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Lower extremity bypass

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https://www.readbyqxmd.com/read/29672398/evaluating-quality-metrics-and-cost-after-discharge-a-population-based-cohort-study-of-value-in-health-care-following-elective-major-vascular-surgery
#1
Charles de Mestral, Konrad Salata, Mohamad A Hussain, Ahmed Kayssi, Mohammed Al-Omran, Graham Roche-Nagle
BACKGROUND: Early readmission to hospital after surgery is an omnipresent quality metric across surgical fields. We sought to understand the relative importance of hospital readmission among all health services received after hospital discharge. OBJECTIVE: The aim of this study was to characterize 30-day postdischarge cost and risk of an emergency department (ED) visit, readmission, or death after hospitalization for elective major vascular surgery. METHODS: This is a population-based retrospective cohort study of patients who underwent elective major vascular surgery - carotid endarterectomy, EVAR, open AAA repair, bypass for lower extremity peripheral arterial disease - in Ontario, Canada, between 2004 and 2015...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29661291/hemodialysis-patients-have-worse-outcomes-after-infrageniculate-revascularization-procedures
#2
Caitlin W Hicks, Joseph K Canner, Kevin Kirkland, Mahmoud B Malas, James H Black, Christopher J Abularrage
BACKGROUND: Hemodialysis (HD) has been shown to be an independent predictor of poor outcomes after femoropopliteal revascularization procedures in patients with chronic limb-threatening ischemia. However, HD patients tend to have isolated infrageniculate disease, an anatomic risk factor for inferior patency. We aimed to compare outcomes for HD versus non-HD patients after infrageniculate open lower extremity bypass (LEB) and endovascular peripheral vascular interventions (PVIs). METHODS: Data from the Society for Vascular Surgery Vascular Quality Initiative database (2008-2014) were analyzed...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29660388/outcomes-of-gracilis-muscle-flaps-in-the-management-of-groin-complications-after-arterial-bypass-with-prosthetic-graft
#3
Anahita Dua, Vy T Ho, Christina Rao, Sapan S Desai
INTRODUCTION: This study details two-year outcomes of a modified gracilis muscle flap (GMF) technique in providing tissue coverage for groin complications after arterial bypass surgery with synthetic graft. METHODS: All patients who developed groin infections after lower extremity arterial bypass with synthetic graft that underwent a GMF were included from June 2014 to March 2017 from a prospectively collected, purpose-built institutional database. Modifications to the standard technique included identification of the muscle using ultrasound to ensure precise skip incisions, preservation of the segmental blood supply, widening of the tunnel through which the muscle is retroflexed, placement of a wound VAC for healing, and lifelong antibiotics...
April 13, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29627780/double-venous-compression-due-to-duplicated-inferior-vena-cava-induced-right-common-iliac-vein-thrombosis
#4
Yuichi Mukai, Shuhei Nozawa, Toshiro Suzuki
Venous compression syndromes are caused by extrinsic venous compression of anatomical structures, such as the adjacent arteries and bones. Chronic venous compression and pulsative vibratory arterial pressure accelerate the development of deep vein thrombosis. Herein, we report the first case of double venous compressions due to a duplicated inferior vena cava-induced right-sided common iliac vein thrombosis. The thrombus was induced by left-sided inferior vena cava entrapment and right-sided common iliac vein compression, resembling nutcracker syndrome and May-Thurner syndrome, respectively...
April 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29627109/myocardial-infarction-subtypes-in-patients-with-type-2-diabetes-mellitus-and-the-effect-of-liraglutide-therapy-from-the-leader-trial
#5
Steven P Marso, Michael A Nauck, Tea Monk Fries, Søren Rasmussen, Marianne Bach Treppendahl, John B Buse
Diabetes mellitus (DM) is a known risk factor for myocardial infarction (MI); however, data regarding MI subtypes in people with diabetes are limited. In the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) trial (n = 9,340), liraglutide significantly reduced the risk of major adverse cardiovascular (CV) events (composite of CV death, nonfatal MI, or nonfatal stroke) versus placebo in patients with type 2 DM and high CV risk. Liraglutide also reduced risk of first MI (292 events with liraglutide vs 339 with placebo)...
