each region. METHODS: We identified adult patients who underwent infra-inguinal LEB in the Premier database between June 2009 and March 2015...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29066242/estimating-risk-of-adverse-cardiac-event-after-vascular-surgery-using-currently-available-online-calculators
#19
Danielle A Moses, Lily E Johnston, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
BACKGROUND: The decision to proceed with vascular surgical interventions requires evaluation of cardiac risk. Recently, several online risk calculators were created to predict outcomes and to lead to a more informed conversation between surgeons and patients. The objective of this study was to compare and further validate these online calculators with actual adverse cardiac outcomes at a single institution. METHODS: All patients from January 2011 through December 2015 undergoing carotid endarterectomy (CEA), infrainguinal lower extremity bypass, open abdominal aortic aneurysm (AAA) repair, and endovascular aneurysm repair (EVAR) on the vascular surgical service were included using the Society for Vascular Surgery Vascular Quality Initiative database at our health system...
January 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29049809/association-of-quality-improvement-registry-participation-with-appropriate-follow-up-after-vascular-procedures
#20
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
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