Journal of vascular surgery
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Multicenter Study Comparative Study
The results of stent graft versus medication therapy for chronic type B dissection.
This prospective multicenter comparative study examined early and midterm results of medication and stent-graft therapies on chronic type B aortic dissection in China. ⋯ This was the first prospective multicenter comparative study on the treatment of type B aortic dissection in China. TEVAR had a significantly lower aorta-related mortality compared with OMT but failed to improve overall survival rate or lower the aorta-related adverse event rate.
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Review Meta Analysis
Systematic review and meta-analysis of open surgical and endovascular management of thoracic outlet vascular injuries.
Junctional vascular trauma such as that at the thoracic outlet poses particular challenges in surgical management. The use of endovascular techniques for such injuries is attractive as repair may be facilitated without the need for thoracotomy; however, the utility of such techniques is currently based on opinion, small retrospective series, and literature reviews of narrative and not systematic quality. The objective of this study is to provide a complete and systematic analysis of the literature pertaining to open surgery (OS) and endovascular management (EM) of thoracic outlet vascular injuries. ⋯ The current evidence is weak and fails to show superiority of one modality over the other. EM is currently used primarily in highly selected cases, but there are reports of a broader applicability in trauma. High-quality randomized studies or large-scale registry data are needed to further comment on the relative merits or disadvantages of EM in comparison to OS.
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Multicenter Study
Risk index for predicting perioperative stroke, myocardial infarction, or death risk in asymptomatic patients undergoing carotid endarterectomy.
The latest guidelines recommend performance of carotid endarterectomy (CEA) on asymptomatic patients with high-grade carotid stenosis, only if the combined perioperative stroke, myocardial infarction (MI), or death risk is ≤3%. Our objective was to develop and validate a risk index to estimate the combined risk of perioperative stroke, MI, or death in asymptomatic patients undergoing elective CEA. ⋯ The validated risk index can help identify asymptomatic patients who are at greatest risk for 30-day stroke, MI, and death after CEA, thereby aiding patient selection.
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Multicenter Study
B-type natriuretic peptide predicts postoperative cardiac events and mortality after elective open abdominal aortic aneurysm repair.
The aim of this study was to determine if a single preoperative B-type natriuretic peptide (BNP) level correlated with perioperative cardiac events, cardiac death, and all-cause mortality in elective open abdominal aortic aneurysm (AAA) repair in the short term, intermediate term, and long term. ⋯ Preoperative serum BNP concentration predicted postoperative cardiac events, cardiac death, and all-cause mortality in patients undergoing elective open AAA repair on short-term, intermediate-term, and long-term follow-up on an individual basis with greater accuracy than currently available risk prediction tools.
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Review
Contrast alternatives for iodinated contrast allergy and renal dysfunction: options and limitations.
Diagnostic angiography and vascular interventions make routine use of iodinated contrast material (ICM). Patients with renal disease or contrast allergy pose limitations on the use of ICM. ⋯ Each of these alternatives has its own unique features and limitations. In the present review article, the current alternatives to ICM are explored, with a focus on the applications and restrictions of each.