March 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29615358/outcomes-of-infrageniculate-retrograde-versus-transfemoral-access-for-endovascular-intervention-for-chronic-lower-extremity-ischemia
#6
Ashraf G Taha, Adham N Abou Ali, George Al-Khoury, Michael J Singh, Michel S Makaroun, Efthymios D Avgerinos, Rabih A Chaer
OBJECTIVE: Retrograde infrageniculate access is an alternative treatment strategy for patients who have failed to respond to antegrade endovascular intervention. This study compares the outcomes of infrageniculate retrograde arterial access with the conventional transfemoral access for the endovascular management of chronic lower extremity ischemia. METHODS: This was a retrospective single-center review of retrograde endovascular intervention (REI) from 2012 to 2016...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29615354/improved-access-to-health-care-in-massachusetts-after-2006-massachusetts-healthcare-reform-law-is-associated-with-a-significant-decrease-in-mortality-among-vascular-surgery-patients
#7
Mohammad H Eslami, Katherine Moll Reitz, Denis V Rybin, Gheorghe Doros, Alik Farber
BACKGROUND: Access to medical care, by adequate insurance coverage, has a direct impact on outcomes for patients undergoing vascular procedures. We evaluated in-hospital mortality for patients undergoing index vascular procedures before and after the Massachusetts Healthcare Reform Law (MHRL) in 2006, which mandated insurance for all Massachusetts residents, both in Massachusetts and throughout the United States. METHODS: The National Inpatient Sample was queried to identify patients undergoing interventions for peripheral arterial disease, carotid artery stenosis, and abdominal aortic aneurysms based on International Classification of Diseases, Ninth Revision, Clinical Modification procedural and diagnostic codes...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29611866/gamma-knife-radiosurgery-for-arteriovenous-malformations-general-principles-and-preliminary-results-in-a-swiss-cohort
#8
Matthieu Raboud, Constantin Tuleasca, Philippe Maeder, Luis Schiappacasse, Maud Marguet, Roy Thomas Daniel, Marc Levivier
INTRODUCTION: Arteriovenous malformations (AVMs) are a type of vascular malformation characterised by an abnormal connection between arteries and veins, bypassing the capillary system. This absence of capillaries generates an elevated pressure (hyperdebit), in both the AVM and the venous drainage, increasing the risk of rupture. Management modalities are: observation, microsurgical clipping, endovascular treatment and radiosurgery. The former can be used alone or in the frame of a multidisciplinary approach...
April 3, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29606569/preoperative-dementia-is-associated-with-increased-cost-and-complications-after-vascular-surgery
#9
J Hunter Mehaffey, Robert B Hawkins, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
OBJECTIVE: Dementia represents a major risk factor for medical complications and has been linked to higher rates of complication after surgery. Given the systemic nature of vascular disease, medical comorbidities significantly increase cost and complications after vascular surgery. We hypothesize that the presence of dementia is an independent predictor of increased postoperative complications and higher health care costs after vascular surgery. METHODS: The Vascular Quality Initiative database was queried for all patients undergoing vascular surgery at a single academic medical center from 2012 to 2017...
March 29, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602472/local-anesthesia-for-percutaneous-endovascular-abdominal-aortic-aneurysm-repair-is-associated-with-fewer-pulmonary-complications
#10
Kathryn Van Orden, Alik Farber, Marc L Schermerhorn, Philip P Goodney, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Percutaneous endovascular aneurysm repair (EVAR) can be performed with general anesthesia (GA) or local anesthesia (LA). Our goal was to assess perioperative outcomes comparing anesthesia type in percutaneous EVAR. METHODS: The Vascular Quality Initiative database was queried for all exclusively percutaneous EVAR procedures. Univariable analysis was used to compare which patients were offered LA. Multivariable analysis was used to determine the independent effect of anesthesia type...
March 27, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29601806/remote-ischemic-preconditioning-does-not-prevent-white-matter-injury-in-neonates
#11
J William Gaynor, Susan C Nicolson, Diane M Spray, Nancy B Burnham, Jesse L Chittams, Therese Sammarco, Kevin W Walsh, Thomas L Spray, Daniel J Licht
BACKGROUND: Remote ischemic preconditioning (RIPC) is a mechanism to protect tissues from injury during ischemia and reperfusion. We investigated the neuroprotective effects of RIPC in neonates undergoing cardiac surgery. METHODS: The outcome was white matter injury (WMI), assessed by the change in volume of WMI from preoperative to postoperative brain MRI. Subjects were randomized to RIPC or SHAM. RIPC was induced prior to cardiopulmonary bypass by four 5 minute cycles of blood pressure cuff inflation to produce ischemia of the lower extremity...
March 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29601328/statin-loading-in-cardiovascular-surgery-never-too-early-to-treat
#12
Niki Katsiki, Filippos Triposkiadis, Athanasios D Giannoukas, Dimitri P Mikhailidis
PURPOSE OF REVIEW: The effects of statin loading before, during or after vascular interventions on cardiovascular and renal outcomes are discussed. Furthermore, the selection of optimal statin type and dose, according to current evidence or guidelines, is considered. The importance of treating statin intolerance and avoiding statin discontinuation is also discussed. RECENT FINDINGS: Statin loading has been shown to beneficially affect cardiovascular outcomes, total mortality and/or contrast-induced acute kidney injury, in patients undergoing vascular procedures such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CEA), carotid artery stenting, endovascular aneurysm repair, open abdominal aortic aneurysms (AAA) repair and lower extremities vascular interventions...
March 29, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29576404/treatment-outcomes-in-diabetic-patients-with-chronic-limb-threatening-ischemia
#13
Patric Liang, Peter A Soden, Sara L Zettervall, Katie E Shean, Sarah E Deery, Raul J Guzman, Allen D Hamdan, Marc L Schermerhorn
OBJECTIVE: There are conflicting reports about outcomes after infrainguinal bypass for chronic limb-threatening ischemia (CLTI) in patients with diabetes. We compared perioperative outcomes between patients with and patients without diabetes in the current era. METHODS: The National Surgical Quality Improvement Program vascular module, 2011 to 2014, was used to identify patients undergoing infrainguinal revascularization for CLTI. Patients with and without diabetes were compared in terms of presentation, comorbidities, operative approach, and 30-day outcomes...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29566162/recombinant-activated-factor-vii-is-associated-with-postoperative-thromboembolic-adverse-events-in-bleeding-after-coronary-surgery
#14
Aly Makram Habib, Antonio Maria Calafiore, Marco Cargoni, Massimiliano Foschi, Michele Di Mauro
OBJECTIVES: To evaluate the impact of recombinant activated factor VII (rFVIIa) administration on thromboembolic adverse events (TAEs) in coronary artery bypass grafting (CABG) surgery patients showing postoperative bleeding. METHODS: From January 2004 to May 2015, 180 CABG surgery patients with postoperative bleeding were included in the study. All patients were managed conservatively and 81 (45%) also received rFVIIa. RESULTS: Ten patients developed new TAEs (5...
March 16, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29530886/hyperacute-monocyte-gene-response-patterns-are-associated-with-lower-extremity-vein-bypass-graft-failure
#15
Jonathan P Rehfuss, Kenneth M DeSart, Jared M Rozowsky, Kerri A O'Malley, Lyle L Moldawer, Henry V Baker, Yaqun Wang, Rongling Wu, Peter R Nelson, Scott A Berceli
BACKGROUND: Despite being the definitive treatment for lower extremity peripheral arterial disease, vein bypass grafts fail in half of all cases. Early repair mechanisms after implantation, governed largely by the immune environment, contribute significantly to long-term outcomes. The current study investigates the early response patterns of circulating monocytes as a determinant of graft outcome. METHODS: In 48 patients undergoing infrainguinal vein bypass grafting, the transcriptomes of circulating monocytes were analyzed preoperatively and at 1, 7, and 28 days post-operation...
March 2018: Circulation. Genomic and precision medicine
https://www.readbyqxmd.com/read/29525414/outcomes-of-reintervention-for-recurrent-symptomatic-disease-after-tibial-endovascular-intervention
#16
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. Restenosis and occlusion remain barriers to durability after intervention. The aim of this study was to examine the patient-centered outcomes of open and endovascular reintervention for symptomatic recurrent disease after a primary isolated tibial endovascular intervention. METHODS: A database of patients undergoing isolated primary lower extremity tibial endovascular interventions between 2006 and 2016 was retrospectively queried...
March 8, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29523437/active-smoking-in-claudicants-undergoing-lower-extremity-bypass-predicts-decreased-graft-patency-and-worse-overall-survival
#17
Douglas W Jones, Philip P Goodney, Jens Eldrup-Jorgensen, Marc L Schermerhorn, Jeffrey J Siracuse, Jeanwan Kang, Jesse A Columbo, Bjoern D Suckow, David H Stone
OBJECTIVE: Performing lower extremity bypass (LEB) in actively smoking claudicants remains controversial. Whereas some surgeons advocate a strict nonoperative approach to active smokers, citing perceived inferior outcomes, others will proceed with surgical bypass if the patient is anatomically suited and medical management has failed. The purpose of this study was to determine the impact of active smoking on LEB outcomes among claudicants. METHODS: All patients undergoing infrainguinal LEB for claudication in the Vascular Study Group of New England from 2003 to 2016 were analyzed...
March 6, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29518503/early-outcomes-following-endovascular-open-surgical-and-hybrid-revascularization-for-lower-extremity-acute-limb-ischemia
#18
Frank M Davis, Jeremy Albright, Katherine A Gallagher, Hitinder S Gurm, Gerald C Koenig, Theodore Schreiber, P Michael Grossman, Peter K Henke
BACKGROUND: Acute limb ischemia (ALI) of the lower extremity is a potentially devastating condition that requires urgent and definitive management. This challenging scenario is often treated with endovascular, open surgical, or hybrid revascularization (HyR) in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare the outcomes of endovascular, open surgical, and HyR for ALI in the contemporary era. METHODS: A large statewide cardiovascular consortium of 45 hospitals was queried for patients between January 2012 and June 2015 who underwent an endovascular, open surgical, or HyR for ALI deemed at high risk of limb loss if not treated within 24 hr (Rutherford class IIA or IIB)...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29502996/fenestrated-branched-endografts-and-visceral-debranching-plus-stenting-hybrid-for-complex-aortic-aneurysm-repair
#19
Nikolas Tsilimparis, Sebastian E Debus, Max Biehl, Konstantinos Spanos, Axel Larena-Avellaneda, Sabine Wipper, Fiona Rohlffs, Tilo Kölbel
OBJECTIVE: The aim of this study was to assess the immediate postoperative and midterm outcome of complex aortic aneurysm treatment necessitating four-vessel revascularization with either a total endovascular approach (fenestrated-branched stent graft [FBSG]) or a hybrid technique of visceral debranching plus stenting. METHODS: The clinical data of consecutively treated patients presenting with a complex aortic aneurysm that necessitated four-vessel revascularization between 2010 and 2015 were retrospectively analyzed...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29483744/-segmental-vena-cava-resection-for-the-treatment-of-renal-tumor-with-invading-tumor-thrombus
#20
J F Ye, L L Ma, L Zhao, G L Wang
OBJECTIVE: To investigate the safety and perioperative experience of the segmental resection of the vena cava. METHODS: From May 2015 to July 2017, 92 renal tumor patients with venous tumor thrombus were treated in Peking University Third Hospital, of whom 17 underwent nephrectomy with resection of the invaded vena cava for renal tumor with tumor thrombus invading vena cava. The preoperative features included that 15 patients were male and 2 female, the mean age was (59...
February 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
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